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Araujo JM, De la Cruz-Ku G, Cornejo M, Doimi F, Dyer R, Gomez HL, Pinto JA. Prognostic Capability of TNBC 3-Gene Score among Triple-Negative Breast Cancer Subtypes. Cancers (Basel) 2022; 14:cancers14174286. [PMID: 36077821 PMCID: PMC9454544 DOI: 10.3390/cancers14174286] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Triple-negative breast cancer (TNBC) is a complex and molecularly heterogeneous entity, with the poorest outcome compared with other breast cancer subtypes. Previously, we developed a TNBC 3-gene score with a significant prognostic capability. This study aims to test the 3-gene score in the different TNBC subtypes. Methods: Data from 204 TNBC patients treated with neoadjuvant chemotherapy were retrieved from public datasets and pooled (GSE25066, GSE58812, and GSE16446). After removing batch effects, cases were classified into Lehman’s TNBC subtypes and then the TNBC 3-gene score was used to evaluate the risk of distant recurrence in each subgroup. In addition, the association with tumor-infiltrating lymphocyte (TILs) levels was evaluated in a retrospective group of 72 TNBC cases. Results: The TNBC 3-gene score was able to discriminate patients with different risks within the pooled cohort (HR = 2.41 for high vs. low risk; 95%CI: 1.50−3.86). The score showed predictive capability in the immunomodulatory subtype (HR = 4.16; 95%CI: 1.63−10.60) and in the mesenchymal stem-like subtype (HR = 18.76; 95%CI: 1.68−208.97). In the basal-like 1, basal-like-2, and mesenchymal subtypes, the observed differential risk patterns showed no statistical significance. The score had poor predictive capability in the luminal androgen receptor subtype (p = 0.765). In addition, a low TNBC 3-gene score was related to a high level of TIL infiltration (p < 0.001). Conclusions: The TNBC 3-gene score is able to predict the risk of distant recurrence in TNBC patients, specifically in the immunomodulatory and mesenchymal stem-like subtype. Despite a small sample size in each subgroup, an improved prognostic capability was seen in TNBC subtypes with tumor-infiltrating components.
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Affiliation(s)
- Jhajaira M. Araujo
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima 15067, Peru
| | - Gabriel De la Cruz-Ku
- Department of Surgery, University of Massachusetts, Worcester, MA 01604, USA
- Universidad Cientifica del Sur, Lima 15067, Peru
| | - Melanie Cornejo
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
| | - Franco Doimi
- Departamento de Patología, Oncosalud-AUNA, Lima 15036, Peru
| | - Richard Dyer
- Departamento de Patología, Oncosalud-AUNA, Lima 15036, Peru
| | - Henry L. Gomez
- Departamento de Medicina Oncológica, Oncosalud-AUNA, Lima 15036, Peru
| | - Joseph A. Pinto
- Centro de Investigación Básica y Traslacional, AUNA Ideas, Lima 15036, Peru
- Correspondence: ; Tel.: +51-1-5137900 (ext. 2231)
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Kaniyamattam K, Hertl J, Lhermie G, Tasch U, Dyer R, Gröhn YT. Cost benefit analysis of automatic lameness detection systems in dairy herds: A dynamic programming approach. Prev Vet Med 2020; 178:104993. [PMID: 32334285 DOI: 10.1016/j.prevetmed.2020.104993] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 04/09/2019] [Revised: 01/07/2020] [Accepted: 04/06/2020] [Indexed: 11/24/2022]
Abstract
Epidemiological data establish that lameness is second only to mastitis as the dairy industry's most prevalent and costly animal welfare issue. Using an automatic lameness detection (ALD) system in which continuous, accurate detection is coupled with proper treatment, is key for reducing economic losses due to lameness. It is reasonable to assume that the cost of lameness would vary with its severity. Therefore, our first objective was to estimate the cost of different lameness severity levels as a function of milk production, lameness risk, conception probability, and treatment cost using a dynamic programming (DP) model. Our second objective was to conduct a cost benefit analysis for ALD systems which can reduce production losses through early detection and treatment of lameness, when compared to visual-detection (VD; i.e., performed by humans) systems. The default production loss parameters for the VD system used as inputs to the DP model were either sourced from the literature or were estimated based on data from a field trial. The production loss parameters for the ALD system used as inputs to the DP model were based on extrapolations of parameter values used for the VD system. The profit per present cow per year under assumed expenses and revenues decreased from $426.05 (when lameness incidence was assumed to be 0%) to $389.69 when lameness incidence was 19.5 %. Out of the 19.5 % lameness incidence in our default scenario, 9.8 % were moderate cases and 9.7 % were severe cases. Average cost of lameness was $36.36 at 19.5 % incidence. Average cost of lameness increased with increased incidence and was respectively $82.05, $195.05, and $286.87 at the low, medium, and high incidence scenarios. We used an operational framework which compared the lameness costs between the VD and ALD systems with 25 %, 50 % and 75 % net avoided costs (NAC) for the 10 year lifespan of the ALD system, at default, low, medium and high lameness incidence scenarios. The net return per cow per year from using an ALD system over a VD system was $13, at low incidence and 25 % NAC. The net return per cow per year for the ALD system was as high as $99 at high incidence and 75 % NAC. Out of 351 (3 system prices, 3 system efficiencies, 3 levels of lameness incidence and 13 different herd sizes) scenarios tested, 295 resulted in a net profit within the system lifespan of 10 years, thus justifying the investment in ALD systems.
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Affiliation(s)
- K Kaniyamattam
- Section of Epidemiology, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853. USA.
| | - J Hertl
- Section of Epidemiology, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853. USA
| | - G Lhermie
- Section of Epidemiology, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853. USA
| | - U Tasch
- Step Analysis, LLC. 5 Ruby Field Ct., Baltimore, MD 21209. USA
| | - R Dyer
- Department of Animal and Food Science, College of Agriculture and Natural Resources, University of Delaware, Newark, DE 19717. USA
| | - Y T Gröhn
- Section of Epidemiology, Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853. USA
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Alarco R, Ponce J, Pinto J, Doimi F, Dyer R, Ledesma R, Vigil C. Experience and results in sentinel lymph node (SLN) biopsy in a peruvian clinic. Breast 2019. [DOI: 10.1016/s0960-9776(19)30403-5] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Araujo J, Flores C, Schwarz L, Doimi F, Dyer R, Gomez H, Pinto J. Prognostic capability of a TNBC 3-genes score among triplenegative breast cancer subtypes. Breast 2019. [DOI: 10.1016/s0960-9776(19)30141-9] [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: 11/30/2022] Open
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Abstract
Background: Like other LMICs, many Pacific Island countries and territories (PICTs) have fragile and overburdened health systems with which to combat an increasing burden of cancer. Additionally, a combination of small geographically dispersed populations, limited resources, isolation and frequent natural disasters make cancer control in Pacific Islands also significantly different to elsewhere in the world. No prior work has provided a stocktake of current capacity for diagnosis and treatment of cancer across the region to date. Aim: To describe the specialized health services available for cancer control in the Pacific region, and show the complexity associated with accessing cancer care for Pacific Islanders. Methods: A cross-sectional review of medical services and human resources available for cancer control was undertaken for 21 Pacific Community (SPC) member countries and territories in April-May 2018 , specifically diagnosis (pathology and radiology) and treatment (chemotherapy, radiotherapy and surgical modalities and overseas referrals for services not available on-island) by contacting individual countries and territories. Common travel routes were mapped individually for 4 PICTs; Papua New Guinea, Solomon Islands, Kiribati and Tokelau; as examples of the unique challenges faced by rural dwelling Pacific Islanders when accessing the highest level of care available in-country. Results: Capacity for cancer diagnosis and care is extremely limited in the Pacific region. The exceptions are the 2 French territories (French Polynesia and New Caledonia) and Guam where a near full complement of services for diagnosis and treatment are operational. Some pathology services are generally available in the larger PICTs, while specimens are sent to affiliated off island laboratories for the rest. Plain x-ray and ultrasound are available at 1 or more locations in all PICTs. General and gynecologic surgery is the most widespread treatment modality available. Some to full chemotherapy administered in 7 and radiotherapy in 3 (formerly 4) PICTs. Overseas referrals for medical services not available in-country are a common feature to all PICTs health systems. A need to travel long distances to access health care is a challenged faced by Pacific Islanders on outer islands and rural villages. Examples will be presented. Conclusion: Cancer control services are few and far between in the Pacific region, and PICTs will always likely rely on overseas referrals for care not available. Access barriers exist for those on outer islands and in villages, and an unknown number seek treatment late or not at all for these reasons. Governments need to invest into strengthening primary and secondary care services, making them an option that is more easily accessible to remote populations. Collaboration between transport and health sectors to look at ways to improve frequency, regulation and safety of modes of transportation to outer islands to improve current systems.
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Affiliation(s)
- R. Dyer
- University of Otago, Wellington, New Zealand
| | | | - I. Meredith
- Capital and Coast District Health Board, Wellington, New Zealand
| | - D. Sarfati
- University of Otago, Wellington, New Zealand
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Audette Y, O'Halloran IP, Nowell PM, Dyer R, Kelly R, Voroney RP. Speciation of Phosphorus from Agricultural Muck Soils to Stream and Lake Sediments. J Environ Qual 2018; 47:884-892. [PMID: 30025054 DOI: 10.2134/jeq2018.02.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The nature and management of agricultural soils can influence the forms of legacy P present in affected sediments; however, few studies have specifically characterized P in sediments affected by polder agriculture. In this study, the speciation of P as it flows from the muck soils of the Holland Marsh to the sediments of the West Holland River and Lake Simcoe, Ontario, Canada, was investigated. The distribution of P fractions and the characterization of organic P were analyzed by the sequential fractionation method and solution P nuclear magnetic resonance spectroscopy, respectively. Organic P was the predominant P form (∼58% of total P) in muck soils, whereas the redox-sensitive P fraction was predominant in surface stream sediments rich in organic matter (∼41-48% of total P), despite these sediments exhibiting near-neutral pH and high concentrations of both Ca and P. The proportion of relatively recalcitrant organic P forms was much greater in the muck soils than that exhibited by both stream and lake sediments. The decreasing proportion of recalcitrant organic P forms in sediments downstream from the Holland Marsh indicated the potential for faster organic P cycling. Our findings support the notion that diesters and pyrophosphate should be monitored, in addition to loosely bound inorganic P, due to their potential impact on water quality. The unique environment of the streams and lake area is considered to be particularly vulnerable to excessive fertilizer P use in adjacent croplands.
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Poly WJ, Dyer R. Dr. William Gerald Dyer. J Parasitol 2018; 104:183-185. [DOI: 10.1645/18-4] [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] [Indexed: 11/10/2022] Open
Affiliation(s)
- William J. Poly
- Department of Ichthyology, California Academy of Sciences, 55 Music Concourse Drive, Golden Gate Park, San Francisco, California 94118
| | - Richard Dyer
- Office of Equity and Compliance, Southern Illinois University Carbondale, 1075 South Normal Avenue, Carbondale, Illinois 62901
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Araujo JM, Prado A, Cardenas NK, Zaharia M, Dyer R, Doimi F, Bravo L, Pinillos L, Morante Z, Aguilar A, Mas LA, Gomez HL, Vallejos CS, Rolfo C, Pinto JA. Repeated observation of immune gene sets enrichment in women with non-small cell lung cancer. Oncotarget 2018; 7:20282-92. [PMID: 26958810 PMCID: PMC4991454 DOI: 10.18632/oncotarget.7943] [Citation(s) in RCA: 20] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 02/11/2016] [Indexed: 12/26/2022] Open
Abstract
There are different biological and clinical patterns of lung cancer between genders indicating intrinsic differences leading to increased sensitivity to cigarette smoke-induced DNA damage, mutational patterns of KRAS and better clinical outcomes in women while differences between genders at gene-expression levels was not previously reported. Here we show an enrichment of immune genes in NSCLC in women compared to men. We found in a GSEA analysis (by biological processes annotated from Gene Ontology) of six public datasets a repeated observation of immune gene sets enrichment in women. "Immune system process", "immune response", "defense response", "cellular defense response" and "regulation of immune system process" were the gene sets most over-represented while APOBEC3G, APOBEC3F, LAT, CD1D and CCL5 represented the top-five core genes. Characterization of immune cell composition with the platform CIBERSORT showed no differences between genders; however, there were differences when tumor tissues were compared to normal tissues. Our results suggest different immune responses in NSCLC between genders that could be related with the different clinical outcome.
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Affiliation(s)
- Jhajaira M Araujo
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Alexandra Prado
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Nadezhda K Cardenas
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima 09, Peru
| | - Mayer Zaharia
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Richard Dyer
- Departamento de Patología, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Franco Doimi
- Departamento de Patología, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Leny Bravo
- Escuela de Medicina Humana, Universidad Privada San Juan Bautista, Chorrillos, Lima 09, Peru
| | - Luis Pinillos
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Zaida Morante
- Departamento de Medicina Oncológica, Instituto Nacional de Enfermedades Neoplásicas, Surquillo, Lima 41, Peru
| | - Alfredo Aguilar
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Luis A Mas
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Henry L Gomez
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Carlos S Vallejos
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
| | - Christian Rolfo
- Phase I - Early Clinical Trials Unit, Antwerp University Hospital, Antwerp, 2650 Edegem, Belgium
| | - Joseph A Pinto
- Unidad de Investigación Básica y Traslacional, Oncosalud-AUNA, San Borja, Lima 41, Peru
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Peters S, Edogawa S, Sundt W, Dyer R, Dalenberg D, Mazzone A, Singh R, Moses N, Weber C, Linden DR, MacNaughton WK, Turner JR, Camilleri M, Katzka D, Farrugia G, Grover M, Grover M. Constipation-Predominant Irritable Bowel Syndrome Females Have Normal Colonic Barrier and Secretory Function. Am J Gastroenterol 2017; 112:913-923. [PMID: 28323272 PMCID: PMC5502210 DOI: 10.1038/ajg.2017.48] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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] [Received: 10/01/2016] [Accepted: 01/02/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The objective of this study was to determine whether constipation-predominant irritable bowel syndrome (IBS-C) is associated with changes in intestinal barrier and secretory function. METHODS A total of 19 IBS-C patients and 18 healthy volunteers (all females) underwent saccharide excretion assay (0.1 g 13C mannitol and 1 g lactulose), measurements of duodenal and colonic mucosal barrier (transmucosal resistance (TMR), macromolecular and Escherichia coli Bio-Particle translocation), mucosal secretion (basal and acetylcholine (Ach)-evoked short-circuit current (Isc)), in vivo duodenal mucosal impedance, circulating endotoxins, and colonic tight junction gene expression. RESULTS There were no differences in the in vivo measurements of barrier function between IBS-C patients and healthy controls: cumulative excretion of 13C mannitol (0-2 h mean (s.e.m.); IBS-C: 12.1 (0.9) mg vs. healthy: 13.2 (0.8) mg) and lactulose (8-24 h; IBS-C: 0.9 (0.5) mg vs. healthy: 0.5 (0.2) mg); duodenal impedance IBS-C: 729 (65) Ω vs. healthy: 706 (43) Ω; plasma mean endotoxin activity level IBS-C: 0.36 (0.03) vs. healthy: 0.35 (0.02); and in colonic mRNA expression of occludin, zonula occludens (ZO) 1-3, and claudins 1-12 and 14-19. The ex vivo findings were consistent, with no group differences: duodenal TMR (IBS-C: 28.2 (1.9) Ω cm2 vs. healthy: 29.8 (1.9) Ω cm2) and colonic TMR (IBS-C: 19.1 (1.1) Ω cm2 vs. healthy: 17.6 (1.7) Ω cm2); fluorescein isothiocyanate (FITC)-dextran (4 kDa) and E. coli Bio-Particle flux. Colonic basal Isc was similar, but duodenal basal Isc was lower in IBS-C (43.5 (4.5) μA cm-2) vs. healthy (56.9 (4.9) μA cm-2), P=0.05. Ach-evoked ΔIsc was similar. CONCLUSIONS Females with IBS-C have normal colonic barrier and secretory function. Basal duodenal secretion is decreased in IBS-C.
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Affiliation(s)
- S Peters
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S Edogawa
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - W Sundt
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - R Dyer
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - D Dalenberg
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - A Mazzone
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - R Singh
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - N Moses
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - C Weber
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - DR Linden
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - WK MacNaughton
- Department of Physiology and Pharmacology, University of Calgary, Calgary, AB, Canada
| | - JR Turner
- Departments of Pathology and Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - M Camilleri
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - D Katzka
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - G Farrugia
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - M Grover
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Madhusudan Grover
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
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Duys R, Duma S, Dyer R. A pilot of the use of Short Message Service (SMS) as a training tool for anaesthesia nurses. Southern African Journal of Anaesthesia and Analgesia 2017. [DOI: 10.1080/22201181.2017.1317422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- R Duys
- Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - S Duma
- School of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - R Dyer
- Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
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Oscanoa J, Doimi F, Dyer R, Araujo J, Pinto J, Castaneda B. Automated segmentation and classification of cell nuclei in immunohistochemical breast cancer images with estrogen receptor marker. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:2399-2402. [PMID: 28268808 DOI: 10.1109/embc.2016.7591213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Breast cancer is the most common malignant tumor in women worldwide. In recent years, there has been an increasing use of immunohistochemistry (the process of detecting the expression of certain proteins in cytological images) to obtain useful information for diagnosis. This paper presents an efficient algorithm that automatically detects breast cancer cell nuclei and divides them into two groups: those that express the ER marker and those that do not. First, the areas that belong to the carcinoma are automatically identified. Then, the algorithm evaluates features such as size and shape to correctly segment the nuclei in these fields. Finally, the Fuzzy C-Means algorithm is used to classify the detected nuclei. The method proposed was evaluated with a set of 10 images which contained 4093 cell nuclei. The algorithm correctly identified 93.1% of the nuclei, and sensitivity and specificity of the classification were 95.7% and 93.2% respectively.
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El-Helali A, Plummer R, Jayson G, Coyle V, Rogers C, D'Arcangelo M, Graham D, Drew Y, Clamp A, McCann J, McCavigan A, Knight L, McCabe N, Keating K, Dyer R, Harrison T, Harkin P, Robson T, Kennedy R, Wilson R. A biomarker-guided first-in-human trial of subcutaneous ALM201 in patients with solid tumours. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.91] [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: 11/12/2022] Open
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Faubion WA, Camilleri M, Murray JA, Kelly P, Amadi B, Kosek MN, Enders F, Larson J, Grover M, Boe G, Dyer R, Singh R. Improving the detection of environmental enteric dysfunction: a lactulose, rhamnose assay of intestinal permeability in children aged under 5 years exposed to poor sanitation and hygiene. BMJ Glob Health 2016; 1:e000066. [PMID: 28588929 PMCID: PMC5321325 DOI: 10.1136/bmjgh-2016-000066] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 04/18/2016] [Revised: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 12/01/2022] Open
Abstract
Background Environmental enteric dysfunction (EED) is an asymptomatic intestinal disorder affecting populations living in conditions of poor sanitation and hygiene. The study tested intestinal barrier function in infants with EED. Methods We prospectively studied an advanced high-performance liquid chromatography mass spectrometry assay of urine collected after oral intake of the monosaccharide, L-rhamnose and the disaccharide, lactulose, in 112 children from three continents. Findings Compared to the US cohort (n=27), the cohorts of children from Peru (n=19) and Zambia (n=85) were older with evidence of growth impairment. The median (range) of age (months) was 8.0 (2.0 to 13.0), 27.0 (15.0 to 29.0) and 21.0 (12.0 to 36.0), respectively. The median (range) of height for age Z score was −0.1 (−1.8 to 2.4), −1.8 (−3.3 to −0.2) and −2.3 (−8.5 to 1.2), respectively. Among children with valid sugar data (n=22 USA, n=19 Peru, n=73 Zambia), there were no significant differences in the median rhamnose urine concentrations between the three groups. The median (range) lactulose concentration (µg/mL) was 6.78 (0.29 to 31.90), 47.60 (4.23 to 379.00) and 75.40 (0.67 to 873.00) in the US, Peruvian and Zambian cohorts, respectively (p<0.001). The lactulose/rhamnose ratio (LRR) was higher in cohorts from Peru (0.75, 0.15, 5.02) and Zambia (2.26, 0.08, 14.48) compared to the US (0.14, 0.06, 1.00) cohort (p<0.001). In a multivariate effect modification model, higher weight-for-age z scores were associated with lower post-dose lactulose when rhamnose excretion was constant (p=0.003). Conclusions This non-invasive two saccharide permeability protocol measures changes in intestinal permeability in children with EED and permits the identification of individuals for interventional trials.
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Affiliation(s)
- W A Faubion
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - M Camilleri
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - J A Murray
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - P Kelly
- Queen Mary, University of London, University of Zambia School of Medicine, London, UK
| | - B Amadi
- Queen Mary, University of London, University of Zambia School of Medicine, London, UK
| | - M N Kosek
- Department of International Health, John's Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - F Enders
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - J Larson
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | | | - G Boe
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - R Dyer
- Immunochemical Core Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - R Singh
- Immunochemical Core Laboratory, Mayo Clinic, Rochester, Minnesota, USA
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Mädler S, Sun F, Tat C, Sudakova N, Drouin P, Tooley RJ, Reiner EJ, Switzer TA, Dyer R, Kingston HMS, Pamuku M, Furdui VI. Trace-Level Analysis of Hexavalent Chromium in Lake Sediment Samples Using Ion Chromatography Tandem Mass Spectrometry. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/jep.2016.73037] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Heiberg J, Hansen LS, Wemmelund K, Sørensen AH, Ilkjaer C, Cloete E, Nolte D, Roodt F, Dyer R, Swanevelder J, Sloth E. Point-of-Care Clinical Ultrasound for Medical Students. Ultrasound Int Open 2015; 1:E58-66. [PMID: 27689155 PMCID: PMC5023212 DOI: 10.1055/s-0035-1565173] [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] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 10/23/2015] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Our institution has recently implemented a point-of-care (POC) ultrasound training program, consisting of an e-learning course and systematic practical hands-on training. The aim of this prospective study was to evaluate the learning outcome of this curriculum. MATERIALS AND METHODS 16 medical students with no previous ultrasound experience comprised the study group. The program covered a combination of 4 well-described point-of-care (POC) ultrasound protocols (focus assessed transthoracic echocardiography, focused assessment with sonography in trauma, lung ultrasound, and dynamic needle tip positioning for ultrasound-guided vascular access) and it consisted of an e-learning course followed by 4 h of practical hands-on training. Practical skills and image quality were tested 3 times during the study: at baseline, after e-learning, and after hands-on training. RESULTS Practical skills improved for all 4 protocols; after e-learning as well as after hands-on training. The number of students who were able to perform at least one interpretable image of the heart increased from 7 at baseline to 12 after e-learning, p<0.01, and to all 16 students after hands-on-training, p<0.01. The number of students able to cannulate an artificial vessel increased from 3 to 8 after e-learning and to 15 after hands-on training. CONCLUSION Medical students with no previous ultrasound experience demonstrated a considerable improvement in practical skill after interactive e-learning and 4 h of hands-on training.
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Affiliation(s)
- J. Heiberg
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - L. S. Hansen
- Department of Anaesthesia and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - K. Wemmelund
- Department of Anaesthesia and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - A. H. Sørensen
- Department of Anaesthesia and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - C. Ilkjaer
- Department of Cardiothoracic & Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - E. Cloete
- Department of Anaesthesia, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - D. Nolte
- Department of Anaesthesia, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - F. Roodt
- Department of Anaesthesia, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - R. Dyer
- Department of Anaesthesia, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - J. Swanevelder
- Department of Anaesthesia, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - E. Sloth
- Department of Anaesthesia and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
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Pinto JA, Flores CJ, Valdiviezo PI, Aguilar A, Suazo JF, Zaharia M, Dyer R, Vigil C, Vallejos CS, Gomez H. A 5-gene signature based on TLR4 signaling as predictive of risk of distant relapse in breast cancer treated with taxane-anthracycline neoadjuvant chemotherapy. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.11066] [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] [Indexed: 11/20/2022] Open
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Mendoza J, Martinez-Cedillo J, Hernández CA, Pérez-Montiel D, Castro C, Fabián-Morales E, Santibañez M, González-Barrios R, Díaz-Chávez J, Andonegui MA, Onate-Ocana LF, Jimenez M, Reynoso N, Núñez M, Dyer R, Herrera LA. Association between ERCC1 and XPA expression and polymorphisms and the response to cisplatin in patients with non-seminomatous testicular germ cell tumors. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.4555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4555 Background: Cisplatin-based chemotherapy cures over 80% of testicular germ cell tumors (TGCTs); nucleotide-excision repair (NER) modifies the sensitivity to cisplatin. In this work we explored the association between NER-proteins and their polymorphisms (SNPs) with cisplatin-sensitivity (CPS) and overall survival (OS) of patients with advanced non-seminomatous (ns)-TGCTs treated with bleomycin-etoposide-cisplatin (BEP). Methods: ERCC1, XPA-expression and gammaH2AX-presence, were tested in cisplatin-treated cancer cell lines. ERCC1 and XPA-expression were also analyzed in ns-TGCTs by qPCR. Immunohistochemistry was performed to detect ERCC1 protein in ns-TGCTs specimens. The SNPs were genotyped by PCR-RFLPs technique. Results: High basal ERCC1-expression was observed in non-CPS cancer cell lines; ERCC1-expression augmented further, as well as gammaH2AX, after cisplatin-treatment. Basal ERCC1 expression increases in the non-CPS patients in Mexican and Peruvian populations compared to CPS patients (p<0.001; p=0.002). XPAexpression levels weren’t different. These polymorphisms weren’t associated with CPS or OS. ERCC1-positive immunostaining was observed in 30/108 patients (27.8%). From 76 patients that were CPS, 59 (77.6%) were ERCC1-negative, compared with 17 (22.4%) that were ERCC1-positive (p=0.05). 5-year OS probability was smaller for those patients ERCC1-positive and non-CPS (15.38%) than tumor ERCC1-negative and CPS (89.3%) (p<0.001). Using the Cox Model, adjusted on the prognosis groups, the hazard ratio (HR) of death in patients with ERCC1-negative and non-CPS was >14.43 and in patients ERCC1-positive and non-CPS the HR was >11.86 (p<0.001). Conclusions: High-levels of ERCC1-expression and ERCC1-protein are associated with non-CPS, suggesting the use of ERCC1 as a potential indicator of response to cisplatin-based chemotherapy and the prognosis in patients with ns-TGCTs. Moreover, it’s important to identify patients potentially non-CPS in order to diminish the toxicity of cisplatin and improved quality of life avoiding adverse effects due to this agent. Work supported by CONACYT 83959 and PAPIIT IN213311-3.
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Affiliation(s)
- Julia Mendoza
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | | | | | | | | | | | | | | | | | | | | | | | - Nancy Reynoso
- Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Marlene Núñez
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Richard Dyer
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
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Munive C, Gallo A, Neciosup SP, Doimi F, Dyer R, Pinto J, Lopez-Ilasaca M, Gomez H. Frequency of PIK3CA mutations in HER2+ surgically resected breast cancers in a Hispanic cohort. J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.e11066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e11066 Background: PI3K signaling pathway is responsible for balancing cell survival and apoptosis, and plays an important role in the pathogenesis and progression of human breast cancers. Alterations in this pathway could influence the response to targeted therapy. Our aim is to know the frequency of mutations in the PIK3CA gene in HER2+, operable breast tumors in an Andean population. Methods: We include a cohort of 59 patients with HER2+ surgically resected breast cancer that received adjuvant anti-HER2 targeted therapy at the Instituto Nacional de Enfermedades Neoplásicas. Genomic DNA was extracted from Paraffin embedded-formalin fixed tumor samples and mutational status of PIK3CA gene was using PCR-based DNA sequencing Results: At the current date, the median of follow-up in our cohort is 2.4 years and two recurrences have been registered. Four samples were not evaluable for molecular analysis. Mutation in PIK3CA gene was detected in 12 cases (20.3%). In cases where PIK3CA mutation was detected, eight cases (66.7%) had mutations in exon 9 (A1634C/E545A in 6 cases; G1624A/E542K in 1 case and G1633A/E545K in 1 case). Four cases (33.3%) had exon 20 mutated (A3140G/H1047R in all cases). There was not coexistence of mutations in both exons. One case of tumor recurrence had mutation in exon 9. Conclusions: We found similar rates of PIK3CA mutations as described previously to HER2+, breast tumors. A longest follow upwill show the prognostic value of PIK3CA status in our cohort treated with targeted anti-HER2 therapy. [Table: see text]
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Affiliation(s)
- Carlos Munive
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Aly Gallo
- Center for Molecular Diagnostics, Lima, Peru
| | | | - Franco Doimi
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Richard Dyer
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | | | | | - Henry Gomez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Hatzis C, Pusztai L, Valero V, Booser DJ, Esserman L, Lluch A, Vidaurre T, Holmes F, Souchon E, Martin M, Cotrina J, Gomez H, Hubbard R, Chacón JI, Ferrer-Lozano J, Dyer R, Buxton M, Gong Y, Wu Y, Ibrahim N, Andreopoulou E, Ueno NT, Hunt K, Yang W, Nazario A, DeMichele A, O’Shaughnessy J, Hortobagyi GN, Symmans WF. A genomic predictor of response and survival following taxane-anthracycline chemotherapy for invasive breast cancer. JAMA 2011; 305:1873-81. [PMID: 21558518 PMCID: PMC5638042 DOI: 10.1001/jama.2011.593] [Citation(s) in RCA: 452] [Impact Index Per Article: 34.8] [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: 02/03/2023]
Abstract
CONTEXT Prediction of high probability of survival from standard cancer treatments is fundamental for individualized cancer treatment strategies. OBJECTIVE To develop a predictor of response and survival from chemotherapy for newly diagnosed invasive breast cancer. DESIGN, SETTING, AND PATIENTS Prospective multicenter study conducted from June 2000 to March 2010 at the M. D. Anderson Cancer Center to develop and test genomic predictors for neoadjuvant chemotherapy. Patients were those with newly diagnosed ERBB2 (HER2 or HER2/neu)-negative breast cancer treated with chemotherapy containing sequential taxane and anthracycline-based regimens (then endocrine therapy if estrogen receptor [ER]-positive). Different predictive signatures for resistance and response to preoperative (neoadjuvant) chemotherapy (stratified according to ER status) were developed from gene expression microarrays of newly diagnosed breast cancer (310 patients). Breast cancer treatment sensitivity was then predicted using the combination of signatures for (1) sensitivity to endocrine therapy, (2) chemoresistance, and (3) chemosensitivity, with independent validation (198 patients) and comparison with other reported genomic predictors of chemotherapy response. MAIN OUTCOME MEASURES Distant relapse-free survival (DRFS) if predicted treatment sensitive and absolute risk reduction ([ARR], difference in DRFS between 2 predicted groups) at median follow-up (3 years). RESULTS Patients in the independent validation cohort (99% clinical stage II-III) who were predicted to be treatment sensitive (28%) had 56% (95% CI, 31%-78%) probability of excellent pathologic response and DRFS of 92% (95% CI, 85%-100%), with an ARR of 18% (95% CI, 6%-28%). Survival was predicted in ER-positive (30% predicted sensitive; DRFS, 97% [95% CI, 91%-100%]; ARR, 11% [95% CI, 0.1%-21%]) and ER-negative (26% predicted sensitive; DRFS, 83% [95% CI, 68%-100%]; ARR, 26% [95% CI, 4%-48%]) subsets and was significant in multivariate analysis. Other genomic predictors showed paradoxically worse survival for patients predicted to be responsive to chemotherapy. CONCLUSION A genomic predictor combining ER status, predicted chemoresistance, predicted chemosensitivity, and predicted endocrine sensitivity identified patients with high probability of survival following taxane and anthracycline chemotherapy.
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Affiliation(s)
| | - Lajos Pusztai
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Vicente Valero
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | | | - Laura Esserman
- on behalf of iSPY Clinical Trial Investigators for the Cancer and Leukemia Group B
| | - Ana Lluch
- on behalf of Grupo Español de Investigación en Cáncer de Mama (GEICAM), Spain
| | | | - Frankie Holmes
- on behalf of US Oncology, Lyndon B. Johnson Hospital, Houston, TX
| | - Eduardo Souchon
- The University of Texas Health Sciences Center, Lyndon B. Johnson Hospital, Houston, TX
| | - Miguel Martin
- on behalf of Grupo Español de Investigación en Cáncer de Mama (GEICAM), Spain
| | - José Cotrina
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Henry Gomez
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Rebekah Hubbard
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | - J. Ignacio Chacón
- on behalf of Grupo Español de Investigación en Cáncer de Mama (GEICAM), Spain
| | - Jaime Ferrer-Lozano
- on behalf of Grupo Español de Investigación en Cáncer de Mama (GEICAM), Spain
| | - Richard Dyer
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Meredith Buxton
- on behalf of iSPY Clinical Trial Investigators for the Cancer and Leukemia Group B
| | - Yun Gong
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Yun Wu
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Nuhad Ibrahim
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | | | - Naoto T. Ueno
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Kelly Hunt
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Wei Yang
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Arlene Nazario
- The University of Texas M.D. Anderson Cancer Center, Houston TX
| | - Angela DeMichele
- on behalf of iSPY Clinical Trial Investigators for the Cancer and Leukemia Group B
| | | | | | - W. Fraser Symmans
- The University of Texas M.D. Anderson Cancer Center, Houston TX
- Address correspondence and reprint requests to: W. Fraser Symmans, M.D., Department of Pathology, Box 85, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, Tel: (713) 792-7962, Fax: (713) 745-5709,
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Symmans WF, Hatzis C, Valero V, Booser DJ, Esserman L, Martin M, Vidaurre T, Holmes F, Souchon EA, Lluch A, Cotrina J, Gomez H, Hubbard R, Ferrer-Lozano J, Dyer R, Buxton M, Gong Y, Wu Y, Ibrahim N, Andreopoulou E, Ueno NT, Hunt K, Yang W, Nazario A, DeMichele A, O'Shaughnessy J, Hortobagyi GN, Pusztai L. M. Abstract PD07-03: A Genomic Predictor of Survival Following Taxane-Anthracycline Chemotherapy for Breast Cancer. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-pd07-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: There is currently no predictive assay for patients with clinical Stage II-III breast cancer from which predicted sensitivity to treatment is associated with high probability of survival following chemotherapy.
Patients & Methods: We performed Affymetrix gene expression microarrays of prospectively collected tumor biopsies from 508 patients with newly diagnosed HER2-normal invasive breast cancer prior to neoadjuvant taxane-anthracycline chemotherapy followed by adjuvant endocrine therapy (if hormone receptor-positive). The predictor was developed from 310 samples (from MDACC & I-SPY) by combining: 1) a signature to predict sensitivity to endocrine therapy (SET); 2) estrogen receptor (ER)-stratified predictive signatures of resistance to chemotherapy, defined as extensive residual cancer burden (RCB-III) or relapse within 3 years; and 3) ER-stratified predictive signatures of response to chemotherapy, defined as pathologic complete response (pCR) or minimal RCB (RCB-I). The predictor classified tumors as treatment sensitive if high or intermediate SET, or if predicted to be responsive (and not resistant) to chemotherapy. Otherwise, tumors were classified as treatment insensitive. The predictor was then tested on an independent cohort (N= 198, 98% with clinical Stage II-III) who received neoadjuvant (N= 180) or adjuvant (N= 18) taxane-anthracycline chemotherapy (from MDACC, USO, GEICAM, Peru, LBJ). Distant relapse-free survival (DRFS) was evaluated at a 3-year median follow up using negative predictive value (NPV, absence of event if predicted to be sensitive), and absolute risk reduction (ARR) for those predicted to be sensitive (versus insensitive), with 95% confidence interval (CI). The independent predictive value was assessed in multivariate Cox regression analysis based on the likelihood ratio test (P≥0.05). Results: Patients in the independent validation cohort who were predicted to be treatment sensitive (28%) had excellent DRFS, with NPV 92% (CI 85-100) and significant absolute risk reduction (ARR 18%, CI 6-28) at 3 years, compared to those predicted to be insensitive. This was similar to the DRFS observed in patients who achieved pCR after they completed neoadjuvant chemotherapy (NPV 93%, CI 85-100). Predictions were accurate in each phenotypic subset: ER+/HER2- (30% predicted sensitive, NPV 97%, CI 91-100; ARR 11%, CI 0.1-21) and ER-/HER2- (26% predicted sensitive, NPV 83%, CI 68-100; ARR 26%, CI 4-28). Predicted treatment sensitivity (HR 0.20, CI 0.07-0.57), ER+ status (HR 0.32, CI 0.17-0.63), clinical tumor stage T3-4 (HR 2.04, CI 1.07-3.88) and age >50 (HR 0.50, CI 0.25-0.98) were significant in a multivariate model that also included clinical nodal status, grade, and type of taxane used.
Conclusion: We report validation results for the first molecular predictor of sensitivity to neoadjuvant/adjuvant systemic therapy for clinical Stage II-III breast cancer that is independently associated with excellent DRFS in those predicted to be sensitive. Predictions were accurate for both ER+/HER2- and ER-/HER2- invasive breast cancer.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD07-03.
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Affiliation(s)
- WF Symmans
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - C Hatzis
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - V Valero
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - DJ Booser
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - L Esserman
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - M Martin
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - T Vidaurre
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - F Holmes
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - EA Souchon
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - A Lluch
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - J Cotrina
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - H Gomez
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - R Hubbard
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - J Ferrer-Lozano
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - R Dyer
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - M Buxton
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - Y Gong
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - Y Wu
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - N Ibrahim
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - E Andreopoulou
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - NT Ueno
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - K Hunt
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - W Yang
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - A Nazario
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - A DeMichele
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - J O'Shaughnessy
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - GN Hortobagyi
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
| | - M.D. Pusztai L.
- Anderson Cancer Center; Nuvera Biosciences, Inc.; I-SPY Clinical Trial Investigators; GEICAM Investigators, Spain; Instituto Nacional de Enfermedades Neoplacicas, Lima, Peru; US Oncology; Lyndon B. Johnson Hospital, Houston; US Oncology/Baylor Sammmons Cancer Center, Dallas
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Butwick A, Dyer R. ST depression at caesarean section and the relation to oxytocin dose. A randomised controlled trial. BJOG 2010; 117:1165; author reply 1165-6. [DOI: 10.1111/j.1471-0528.2010.02625.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Astigueta JC, Abad MA, Pow-Sang MR, Morante C, Meza L, Destefano V, Dyer R. Angiomiolipoma epitelioide: una variante rara del angiomiolipoma renal. ARCH ESP UROL 2009. [DOI: 10.4321/s0004-06142009000600010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Astigueta JC, Abad MA, Pow-Sang MR, Morante C, Meza L, Destefano V, Dyer R. Epithelioid angiomyolipoma: a rare variant of renal angiomyolipoma. ARCH ESP UROL 2009; 62:493-497. [PMID: 19736381] [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: 05/28/2023]
Abstract
OBJECTIVE We present a case of primary renal epithelioid angiomyolipoma, its association with tuberous sclerosis and review the literature. METHODS We present the case of a 12 year-old male with past medical history of tuberous sclerosis, characterized by developmental delay, tonic and clonic seizures, and cutaneous abnormalities. He presented with macroscopic hematuria and abdominal pain. CT scan of the abdomen showed the presence of a left renal tumor. He underwent left radical nephrectomy. Pathologic study of the specimen showed primary renal epithelioid angiomyolipoma, corroborated by immunohistochemistry staining. Review of the literature was performed for this rare variant and its malignant potential. RESULTS The presence of this epithelial variant is rare and must be taken into account because of its malignant potential and, thus, with different prognosis and follow up, compared to classical angiomyolipoma. CONCLUSIONS Renal angiomyolipoma is an uncommon benign tumor, representing a challenge for clinical and pathological diagnosis. Despite the big size they can reach, as well as bilaterality, multiplicity of lesions and/or lymphatic regional involvement, its malignant potential has not been established. Nevertheless, the epithelioid variant has been described recently, a rare entity with aggressive behavior, difficult histological characterization and poor prognosis.
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Affiliation(s)
- Juan Carlos Astigueta
- Department of Urologic Surgery, Instituto Regional de Enfermedades Neoplásicas Norte, Trujillo, Perú.
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El-Toukhy T, Sunkara SK, Khairy M, Dyer R, Khalaf Y, Coomarasamy A. A systematic review and meta-analysis of acupuncture inin vitrofertilisation. BJOG 2008; 115:1203-13. [DOI: 10.1111/j.1471-0528.2008.01838.x] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jenkins MC, Parker C, Hill D, Pinckney RD, Dyer R, Dubey JP. Neospora caninum detected in feral rodents. Vet Parasitol 2006; 143:161-5. [PMID: 16997474 DOI: 10.1016/j.vetpar.2006.08.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 08/02/2006] [Accepted: 08/02/2006] [Indexed: 11/17/2022]
Abstract
The role of rodents in the epidemiology of neosporosis was investigated by assaying brain tissue of feral mice (Mus musculus) and rats (Rattus norvegicus) for Neospora caninum. Both mouse and rat brain tissue were extracted for total DNA, and subjected to two different N. caninum-specific nested polymerase chain reaction (PCR) assays. A portion of brain tissue from the mice and rats were also assayed for N. caninum in gerbils or gamma-interferon gene knockout (KO) mice. Of the 105 feral mice tested, 10% were positive in the N. caninum-specific PCR assays. Of the 242 rats tested, 30% were positive in both assays. Although mice and rats had N. caninum by PCR testing, clinical signs of N. caninum infection were not observed nor were N. caninum parasites observed in gerbils or KO mice inoculated with the rodent brain tissue.
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Affiliation(s)
- M C Jenkins
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Building 1040, BARC-EAST, Beltsville, MD 20705, USA.
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27
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García JL, Wachtel AE, Pérez C, Marcial J, Dyer R, Doimi F. Prognostic significance of myeloid associated antigen expression in childhood acute lymphoblastic leukemia in Peru. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.9030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9030 Background: The prognostic significance of coexpression of myeloid antigens in pediatric patients with acute lymphoblastic leukemia (ALL) has been reported by several authors, with a frequency that has ranged widely. All of these authors are from developed countries, the aim of this study is to evaluate the prognostic significance of these antigens in childhood ALL in a developing country. Methods: We retrospectively reviewed 729 newly diagnosed patients with ALL under 14 years of age, who had a bone marrow flow cytometry performed at our institution, between 1996–2002. Clinical data and treatment outcomes were reviewed and compared between patients with ALL who expressed myeloid antigens and those who did not using chi-square test. Results: 729 medical charts were studied, 81.6% of them were B-common, 8.2% were pro-B, 8.2% were T-cell and 2.1% were pre-B ALL patients. Overall frequency of myeloid antigen expression was 36.6%. The most frequent specific antigens found were: CD13, 15.5%; CD15, 6.0% and CD33, 4.5%. Evaluating the B-common ALL patients the presence of myeloid antigens rises to 43%. Patients who had coexpression of myeloid antigens had a relapse rate (any site) of 49.2% while 36.3% who had no coexpression had a relapse (p=0.001). There has also been statistical significance in bone marrow response on day 14 of induction with 64.9% having less than 5% blasts in the group without coexpression and 46.4% in the group with coexpression (p<0.0001). Conclusions: The present retrospective review shows the presence of associated myeloid antigens in our ALL patients in 36.6%. We have shown that it is an adverse prognostic factor for childhood ALL in a developing country, unlike reports from other centers in developed countries. No significant financial relationships to disclose.
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Affiliation(s)
- J. L. García
- Instituto de Enfermedades Neoplasicas, Lima, Peru
| | | | - C. Pérez
- Instituto de Enfermedades Neoplasicas, Lima, Peru
| | - J. Marcial
- Instituto de Enfermedades Neoplasicas, Lima, Peru
| | - R. Dyer
- Instituto de Enfermedades Neoplasicas, Lima, Peru
| | - F. Doimi
- Instituto de Enfermedades Neoplasicas, Lima, Peru
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Barrington JW, Dyer R, Bano F. Bladder augmentation using PelvicolTM implant for intractable overactive bladder syndrome. Int Urogynecol J 2005; 17:50-3. [PMID: 16001132 DOI: 10.1007/s00192-005-1345-y] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Received: 01/13/2005] [Accepted: 06/05/2005] [Indexed: 11/24/2022]
Abstract
The objective of the study was to evaluate the effectiveness of an implant of porcine dermis to augment the bladder in women with refractory overactive bladder syndrome (OAB). Twelve women underwent a Pelvicol bladder augmentation. A visual analogue score for severity of incontinence and a quality of life questionnaire was carried out pre-operatively and at 12 months post-operatively. Follow up cystoscopy was carried out in three women in addition. Three women were dry and cured; five women were significantly improved; two women were slightly improved and the procedure was unsuccessful in the remaining two women. There were no significant complications and voiding was spontaneous in every case. A bladder augmentation using porcine dermis may have a role in the surgical management of non-neuropathic women with OAB that has failed to respond to conservative therapy.
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Affiliation(s)
- J W Barrington
- Department of Obstetrics and Gynaecology, Torbay Hospital, Torquay, Devon, TQ2 7AA, UK.
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Bano F, Barrington JW, Dyer R. Comparison between porcine dermal implant (Permacol) and silicone injection (Macroplastique) for urodynamic stress incontinence. Int Urogynecol J 2004; 16:147-50; discussion 150. [PMID: 15378234 DOI: 10.1007/s00192-004-1216-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2004] [Accepted: 07/06/2004] [Indexed: 10/26/2022]
Abstract
The objective of this study was to compare the efficacy of porcine dermal implant injection (Permacol) and silicone injection (Macroplastique) in the treatment of female urodynamic stress incontinence (USI) in a prospective randomized trial. Fifty women with urodynamically proven stress incontinence were recruited and randomised to receive either Permacol or Macroplastique injection. Twenty-five patients were enrolled in each case. An International Continence Society (ICS) standard 1-h pad test was carried out prior to the injection and a subjective analysis of incontinence made using a Stamey scoring system. In addition, a Kings College Hospital Quality of Health Questionnaire (KCQ) was completed. The women were followed up at 6 weeks and 6 months and the same methods used to gauge the success or failure of the operation. Preoperatively there were no significant differences in pad losses, Stamey score or King's score between the two groups. The mean age of the women was 61 years (range 28-80 years). At 6 weeks there were significant reductions in the mean and median values in pad losses, Stamey score and King's score in both Permacol and Macroplastique patients but the effects were more pronounced in Permacol patients than Macroplastique patients. Of the Permacol patients, 64% were improved on quantified pad losses out of which 60% were dry whereas 54% of Macroplastique patients were improved on pad losses of which 41.6% were dry. Of the Permacol patients, 64% and 60% had reduction in Stamey and KCQ score, respectively, whereas Macroplastique patients had 46% reduction in one or more grades of Stamey scores and 42% reduction in KCQ scores. At 6 months the results in the Permacol patients appeared to be sustained but not for Macroplastique patients. This study has shown that Permacol injection when used as a urethral bulking agent appears to have a higher cure rate for urodynamic stress incontinence than Macroplastique and these results persist until the follow-up period of 6 months. The use of Permacol injection is an attractive alternative in the treatment of urodynamic stress incontinence.
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Affiliation(s)
- F Bano
- Department of Obstetrics and Gynaecology, Torbay Hospital, Torquay, Devon, TQ2 7AA, UK.
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30
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Abstract
Savannas occur across all of northern Australia and are extensively used as rangelands. A recent surge in live cattle exports to Southeast Asia has caused excessive grazing impacts in some areas, especially near watering points. An important ecological and management question is "how resilient are savanna ecosystems to grazing disturbances?" Resilience refers to the ability of an ecosystem to remain in its current state (resist change) and return to this state (recover) if disturbed. Resilience responses can be measured using field data. These responses can then be modelled to predict the likely resistance and recovery of savannas to grazing impacts occurring under different climatic conditions. Two approaches were used to model resilience responses. First, a relatively simple mathematical model based on a sigmoid response function was used. This model proved useful for comparing the relative resilience of different savanna ecosystems, but was limited to ecosystems and conditions for which data were available. Second, a complex process model, SAVANNA, was parameterised to simulate the structure and function of Australian savannas. Simulations were run for 50 years at two levels of grazing to evaluate resistance and then for another 50 years with no grazing to evaluate recovery. These runs predicted that savanna grasslands were more resistant to grazing (changed less) than red-loam woodlands, which recovered relatively slowly from grazing impacts. The SAVANNA model also predicted that these woodlands would recover slightly slower under the climate change scenario projected for northern Australia.
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Affiliation(s)
- J A Ludwig
- Tropical Savannas CRC, c/- CSIRO Sustainable Ecosystems, Winnellie, Darwin, Australia
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Liedloff AC, Coughenour MB, Ludwig JA, Dyer R. Modelling the trade-off between fire and grazing in a tropical savanna landscape, northern Australia. Environ Int 2001; 27:173-180. [PMID: 11697666 DOI: 10.1016/s0160-4120(01)00079-4] [Citation(s) in RCA: 20] [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: 05/23/2023]
Abstract
As savannas are widespread across northern Australia and provide northern rangelands, the sustainable use of this landscape is crucial. Both fire and grazing are known to influence the tree-grass character of tropical savannas. Frequent fires open up the tree layer and change the ground layer from perennials to that dominated by annuals. Annual species in turn produce copious quantities of highly flammable fuel that perpetuates frequent, hot fires. Grazing reduces fuel loads because livestock consumes fuel-forage. This trade-off between fire and grazing was modelled using a spatially explicit, process-orientated model (SAVANNA) and field data from fire experiments performed in the Victoria River District of northern Australia. Results of simulating fire (over 40 years) with minimal or no grazing pressure revealed a reduction in the shrub and woody plants, a reduction in grasses, and no influence on the tree structure given mild fires. While mature trees were resistant to fire, immature trees, which are more likely associated with the shrub layer, were removed by fire. The overall tree density may be reduced with continual burning over longer time periods because of increasing susceptibility of old trees to fire and the lack of recruitment. Increases in stocking rates created additional forage demands until the majority of the fuel load was consumed, thus effectively suppressing fire and reverting to the grazing and suppressed fire scenario where trees and shrubs established.
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Affiliation(s)
- A C Liedloff
- Tropical Savannas CRC, c/- CSIRO Sustainable Ecosystems, Winnellie, Darwin, Australia
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32
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Loehr SP, Hamilton C, Dyer R. Retrieval of entrapped guide wire in an IVC filter facilitated with use of a myocardial biopsy forceps and snare device. J Vasc Interv Radiol 2001; 12:1116-9. [PMID: 11535778 DOI: 10.1016/s1051-0443(07)61602-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Héctor Nicho S, Julio Amado R, José De Los Ríos C, Alvaro Rojas S, Dyer R. [Complicated acute appendicitis as intercurrent disease in patient with advanced gastric cancer]. Rev Gastroenterol Peru 2001; 21:64-6. [PMID: 12170289] [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
We report a case of a male 64 years old with acute abdomen who was operated with the presumptive diagnosis of complicated acute appendicitis. However the patient had black stools for two months, associated with epigastric pain. Endoscopic diagnosis was: Advanced Gastric Cancer: Borrmann II. Histology was informed as: Infiltrating adenocarcinoma intestinal type middlingly differentiated. Surgery findings were: peritonitis with perforated appendicitis in its base: Free coprolites and carcinomatosis. Histology was reported as: ulcerated mucous in caecal appendix, necrosis and perforation of the muscular wall in the base. Mesentery samples were informed with fat tissue involvement by infiltration of tubular adenocarcinoma.middlingly differentiated, suitable with primary gastric cancer.
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Affiliation(s)
- S Héctor Nicho
- Médico Gastroenterólogo del Servicio de Gastroenterología de la Clínica San Pedro-Huacho
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34
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Abstract
The purpose of this study is to quantify some of the parameters needed to perform near-field modelling of sites in the Kara Sea that were impacted by the disposal of radioactive waste. The parameters of interest are: the distribution coefficients (Kd) for several important radionuclides, the mineralogy of the sediment, and the relationship of Kd to liquid-to-solid ratio. Sediment from the Kara Sea (location: 73 degrees 00'N, 58 degrees 00'E) was sampled from a depth of 287 m on August 23/24, 1992. Analysis of the material included mineralogy, grain size and total organic carbon (TOC). Uptake kinetics were determined for 85Sr, 137Cs, 241Am, 99Tc, 1251, 232U and 210Pb and distribution coefficients (Kd) were determined for these radionuclides using batch type experiments. Sorption isotherms, developed for 137Cs, 85Sr and 99Tc, were linear in each case. Increasing the liquid-to-solid ratio strongly increased uptake of 137Cs and moderately increased uptake of 99Tc. Analysis for anthropogenic radionuclides indicated the presence only of 239/240Pu in the sediment with the highest activity (at the top section of the core) being 0.420 Bq kg(-1). Other anthropogenic radionuclides were below detection limits.
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Affiliation(s)
- M Fuhrmann
- Brookhaven National Laboratory, Environmental and Waste Technology Center, Upton, NY 11973-5000, USA.
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35
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Abstract
Rieger syndrome, an autosomal dominant disorder, includes ocular, craniofacial and umbilical abnormalities. The pitx2 homeobox gene, which is mutated in Rieger syndrome, has been proposed to be the effector molecule interpreting left-right axial information from the early embryonic trunk to each organ. Here we have used gene targeting in mice to generate a loss-of-function allele that would be predicted to result in organ randomization or isomerization. Although pitx2-/- embryos had abnormal cardiac morphogenesis, mutant hearts looped in the normal direction. Pitx2-/- embryos had correctly oriented, but arrested, embryonic rotation and right pulmonary isomerism. They also had defective development of the mandibular and maxillary facial prominences, regression of the stomodeum and arrested tooth development. Fgf8 expression was absent, and Bmp4 expression was expanded in the branchial-arch ectoderm. These data reveal a critical role for pitx2 in left-right asymmetry but indicate that pitx2 may function at an intermediate step in cardiac morphogenesis and embryonic rotation.
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Affiliation(s)
- M F Lu
- Alkek Institute of Biosciences and Technology, Center for Cancer Biology and Nutrition, Texas A&M University System Health Science Center, Houston 77030, USA
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36
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Rodriguez W, Pizarro R, Misad O, Herrera V, Argumanis E, Dyer R, Casanova L, Silva M, Flores C, Vallejos C. A case control study about HTLV-I in lymphoid malignancies (LM) with special reference to adult t-cell leukemia-lymphoma (ATL). Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81530-5] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ginzinger DG, Clee SM, Dallongeville J, Lewis ME, Henderson HE, Bauje E, Rogers QR, Jensen DR, Eckel RH, Dyer R, Innis S, Jones B, Fruchart JC, Hayden MR. Lipid and lipoprotein analysis of cats with lipoprotein lipase deficiency. Eur J Clin Invest 1999; 29:17-26. [PMID: 10092984 DOI: 10.1046/j.1365-2362.1999.00435.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [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: 11/20/2022]
Abstract
BACKGROUND We have previously described a colony of domestic cats with a naturally occurring mutation in the lipoprotein lipase (LPL) gene. We have now further characterized cats homozygous for LPL deficiency (LPL -/-, homozygotes), and have contrasted these with heterozygotes (LPL +/-) and normal cats (LPL +/+). MATERIALS AND METHODS Density gradient ultracentrifugation with subsequent lipid analysis, agarose and polyacrylamide gel electrophoresis was used to examine detailed liproprotein differences between the genotypes. Oral fat loading studies and breast milk fatty acid analysis were also performed to further characterize the phenotypic expression of LPL deficiency in this model system. RESULTS Several lipid abnormalities associated with homozygosity for LPL deficiency were evident. Triglyceride-rich lipoprotein-triglycerides (TRL-TG) and cholesterol (TRL-C) were higher (TRL-TG 2.09 +/- 1.14 vs. 0.15 +/- 0.04 mmol L-1, P < 0.001; TRL-C 0.42 +/- 0.30 vs. 0.11 +/- 0.16 mmol L-1, P < 0.05) in male -/- than in male +/+ cats, as was HDL-cholesterol (HDL-C, 1.75 +/- 0.24 vs. 1.41 +/- 0.14 mmol L-1, P < 0.05). LDL-C levels were lower in homozygous cats than in control cats, similar to what is seen in human LPL deficiency. Oral fat loading studies revealed that homozygous cats have a marked reduced ability to clear plasma TGs in terms of peak time (7 h vs. 3 h), peak height (9.36 vs. 1.1 mmol L-1), area under the TG clearance curve (AUC, 280.3 vs. 2.2 h mmol L-1) and time to return to baseline. Fasting lipid and lipoprotein levels were not significantly different between heterozygous and normal cats. However, oral fat loading in heterozygotes revealed an intermediate phenotype (peak of 2.35 mmol L-1 at 5 h, AUC 13.1 h mmol L-1), highlighting the impaired TG clearance in these animals. CONCLUSION Thus, LPL deficiency in the cat results in a lipid and lipoprotein phenotype that predominantly parallels human LPL deficiency, further validating the use of these animals in studies on the pathobiology of LPL.
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Affiliation(s)
- D G Ginzinger
- Department of Medical Genetics, University of British Columbia, Vancouver, Canada
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Abstract
Matrix metalloproteinases are a family of highly regulated peptidases that are collectively responsible for the degradation of extracellular matrix during tissue remodeling. Dysregulated activity has long been implicated in the pathologies of cancer and arthritis, and the number of diseases more recently associated with these enzymes has been increasing. In the past year, new transgenic models of matrix metalloproteinase knockouts have been described, allowing the direct assessment of specific enzyme activity in particular disease models. In addition, more selective inhibitors with improved pharmacokinetic profiles have entered clinical trials, allowing the assessment of the safety and efficacy of this strategy.
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Affiliation(s)
- L L Johnson
- Department of Biochemistry, Parke-Davis Pharmaceutical Research, Division of Warner-Lambert Company, Ann Arbor, MI 48105, USA.
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Djuric S, Dyer R, Glaser KB. Therapeutic regulation of allergic and inflammatory diseases, Fifth Annual Midwest Meeting, Chicago, IL, USA, 11 April 1997. Inflamm Res 1997; 46:482-5. [PMID: 9459077 DOI: 10.1007/s000110050229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- S Djuric
- Immunologic Disease Research Area, Abbott Laboratories, Abbott Park, IL 60064, USA
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40
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Fuhrmann M, Zhou H, Neiheisel J, Schoonen MA, Dyer R. Sorption/desorption of radioactive contaminants by sediment from the Kara Sea. Sci Total Environ 1997; 202:5-24. [PMID: 9241875 DOI: 10.1016/s0048-9697(97)00101-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
To understand the long term impact of the disposal of radioactive waste on the Kara Sea, partition coefficients (Kd) for several important radionuclides, the mineralogy of the sediment, and the relationship of Kd to liquid-to-solid ratio were quantified. Sediment was obtained from four locations in the Kara Sea area. Slow sorption kinetics were observed for 85Sr, 232U, 125I and 99Tc, whilst sorption was rapid (less than 50 h to steady-state) for 137Cs, 210Pb, and 241Am. Partition coefficients (Kd) were determined using batch type experiments and sorption isotherms which were developed for 85Sr, 99Tc, 125I, U and 137Cs. Partition coefficients for 137Cs were approx. 350 ml/g for sediment from the Trough and 180 ml/g for Stepovogo Fjord. This difference may be caused by the lower fraction of expandable clay in sediment from the fjord. Uptake of 85Sr, 99Tc, 125I, and U were all similar for both locations, with Kd values averaging 4, 3, 17 and 60 ml/g, respectively. The Kd for 137 Cs varied non-linearly from 40 to 3800 ml/g as the liquid-to-solid ratio varied from 3.4 to 6500, but only when the sorption capacity was high compared to the mass of 137Cs in the closed system of the experiment. Under identical conditions, sediment with lower Kd values showed no effect. Oxidation of sediment effectively desorbed 99Tc from the solid phase, whilst it caused increased uptake of 85Sr and U. In sequential rinses with fresh seawater, desorption was limited to 60% of 137Cs and 85Sr, and 35% of uranium.
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Affiliation(s)
- M Fuhrmann
- Environmental and Waste Technology Center, Brookhaven National Laboratory, Upton, New York 11973-5000, USA
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41
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Innis SM, Dyer R. Dietary triacylglycerols with palmitic acid (16:0) in the 2-position increase 16:0 in the 2-position of plasma and chylomicron triacylglycerols, but reduce phospholipid arachidonic and docosahexaenoic acids, and alter cholesteryl ester metabolism in formula-Fed piglets. J Nutr 1997; 127:1311-9. [PMID: 9202085 DOI: 10.1093/jn/127.7.1311] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.2] [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: 02/04/2023] Open
Abstract
Milk triacylglycerols have an unusual fatty acid distribution, with palmitic acid (16:0) esterified predominately at the center (sn-2) position. Other dietary triacylglycerols contain 16:0 predominantly at the sn-1,3 positions. This study was designed to evaluate the effect of formula triacylglycerol fatty acid distribution on the composition and distribution of plasma lipoprotein fatty acids in piglets fed formula containing synthesized triacylglycerols or palm olein oil with about 32 or 4.2% 16:0, respectively, in fatty acids at the sn-2 position, with comparison to piglets fed sow's milk. Feeding formula with 16:0 at the triglyceride sn-2 position or sow's milk resulted in higher chylomicron triacylglycerol sn-2 16:0 than when palm olein was fed. This suggests that dietary triacylglycerol sn-2 position fatty acids are conserved during digestion, absorption and reassembly to chylomicron triacylglycerols. The increased chylomicron triacylglycerol sn-2 position 16:0 in piglets fed synthesized triacylglycerols was accompanied by lower chylomicron triacylglycerol arachidonic and docosahexaenoic acid than in piglets fed formula with palm olein, suggesting an interaction between dietary triacylglycerol saturated fatty acid distribution and (n-6) and (n-3) fatty acid transport.
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Affiliation(s)
- S M Innis
- Department of Pediatrics, University of British Columbia, Vancouver V5Z 4H4, Canada
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42
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Rioux FM, Innis SM, Dyer R, MacKinnon M. Diet-induced changes in liver and bile but not brain fatty acids can be predicted from differences in plasma phospholipid fatty acids in formula- and milk-fed piglets. J Nutr 1997; 127:370-7. [PMID: 9039842 DOI: 10.1093/jn/127.2.370] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [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: 02/03/2023] Open
Abstract
The fatty acid composition of plasma phospholipids differs between infants fed formula and infants fed human milk, but the extent to which this is accompanied by differences in tissue phospholipid fatty acids is unclear. This paper describes analysis of plasma, liver and brain fatty acids from piglets fed one of seven formulas, varying in saturated, monounsaturated, (n-6) and (n-3) fatty acids or sow milk from birth for 18 d. Bile fatty acids were analyzed because they are secreted from liver and may be an important source of fatty acids for intestinal lipoprotein synthesis. The results were used to determine the relation between diet-related differences in plasma phospholipid fatty acids and those in brain, liver and bile. Where significant associations were found, prediction limits were constructed to assess the usefulness of analysis of plasma phospholipid fatty acids to predict diet-induced changes in tissue fatty acids. The proportions (g/100 g fatty acids) of 16:0, 18:0, 18:1, 18:2(n-6) and 20:4(n-6) in plasma phospholipids were significantly associated with the proportions of the same fatty acids in liver and bile, but not brain. The results show a reasonably precise, predictable association between plasma and liver, and plasma and bile fatty acids. Brain 20:4(n-6) and 22:6(n-3), in contrast, were not reliably associated with plasma phospholipid 20:4(n-6) and 22:6(n-3) for piglets fed milk or formula providing about 1.5% energy as 18:3(n-3).
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Affiliation(s)
- F M Rioux
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Innis SM, Dyer R, Quinlan PT, Diersen-Schade D. Dietary triacylglycerol structure and saturated fat alter plasma and tissue fatty acids in piglets. Lipids 1996; 31:497-505. [PMID: 8727642 DOI: 10.1007/bf02522643] [Citation(s) in RCA: 19] [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: 02/01/2023]
Abstract
Human and pig milk triacylglycerols contain a large proportion of palmitic acid (16:0) which is predominately esterified in the 2-position. Other dietary fats contain variable amounts of 16:0, with unsaturated fatty acids predominantly esterified in the 2-position. These studies determined if the amount or position of 16:0 in dietary fat influences the composition or distribution of liver, adipose tissue, lung, or plasma fatty acids in developing piglets. Piglets were fed to 18 d with sow milk or formula with saturated fat from medium-chain triglyceride (MCT), coconut or palm oil, or synthesized triacylglycerols (synthesized to specifically direct 16:0 to the 2-position) with, in total fatty acids, 30.7, 4.3, 6.5, 27.0, and 29.6% 16:0, and in 2-position fatty acids, 55.3, 0.4, 1.3, 4.4, and 69.9% 16:0, respectively. The percentage of 16:0 in the 2-position of adipose fat from piglets fed sow milk, palm oil, and synthesized triacylglycerols were similar and higher than in piglets fed MCT or coconut oil. Thus, the amount, not the position, of dietary 16:0 determines piglet adipose tissue 16:0 content. The effects of the diets on the plasma and liver triacylglycerols were similar, with significantly lower 16:0 in total and 2-position fatty acids of the MCT and coconut oil groups, and significantly higher 16:0 in the plasma and liver triacylglycerol 2-position of piglets fed the synthesized triacylglycerols rather than sow milk or palm oil. The lung phospholipid total and 2-position 16:0 was significantly lower in the MCT, coconut, and palm oil groups, but similar in the synthesized triacylglycerol group and sow milk group. The lung phospholipid total and 2-position percentage of arachidonic acid (20:4n-6) was significantly lower in all of the formula-fed piglets than in milk-fed piglets. The physiological significance of this is not known.
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Affiliation(s)
- S M Innis
- Department of Paediatrics, University of British Columbia, Canada
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Abstract
Sprains of the lateral ligamentous structures of the ankle joint as a result of inversion are common and frequently result in pain. In most cases, the pain is related to soft-tissue injury and the associated hemorrhage and swelling. This case report describes the complication of posttraumatic false aneurysm of the peroneal artery following an inversion ankle sprain in a 22-year-old athlete, a complication which should be added to the differential diagnosis as a rare, but important possibility. Emphasis of the case report is placed on the rehabilitation of the patient following medical intervention.
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Affiliation(s)
- W D Bandy
- Department of Physical Therapy, University of Central Arkansas, Conway 72035-0001, USA
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Santos C, Galdos R, Alvarez M, Velarde C, Barriga O, Dyer R, Estrada H, Almonte M. One-session management of cervical intraepithelial neoplasia: a solution for developing countries. Gynecol Oncol 1996; 61:11-5. [PMID: 8626096] [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
Six hundred thirty-nine patients with CIN on referral Pap were evaluated cytocolposcopically at the first visit and decided whether to be treated the same day or not. One hundred ninety-two patients (30%) were considered negative. Follow-up evidenced later appearance of CIN in five of them. One hundred fifty-three (24%) were candidates for delayed treatment due to conditions contraindicating same-day treatment. Two hundred ninety-four patients (46%) were randomly allocated in LEEP (149) or excisional laser (145) arms, and treated the same day under local anesthesia. Both arms were comparable. There were three microinvasive carcinomas diagnosed in the surgical specimen. LEEP was faster and produced less bleeding than laser, although required a mean of four slices to remove the lesion. Arterial hypertension after anesthetic infiltration was detected in 26% of cases. Two intraoperative and two delayed bleeders required surgery. The size of lesion and surgical defect were larger than those reported in the literature. Margins were involved in 8 patients (2.7%). Only 4.7% (7/149) of patients randomized to LEEP and 3.4% (5/145) with excisional laser had persistent or recurrent CIN on follow-up. Factors predisposing to failure included depth of surgical defect, grade of lesion, and operator's expertise. With this approach, 69% of patients referred for cytology of CIN were adequately managed in the first visit, which contrasts to classical management that reaches the state of treatment in 30% of patients. LEEP appears to be faster, less costly, and requires less expertise. Its use in conjunction with adequate screening is recommended for developing countries.
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Affiliation(s)
- C Santos
- Department of Gynecology, Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú
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46
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Affiliation(s)
- R Dyer
- Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA
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47
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Pow-Sang M, Orihuela E, Motamedi M, Pow-Sang JE, Cowan DF, Dyer R, Warren MM. Thermocoagulation effect of diode laser radiation in the human prostate: acute and chronic study. Urology 1995; 45:790-4. [PMID: 7747372 DOI: 10.1016/s0090-4295(99)80085-5] [Citation(s) in RCA: 8] [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] [Indexed: 01/26/2023]
Abstract
OBJECTIVES To evaluate the safety and efficacy of low-power slow-heating diode laser-induced photocoagulation of prostatic tissue for treatment of benign prostatic hyperplasia, we conducted a series of acute and chronic studies using a diode laser (810 nm) to irradiate human prostate. METHODS The study included 6 patients undergoing radical prostatectomy because of malignancy. Laser radiation to the prostate was given transurethrally, in a noncontact mode, at the time of the procedure in 2 patients (acute group): 10 W for 300 seconds on the right side of the prostate and 15 W for 180 seconds on the left. In the remaining 4 patients (chronic group), laser radiation was given at 1, 7, 10, and 12 weeks prior to the prostatectomy. RESULTS In the acute group the average depth of coagulation was 8.5 and 9.0 mm for the laser regimens of 15 W for 180 seconds and the 10 W for 300 seconds, respectively. In the chronic group, the average depth of coagulation was 8.9 mm for both laser regimens studied. In the acute group, there was an ill-defined hemorrhagic ring at the periphery of the lesion. At 1 week, an intact necrotic coagulum was present. At 7 weeks, some of the coagulated tissue had already sloughed off. Longer follow-up at 10 and 12 weeks demonstrated formation of a well-defined cavity with mostly re-epithelialized surface. CONCLUSIONS Our findings suggest that noncontact diode laser (810 nm) irradiation can induce in the human prostate significant coagulation necrosis followed by sloughing of tissue and cavitation of the prostatic urethra.
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Affiliation(s)
- M Pow-Sang
- Department of Surgery, University of Texas Medical Branch, Galveston, USA
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Innis SM, Dyer R, Quinlan P, Diersen-Schade D. Palmitic acid is absorbed as sn-2 monopalmitin from milk and formula with rearranged triacylglycerols and results in increased plasma triglyceride sn-2 and cholesteryl ester palmitate in piglets. J Nutr 1995; 125:73-81. [PMID: 7815179 DOI: 10.1093/jn/125.1.73] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Milk fatty acids contain 20-30% palmitic acid (16:0), with approximately 70% of the 16:0 esterified to the sn-2 position of the milk triacylglycerol. Formulae containing vegetable and oleo oils contain different amounts of 16:0, but all have unsaturated fatty acids esterified to the triacylglycerol sn-2 position. Intraluminal triacylglycerol hydrolysis by endogenous lipases produces sn-2 monoacylglycerols and free fatty acids, which are absorbed and re-esterified in the enterocyte for secretion to plasma. The extent of absorption and re-esterification of sn-2 monoacylglycerols from milk or formula fats in infants is unknown. This was studied by feeding piglets sow milk or formulae containing similar total saturated fat, 18:1, 18:2(n-6) and 18:3(n-3) with unsaturated fatty acids at the sn-2 position or with rearranged triacylglycerols containing approximately 30% 16:0, with 70% 16:0 in fatty acids at the sn-2 position. Feeding milk or 16:0 on the sn-2 position of formula with rearranged triacylglycerols resulted in higher 16:0 esterified to the plasma triacylglycerol sn-2 position and in cholesteryl esters than feeding formulae with 0.4 to 4.4% 16:0 in the sn-2 position fatty acids. The absorption of 16:0 as monopalmitin from milk and any metabolic importance in human infants has yet to be determined.
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Affiliation(s)
- S M Innis
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
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Abstract
Milk fatty acids consist of about 20-25% palmitic acid (16:0), with about 70% of 16:0 esterified to the sn-2 position of the milk triacylglycerols. Hydrolysis of dietary triacylglycerols by endogeneous lipases produces sn-2 monoacylglycerols and free fatty acids, which are absorbed, reesterified, and then secreted into plasma. Unesterified 16:0 is not well absorbed and readily forms soaps with calcium in the intestine. The positioning of 16:0 at the sn-2 position of milk triacylglycerols could explain the high coefficient of absorption of milk fat. However, the milk lipase, bile salt-stimulated lipase, has been suggested to complete the hydrolysis of milk fat to free fatty acids and glycerol. These studies determined whether 16:0 is absorbed from human milk as sn-2 monopalmitin by comparison of the plasma triacylglycerol total and sn-2 position fatty acid composition between breast-fed and formula-fed term gestation infants. The human milk and formula had 21.0 and 22.3% of 16:0, respectively, with 54.2 and 4.8% 16:0 in the fatty acids esterified to the 2 position. The plasma triacylglycerol total fatty acids had 26.0 +/- 0.6 and 26.2 +/- 0.6% of 16:0, and the sn-2 position fatty acids had 23.3 +/- 3.3 and 7.4 +/- 0.7% of 16:0 in the three-month-old exclusively breast-fed (n = 17) and formula-fed (n = 18) infants, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S M Innis
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
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Innis SM, Dyer R, Wadsworth L, Quinlan P, Diersen-Schade D. Dietary saturated, monounsaturated, n-6 and n-3 fatty acids, and cholesterol influence platelet fatty acids in the exclusively formula-fed piglet. Lipids 1993; 28:645-50. [PMID: 8355594 DOI: 10.1007/bf02536060] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Platelet lipid composition is important to normal platelet morphology and function, and is influenced by dietary fatty acids and cholesterol. The fatty acid composition and cholesterol content of infant formulas differs from those of human milk, but the possible effects on platelet lipids in young infants is not known. This was studied in piglets fed from birth to 18 d of age with one of eight formulas differing in saturated fatty acid chain length, or content of 18:1, 20:5n-3 plus 22:6n-3, or cholesterol. A reference group of piglets fed sow milk was also studied. Sow milk has a fatty acid composition and cholesterol content similar to that of human milk. Piglets fed formulas high in 18:1 (34.9-40.8% wt fatty acids) and low in 16.0 (< or = 6.5% wt fatty acids) had lower platelet counts and greater platelet size than piglets fed sow milk (40.4% 18:1, 30.7% 16:0). Piglets fed formulas high in 16:0 (27-29.6%) and 18:1 (40-40.6%), or low in both 16:0 (5.9-6.1%) and 18:1 (10.8-11.2%), had similar platelet counts and size to piglets fed sow milk. Platelet phospholipid % 20:4n-6 was lower in all the groups of piglets fed formula than in the group fed sow milk. Addition of fish oil with 20:5n-3 plus 22:6n-3 to the formula further decreased platelet phospholipid 20:4n-6. Addition of cholesterol to the formula increased the platelet phospholipid % 20:4n-6 and platelet volume.
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Affiliation(s)
- S M Innis
- Department of Paediatrics, University of British Columbia, Vancouver, Canada
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