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Haskell A, White BP, Rogers RE, Goebel E, Lopez MG, Syvyk AE, de Oliveira DA, Barreda HA, Benton J, Benavides OR, Dalal S, Bae E, Zhang Y, Maitland K, Nikolov Z, Liu F, Lee RH, Kaunas R, Gregory CA. Scalable manufacture of therapeutic mesenchymal stromal cell products on customizable microcarriers in vertical wheel bioreactors that improve direct visualization, product harvest, and cost. Cytotherapy 2024; 26:372-382. [PMID: 38363250 DOI: 10.1016/j.jcyt.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND AIMS Human mesenchymal stromal cells (hMSCs) and their secreted products show great promise for treatment of musculoskeletal injury and inflammatory or immune diseases. However, the path to clinical utilization is hampered by donor-tissue variation and the inability to manufacture clinically relevant yields of cells or their products in a cost-effective manner. Previously we described a method to produce chemically and mechanically customizable gelatin methacryloyl (GelMA) microcarriers for culture of hMSCs. Herein, we demonstrate scalable GelMA microcarrier-mediated expansion of induced pluripotent stem cell (iPSC)-derived hMSCs (ihMSCs) in 500 mL and 3L vertical wheel bioreactors, offering several advantages over conventional microcarrier and monolayer-based expansion strategies. METHODS Human mesenchymal stromal cells derived from induced pluripotent cells were cultured on custom-made spherical gelatin methacryloyl microcarriers in single-use vertical wheel bioreactors (PBS Biotech). Cell-laden microcarriers were visualized using confocal microscopy and elastic light scattering methodologies. Cells were assayed for viability and differentiation potential in vitro by standard methods. Osteogenic cell matrix derived from cells was tested in vitro for osteogenic healing using a rodent calvarial defect assay. Immune modulation was assayed with an in vivo peritonitis model using Zymozan A. RESULTS The optical properties of GelMA microcarriers permit noninvasive visualization of cells with elastic light scattering modalities, and harvest of product is streamlined by microcarrier digestion. At volumes above 500 mL, the process is significantly more cost-effective than monolayer culture. Osteogenic cell matrix derived from ihMSCs expanded on GelMA microcarriers exhibited enhanced in vivo bone regenerative capacity when compared to bone morphogenic protein 2, and the ihMSCs exhibited superior immunosuppressive properties in vivo when compared to monolayer-generated ihMSCs. CONCLUSIONS These results indicate that the cell expansion strategy described here represents a superior approach for efficient generation, monitoring and harvest of therapeutic MSCs and their products.
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Affiliation(s)
- Andrew Haskell
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Berkley P White
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Robert E Rogers
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Erin Goebel
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA; Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Megan G Lopez
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Andrew E Syvyk
- National Center for Therapeutics Manufacturing, Texas A&M University, College Station, Texas, USA
| | - Daniela A de Oliveira
- National Center for Therapeutics Manufacturing, Texas A&M University, College Station, Texas, USA; Biological and Agricultural Engineering, Texas A&M University, College Station, Texas, USA
| | - Heather A Barreda
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Joshua Benton
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Oscar R Benavides
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA
| | - Sujata Dalal
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - EunHye Bae
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Yu Zhang
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Kristen Maitland
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA; Imaging Program, Chan Zuckerberg Initiative, Redwood City, California, USA
| | - Zivko Nikolov
- National Center for Therapeutics Manufacturing, Texas A&M University, College Station, Texas, USA; Biological and Agricultural Engineering, Texas A&M University, College Station, Texas, USA
| | - Fei Liu
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Ryang Hwa Lee
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA
| | - Roland Kaunas
- Department of Biomedical Engineering, Texas A&M University, College Station, Texas, USA.
| | - Carl A Gregory
- Department of Cell Biology and Genetics, Texas A&M School of Medicine, Bryan, Texas, USA.
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Rogers RE, Haskell A, White BP, Dalal S, Lopez M, Tahan D, Pan S, Kaur G, Kim H, Barreda H, Woodard SL, Benavides OR, Dai J, Zhao Q, Maitland KC, Han A, Nikolov ZL, Liu F, Lee RH, Gregory CA, Kaunas R. A scalable system for generation of mesenchymal stem cells derived from induced pluripotent cells employing bioreactors and degradable microcarriers. Stem Cells Transl Med 2021; 10:1650-1665. [PMID: 34505405 PMCID: PMC8641084 DOI: 10.1002/sctm.21-0151] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/21/2021] [Accepted: 08/11/2021] [Indexed: 02/06/2023] Open
Abstract
Human mesenchymal stem cells (hMSCs) are effective in treating disorders resulting from an inflammatory or heightened immune response. The hMSCs derived from induced pluripotent stem cells (ihMSCs) share the characteristics of tissue derived hMSCs but lack challenges associated with limited tissue sources and donor variation. To meet the expected future demand for ihMSCs, there is a need to develop scalable methods for their production at clinical yields while retaining immunomodulatory efficacy. Herein, we describe a platform for the scalable expansion and rapid harvest of ihMSCs with robust immunomodulatory activity using degradable gelatin methacryloyl (GelMA) microcarriers. GelMA microcarriers were rapidly and reproducibly fabricated using a custom microfluidic step emulsification device at relatively low cost. Using vertical wheel bioreactors, 8.8 to 16.3‐fold expansion of ihMSCs was achieved over 8 days. Complete recovery by 5‐minute digestion of the microcarriers with standard cell dissociation reagents resulted in >95% viability. The ihMSCs matched or exceeded immunomodulatory potential in vitro when compared with ihMSCs expanded on monolayers. This is the first description of a robust, scalable, and cost‐effective method for generation of immunomodulatory ihMSCs, representing a significant contribution to their translational potential.
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Affiliation(s)
- Robert E Rogers
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Andrew Haskell
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Berkley P White
- Department of Biomedical Engineering, Texas A&M University, Emerging Technologies Building, College Station, Texas, USA
| | - Sujata Dalal
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Megan Lopez
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Daniel Tahan
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Simin Pan
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Gagandeep Kaur
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Hyemee Kim
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Heather Barreda
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Susan L Woodard
- National Center for Therapeutics Manufacturing, Texas A&M University, College Station, Texas, USA
| | - Oscar R Benavides
- Department of Biomedical Engineering, Texas A&M University, Emerging Technologies Building, College Station, Texas, USA
| | - Jing Dai
- Department of Electrical and Computer Engineering, Texas A&M University, Wisenbaker Engineering Building, College Station, Texas, USA
| | - Qingguo Zhao
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Kristen C Maitland
- Department of Biomedical Engineering, Texas A&M University, Emerging Technologies Building, College Station, Texas, USA
| | - Arum Han
- Department of Biomedical Engineering, Texas A&M University, Emerging Technologies Building, College Station, Texas, USA.,Department of Electrical and Computer Engineering, Texas A&M University, Wisenbaker Engineering Building, College Station, Texas, USA
| | - Zivko L Nikolov
- National Center for Therapeutics Manufacturing, Texas A&M University, College Station, Texas, USA.,Biological and Agricultural Engineering, Texas A&M University, Scoates Hall, College Station, Texas, USA
| | - Fei Liu
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Ryang Hwa Lee
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Carl A Gregory
- Department of Molecular and Cellular Medicine, Texas A&M Health Science Center, College of Medicine, Bryan, Texas, USA
| | - Roland Kaunas
- Department of Biomedical Engineering, Texas A&M University, Emerging Technologies Building, College Station, Texas, USA
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Mota SM, Rogers RE, Haskell AW, McNeill EP, Kaunas R, Gregory CA, Giger ML, Maitland KC. Automated mesenchymal stem cell segmentation and machine learning-based phenotype classification using morphometric and textural analysis. J Med Imaging (Bellingham) 2021; 8:014503. [PMID: 33542945 PMCID: PMC7849042 DOI: 10.1117/1.jmi.8.1.014503] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 01/11/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose: Mesenchymal stem cells (MSCs) have demonstrated clinically relevant therapeutic effects for treatment of trauma and chronic diseases. The proliferative potential, immunomodulatory characteristics, and multipotentiality of MSCs in monolayer culture is reflected by their morphological phenotype. Standard techniques to evaluate culture viability are subjective, destructive, or time-consuming. We present an image analysis approach to objectively determine morphological phenotype of MSCs for prediction of culture efficacy. Approach: The algorithm was trained using phase-contrast micrographs acquired during the early and mid-logarithmic stages of MSC expansion. Cell regions are localized using edge detection, thresholding, and morphological operations, followed by cell marker identification using H-minima transform within each region to differentiate individual cells from cell clusters. Clusters are segmented using marker-controlled watershed to obtain single cells. Morphometric and textural features are extracted to classify cells based on phenotype using machine learning. Results: Algorithm performance was validated using an independent test dataset of 186 MSCs in 36 culture images. Results show 88% sensitivity and 86% precision for overall cell detection and a mean Sorensen-Dice coefficient of 0.849 ± 0.106 for segmentation per image. The algorithm exhibited an area under the curve of 0.816 (CI 95 = 0.769 to 0.886) and 0.787 (CI 95 = 0.716 to 0.851) for classifying MSCs according to their phenotype at early and mid-logarithmic expansion, respectively. Conclusions: The proposed method shows potential to segment and classify low and moderately dense MSCs based on phenotype with high accuracy and robustness. It enables quantifiable and consistent morphology-based quality assessment for various culture protocols to facilitate cytotherapy development.
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Affiliation(s)
- Sakina M. Mota
- Texas A&M University, Department of Biomedical Engineering, College Station, Texas, United States
| | - Robert E. Rogers
- Texas A&M Health Science Center, College of Medicine, Bryan, Texas, United States
| | - Andrew W. Haskell
- Texas A&M Health Science Center, College of Medicine, Bryan, Texas, United States
| | - Eoin P. McNeill
- Texas A&M Health Science Center, College of Medicine, Bryan, Texas, United States
| | - Roland Kaunas
- Texas A&M University, Department of Biomedical Engineering, College Station, Texas, United States
- Texas A&M Health Science Center, College of Medicine, Bryan, Texas, United States
| | - Carl A. Gregory
- Texas A&M Health Science Center, College of Medicine, Bryan, Texas, United States
| | - Maryellen L. Giger
- University of Chicago, Department of Radiology, Committee on Medical Physics, Chicago, Illinois, United States
| | - Kristen C. Maitland
- Texas A&M University, Department of Biomedical Engineering, College Station, Texas, United States
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4
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Rogers RE, Yee DA. Response of Aedes aegypti and Aedes albopictus (Diptera: Culicidae) Survival, Life History, and Population Growth to Oak Leaf and Acorn Detritus. J Med Entomol 2019; 56:303-310. [PMID: 30668756 DOI: 10.1093/jme/tjy172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Indexed: 06/09/2023]
Abstract
Aedes albopictus (Skuse) (Diptera: Culicidae) and Aedes aegypti (L.) (Diptera: Culicidae) are invasive container mosquitoes that are of potential medical importance in the southern United States. Seeds (acorns) and leaves from oak trees can contribute seasonally to the detritus of larval container habitats. Herein, we examined the effect of acorns and leaves from the southern live oak (Quercus virginiana Mill.), which has a concomitant range with these mosquitoes, on the population performance of Ae. aegypti and Ae. albopictus. Three levels of acorns and oak leaves were used (0.99, 1.98, and 7.94 g), along with two mixtures (leaf + acorn: 0.50 + 1.48 and 1.48 + 0.50 g). Tannins, secondary plant metabolites that effect herbivory, were measured across all treatment levels; nitrogen and carbon was also measured for detritus and representative females. Survival, female mass, development time, and λ' (per capita rate of population increase) were used to evaluate population performance of both species. Detritus amount but not type led to differences in tannins; however, these differences did not correspond to differences in performance. Acorns had higher carbon and C:N than leaves. Survival for both species was lower in medium amounts of acorns. Female mass varied with leaf amount, whereas development time differed between amounts of pure leaf and acorn. λ' was lowest in medium and high acorns compared with leaves or mixtures. Thus, acorns do appear to limit mosquito survival and affect population growth, suggesting that inputs of this common detritus type may negatively affect container Aedes production.
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Affiliation(s)
- R E Rogers
- School of Biological, Environmental, and Earth Sciences, University of Southern Mississippi, Hattiesburg, Mississippi
| | - D A Yee
- School of Biological, Environmental, and Earth Sciences, University of Southern Mississippi, Hattiesburg, Mississippi
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5
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Singh SP, Schwartz MP, Tokuda EY, Luo Y, Rogers RE, Fujita M, Ahn NG, Anseth KS. A synthetic modular approach for modeling the role of the 3D microenvironment in tumor progression. Sci Rep 2015; 5:17814. [PMID: 26638791 PMCID: PMC4671067 DOI: 10.1038/srep17814] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 07/06/2015] [Accepted: 10/22/2015] [Indexed: 11/09/2022] Open
Abstract
Here, we demonstrate the flexibility of peptide-functionalized poly(ethylene glycol) (PEG) hydrogels for modeling tumor progression. The PEG hydrogels were formed using thiol-ene chemistry to incorporate a matrix metalloproteinase-degradable peptide crosslinker (KKCGGPQG↓IWGQGCKK) permissive to proteolytic remodeling and the adhesive CRGDS peptide ligand. Tumor cell function was investigated by culturing WM239A melanoma cells on PEG hydrogel surfaces or encapsulating cells within the hydrogels, and either as monocultures or indirect (non-contact) cocultures with primary human dermal fibroblasts (hDFs). WM239A cluster size and proliferation rate depended on the shear elastic modulus for cells cultured on PEG hydrogels, while growth was inhibited by coculture with hDFs regardless of hydrogel stiffness. Cluster size was also suppressed by hDFs for WM239A cells encapsulated in PEG hydrogels, which is consistent with cells seeded on top of hydrogels. Notably, encapsulated WM239A clusters and single cells adopted invasive phenotypes in the hDF coculture model, which included single cell and collective migration modes that resembled invasion from human melanoma patient-derived xenograft tumors encapsulated in equivalent PEG hydrogels. Our combined results demonstrate that peptide-functionalized PEG hydrogels provide a useful platform for investigating aspects of tumor progression in 2D and 3D microenvironments, including single cell migration, cluster growth and invasion.
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Affiliation(s)
- S P Singh
- Department of Chemical and Biological Engineering and the BioFrontiers Institute, University of Colorado at Boulder, Boulder, Colorado, United States of America
| | - M P Schwartz
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - E Y Tokuda
- Department of Chemical and Biological Engineering and the BioFrontiers Institute, University of Colorado at Boulder, Boulder, Colorado, United States of America
| | - Y Luo
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - R E Rogers
- College of Medicine, Texas A&M Health Science Center, Bryan, Texas, United States of America
| | - M Fujita
- Department of Dermatology, University of Colorado School of Medicine, Aurora, Colorado, United States of America.,Denver Veterans Affairs Medical Center, Denver, Colorado, United States of America
| | - N G Ahn
- Department of Chemistry and Biochemistry, University of Colorado at Boulder, Boulder, Colorado, United States of America
| | - K S Anseth
- Department of Chemical and Biological Engineering and the BioFrontiers Institute, University of Colorado at Boulder, Boulder, Colorado, United States of America.,Howard Hughes Medical Institute, University of Colorado at Boulder, Boulder, Colorado, United States of America
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6
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Schwartz MP, Rogers RE, Singh SP, Lee JY, Loveland SG, Koepsel JT, Witze ES, Montanez-Sauri SI, Sung KE, Tokuda EY, Sharma Y, Everhart LM, Nguyen EH, Zaman MH, Beebe DJ, Ahn NG, Murphy WL, Anseth KS. A quantitative comparison of human HT-1080 fibrosarcoma cells and primary human dermal fibroblasts identifies a 3D migration mechanism with properties unique to the transformed phenotype. PLoS One 2013; 8:e81689. [PMID: 24349113 PMCID: PMC3857815 DOI: 10.1371/journal.pone.0081689] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 10/25/2013] [Indexed: 01/09/2023] Open
Abstract
Here, we describe an engineering approach to quantitatively compare migration, morphologies, and adhesion for tumorigenic human fibrosarcoma cells (HT-1080s) and primary human dermal fibroblasts (hDFs) with the aim of identifying distinguishing properties of the transformed phenotype. Relative adhesiveness was quantified using self-assembled monolayer (SAM) arrays and proteolytic 3-dimensional (3D) migration was investigated using matrix metalloproteinase (MMP)-degradable poly(ethylene glycol) (PEG) hydrogels (“synthetic extracellular matrix” or “synthetic ECM”). In synthetic ECM, hDFs were characterized by vinculin-containing features on the tips of protrusions, multipolar morphologies, and organized actomyosin filaments. In contrast, HT-1080s were characterized by diffuse vinculin expression, pronounced β1-integrin on the tips of protrusions, a cortically-organized F-actin cytoskeleton, and quantitatively more rounded morphologies, decreased adhesiveness, and increased directional motility compared to hDFs. Further, HT-1080s were characterized by contractility-dependent motility, pronounced blebbing, and cortical contraction waves or constriction rings, while quantified 3D motility was similar in matrices with a wide range of biochemical and biophysical properties (including collagen) despite substantial morphological changes. While HT-1080s were distinct from hDFs for each of the 2D and 3D properties investigated, several features were similar to WM239a melanoma cells, including rounded, proteolytic migration modes, cortical F-actin organization, and prominent uropod-like structures enriched with β1-integrin, F-actin, and melanoma cell adhesion molecule (MCAM/CD146/MUC18). Importantly, many of the features observed for HT-1080s were analogous to cellular changes induced by transformation, including cell rounding, a disorganized F-actin cytoskeleton, altered organization of focal adhesion proteins, and a weakly adherent phenotype. Based on our results, we propose that HT-1080s migrate in synthetic ECM with functional properties that are a direct consequence of their transformed phenotype.
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Affiliation(s)
- Michael P. Schwartz
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- * E-mail: (MPS); (KSA)
| | - Robert E. Rogers
- College of Medicine, Texas A&M Health Science Center, Bryan, Texas, United States of America
| | - Samir P. Singh
- Department of Chemical and Biological Engineering, University of Colorado at Boulder, Boulder, Colorado, United States of America
| | - Justin Y. Lee
- Department of Chemical and Biological Engineering, University of Colorado at Boulder, Boulder, Colorado, United States of America
| | - Samuel G. Loveland
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Justin T. Koepsel
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Eric S. Witze
- Department of Cancer Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, , United States of America
| | - Sara I. Montanez-Sauri
- Materials Science Program, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Paul P. Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kyung E. Sung
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Paul P. Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Emi Y. Tokuda
- Department of Chemical and Biological Engineering, University of Colorado at Boulder, Boulder, Colorado, United States of America
| | - Yasha Sharma
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - Lydia M. Everhart
- Department of Chemical and Materials Engineering, University of Dayton, Dayton, Ohio, United States of America
| | - Eric H. Nguyen
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Muhammad H. Zaman
- Department of Biomedical Engineering, Boston University, Boston, Massachusetts, United States of America
| | - David J. Beebe
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Paul P. Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Laboratory for Optical and Computational Instrumentation, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Natalie G. Ahn
- Department of Chemistry and Biochemistry, University of Colorado at Boulder, Boulder, Colorado, United States of America
- Howard Hughes Medical Institute, University of Colorado at Boulder, Boulder, Colorado, United States of America
| | - William L. Murphy
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Materials Science Program, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Kristi S. Anseth
- Department of Chemical and Biological Engineering, University of Colorado at Boulder, Boulder, Colorado, United States of America
- Howard Hughes Medical Institute, University of Colorado at Boulder, Boulder, Colorado, United States of America
- * E-mail: (MPS); (KSA)
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Abstract
We report a male infant with L-2-hydroxyglutaric aciduria and Wilms tumor. L-2-hydroxyglutaric aciduria is a rare, autosomal-recessive, inborn error of metabolism characterized by a variable degree of progressive encephalopathy. Of the fewer than 100 cases reported in the literature, at least 9 patients have developed tumors of the central nervous system. To our knowledge, the present case is the 1st example of an extracranial tumor associated with L-2-hydroxyglutaric aciduria. This observation potentially widens the tumor spectrum in this metabolic disorder and may lead to further insight into the relationship between L-2-hydroxyglutaric acid and cellular transformation.
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Affiliation(s)
- Robert E Rogers
- 1Department of Pathology, Children's Medical Center, Dallas, TX, USA
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8
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Schwartz MP, Fairbanks BD, Rogers RE, Rangarajan R, Zaman MH, Anseth KS. A synthetic strategy for mimicking the extracellular matrix provides new insight about tumor cell migration. Integr Biol (Camb) 2009; 2:32-40. [PMID: 20473410 DOI: 10.1039/b912438a] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Understanding the role of the tumor microenvironment during cancer progression and metastasis is complicated by interactions between cells, the extracellular matrix (ECM), and a variety of biomolecules. Using a synthetic strategy, we investigated proteolytic modes of migration for HT-1080 fibrosarcoma cells in an environment that limited confounding extracellular influences. A large percentage of HT-1080s migrated through a Rho kinase (ROCK)-dependent rounded morphology with a leading edge protrusion that defined the direction of migration, and migration was only weakly dependent on the adhesive peptide RGDS. HT-1080s migrating in thiol-ene hydrogels are more rounded and exhibit much more invasive behavior than dermal fibroblasts. Our results indicate that HT-1080s have the capacity to migrate through a mechanism that is distinct from mesenchymal cells, with significant amoeboid character even when utilizing a proteolytic migration strategy. The migration mode observed here provides insight into the invasiveness of metastatic cells in vivo and demonstrates the potential of a synthetic strategy for investigating complex biological problems.
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Affiliation(s)
- Michael P Schwartz
- Department of Chemical and Biological Engineering, Howard Hughes Medical Institute, University of Colorado at Boulder, ECCH111, CB424, Boulder, CO 80309, USA.
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Barraj LM, Scrafford CG, Eaton WC, Rogers RE, Jeng CJ. Arsenic levels in wipe samples collected from play structures constructed with CCA-treated wood: impact on exposure estimates. Sci Total Environ 2009; 407:2586-2592. [PMID: 19217647 DOI: 10.1016/j.scitotenv.2008.12.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Revised: 12/05/2008] [Accepted: 12/12/2008] [Indexed: 05/27/2023]
Abstract
Lumber treated with chromated copper arsenate (CCA) has been used in residential outdoor wood structures and playgrounds. The U.S. EPA has conducted a probabilistic assessment of children's exposure to arsenic from CCA-treated structures using the Stochastic Human Exposure and Dose Simulation model for the wood preservative scenario (SHEDS-Wood). The EPA assessment relied on data from an experimental study using adult volunteers and designed to measure arsenic in maximum hand and wipe loadings. Analyses using arsenic handloading data from a study of children playing on CCA-treated play structures in Edmonton, Canada, indicate that the maximum handloading values significantly overestimate the exposure that occurs during actual play. The objective of our paper is to assess whether the dislodgeable arsenic residues from structures in the Edmonton study are comparable to those observed in other studies and whether they support the conclusion that the values derived by EPA using modeled maximum loading values overestimate hand exposures. We compared dislodgeable arsenic residue data from structures in the playgrounds in the Edmonton study to levels observed in studies used in EPA's assessment. Our analysis showed that the dislodgeable arsenic levels in the Edmonton playground structures are similar to those in the studies used by EPA. Hence, the exposure estimates derived using the handloading data from children playing on CCA-treated structures are more representative of children's actual exposures than the overestimates derived by EPA using modeled maximum values. Handloading data from children playing on CCA-treated structures should be used to reduce the uncertainty of modeled estimates derived using the SHEDS-Wood model.
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Affiliation(s)
- Leila M Barraj
- Chemical Regulation and Food Safety, Exponent, Inc., Suite 1100, 1150 Connecticut Ave., NW, Washington, DC 20036, USA.
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10
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Rogers RE, Isola DA, Jeng CJ, Lefebvre A, Smith LW. Simulated inhalation levels of fragrance materials in a surrogate air freshener formulation. Environ Sci Technol 2005; 39:7810-6. [PMID: 16295841 DOI: 10.1021/es040534q] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This study measured postapplication exposure levels of fragrance materials in a surrogate air freshener formulation in an environmentally-controlled exposure room (ECER). A five-s spray was released to simulate normal consumer use conditions. Time-course airborne fragrance material levels were sampled with Tenax tubes, and aerosol size distributions were monitored with a TSI 3320 aerodynamic particle sizer. Triplicate experiments were performed for each of the control/test substances. The control substance (unfragranced formulation) experiments indicated that the airborne fragrance materials were not detected, suggesting that the base propellant formulation did not interfere with the sampling procedure or analytical results. The test substance experiments found that the higher the volatility of the fragrance material, the higherthe airborne fragrance concentration within the ECER. In the adult breathing zone height, the maximum concentrations of the nine fragrance materials ranged from 108 to 347 microg/m3 during the first minute postapplication. In the child breathing zone height, the maximum fragrance material concentrations ranged from 125 to 362 microg/m3 during 2-6 min postapplication. Particle size distributions indicated that approximately 60-70% of the generated aerosols were less than 1 microm aerodynamic diameter. Initial peak particle mass concentrations (<5 microm) were 800-1000 microg/m3 during the first minute postapplication. Following initial peak concentrations, there was approximately 10-15 min of fluctuation, and then particle levels decayed gradually and exponentiallyto near background levels. Exposure to the test formulation would originate from two components: particle-bound and vapor-phase fragrance materials. Particle-bound fragrance exposure accounted for approximately 47% and 72% of the total exposures during the first minute postapplication period in the adult and child breathing zone heights, respectively.
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Affiliation(s)
- Robert E Rogers
- Toxcon Health Sciences Research Centre Inc., 9607-41 Avenue, Edmonton, Alberta, Canada
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Hurd WW, Barhan SM, Rogers RE. Obstetrician-gynecologist as primary care provider. Am J Manag Care 2001; 7 Spec No:SP19-24. [PMID: 11599671] [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: 02/21/2023]
Abstract
Obstetrics and gynecology is a unique field that combines preventive and primary care with female pelvic surgery and obstetrics. With the evolution of managed care, it has been a challenge to fit this field into the standard primary care paradigm. This article describes a 3-tiered, patient-oriented definition of primary care that encompasses the essential aspects of all primary care specialties, followed by a critical examination of how primary care specialties, including obstetrics and gynecology, fit into this definition. This approach suggests that to better meet the primary care needs of both patients and society, obstetrician-gynecologists must continue to improve their skills in preventive care, diagnosis and treatment of self-limited conditions, and diagnosis of serious nongynecologic conditions.
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Affiliation(s)
- W W Hurd
- Department of Obstetrics and Gynecology, Wright State University, Dayton, OH 45409, USA.
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Affiliation(s)
- R D Halpert
- Department of Radiology, University of Texas Medical Branch, Galveston 77550-2780
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Garagiola DM, Tarver RD, Gibson L, Rogers RE, Wass JL. Anatomic changes in the pelvis after uncomplicated vaginal delivery: a CT study on 14 women. AJR Am J Roentgenol 1989; 153:1239-41. [PMID: 2816641 DOI: 10.2214/ajr.153.6.1239] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.3] [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: 01/02/2023]
Abstract
We analyzed CT scans of the pelvis made within 24 hr of an uncomplicated term vaginal delivery in 14 women to document the anatomic changes that occur in the immediate postpartum period. Scans were interpreted by three radiologists, and the results were compared with those from pelvic CT scans made from normal, age-matched, nonpregnant women. In addition to soft-tissue windows, bone windows also were obtained to assess the pubic symphysis and sacroiliac joints in both the postpartum women and the control subjects. The mean uterine length, transverse width, and anteroposterior diameter in the postpartum women (14 +/- 1.4, 12 +/- 1.5, and 9 +/- 1.6 cm, respectively) were significantly larger than in the nonpregnant women (7 +/- 1.4, 5 +/- 0.8, and 4 +/- 0.9 cm) (p less than .0001). CT scans showed intrauterine blood in nine of the postpartum women (64%), and three (21%) had intrauterine gas. There was widening of the sacroiliac joint in one (7%) of the postpartum women compared with none of the control subjects. Widening of the pubic symphysis was present in six (42%) of the postpartum women and in none of the control subjects. Six (42%) of the postpartum women had gas in the sacroiliac joints, 33% of which occurred bilaterally; gas in the pubic symphysis was seen in four (28%) of the postpartum scans. In one patient, an asymptomatic muscle hematoma was discovered. We conclude that normal changes in the pelvis after uncomplicated term vaginal delivery include enlargement of the uterus, intrauterine blood, widening of the symphysis and sacroiliac joints, and gas in the sacroiliac joints.
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Affiliation(s)
- D M Garagiola
- Department of Radiology, Indiana University Medical Center, Wishard Memorial Hospital, Indianapolis 46202
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el-Dabh A, Rogers RE, Davis TE, Sutton GP. The role of endocervical curettage in satisfactory colposcopy. Obstet Gynecol 1989; 74:159-64. [PMID: 2748050] [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: 01/02/2023]
Abstract
The role of endocervical curettage was studied in women with cervical dysplasia who underwent satisfactory colposcopic evaluation. Among 1130 women seen in the colposcopy clinic of a large city hospital during a 2-year period, 96 with satisfactory colposcopy and positive endocervical curettage constituted the study group. In these patients, the extent of dysplasia in the endocervical canal in cone biopsy specimens was measured using an ocular micrometer. When true-positive endocervical curettage was defined as dysplasia extending 5 mm or more inside the transformation zone, the false-positive rate for endocervical curettage was 81.8%. No patient with mild or moderate dysplasia on endocervical curettage had dysplasia that was more than moderate in degree or that extended more than 4.5 mm inside the transformation zone on histopathologic examination of the cone biopsy specimen. Because of the high rate of false-positive endocervical curettage, patients with mild and moderate dysplasia and selected women with severe dysplasia in endocervical curettings could be treated by local cervical ablation, with follow-up by endocervical curettage.
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Affiliation(s)
- A el-Dabh
- Department of Obstetrics and Gynecology, Indiana University Medical Center, Indianapolis
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Abstract
When a 32-year-old woman was first seen, physical findings suggested she had a large levator hernia, but at the time of surgical resection an aggressive angiomyxoma was found.
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Affiliation(s)
- G P Sutton
- Department of Obstetrics and Gynecology, Indiana, University School of Medicine, Indianapolis 46223
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Rogers RE. Complications at cesarean section. Obstet Gynecol Clin North Am 1988; 15:673-84. [PMID: 3226671] [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: 01/04/2023]
Abstract
Despite the dramatic improvements in the mortality and morbidity rates of cesarean section, abdominal delivery is inherently more hazardous than vaginal delivery. Much of the mortality and morbidity that we recognize today is the result of the condition that mandated the cesarean section rather than of the procedure itself. The surgeon who recognizes complications early and acts skillfully to limit or repair damage will protect the patient from resulting morbidity. We must not be lulled by the routine nature of cesarean section; complications await the complacent.
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Affiliation(s)
- R E Rogers
- Gynecology Division, Indiana University School of Medicine, Indianapolis
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Rogers RE, Hansell R. Evaluation of the uterine cervix for cancer. Indiana Med 1988; 81:393-7. [PMID: 3290327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Abstract
The prevalence of human papillomavirus (HPV) infection of the cervix was determined in an unselected population of pregnant women presenting to an inner-city Obstetrics Clinic in the first trimester. Cervical scrape specimens were screened for the presence of HPV types 6, 11, 16, 18, and 31 DNA by using three different blot hybridization methods. Specimens from 26 (11.1%) of 234 patients contained HPV DNA sequences. HPV-16 and -31 were detected in six specimens each, whereas HPV-6, -11, and -18 were each identified in three specimens. Five additional specimens contained HPV DNA sequences of undetermined type. Only two of the 26 positive specimens were obtained from patients with genital warts; an additional 12 specimens were from patients with cytological abnormalities. We conclude that cervical HPV infections in some pregnant populations are common and that many such infections are not clinically apparent.
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Affiliation(s)
- K H Fife
- Department of Medicine, Indiana University School of Medicine, Indianapolis
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Webb DH, Rogers RE, Fife KH. A one-step method for detecting and typing human papillomavirus DNA in cervical scrape specimens from women with cervical dysplasia. J Infect Dis 1987; 156:912-9. [PMID: 2824626 DOI: 10.1093/infdis/156.6.912] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
We studied 66 women with a previous dysplastic cervical cytological smear who were referred for colposcopy and biopsy for the presence of human papillomavirus (HPV) types 6, 11, 16, 18, and 31 DNA in cervical specimens. The specimens were analyzed by a novel hybridization method termed reverse blotting, in which cellular DNA is radiolabeled and used to probe a battery of cloned HPV DNAs immobilized on nitrocellulose. Reconstruction experiments demonstrated that this method could detect about one HPV genome equivalent per cell. HPV DNA sequences were detected in 52 (96%) of 54 patients who showed either condylomatous changes or dysplasia by cervical biopsy. HPV-16 was most commonly detected overall and was detected in 61% of moderate or severe dysplastic samples. HPV DNA was also detected in seven of 12 cervical scrapes from women with a history of dysplasia but with either normal or inflammatory changes noted on cervical biopsy. Our results indicate that the reverse-blot method can detect DNA homologous to various HPV types in a single experiment using DNA from the small numbers of cells obtained by cervical scraping.
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Affiliation(s)
- D H Webb
- Department of Medicine, Indiana University School of Medicine, Indianapolis
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Smith JW, Rogers RE, Katz BP, Brickler JF, Lineback PL, Van der Pol B, Jones RB. Diagnosis of chlamydial infection in women attending antenatal and gynecologic clinics. J Clin Microbiol 1987; 25:868-72. [PMID: 3294888 PMCID: PMC266106 DOI: 10.1128/jcm.25.5.868-872.1987] [Citation(s) in RCA: 68] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Two antigen detection systems (MicroTrak [MT], Syva Co., Palo Alto, Calif.; and Chlamydiazyme [CZ], Abbott Laboratories, North Chicago, Ill.) were compared with semiquantitative culture for diagnosis of chlamydial infection in 1,059 patients. Cultures were done on microtiter plates and blind passaged once. Culture-negative but CZ- or MT-positive specimens were recultured. True positives were positive by either initial or repeat cultures. Of 827 nonpregnant and 231 pregnant patients, 9.1 and 12.1%, respectively, had positive cultures. Overall sensitivity of the initial culture was 48.5% without passage and 86.4% with passage. The sensitivity of CZ was 67%. The sensitivity of MT in our laboratory was 50%; however, further review of these specimens by Syva employees gave a combined sensitivity of 71.6%. MT and CZ were more sensitive for pregnant patients (MT, 84.6%; CZ, 85.7%) than for nonpregnant patients (MT, 65.5%; CZ, 60.0%). All the tests had specificities above 95%. Of the specimens that were positive after initial culture without subculture, MT-negative specimens had a mean of 3.7 inclusions in culture, and MT-positive specimens had a mean of 24.8 (P = 0.002); CZ-negative specimens had a mean of 4.3 inclusions, and CZ-positive specimens had a mean of 20.0 (P = 0.026). In addition, cultures of specimens from pregnant patients had more inclusions than did those from gynecology patients, but this was not statistically significant (P = 0.096). No method is ideal; however, MT and CZ were less sensitive than was this culture system for detecting chlamydial infection in patients in gynecology clinics and were of comparable sensitivity for pregnant patients.
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Rogers RE. The challenge of gerontological nursing. J Pract Nurs 1982; 32:18-21. [PMID: 6923927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
This study evaluated the effect of a low concentration of hydrogen sulfide on the rat antibacterial defense system. Rats exposed to 45 ppm hydrogen sulfide (threshold limit value for hydrogen sulfide = 10 ppm) for 4 or 6 hr exhibited a significant (P less .01) reduction in the inactivation of viable staphylococci deposited in the lungs during a bacterial aerosol challenge. Pre-exposure of rats to 46 ppm hydrogen sulfide for 2 hr, however, did not alter intrapulmonary staphylococcal inactivation. We hypothesize that impairment of the alveolar macrophage is the basis of these findings.
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Rogers RE. Gerontological nursing in review. Aging Leis Living 1980; 3:9-13. [PMID: 10297719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
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Rogers RE. Gerontological nursing practice: out of the everywhere into the here. J Am Health Care Assoc 1977; 3:59-65. [PMID: 10324766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Rogers RE. Out of the everywhere into the here. J Am Health Care Assoc 1977; 3:59-65. [PMID: 326855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Spence MR, Whitson LG, Rogers RE. Colposcopy as a Diagnostic and Teaching Technique. Mil Med 1976. [DOI: 10.1093/milmed/141.10.689] [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: 11/13/2022] Open
Affiliation(s)
- Michael R. Spence
- Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, D.C. 20012
| | - Leland G. Whitson
- Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, D.C. 20012
| | - Robert E. Rogers
- Department of Obstetrics and Gynecology, Walter Reed Army Medical Center, Washington, D.C. 20012
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Spence MR, Whitson LG, Rogers RE. Colposcopy as a diagnostic and teaching technique. Mil Med 1976; 141:689-90. [PMID: 823451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Biggerstaff ED, Menutti MU, Yetter JF, Rogers RE. Maternal midtrimester sepsis in association with the intrauterine contraceptive device: early histopathologic findings. Am J Obstet Gynecol 1976; 124:207. [PMID: 1108659 DOI: 10.1016/s0002-9378(16)33301-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Affiliation(s)
- Robert E. Rogers
- Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Wash. 98431
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Rogers RE. Evaluation of post-episiorrhaphy pain: polyglycolic acid vs catgut sutures. Mil Med 1974; 139:102-4. [PMID: 4204803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Park RC, Patow WE, Rogers RE, Zimmerman EA. Treatment of stage I carcinoma of the cervix. Obstet Gynecol 1973; 41:117-22. [PMID: 4682607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Levens AJ, Belcher HV, Katz S, Jones FD, Littman A, Kent DC, Clark JH, Rogers RE, Blom J, Peterson EW, Conrad ME. Book Reviews. Mil Med 1970. [DOI: 10.1093/milmed/135.11.1101] [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: 11/13/2022] Open
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Yokoyama M, Yamakido M, Chandor SB, Rogers RE. Isoagglutinin and immunoglobulin levels in maternal and cord sera. Z Immunitatsforsch Allerg Klin Immunol 1970; 139:445-54. [PMID: 4194161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Rogers RE. How to develop better patient care policies. Geriatr Nurs 1968; 4:20-2. [PMID: 5183974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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