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Li R, Li WL, Yuan GS, Pang HJ, Li Q, Hu XY, Guo YB, Chen JZ, Zang MY. [Study on the comparison of postoperative liver injury caused by hepatic arterial perfusion chemotherapy combined with targeted immunotherapy with hepatic arterial chemoembolization combined with targeted immunotherapy for intermediate-and advanced-stage liver cancer]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:1163-1168. [PMID: 38238949 DOI: 10.3760/cma.j.cn501113-20230827-00070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
Objective: To compare the postoperative liver function injury condition in patients with intermediate-and advanced-stage hepatocellular carcinoma (HCC) treated with hepatic artery infusion chemotherapy (HAIC) and hepatic artery chemoembolization (TACE) combined with immune checkpoint inhibitors (ICIs) and multi-target tyrosine kinase inhibitors (TKIs). Methods: Patients with intermediate-and advanced-stage HCC who were admitted and treated with HAIC/TACE+ICIs+TKIs therapy at Nanfang Hospital of Southern Medical University from January 2019 to November 2021, with follow-up up to July 2023, were retrospectively enrolled. The results of liver function tests within one week before interventional surgery and on the first day after surgery were recorded. The degree of postoperative liver injury was graded according to the common terminology criteria for adverse events 5.0 (CTCAE 5.0). The treatment efficacy was evaluated according to RECIST 1.1 criteria. Measurement data were compared between groups using a t-test or a non-parametric rank sum test. Enumeration data were compared between the groups using the χ(2) test or Fisher's exact probability method. The survival condition differences were analyzed by the log-rank method. Results: This study included 82 and 77 cases in the HAIC and TACE groups. There were no statistically significant differences between the two groups of patients in terms of gender, age, physical condition score, number of tumors, presence or absence of liver cirrhosis, Child-Pugh grade, albumin-bilirubin (ALBI) grade, and combined ICIs and TKIs . The HAIC group had later tumor staging, a greater tumor burden, poorer liver reserve function, and a larger proportion of patients in stage C (81.7% vs. 63.6%), χ(2)=6.573, P = 0.01). There were 53 cases (64.6% vs. 32.5%) with a maximum tumor diameter of ≥ 10cm, χ(2)=16.441, P < 0.001), and more patients had a retention rate of ≥ 10% for indocyanine green (ICG) at 15 minutes (68.3% vs. 51.9%, P = 0.035). The postoperative incidence rate of increased levels of alanine aminotransferase, aspartate aminotransferase, and total bilirubin was significantly lower in the HAIC group than that in the TACE group (28.0% vs. 63.6%, χ(2)=20.298, P < 0.001, 54.9% vs. 85.7%, χ(2)=17.917, P < 0.001;40.2% vs. 55.8%, χ(2)=3.873, P = 0.049). The number of patients with postoperative ALBI grade 3 was significantly lower in the HAIC group than that in the TACE group (6.1% vs. 16.9%, χ(2)=4.601, P = 0.032). There was no statistically significant difference in the incidence rate of postoperative hypoalbuminemia, activated partial thromboplastin time, or increased international standardized ratio between the two groups of patients. There was no statistically significant difference in median progression-free survival (7.3 months vs. 8.2 months, P = 0.296) or median overall survival (16.5 months vs. 21.9 months, P = 0.678) between the two groups of patients. Conclusion: The incidence rate of postoperative liver injury is higher in patients with intermediate-and advanced-stage HCC treated with TACE combined with ICIs and TKIs than in patients with HAIC combined with ICIs and TKIs.
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Affiliation(s)
- R Li
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - W L Li
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - G S Yuan
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - H J Pang
- Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Q Li
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X Y Hu
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Y B Guo
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J Z Chen
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - M Y Zang
- Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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Dong SY, Deng SY, Fan R, Chen JZ, Cheng X, Hao X, Dai WC. [Predictive value of aMAP risk score for early recurrence of small hepatocellular carcinoma after microwave ablation]. Zhonghua Nei Ke Za Zhi 2023; 62:1329-1334. [PMID: 37935500 DOI: 10.3760/cma.j.cn112138-20221108-00835] [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: 11/09/2023]
Abstract
Objective: To explore the value of the aMAP risk score (age, male, albumin-bilirubin, and platelets) to predict early recurrence within one year after microwave ablation in patients with small hepatocellular carcinoma. Methods: This was a retrospective study that enrolled 142 patients diagnosed with hepatocellular carcinoma who were treated with microwave ablation in the Department of Hepatology Unit of Nanfang Hospital, Southern Medical University from July 2016 to July 2021. The cohort enrolled 121 male and 21 female patients, including 110 patients that were <60 years old. All the patients were followed-up after microwave ablation to evaluate residual tumor and recurrence of tumor by computed tomography or magnetic resonance imaging. The observation indices mainly included general data and imaging data of patients. Using the X-tile tools, patients were divided into two groups: a high aMAP score group and a low aMAP score group. Multivariate Cox regression analysis was conducted for comparison of independent risk factors. Results: Multivariate Cox regression showed that high aMAP score, maximum tumor diameter >20 mm, and high AFP were the independent risk factors of early recurrence (all P<0.05). Kaplan-Meier survival curves showed that the median recurrence-free survival was 25.5 months in the low aMAP score group and 6.1 months in the high aMAP score group (P=0.001). Conclusions: The aMAP score could predict the early recurrence within 1 year of small hepatocellular carcinoma after microwave ablation. Patients with high aMAP score should undergo rigorous postoperative follow-up evaluations..
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Affiliation(s)
- S Y Dong
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Institute of Liver Diseases, Guangzhou 510515, China First Clinical Medical College, Southern Medical University, Guangzhou, Guangzhou, 510515, China
| | - S Y Deng
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Institute of Liver Diseases, Guangzhou 510515, China
| | - R Fan
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Institute of Liver Diseases, Guangzhou 510515, China
| | - J Z Chen
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Institute of Liver Diseases, Guangzhou 510515, China
| | - X Cheng
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Institute of Liver Diseases, Guangzhou 510515, China
| | - X Hao
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Institute of Liver Diseases, Guangzhou 510515, China
| | - W C Dai
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Guangdong Provincial Institute of Liver Diseases, Guangzhou 510515, China
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Bao HY, Wang W, Sun HB, Chen JZ. Binding modes of GDP, GTP and GNP to NRAS deciphered by using Gaussian accelerated molecular dynamics simulations. SAR QSAR Environ Res 2023; 34:65-89. [PMID: 36762439 DOI: 10.1080/1062936x.2023.2165542] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 11/23/2022] [Accepted: 12/31/2022] [Indexed: 06/18/2023]
Abstract
Probing binding modes of GDP, GTP and GNP to NRAS are of significance for understanding the regulation mechanism on the activity of RAS proteins. Four separate Gaussian accelerated molecular dynamics (GaMD) simulations were performed on the apo, GDP-, GTP- and GNP-bound NRAS. Dynamics analyses suggest that binding of three ligands highly affects conformational states of the switch domains from NRAS, which disturbs binding of NRAS to its effectors. The analyses of free energy landscapes (FELs) indicate that binding of GDP, GTP and GNP induces more energetic states of NRAS compared to the apo NRAS but the presence of GNP makes the switch domains more ordered than binding of GDP and GNP. The information of interaction networks of ligands with NRAS reveals that the π-π interaction of residue F28 and the salt bridge interactions of K16 and D119 with ligands stabilize binding of GDP, GTP and GNP to NRAS. Meanwhile magnesium ion plays a bridge role in interactions of ligands with NRAS, which is favourable for associations of GDP, GTP and GNP with NRAS. This work is expected to provide useful information for deeply understanding the function and activity of NRAS.
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Affiliation(s)
- H Y Bao
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - W Wang
- School of Science, Shandong Jiaotong University, Jinan, China
| | - H B Sun
- School of Science, Shandong Jiaotong University, Jinan, China
| | - J Z Chen
- School of Science, Shandong Jiaotong University, Jinan, China
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Chen K, Chang L, Chen JZ, Wei X, Guo GJ, Lu JR, Wang K, Kang LN, Wang L, Xu B. [A case of primary cardiac lymphoma diagnosed by intravenous right atrial catheter forceps biopsy]. Zhonghua Xin Xue Guan Bing Za Zhi 2022; 50:1105-1107. [PMID: 36418280 DOI: 10.3760/cma.j.cn112148-20220303-00143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- K Chen
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - L Chang
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - J Z Chen
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - X Wei
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - G J Guo
- Department of Ultrasound, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - J R Lu
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - K Wang
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - L N Kang
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - L Wang
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Biao Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
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Huai B, Liang MJ, Bai M, He HJ, Chen JZ, Wu H. Localization of CgVPE1 in secondary cell wall formation during tracheary element differentiation in the pericarp of Citrus grandis 'Tomentosa' fruits. Planta 2022; 256:89. [PMID: 36169724 DOI: 10.1007/s00425-022-04001-2] [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] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
CgVPE1 is important in the differentiation of TE cells in C. grandis 'Tomentosa' fruits as it may directly affects secondary cell wall construction while participating in PCD. The vacuolar processing enzyme (VPE) plays an important role in both developmental and environmentally inducible programmed cell death (PCD); it was originally identified as a cysteine protease localized in the vacuole to activate and mature vacuolar proteins in plants. Interestingly, we found a VPE called CgVPE1 to be associated with deposition of the secondary cell wall in tracheary element (TE) cells in the pericarp of Citrus grandis 'Tomentosa' fruits. We then used ultrathin sections and the TUNEL assay to verify that PCD is involved in TE development. Furthermore, CgVPE1 was found to be mainly expressed in secretory cavities and TEs in the pericarp of Citrus grandis 'Tomentosa' fruits. Immunolocalization of CgVPE1 in the pericarp indicated that CgVPE1 is mainly distributed in the central large vacuole, endoplasmic reticulum, Golgi vesicles, cytosol, and secondary wall before TE maturation. CgVPE1 appeared earlier in the endoplasmic reticulum and Golgi vesicles of TEs cells. The vesicles containing CgVPE1 near the large central vacuole and secondary wall were observed, respectively. CgVPE1 proteins content in the cytoplasm decreased sharply, while the CgVPE1 content in the secondary cell wall did not change significantly after vacuole rupture. CgVPE1 protein contents in the secondary cell wall were significantly reduced until the TE cells developed into hollow thick-walled cells. Furthermore, labeling of VPE homologues in Arabidopsis thaliana using immunoelectron microscopy with anti-CgVPE1 antibody revealed that VPE homologues were specifically distributed in the secondary cell wall of stem TEs. Overall, these results suggested that CgVPE1 is not only involved PCD during TE cell development; furthermore, it may directly participate in the construction of plant secondary cell walls.
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Affiliation(s)
- B Huai
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, South China Agricultural University, Guangzhou, 510642, China
| | - M J Liang
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, South China Agricultural University, Guangzhou, 510642, China
| | - M Bai
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, South China Agricultural University, Guangzhou, 510642, China
- Guangdong Technology Research Center for Traditional Chinese Veterinary Medicine and Natural Medicine, South China Agricultural University, Guangzhou, 510642, China
| | - H J He
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, South China Agricultural University, Guangzhou, 510642, China
- Guangdong Technology Research Center for Traditional Chinese Veterinary Medicine and Natural Medicine, South China Agricultural University, Guangzhou, 510642, China
| | - J Z Chen
- College of Horticulture, South China Agricultural University, Guangzhou, 510642, China
| | - H Wu
- State Key Laboratory for Conservation and Utilization of Subtropical Agro-Bioresources, South China Agricultural University, Guangzhou, 510642, China.
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou, 510642, China.
- Guangdong Technology Research Center for Traditional Chinese Veterinary Medicine and Natural Medicine, South China Agricultural University, Guangzhou, 510642, China.
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Iredale E, Voigt B, Rankin A, Kim KW, Chen JZ, Schmid S, Hebb MO, Peters TM, Wong E. Planning System for the Optimization of Electric Field Delivery using Implanted Electrodes for Brain Tumor Control. Med Phys 2022; 49:6055-6067. [PMID: 35754362 DOI: 10.1002/mp.15825] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/06/2022] [Accepted: 06/17/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The use of non-ionizing electric fields from low intensity voltage sources (<10 V) to control malignant tumor growth is showing increasing potential as a cancer treatment modality. A method of applying these low intensity electric fields using multiple implanted electrodes within or adjacent to tumor volumes has been termed as intratumoral modulation therapy (IMT). PURPOSE This study explores advancements in the previously established IMT optimization algorithm, and the development of a custom treatment planning system for patient specific IMT. The practicality of the treatment planning system is demonstrated by implementing the full optimization pipeline on a brain phantom with robotic electrode implantation, post-operative imaging, and treatment stimulation. METHODS The integrated planning pipeline in 3D Slicer begins with importing and segmenting patient magnetic resonance images (MRI) or computed tomography (CT) images. The segmentation process is manual, followed by a semi-automatic smoothing step that allows the segmented brain and tumor mesh volumes to be smoothed and simplified by applying selected filters. Electrode trajectories are planned manually on the patient MRI or CT by selecting insertion and tip coordinates for a chosen number of electrodes. The electrode tip positions, and stimulation parameters (phase shift and voltage) can then be optimized with the custom semi-automatic IMT optimization algorithm where users can select the prescription electric field, voltage amplitude limit, tissue electrical properties, nearby organs at risk, optimization parameters (electrode tip location, individual contact phase shift and voltage), desired field coverage percent, and field conformity optimization. Tables of optimization results are displayed, and the resulting electric field is visualized as a field-map superimposed on the MR or CT image, with 3D renderings of the brain, tumor, and electrodes. Optimized electrode coordinates are transferred to robotic electrode implantation software to enable planning and subsequent implantation of the electrodes at the desired trajectories. RESULTS An IMT treatment planning system was developed that incorporates patient specific MRI or CT, segmentation, volume smoothing, electrode trajectory planning, electrode tip location and stimulation parameter optimization, and results visualization. All previous manual pipeline steps operating on diverse software platforms were coalesced into a single semi-automated 3D Slicer based user interface. Brain phantom validation of the full system implementation was successful in pre-operative planning, robotic electrode implantation, and post-operative treatment planning to adjust stimulation parameters based on actual implant locations. Voltage measurements were obtained in the brain phantom to determine the electrical parameters of the phantom and validate the simulated electric field distribution. CONCLUSIONS A custom treatment planning and implantation system for IMT has been developed in this study, and validated on a phantom brain model, providing an essential step in advancing IMT technology towards future clinical safety and efficacy investigations. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Erin Iredale
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Brynn Voigt
- Department of Physics and Astronomy, Western University, London, ON, Canada
| | - Adam Rankin
- Robarts Research Institute, Western University, London, ON, Canada
| | - Kyungho W Kim
- Department of Physics and Astronomy, Western University, London, ON, Canada
| | - Jeff Z Chen
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Susanne Schmid
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Matthew O Hebb
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Terry M Peters
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Robarts Research Institute, Western University, London, ON, Canada
| | - Eugene Wong
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Physics and Astronomy, Western University, London, ON, Canada
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Yaremko BP, Capaldi DP, Sheikh K, Palma DA, Warner A, Dar AR, Yu E, Rodrigues GB, Louie AV, Landis M, Sanatani M, Vincent MD, Younus J, Kuruvilla S, Chen JZ, Erickson A, Gaede S, Parraga G, Hoover DA. Functional Lung Avoidance for Individualized Radiotherapy (FLAIR): Results of a Double-Blind, Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 2022; 113:1072-1084. [DOI: 10.1016/j.ijrobp.2022.04.047] [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] [Received: 02/14/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
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Sawada H, Katsumata Y, Higashi H, Zhang C, Li Y, Morgan S, Lee LH, Singh SA, Chen JZ, Franklin MK, Moorleghen JJ, Howatt DA, Rateri DL, Shen YH, LeMaire SA, Aikawa M, Majesky MW, Lu HS, Daugherty A. Second Heart Field-derived Cells Contribute to Angiotensin II-mediated Ascending Aortopathies. Circulation 2022; 145:987-1001. [PMID: 35143327 PMCID: PMC9008740 DOI: 10.1161/circulationaha.121.058173] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: The ascending aorta is a common location for aneurysm and dissection. This aortic region is populated by a mosaic of medial and adventitial cells that are embryonically derived from either the second heart field (SHF) or the cardiac neural crest. SHF-derived cells populate areas that coincide with the spatial specificity of thoracic aortopathies. The purpose of this study was to determine whether and how SHF-derived cells contribute to ascending aortopathies. Methods: Ascending aortic pathologies were examined in patients with sporadic thoracic aortopathies and angiotensin II (AngII)-infused mice. Ascending aortas without overt pathology from AngII-infused mice were subjected to mass spectrometry assisted proteomics, and molecular features of SHF-derived cells were determined by single cell transcriptomic analyses. Genetic deletion of either low-density lipoprotein receptor-related protein 1 (Lrp1) or transforming growth factor-β receptor 2 (Tgfbr2) in SHF-derived cells was conducted to examine the impact of SHF-derived cells on vascular integrity. Results: Pathologies in human ascending aortic aneurysmal tissues were predominant in outer medial layers and adventitia. This gradient was mimicked in mouse aortas following AngII infusion that was coincident with the distribution of SHF-derived cells. Proteomics indicated that brief AngII infusion, prior to overt pathology, evoked downregulation of SMC proteins and differential expression of extracellular matrix proteins, including several LRP1 ligands. LRP1 deletion in SHF-derived cells augmented AngII-induced ascending aortic aneurysm and rupture. Single cell transcriptomic analysis revealed that brief AngII infusion decreased Lrp1 and Tgfbr2 mRNA abundance in SHF-derived cells and induced a unique fibroblast population with low abundance of Tgfbr2 mRNA. SHF-specific Tgfbr2 deletion led to embryonic lethality at E12.5 with dilatation of the outflow tract and retroperitoneal hemorrhage. Integration of proteomic and single cell transcriptomics results identified plasminogen activator inhibitor 1 (PAI1) as the most increased protein in SHF-derived SMCs and fibroblasts during AngII infusion. Immunostaining revealed a transmural gradient of PAI1 in both ascending aortas of AngII-infused mice and human ascending aneurysmal aortas that mimicked the gradient of medial and adventitial pathologies. Conclusions: SHF-derived cells exert a critical role in maintaining vascular integrity through LRP1 and TGF-β signaling associated with increases of aortic PAI1.
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Affiliation(s)
- Hisashi Sawada
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY; Saha Aortic Center, College of Medicine, University of Kentucky, Lexington, KY; Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY
| | - Yuriko Katsumata
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY; Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY
| | - Hideyuki Higashi
- Center for Interdisciplinary Cardiovascular Sciences, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Chen Zhang
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX
| | - Yanming Li
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX
| | - Stephanie Morgan
- Center for Interdisciplinary Cardiovascular Sciences, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Lang H Lee
- Center for Interdisciplinary Cardiovascular Sciences, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sasha A Singh
- Center for Interdisciplinary Cardiovascular Sciences, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Jeff Z Chen
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY; Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY
| | - Michael K Franklin
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY
| | - Jessica J Moorleghen
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY
| | - Deborah A Howatt
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY
| | - Debra L Rateri
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY
| | - Ying H Shen
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX
| | - Scott A LeMaire
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX; Department of Cardiovascular Surgery, Texas Heart Institute, Houston, TX
| | - Masanori Aikawa
- Center for Interdisciplinary Cardiovascular Sciences, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Mark W Majesky
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA; Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA
| | - Hong S Lu
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY; Saha Aortic Center, College of Medicine, University of Kentucky, Lexington, KY; Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY
| | - Alan Daugherty
- Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY; Saha Aortic Center, College of Medicine, University of Kentucky, Lexington, KY; Department of Physiology, College of Medicine, University of Kentucky, Lexington, KY
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Badiuk SR, Thiessen JD, Maleki Vareki S, Foster PJ, Chen JZ, Wong E. Glial activation positron emission tomography imaging in radiation treatment of breast cancer brain metastases. Phys Imaging Radiat Oncol 2022; 21:115-122. [PMID: 35359488 PMCID: PMC8961463 DOI: 10.1016/j.phro.2022.02.016] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 11/20/2022] Open
Abstract
Brain metastases affect more breast cancer patients than ever before due to increased overall patient survival with improved molecularly targeted treatments. Approximately 25–34% of breast cancer patients develop brain metastases in their lifetime. Due to the blood–brain barrier (BBB), the standard treatment for breast cancer brain metastases (BCBM) is surgery, stereotactic radiosurgery (SRS) and/or whole brain radiation therapy (WBRT). At the cost of cognitive side effects, WBRT has proven efficacy in treating brain metastases when used with local therapies such as SRS and surgery. This review investigated the potential use of glial activation positron emission tomography (PET) imaging for radiation treatment of BCBM. In order to put these studies into context, we provided background on current radiation treatment approaches for BCBM, our current understanding of the brain microenvironment, its interaction with the peripheral immune system, and alterations in the brain microenvironment by BCBM and radiation. We summarized preclinical literature on the interactions between glial activation and cognition and clinical studies using translocator protein (TSPO) PET to image glial activation in the context of neurological diseases. TSPO-PET is not employed clinically in assessing and guiding cancer therapies. However, it has gained traction in preclinical studies where glial activation was investigated from primary brain cancer, metastases and radiation treatments. Novel glial activation PET imaging and its applications in preclinical studies using breast cancer models and glial immunohistochemistry are highlighted. Lastly, we discuss the potential clinical application of glial activation imaging to improve the therapeutic ratio of radiation treatments for BCBM.
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Affiliation(s)
- Sawyer Rhae Badiuk
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Jonathan D Thiessen
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
- Department of Medical Imaging, University of Western Ontario, London, ON N6A 3K7, Canada
- Imaging Program, Lawson Health Research Institute, London, ON N6A 5W9, Canada
| | - Saman Maleki Vareki
- Cancer Research Laboratory Program, Lawson Health Research Institute, London, ON N6A5 W9, Canada
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, ON N6A 3K7, Canada
- Department of Oncology, Division of Experimental Oncology, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Paula J Foster
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
- Imaging Research Laboratories, Robarts Research Institute, London, ON N6A 5B7, Canada
| | - Jeff Z Chen
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
- London Regional Cancer Program, London Health Sciences Centre, London, ON N6A 5W9, Canada
| | - Eugene Wong
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON N6A 3K7, Canada
- Department of Physics and Astronomy, University of Western Ontario, London, ON N6A 3K7, Canada
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10
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Cheng X, Huang J, Li WF, Zhong T, Cai LJ, Li H, Guo YB, Chen JZ. [Analysis of the effect of microwave ablation in the treatment of small liver cancer]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:1059-1062. [PMID: 34933423 DOI: 10.3760/cma.j.cn501113-20200411-00176] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objective: To explore the clinical effect of microwave ablation in the treatment of early small liver cancer (≤3 cm). Methods: 103 cases with small liver cancer (tumor number < 3 and maximum tumor diameter < 3 cm) who underwent microwave ablation from November 2016 to November 2018 were retrospectively collected. The rate of residual lesions, recurrence rate one-year after the operation, and surgical complications were observed and grouped according to tumor size (< 2 cm and≥2 cm group) and tumor numbers (solitary and 2 ~ 3 lesion groups). The therapeutic effects of each group were compared and analyzed. Results: The tumor residual rate and one-year recurrence rate of small liver cancer after microwave ablation were 11.7% and 35.0%, respectively. The post-ablation syndrome incidence rate was 52.4%, with no serious adverse events. Compared with tumors < 2 cm, patients with≥2 cm had a higher postoperative residual rate (χ(2) = 7.651, P = 0.006), and the one-year recurrence rate of more solitary nodular tumors was lower (χ(2) = 10.125, P = 0.001). Conclusion: Microwave ablation is a safe and effective treatment for early small liver cancer, and it is more effective for small solitary nodules (< 2 cm).
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Affiliation(s)
- X Cheng
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J Huang
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - W F Li
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - T Zhong
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - L J Cai
- Health Management Center, Nanfang Hospital, Southern Medical University, Guangzhou510515, China
| | - H Li
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Y B Guo
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J Z Chen
- Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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11
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Abstract
Molecular targeted drugs are the first choice for systemic treatment of liver cancer. In the past decade, several anti-liver cancer targeted drugs have been launched. More recently, immunotherapy has become a dazzling nova in the field of systemic treatment of liver cancer. Nivolumab and pembrolizumab have been approved as second-line treatments for patients with advanced hepatocellular carcinoma treated with sorafenib. However, the effect of single-agent treatment is always unsatisfactory in advanced liver cancer. An increasing number of evidences suggests that molecular targeted drugs have important immunomodulatory effects for liver cancer, and several targeted combined immunotherapies have also shown promising clinical effectiveness. This paper reviews the immunomodulatory effects of several molecular targeted drugs in the field of liver cancer.
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Affiliation(s)
- X Cheng
- Department of Infectious Diseases, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
| | - J Z Chen
- Department of Infectious Diseases, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
| | - Y B Guo
- Department of Infectious Diseases, Nanfang Hospital of Southern Medical University, Guangzhou 510515, China
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12
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Chen JZ, Sawada H, Ye D, Katsumata Y, Kukida M, Ohno-Urabe S, Moorleghen JJ, Franklin MK, Howatt DA, Sheppard MB, Mullick AE, Lu HS, Daugherty A. Deletion of AT1a (Angiotensin II Type 1a) Receptor or Inhibition of Angiotensinogen Synthesis Attenuates Thoracic Aortopathies in Fibrillin1 C1041G/+ Mice. Arterioscler Thromb Vasc Biol 2021; 41:2538-2550. [PMID: 34407634 PMCID: PMC8458261 DOI: 10.1161/atvbaha.121.315715] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: A cardinal feature of Marfan syndrome is thoracic aortic aneurysm. The contribution of the renin-angiotensin system via AT1aR (Ang II [angiotensin II] receptor type 1a) to thoracic aortic aneurysm progression remains controversial because the beneficial effects of angiotensin receptor blockers have been ascribed to off-target effects. This study used genetic and pharmacological modes of attenuating angiotensin receptor and ligand, respectively, to determine their roles on thoracic aortic aneurysm in mice with fibrillin-1 haploinsufficiency (Fbn1C1041G/+). Approach and Results: Thoracic aortic aneurysm in Fbn1C1041G/+ mice was found to be strikingly sexual dimorphic. Males displayed aortic dilation over 12 months while aortic dilation in Fbn1C1041G/+ females did not differ significantly from wild-type mice. To determine the role of AT1aR, Fbn1C1041G/+ mice that were either +/+ or -/- for AT1aR were generated. AT1aR deletion reduced expansion of ascending aorta and aortic root diameter from 1 to 12 months of age in males. Medial thickening and elastin fragmentation were attenuated. An antisense oligonucleotide against angiotensinogen was administered to male Fbn1C1041G/+ mice to determine the effects of Ang II depletion. Antisense oligonucleotide against angiotensinogen administration attenuated dilation of the ascending aorta and aortic root and reduced extracellular remodeling. Aortic transcriptome analyses identified potential targets by which inhibition of the renin-angiotensin system reduced aortic dilation in Fbn1C1041G/+ mice. Conclusions: Deletion of AT1aR or inhibition of Ang II production exerted similar effects in attenuating pathologies in the proximal thoracic aorta of male Fbn1C1041G/+ mice. Inhibition of the renin-angiotensin system attenuated dysregulation of genes within the aorta related to pathology of Fbn1C1041G/+ mice.
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MESH Headings
- Angiotensinogen/genetics
- Angiotensinogen/metabolism
- Animals
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/pathology
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/metabolism
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/prevention & control
- Disease Models, Animal
- Female
- Fibrillin-1/genetics
- Fibrillin-1/metabolism
- Gene Deletion
- Genetic Predisposition to Disease
- Haploinsufficiency
- Male
- Marfan Syndrome/genetics
- Marfan Syndrome/metabolism
- Marfan Syndrome/pathology
- Mice, Inbred C57BL
- Mice, Knockout
- Oligonucleotides, Antisense/genetics
- Oligonucleotides, Antisense/metabolism
- Phenotype
- Receptor, Angiotensin, Type 1/deficiency
- Receptor, Angiotensin, Type 1/genetics
- Renin-Angiotensin System/genetics
- Sex Characteristics
- Sex Factors
- Transcriptome
- Mice
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Affiliation(s)
- Jeff Z. Chen
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
- Department of Physiology, University of Kentucky, Lexington, KY
| | - Hisashi Sawada
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
- Department of Physiology, University of Kentucky, Lexington, KY
| | - Dien Ye
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
| | - Yuriko Katsumata
- Department Biostatistics, University of Kentucky, Lexington, KY
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY
| | - Masayoshi Kukida
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
| | - Satoko Ohno-Urabe
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
| | - Jessica J. Moorleghen
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
| | - Michael K. Franklin
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
| | - Deborah A. Howatt
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
| | - Mary B. Sheppard
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
- Department of Physiology, University of Kentucky, Lexington, KY
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY
- Department of Surgery, University of Kentucky, Lexington, KY
| | | | - Hong S. Lu
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
- Department of Physiology, University of Kentucky, Lexington, KY
| | - Alan Daugherty
- Saha Cardiovascular Research Center, University of Kentucky, Lexington, KY
- Saha Aortic Center, University of Kentucky, Lexington, KY
- Department of Physiology, University of Kentucky, Lexington, KY
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13
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Gu L, An YB, Ren MY, Wang Q, Zhang HY, Yu G, Chen JZ, Wu M, Xiao Y, Fu ZC, Zhang H, Tong WD, Ma D, Xu Q, Yao HW, Zhang ZT. [Incidence and risk factors of anastomotic leak after transanal total mesorectal excision in China: a retrospective analysis based on national database]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:505-512. [PMID: 34148315 DOI: 10.3760/cma.j.cn.441530-20210226-00084] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Transanal total mesorectal excision (taTME) was a very hot topic in the first few years since its appearance, but now more introspections and controversies on this procedure have emerged. One of the reasons why the Norwegian Ministry of Health stopped taTME was the high incidence of postoperative anastomotic leak. In current study, the incidence and risk factors of anastomotic leak after taTME were analyzed based on the data registered in the Chinese taTME Registry Collaborative (CTRC). Methods: A case-control study was carried out. Between November 15, 2017 and December 31, 2020, clinical data of 1668 patients undergoing taTME procedure registered in the CTRC database from 43 domestic centers were collected retrospectively. After excluding 98 cases without anastomosis and 109 cases without complete postoperative complication data, 1461 patients were finally enrolled for analysis. There were 1036 males (70.9%) and 425 females (29.1%) with mean age of (58.2±15.6) years and mean body mass index of (23.6±3.8) kg/m(2). Anastomotic leak was diagnosed and classified according to the International Study Group of Rectal Cancer (ISREC) criteria. The risk factors associated with postoperative anastomotic leak cases were analyzed. The impact of the cumulative number of taTME surgeries in a single center on the incidence of anastomotic leak was evaluated. As for those centers with the number of taTME surgery ≥ 40 cases, incidence of anastomic leak between 20 cases of taTME surgery in the early and later phases was compared. Results: Of 1461 patients undergoing taTME, 103(7.0%) developed anastomotic leak, including 71 (68.9%) males and 32 (31.1%) females with mean age of (59.0±13.9) years and mean body mass index of (24.5±5.7) kg/m(2). The mean distance between anastomosis site and anal verge was (2.6±1.4) cm. Thirty-nine cases (37.9%) were classified as ISREC grade A, 30 cases (29.1%) as grade B and 34 cases (33.0%) as grade C. Anastomotic leak occurred in 89 cases (7.0%,89/1263) in the laparoscopic taTME group and 14 cases (7.1%, 14/198) in the pure taTME group. Multivariate analysis showed that hand-sewn anastomosis (P=0.004) and the absence of defunctioning stoma (P=0.013) were independently associated with anastomotic leak after taTME. In the 16 centers (37.2%) which performed ≥ 30 taTME surgeries with cumulative number of 1317 taTME surgeries, 86 cases developed anastomotic leak (6.5%, 86/1317). And in the 27 centers which performed less than 30 taTME surgeries with cumulative number of 144 taTME surgeries, 17 cases developed anastomotic leak (11.8%, 17/144). There was significant difference between two kinds of center (χ(2)=5.513, P=0.019). Thirteen centers performed ≥ 40 taTME surgeries. In the early phase (the first 20 cases in each center), 29 cases (11.2%, 29/260) developed anastomotic leak, and in the later phase, 12 cases (4.6%, 12/260) developed anastomotic leak. The difference between the early phase and the later phase was statistically significant (χ(2)=7.652, P=0.006). Conclusion: The incidence of anastomotic leak after taTME may be reduced by using stapler and defunctioning stoma, or by accumulating experience.
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Affiliation(s)
- L Gu
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - Y B An
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
| | - M Y Ren
- Department of Gastrointestinal Surgery, The Affiliated Nanchong Central Hospital of North Sichuan Medical College, Nanchong 637900, Sichuan Province, China
| | - Q Wang
- Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun 130021, China
| | - H Y Zhang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China
| | - G Yu
- Department of Gastrointestinal Surgery, Linzi People's Hospital, Linzi 255200, Shandong Province, China
| | - J Z Chen
- Department of Surgery, Koo Foundation, Sun Yat-sen Cancer Center, Taipei, Taiwan 112, China
| | - M Wu
- Department of Gastrointestinal Hernial Surgery, Yibin Second People's Hospital, Yibin 644000, Sichuan Province, China
| | - Y Xiao
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Z C Fu
- Department of Surgery, Mary Hospital, Hong Kong 999077, China
| | - H Zhang
- Department of Colorectal Cancer, Shengjing Hospital, China Medical University, Shenyang 110004, China
| | - W D Tong
- Department of General Surgery, Daping Hospital, Army Medical University, Chongqing 400042, China
| | - D Ma
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing 400037, China
| | - Q Xu
- Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
| | - H W Yao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
| | - Z T Zhang
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Cancer Invasion and Metastasis Research & National Clinical Research Center for Digestive Diseases, Beijing 100050, China
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14
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Liang SS, Liu XG, Cui YX, Zhang SL, Zhang QG, Chen JZ. Molecular mechanism concerning conformational changes of CDK2 mediated by binding of inhibitors using molecular dynamics simulations and principal component analysis. SAR QSAR Environ Res 2021; 32:1-22. [PMID: 34130570 DOI: 10.1080/1062936x.2021.1934896] [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] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/23/2021] [Indexed: 06/12/2023]
Abstract
Cyclin-dependent kinase 2 (CDK2) has been regarded as a promising drug target for anti-tumour agents. In this study, molecular dynamics (MD) simulations and principal component (PC) analysis were used to explore binding mechanism of three inhibitors 1PU, CDK, 50Z to CDK2 and influences of their bindings on conformational changes of CDK2. The results show that bindings of inhibitors yield obvious impacts on internal dynamics, movement patterns and conformational changes of CDK2. In addition, molecular mechanics generalized Born surface area (MM-GBSA) was applied to calculate binding free energies between three inhibitors and CDK2 and evaluate their binding ability to CDK2. The results show that CDK has the strongest binding to CDK2 among the current three inhibitors. Residue-based free energy decomposition method was further utilized to decode the contributions of a single residue to binding of inhibitors, and it was found that three inhibitors not only produce hydrogen bonding interactions and hydrophobic interactions with key residues of CDK2, which promotes binding of three inhibitors to CDK2, but also share similar binding modes. This work is expected to be helpful for design of efficient drugs targeting CDK2.
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Affiliation(s)
- S S Liang
- School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - X G Liu
- School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Y X Cui
- School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - S L Zhang
- School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - Q G Zhang
- School of Physics and Electronics, Shandong Normal University, Jinan, China
| | - J Z Chen
- School of Science, Shandong Jiaotong University, Jinan, China
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15
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Yuan GS, He WM, Hu XY, Li Q, Zang MY, Cheng X, Huang W, Ruan J, Wang JJ, Hou JL, Chen JZ. [Clinical efficacy and safety analysis of camrelizumab combined with apatinib as a second-line therapy for unresectable hepatocellular carcinoma: a multicenter retrospective study]. Zhonghua Gan Zang Bing Za Zhi 2021; 29:326-331. [PMID: 33979958 DOI: 10.3760/cma.j.cn501113-20210329-00148] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical efficacy and safety of camrelizumab combined with apatinib as a second-line therapy for unresectable hepatocellular carcinoma (HCC). Methods: Ninety-four cases with mid-and advanced-stage HCC who received camrelizumab combined with apatinib as second-line treatment were enrolled. Routine blood test, blood biochemical indexes, tumor stage, tumor imaging characteristics, previous treatment strategies and other clinical data before treatment were documented. Imaging examination follow-up results and adverse reactions during treatment were followed up until the end of follow-up or loss of follow-up or death. Kaplan-Meier method was used to analyze the clinical efficacy. Results: As of the last follow-up, 94 cases with mid-and advanced-stage HCC had received camrelizumab combined with apatinib as second-line treatment. Among them, 15 cases were lost to follow-up, 31 cases died, and 48 cases survived. The overall remission rate was 31.9%. The overall disease control rate was 71.3%. The median time to disease-free progression was 6.6 months. The median time to disease progression was not yet available. The 1-year cumulative survival rate was 62.3%. Grade 3 and above adverse reactions mainly included were thrombocytopenia (7.4%), abdominal pain (4.3%), active hepatitis (4.3%), leukopenia (4.3%), diarrhea (3.2%), hand-foot syndrome (3.2%). All adverse reactions were effectively controlled. Conclusion: Camrelizumab combined with apatinib can effectively prolong the survival period of patients with mid-and advanced-stage HCC, and it is well tolerated.
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Affiliation(s)
- G S Yuan
- Department of Infectious Diseases and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - W M He
- Department of Infectious Diseases and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X Y Hu
- Department of Infectious Diseases and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Q Li
- Department of Infectious Diseases and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - M Y Zang
- Department of Infectious Diseases and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - X Cheng
- Department of Hepatology, Zengcheng Branch of Nanfang Hospital, Southern Medical University, Zengcheng 511300, China
| | - W Huang
- Department of Oncology, Shunde Hospital, Southern Medical University, Shunde 528300, China
| | - J Ruan
- Department of Medical Oncology, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310000, China
| | - J J Wang
- Department of Infectious Disease, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - J L Hou
- Department of Infectious Diseases and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - J Z Chen
- Department of Infectious Diseases and Hepatology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
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16
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Iredale E, Deweyert A, Hoover DA, Chen JZ, Schmid S, Hebb MO, Peters TM, Wong E. Optimization of multi-electrode implant configurations and programming for the delivery of non-ablative electric fields in intratumoral modulation therapy. Med Phys 2020; 47:5441-5454. [PMID: 32978963 DOI: 10.1002/mp.14496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 09/10/2020] [Accepted: 09/12/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE Application of low intensity electric fields to interfere with tumor growth is being increasingly recognized as a promising new cancer treatment modality. Intratumoral modulation therapy (IMT) is a developing technology that uses multiple electrodes implanted within or adjacent tumor regions to deliver electric fields to treat cancer. In this study, the determination of optimal IMT parameters was cast as a mathematical optimization problem, and electrode configurations, programming, optimization, and maximum treatable tumor size were evaluated in the simplest and easiest to understand spherical tumor model. The establishment of electrode placement and programming rules to maximize electric field tumor coverage designed specifically for IMT is the first step in developing an effective IMT treatment planning system. METHODS Finite element method electric field computer simulations for tumor models with 2 to 7 implanted electrodes were performed to quantify the electric field over time with various parameters, including number of electrodes (2 to 7), number of contacts per electrode (1 to 3), location within tumor volume, and input waveform with relative phase shift between 0 and 2π radians. Homogeneous tissue specific conductivity and dielectric values were assigned to the spherical tumor and surrounding tissue volume. In order to achieve the goal of covering the tumor volume with a uniform threshold of 1 V/cm electric field, a custom least square objective function was used to maximize the tumor volume covered by 1 V/cm time averaged field, while maximizing the electric field in voxels receiving less than this threshold. An additional term in the objective function was investigated with a weighted tissue sparing term, to minimize the field to surrounding tissues. The positions of the electrodes were also optimized to maximize target coverage with the fewest number of electrodes. The complexity of this optimization problem including its non-convexity, the presence of many local minima, and the computational load associated with these stochastic based optimizations led to the use of a custom pattern search algorithm. Optimization parameters were bounded between 0 and 2π radians for phase shift, and anywhere within the tumor volume for location. The robustness of the pattern search method was then evaluated with 50 random initial parameter values. RESULTS The optimization algorithm was successfully implemented, and for 2 to 4 electrodes, equally spaced relative phase shifts and electrodes placed equidistant from each other was optimal. For 5 electrodes, up to 2.5 cm diameter tumors with 2.0 V, and 4.1 cm with 4.0 V could be treated with the optimal configuration of a centrally placed electrode and 4 surrounding electrodes. The use of 7 electrodes allow for 3.4 cm diameter coverage at 2.0 V and 5.5 cm at 4.0 V. The evaluation of the optimization method using 50 random initial parameter values found the method to be robust in finding the optimal solution. CONCLUSIONS This study has established a robust optimization method for temporally optimizing electric field tumor coverage for IMT, with the adaptability to optimize a variety of parameters including geometrical and relative phase shift configurations.
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Affiliation(s)
- Erin Iredale
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Andrew Deweyert
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Douglas A Hoover
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada
| | - Jeff Z Chen
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada
| | - Susanne Schmid
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Matthew O Hebb
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Terry M Peters
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Robarts Research Institute, Western University, London, ON, Canada
| | - Eugene Wong
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.,Department of Physics and Astronomy, Western University, London, ON, Canada
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17
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MacFarlane M, Hoover DA, Wong E, Battista JJ, Chen JZ. Technical Note: A fast inverse direct aperture optimization algorithm for volumetric-modulated arc therapy. Med Phys 2020; 47:1558-1565. [PMID: 32027381 DOI: 10.1002/mp.14074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 01/15/2020] [Accepted: 01/28/2020] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In a recent article, our group proposed a fast direct aperture optimization (DAO) algorithm for fixed-gantry intensity-modulated radiation therapy (IMRT) called fast inverse direct aperture optimization (FIDAO). When tested on fixed-gantry IMRT plans, we observed up to a 200-fold increase in the optimization speed. Compared to IMRT, rotational volumetric-modulated arc therapy (VMAT) is a much larger optimization problem and has many more delivery constraints. The purpose of this work is to extend and evaluate FIDAO for inverse planning of VMAT plans. METHODS A prototype FIDAO algorithm for VMAT treatment planning was developed in MATLAB using the open-source treatment planning toolkit matRad (v2.2 dev_VMAT build). VMAT treatment plans using one 3600 arc were generated on the AAPM TG-119 phantom, as well as sample clinical liver and prostate cases. The plans were created by first performing fluence map optimization on 28° equispaced beams, followed by aperture sequencing and arc sequencing with a gantry angular sampling rate of 4°. After arc sequencing, a copy of the plan underwent DAO using the prototype FIDAO algorithm, while another copy of the plan underwent DAO using matRad's DAO method, which served as the conventional algorithm. RESULTS Both algorithms achieved similar plan quality, although the FIDAO plans had considerably fewer hot spots in the unspecified normal tissue. The optimization time (number of iterations) for FIDAO and the conventional DAO algorithm, respectively, were: 65 s (245) vs 602 s (275) in the TG-119 phantom case; 25 s (85) vs 803 s (159) in the liver case; and 99 s (174) vs 754 s (149) in the prostate case. CONCLUSIONS This study demonstrated promising speed enhancements in using FIDAO for the direct aperture optimization of VMAT plans.
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Affiliation(s)
- Michael MacFarlane
- London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada, N6A 5W9.,Department of Medical Biophysics, Western University, London, ON, Canada, N6A 3K7.,Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD, 21201, USA
| | - Douglas A Hoover
- London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada, N6A 5W9.,Department of Medical Biophysics, Western University, London, ON, Canada, N6A 3K7.,Department of Oncology, Western University, London, ON, Canada, N6A 3K7
| | - Eugene Wong
- London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada, N6A 5W9.,Department of Medical Biophysics, Western University, London, ON, Canada, N6A 3K7.,Department of Oncology, Western University, London, ON, Canada, N6A 3K7.,Department of Physics & Astronomy, Western University, London, ON, Canada, N6A 3K7
| | - Jerry J Battista
- London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada, N6A 5W9.,Department of Medical Biophysics, Western University, London, ON, Canada, N6A 3K7.,Department of Oncology, Western University, London, ON, Canada, N6A 3K7.,Department of Physics & Astronomy, Western University, London, ON, Canada, N6A 3K7
| | - Jeff Z Chen
- London Regional Cancer Program, London Health Sciences Centre, London, ON, Canada, N6A 5W9.,Department of Medical Biophysics, Western University, London, ON, Canada, N6A 3K7.,Department of Oncology, Western University, London, ON, Canada, N6A 3K7
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Abstract
Background High frequency ultrasound has facilitated in vivo measurements of murine ascending aortas, allowing aortic strains to be gleaned from two-dimensional images. Thoracic aortic aneurysms associated with mutations in fibrillin-1 (FBN1) display elastin fragmentation, which may impact aortic strain. In this study, we determined the relationship between elastin fragmentation and aortic circumferential strain in wild type and fibrillin-1 hypomorphic (FBN1 mgR/mgR) mice. Methods and Results Luminal diameters of the ascending aorta from wild type and FBN1 hypomorphic (FBN1 mgR/mgR) mice were measured in systole and diastole. Expansion of the ascending aorta during systole in male and female wild type mice was 0.21±0.02 mm (16.3%) and 0.21±0.01 mm (17.0%) respectively, while expansion in male and female FBN1 mgR/mgR mice was 0.11±0.04 mm (4.9%) and 0.07±0.02 mm (4.5%) respectively. Reduced circumferential strain was observed in FBN1 mgR/mgR mice compared to wild type littermates. Elastin fragmentation was inversely correlated to circumferential strain (R^2 = 0.628 p = 0.004) and significantly correlated with aortic diameter. (R^2 = 0.397, p = 0.038 in systole and R^2 = 0.515, p =0.013 in diastole). Conclusions FBN1 mgR/mgR mice had increased aortic diameters, reduced circumferential strain, and increased elastin fragmentation. Elastin fragmentation in FBN1 mgR/mgR and their wild type littermates was correlated with reduced circumferential strain.
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Affiliation(s)
- Jeff Z Chen
- Saha Cardiovascular Research Center.,Department of Physiology
| | | | | | | | - Alan Daugherty
- Saha Cardiovascular Research Center.,Department of Physiology
| | - Mary B Sheppard
- Saha Cardiovascular Research Center.,Department of Physiology.,Department of Family and Community Medicine.,Department of Surgery, University of Kentucky, Lexington, KY
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Sawada H, Chen JZ, Wright BC, Moorleghen JJ, Lu HS, Daugherty A. Ultrasound Imaging of the Thoracic and Abdominal Aorta in Mice to Determine Aneurysm Dimensions. J Vis Exp 2019. [PMID: 30907888 DOI: 10.3791/59013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Contemporary high-resolution ultrasound instruments have sufficient resolution to facilitate the measurement of mouse aortas. These instruments have been widely used to measure aortic dimensions in mouse models of aortic aneurysms. Aortic aneurysms are defined as permanent dilations of the aorta, which occur most frequently in the ascending and abdominal regions. Sequential measurements of aortic dimensions by ultrasound are the principal approach for assessing the development and progression of aortic aneurysms in vivo. Although many reported studies used ultrasound imaging to measure aortic diameters as a primary endpoint, there are confounding factors, such as probe position and cardiac cycle, that may impact the accuracy of data acquisition, analysis, and interpretation. The purpose of this protocol is to provide a practical guide on the use of ultrasound to measure the aortic diameter in a reliable and reproducible manner. This protocol introduces the preparation of mice and instruments, the acquisition of appropriate ultrasound images, and data analysis.
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Affiliation(s)
- Hisashi Sawada
- Saha Cardiovascular Research Center, University of Kentucky
| | - Jeff Z Chen
- Department of Physiology, University of Kentucky
| | | | | | - Hong S Lu
- Saha Cardiovascular Research Center, University of Kentucky; Department of Physiology, University of Kentucky
| | - Alan Daugherty
- Saha Cardiovascular Research Center, University of Kentucky; Department of Physiology, University of Kentucky;
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20
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MacFarlane M, Hoover DA, Wong E, Goldman P, Battista JJ, Chen JZ. A fast inverse direct aperture optimization algorithm for intensity-modulated radiation therapy. Med Phys 2018; 46:1127-1139. [PMID: 30592539 DOI: 10.1002/mp.13368] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/21/2018] [Accepted: 12/21/2018] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The goal of this work was to develop and evaluate a fast inverse direct aperture optimization (FIDAO) algorithm for IMRT treatment planning and plan adaptation. METHODS A previously proposed fluence map optimization algorithm called fast inverse dose optimization (FIDO) was extended to optimize the aperture shapes and weights of IMRT beams. FIDO is a very fast fluence map optimization algorithm for IMRT that finds the global minimum using direct matrix inversion without unphysical negative beam weights. In this study, an equivalent second-order Taylor series expansion of the FIDO objective function was used, which allowed for the objective function value and gradient vector to be computed very efficiently during direct aperture optimization, resulting in faster optimization. To evaluate the speed gained with FIDAO, a proof-of-concept algorithm was developed in MATLAB using an interior-point optimization method to solve the reformulated aperture-based FIDO problem. The FIDAO algorithm was used to optimize four step-and-shoot IMRT cases: on the AAPM TG-119 phantom as well as a liver, prostate, and head-and-neck clinical cases. Results were compared with a conventional DAO algorithm that uses the same interior-point method but using the standard formulation of the objective function and its gradient vector. RESULTS A substantial gain in optimization speed was obtained with the prototype FIDAO algorithm compared to the conventional DAO algorithm while producing plans of similar quality. The optimization time (number of iterations) for the prototype FIDAO algorithm vs the conventional DAO algorithm was 0.3 s (17) vs 56.7 s (50); 2.0 s (28) vs 134.1 s (57); 2.5 s (26) vs 180.6 s (107); and 6.7 s (20) vs 469.4 s (482) in the TG-119 phantom, liver, prostate, and head-and-neck examples, respectively. CONCLUSIONS A new direct aperture optimization algorithm based on FIDO was developed. For the four IMRT test cases examined, this algorithm executed approximately 70-200 times faster without compromising the IMRT plan quality.
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Affiliation(s)
- Michael MacFarlane
- London Regional Cancer Program, London Health Science Center, London, ON, N6A 4L6, Canada.,Department of Medical Biophysics, Western University, London, ON, N6A 3K7, Canada
| | - Douglas A Hoover
- London Regional Cancer Program, London Health Science Center, London, ON, N6A 4L6, Canada.,Department of Medical Biophysics, Western University, London, ON, N6A 3K7, Canada
| | - Eugene Wong
- London Regional Cancer Program, London Health Science Center, London, ON, N6A 4L6, Canada.,Department of Medical Biophysics, Western University, London, ON, N6A 3K7, Canada
| | - Pedro Goldman
- Department of Physics, Ryerson University, Toronto, ON, M5B 2K3, Canada
| | - Jerry J Battista
- Department of Medical Biophysics, Western University, London, ON, N6A 3K7, Canada
| | - Jeff Z Chen
- London Regional Cancer Program, London Health Science Center, London, ON, N6A 4L6, Canada.,Department of Medical Biophysics, Western University, London, ON, N6A 3K7, Canada
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Sawada H, Wright BC, Chen JZ, Lu HS, Daugherty A. Drebrin: a new player in angiotensin II-induced aortopathies. Cardiovasc Res 2018; 114:1699-1701. [PMID: 30107397 DOI: 10.1093/cvr/cvy205] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - Jeff Z Chen
- Saha Cardiovascular Research Center, Lexington, KY, USA.,Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - Hong S Lu
- Saha Cardiovascular Research Center, Lexington, KY, USA.,Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - Alan Daugherty
- Saha Cardiovascular Research Center, Lexington, KY, USA.,Department of Physiology, University of Kentucky, Lexington, KY, USA
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22
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Affiliation(s)
- Chia-Hua Wu
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Pharmacology and Nutritional Sciences (C.-H.W., S.M., A.D., H.S.L.)
| | - Shayan Mohammadmoradi
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Pharmacology and Nutritional Sciences (C.-H.W., S.M., A.D., H.S.L.)
| | - Jeff Z Chen
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Physiology (J.Z.C., A.D., H.S.L.), University of Kentucky, Lexington
| | - Hisashi Sawada
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
| | - Alan Daugherty
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Pharmacology and Nutritional Sciences (C.-H.W., S.M., A.D., H.S.L.)
- Department of Physiology (J.Z.C., A.D., H.S.L.), University of Kentucky, Lexington
| | - Hong S Lu
- From the Saha Cardiovascular Research Center (C.-H.W., S.M., J.Z.C., H.S., A.D., H.S.L.)
- Department of Pharmacology and Nutritional Sciences (C.-H.W., S.M., A.D., H.S.L.)
- Department of Physiology (J.Z.C., A.D., H.S.L.), University of Kentucky, Lexington
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23
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Chen JZ, Sawada H, Moorleghen J, Daugherty A. Abstract 104: Aortic Dilation and Elasticity in Thoracic Aortic Aneurysm in a Marfan Model is Sexually Dimorphic. Arterioscler Thromb Vasc Biol 2018. [DOI: 10.1161/atvb.38.suppl_1.104] [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
Objective:
Meta-analysis of data derived from Marfan patients in the Genetically-Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) consortium revealed that thoracic aortic aneurysms occur more frequently in men than in women. To determine the characteristics of sexual dimorphism in experimental thoracic aortic aneurysms of a Marfan model, we determined ascending aortic and aortic root morphology in male and female fibrillin-1 haploinsufficent (FBN1 C1041G/+) mice using ultrasonography.
Method and Results:
Aortas from 4 to 6 week old male and female FBN1 C1041G/+ mice and their wild type littermates were assessed by high frequency ultrasonography. Mice were anesthetized and maintained at a heart rate of 450-550 beats per minute. Ultrasound images were captured using a Vevo 3100 instrument with a 40 MHz tranducer. The maximal luminal diameter of ascending aortic between the sinotubular junction and the innominate artery, and the aortic root diameter at the sinus of valsalva, were measured in mid-systole and end-diastole by two independent observers who were blinded to mice identity. FBN1 C1041G/+ mice demonstrated greater ascending aortic dilation in male mice compared to female mice, whereas no difference in aortic root diameter were detected between male and female wild type littermates. In addition, modest ascending aortic dilation was detected before aortic root dilation in FBN1 C1041G/+ mice. Ascending aortas from FBN1 C1041G/+ mice also demonstrated loss of elasticity as evidenced by reduced expansion in systole. Interestingly, this difference was detected much earlier than expected.
Conclusion:
The fibrillin-1 haploinsufficent model of Marfan syndrome associated thoracic aortic aneurysm demonstrate sexual dimorphism in ascending aortic dilation. Loss of elasticity in the ascending aorta is also an early manifestation in this thoracic aortic aneurysm model.
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MacFarlane M, Wong D, Hoover DA, Wong E, Johnson C, Battista JJ, Chen JZ. Patient-specific calibration of cone-beam computed tomography data sets for radiotherapy dose calculations and treatment plan assessment. J Appl Clin Med Phys 2018; 19:249-257. [PMID: 29479821 PMCID: PMC5849848 DOI: 10.1002/acm2.12293] [Citation(s) in RCA: 11] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/07/2017] [Accepted: 01/21/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose In this work, we propose a new method of calibrating cone beam computed tomography (CBCT) data sets for radiotherapy dose calculation and plan assessment. The motivation for this patient‐specific calibration (PSC) method is to develop an efficient, robust, and accurate CBCT calibration process that is less susceptible to deformable image registration (DIR) errors. Methods Instead of mapping the CT numbers voxel‐by‐voxel with traditional DIR calibration methods, the PSC methods generates correlation plots between deformably registered planning CT and CBCT voxel values, for each image slice. A linear calibration curve specific to each slice is then obtained by least‐squares fitting, and applied to the CBCT slice's voxel values. This allows each CBCT slice to be corrected using DIR without altering the patient geometry through regional DIR errors. A retrospective study was performed on 15 head‐and‐neck cancer patients, each having routine CBCTs and a middle‐of‐treatment re‐planning CT (reCT). The original treatment plan was re‐calculated on the patient's reCT image set (serving as the gold standard) as well as the image sets produced by voxel‐to‐voxel DIR, density‐overriding, and the new PSC calibration methods. Dose accuracy of each calibration method was compared to the reference reCT data set using common dose‐volume metrics and 3D gamma analysis. A phantom study was also performed to assess the accuracy of the DIR and PSC CBCT calibration methods compared with planning CT. Results Compared with the gold standard using reCT, the average dose metric differences were ≤ 1.1% for all three methods (PSC: −0.3%; DIR: −0.7%; density‐override: −1.1%). The average gamma pass rates with thresholds 3%, 3 mm were also similar among the three techniques (PSC: 95.0%; DIR: 96.1%; density‐override: 94.4%). Conclusions An automated patient‐specific calibration method was developed which yielded strong dosimetric agreement with the results obtained using a re‐planning CT for head‐and‐neck patients.
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Affiliation(s)
- Michael MacFarlane
- London Regional Cancer Program, London Health Science Center, London, ON, Canada.,Department of Medical Biophysics, Western University, London, ON, Canada
| | - Daniel Wong
- London Regional Cancer Program, London Health Science Center, London, ON, Canada
| | - Douglas A Hoover
- London Regional Cancer Program, London Health Science Center, London, ON, Canada.,Department of Medical Biophysics, Western University, London, ON, Canada
| | - Eugene Wong
- London Regional Cancer Program, London Health Science Center, London, ON, Canada.,Department of Medical Biophysics, Western University, London, ON, Canada
| | - Carol Johnson
- London Regional Cancer Program, London Health Science Center, London, ON, Canada
| | - Jerry J Battista
- London Regional Cancer Program, London Health Science Center, London, ON, Canada.,Department of Medical Biophysics, Western University, London, ON, Canada
| | - Jeff Z Chen
- London Regional Cancer Program, London Health Science Center, London, ON, Canada.,Department of Medical Biophysics, Western University, London, ON, Canada
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25
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Du YX, Chen JZ, Wang J, Chen BQ. [Clinical analysis of delayed epistaxis after craniofacial trauma in 16 patients]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1343-1345;1351. [PMID: 29798453 DOI: 10.13201/j.issn.1001-1781.2016.17.001] [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] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the etiology,clinical presentations,diagnosis and treatment of delayed epistaxis after craniocerebral trauma.Method:A retrospective analysis was made including 16 cases who had the traumatic carotid artery injury with massive delayed epistaxis.All of them were finally diagnosed by digital substraction angiography(DSA).Final clinical outcome,radiographic data and follow-up data were analyzed.Result:Two cases of traumatic pesudoaneurysm from internal maxillary artery were embolized with polyvinyl alcohol particles and gelatin sponge.Fourteen cases of traumatic pesudoaneurysm located in ICA cavernous segment was embolized by covered stent.The covered stent placement was successful in all 14 pseudoaneurysms.No procedure-related complications or deaths occurred during follow-up except one of the case with visual field defects and another case with vision loss.Conclusion:Patients with delayed massive epistaxis or recurrent epistaxis after craniofacial trauma which cause pesudoaneurysm should undergo CTA,MRA or DSA examination,and it is would help to get proper diagnosis and treatment as early as possible.No recurrence was found after successful endovascular techniques.
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Affiliation(s)
- Y X Du
- Department of Otolaryngology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan,467000,China
| | - J Z Chen
- Department of Radiotherapy,General Hospital of Pingmei Shenma Medical Group
| | - J Wang
- Department of Otolaryngology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan,467000,China
| | - B Q Chen
- Department of Otolaryngology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan,467000,China
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Zheng Y, Qiu LP, Meng SL, Fan LM, Song C, Li DD, Zhang C, Chen JZ. Effect of polychlorinated biphenyls on oxidation stress in the liver of juvenile GIFT, Oreochromis niloticus. Genet Mol Res 2016; 15:gmr8613. [PMID: 27706695 DOI: 10.4238/gmr.15038613] [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: 11/03/2022]
Abstract
The present study clearly showed that chronic exposure to polychlorinated biphenyls (PCBs) at environmentally relevant concentrations can damage juvenile tilapia livers by modulating antioxidant enzyme activities and gene transcription, which affects toxic bioaccumulation and histological congestion. The results suggest that PCBs caused a decrease in the activity of some hepatic antioxidative and biotransformation enzymes (SOD, CAT, GST, T-GSH, and MDA) in tilapia at 7 days, as well as transcriptional changes (sod, cat, and gst). Except for some antioxidant parameters (T-GSH, GSH/GSSG, T-AOC, and MDA), significant declines and increases occurred at 14 and 21 days, respectively. Most of the antioxidant enzymatic signatures and genotoxicity significantly increased at 14 and 21 days. This study presented evidence that PCBs could result in hepatic toxicity through oxidative stress in the early growth stages of tilapia, and we speculated that oxidative stress plays an important role in embryonic developmental toxicity induced by PCBs.
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Affiliation(s)
- Y Zheng
- Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Wuxi, China .,Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, China
| | - L P Qiu
- Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Wuxi, China
| | - S L Meng
- Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Wuxi, China
| | - L M Fan
- Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Wuxi, China
| | - C Song
- Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Wuxi, China
| | - D D Li
- Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Wuxi, China
| | - C Zhang
- Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Wuxi, China
| | - J Z Chen
- Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Wuxi, China.,Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, China
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MacFarlane M, Hoover DA, Wong E, Read N, Palma D, Venkatesan V, Hammond A, Battista JJ, Chen JZ. Evaluation of unified intensity-modulated arc therapy for the radiotherapy of head-and-neck cancer. Radiother Oncol 2016; 119:331-6. [DOI: 10.1016/j.radonc.2016.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 02/22/2016] [Accepted: 03/19/2016] [Indexed: 12/25/2022]
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Zheng Y, Chen JZ, Wang HP, Li M, Liang HW, Bing XW, Wang ZZ. Large-scale tissue-specific and temporal gene expression profiles in Pengze crucian carp. Genet Mol Res 2016; 15:gmr7642. [PMID: 27051032 DOI: 10.4238/gmr.15017642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
In the present study, the tissue-specific and temporal gene expression profiles of four catalogues of gonadal development-related genes (sex differentiation-related, steroid receptor, steroidogenic, and structural genes) were detected in nine tissues and during 11 successive developmental stages in the Pengze crucian carp (Pcc) (a triploid mono-female gynogenic fish). The results showed that these target genes exhibited overlapping distributions in various tissues, with the exception of Pcc-vasa and Pcc-cyp17a1. Gene expression profiling of the developmental stages showed that all of the target genes simultaneously reached peak expression levels at 40 and 48 days post hatching (dph). Both 40 and 48 dph appeared to be two key time points associated with the process of Pcc gonadal development. These data will provide a clear understanding of gene expression patterns associated with the gonadal development-related genes of this gynogenic teleost.
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Affiliation(s)
- Y Zheng
- Key Open Laboratory of Ecological Environment and Resources of Inland Fisheries, Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences; Key Laboratory of Genetic Breeding and Aquaculture Biology of Freshwater Fishes, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Ministry of Agriculture, Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, China.,College of Animal Science and Technology, Northwest A&F University, Shaanxi Key Laboratory of Molecular Biology for Agriculture, Yangling, Shaanxi, China
| | - J Z Chen
- Key Open Laboratory of Ecological Environment and Resources of Inland Fisheries, Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences; Key Laboratory of Genetic Breeding and Aquaculture Biology of Freshwater Fishes, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Ministry of Agriculture, Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, China
| | - H P Wang
- College of Animal Science and Technology, Northwest A&F University, Shaanxi Key Laboratory of Molecular Biology for Agriculture, Yangling, Shaanxi, China
| | - M Li
- College of Animal Science and Technology, Northwest A&F University, Shaanxi Key Laboratory of Molecular Biology for Agriculture, Yangling, Shaanxi, China
| | - H W Liang
- Yangtze River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Wuhan, Hubei, China
| | - X W Bing
- Key Open Laboratory of Ecological Environment and Resources of Inland Fisheries, Freshwater Fisheries Research Center, Chinese Academy of Fishery Sciences; Key Laboratory of Genetic Breeding and Aquaculture Biology of Freshwater Fishes, Scientific Observing and Experimental Station of Fishery Resources and Environment in the Lower Reaches of the Changjiang River, Ministry of Agriculture, Wuxi Fisheries College, Nanjing Agricultural University, Wuxi, China
| | - Z Z Wang
- College of Animal Science and Technology, Northwest A&F University, Shaanxi Key Laboratory of Molecular Biology for Agriculture, Yangling, Shaanxi, China
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Hoover DA, MacFarlane M, Wong E, Battista JJ, Chen JZ. Feasibility of a unified approach to intensity-modulated radiation therapy and volume-modulated arc therapy optimization and delivery. Med Phys 2015; 42:726-34. [PMID: 25652486 DOI: 10.1118/1.4905373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To study the feasibility of unified intensity-modulated arc therapy (UIMAT) which combines intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) optimization and delivery to produce superior radiation treatment plans, both in terms of dose distribution and efficiency of beam delivery when compared with either VMAT or IMRT alone. METHODS An inverse planning algorithm for UIMAT was prototyped within the pinnacle treatment planning system (Philips Healthcare). The IMRT and VMAT deliveries are unified within the same arc, with IMRT being delivered at specific gantry angles within the arc. Optimized gantry angles for the IMRT and VMAT phases are assigned automatically by the inverse optimization algorithm. Optimization of the IMRT and VMAT phases is done simultaneously using a direct aperture optimization algorithm. Five treatment plans each for prostate, head and neck, and lung were generated using a unified optimization technique and compared with clinical IMRT or VMAT plans. Delivery verification was performed with an ArcCheck phantom (Sun Nuclear) on a Varian TrueBeam linear accelerator (Varian Medical Systems). RESULTS In this prototype implementation, the UIMAT plans offered the same target dose coverage while reducing mean doses to organs at risk by 8.4% for head-and-neck cases, 5.7% for lung cases, and 3.5% for prostate cases, compared with the VMAT or IMRT plans. In addition, UIMAT can be delivered with similar efficiency as VMAT. CONCLUSIONS In this proof-of-concept work, a novel radiation therapy optimization and delivery technique that interlaces VMAT or IMRT delivery within the same arc has been demonstrated. Initial results show that unified VMAT/IMRT has the potential to be superior to either standard IMRT or VMAT.
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Affiliation(s)
- Douglas A Hoover
- Department of Physics and Engineering, London Regional Cancer Program, London, Ontario N6A 4L6, Canada; Department of Oncology, Western University, London, Ontario N6A 3K7, Canada; and Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
| | - Michael MacFarlane
- Department of Physics and Engineering, London Regional Cancer Program, London, Ontario N6A 4L6, Canada and Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
| | - Eugene Wong
- Department of Oncology, Western University, London, Ontario N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada; and Department of Physics and Astronomy, Western University, London, Ontario N6A 3K7, Canada
| | - Jerry J Battista
- Department of Physics and Engineering, London Regional Cancer Program, London, Ontario N6A 4L6, Canada; Department of Oncology, Western University, London, Ontario N6A 3K7, Canada; Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada; and Department of Physics and Astronomy, Western University, London, Ontario N6A 3K7, Canada
| | - Jeff Z Chen
- Department of Physics and Engineering, London Regional Cancer Program, London, Ontario N6A 4L6, Canada; Department of Oncology, Western University, London, Ontario N6A 3K7, Canada; and Department of Medical Biophysics, Western University, London, Ontario N6A 3K7, Canada
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Xhaferllari I, Chen JZ, MacFarlane M, Yu E, Gaede S. Dosimetric planning study of respiratory-gated volumetric modulated arc therapy for early-stage lung cancer with stereotactic body radiation therapy. Pract Radiat Oncol 2015; 5:156-161. [DOI: 10.1016/j.prro.2014.08.009] [Citation(s) in RCA: 4] [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] [Received: 07/03/2014] [Revised: 08/10/2014] [Accepted: 08/11/2014] [Indexed: 02/08/2023]
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Pan QF, Li WT, Dong HC, Chen YZ, Yin L, Liu W, Wang WW, Liu D, Li SG, Gu WY, Chen JZ, Yang L, Zhang WJ, Li F. PTEN hypermethylation profiles of Chinese Kazakh patients with esophageal squamous cell carcinoma. Dis Esophagus 2013; 27:396-402. [PMID: 23980519 DOI: 10.1111/dote.12106] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Aberrant DNA methylation of promoter region CpG islands may serve as an alternative mechanism to genetic defects in the inactivation of tumor suppressor genes (TSGs) in human malignancies. The aim of this study was to examine the promoter methylation status of the PTEN TSG and its association with esophageal squamous cell carcinoma (ESCC) carcinogenesis in a Chinese Kazakh population, which is known to have a relatively high ESCC incidence and mortality. The methylation status of the PTEN promoter region was determined in patients with ESCC (n = 95) and healthy individuals (n = 65) using highly sensitive Sequenom Epityper assays. The methylation level of the PTEN gene was significantly higher in patients with ESCC than in healthy controls. The median methylation level was 10.0% (interquartile range [IQR]: 7.0-11.0%) in patients with ESCC and 6.0% in controls (IQR: 4.0-9.0%; P = 0.001). PTEN methylation levels were higher in male patients with ESCC than in male controls, whereas a trend toward significance was observed between female patients with ESCC and female controls (P = 0.005 and P = 0.086, respectively). The PTEN methylation level was associated with histopathological grade and lymph node metastasis in patients with ESCC (P = 0.002 and P = 0.009, respectively). To our knowledge, this is the first report to show the presence of PTEN promoter CpG hypermethylation in ESCC and its association with tumor metastasis.
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Affiliation(s)
- Q F Pan
- Department of Pathology and Key Laboratory for Xinjiang Endemic and Ethnic Diseases, Shihezi University School of Medicine, Shihezi, China
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Fakir H, Gaede S, Mulligan M, Chen JZ. Development of a novel ArcCHECK(™) insert for routine quality assurance of VMAT delivery including dose calculation with inhomogeneities. Med Phys 2012; 39:4203-8. [PMID: 22830753 DOI: 10.1118/1.4728222] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To design a versatile, nonhomogeneous insert for the dose verification phantom ArcCHECK(™) (Sun Nuclear Corp., FL) and to demonstrate its usefulness for the verification of dose distributions in inhomogeneous media. As an example, we demonstrate it can be used clinically for routine quality assurance of two volumetric modulated arc therapy (VMAT) systems for lung stereotactic body radiation therapy (SBRT): SmartArc(®) (Pinnacle(3), Philips Radiation Oncology Systems, Fitchburg, WI) and RapidArc(®) (Eclipse(™), Varian Medical Systems, Palo Alto, CA). METHODS The cylindrical detector array ArcCHECK(™) has a retractable homogeneous acrylic insert. In this work, we designed and manufactured a customized heterogeneous insert with densities that simulate soft tissue, lung, bone, and air. The insert offers several possible heterogeneity configurations and multiple locations for point dose measurements. SmartArc(®) and RapidArc(®) plans for lung SBRT were generated and copied to ArcCHECK(™) for each inhomogeneity configuration. Dose delivery was done on a Varian 2100 ix linac. The evaluation of dose distributions was based on gamma analysis of the diode measurements and point doses measurements at different positions near the inhomogeneities. RESULTS The insert was successfully manufactured and tested with different measurements of VMAT plans. Dose distributions measured with the homogeneous insert showed gamma passing rates similar to our clinical results (∼99%) for both treatment-planning systems. Using nonhomogeneous inserts decreased the passing rates by up to 3.6% in the examples studied. Overall, SmartArc(®) plans showed better gamma passing rates for nonhomogeneous measurements. The discrepancy between calculated and measured point doses was increased up to 6.5% for the nonhomogeneous insert depending on the inhomogeneity configuration and measurement location. SmartArc(®) and RapidArc(®) plans had similar plan quality but RapidArc(®) plans had significantly higher monitor units (up to 70%). CONCLUSIONS A versatile, nonhomogeneous insert was developed for ArcCHECK(™) for an easy and quick evaluation of dose calculations with nonhomogeneous media and for comparison of different treatment planning systems. The device was tested for SmartArc(®) and RapidArc(®) plans for lung SBRT, showing the uncertainties of dose calculations with inhomogeneities. The new insert combines the convenience of the ArcCHECK(™) and the possibility of assessing dose distributions in inhomogeneous media.
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Affiliation(s)
- H Fakir
- Department of Physics, London Regional Cancer Program, London, Ontario N6A 4L6, Canada.
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Fakir H, Hoover D, Chen JZ. Poster - Thur Eve - 64: Evaluation of SmartArc and RapidArc for lung SBRT treatment planning and delivery. Med Phys 2012; 39:4637. [DOI: 10.1118/1.4740172] [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: 11/07/2022] Open
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Liu XX, Li SH, Chen JZ, Sun K, Wang XJ, Wang XG, Hui RT. Effect of soy isoflavones on blood pressure: a meta-analysis of randomized controlled trials. Nutr Metab Cardiovasc Dis 2012; 22:463-70. [PMID: 21310599 DOI: 10.1016/j.numecd.2010.09.006] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.7] [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] [Received: 01/11/2010] [Revised: 08/19/2010] [Accepted: 09/17/2010] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND AIM The effect of soy isoflavones on blood pressure is controversial. The objective of this study was to evaluate the effect of dietary soy isoflavones on blood pressure. METHODS AND RESULTS Trials were searched in PubMed, the Cochrane Library, Embase and references cited in related reviews and studies. A total of eleven trials were reviewed. Meta-analysis results showed a mean decrease of 2.5 mm Hg (95% CIs, - 5.35 to 0.34 mm Hg; P = 0.08) for systolic blood pressure and 1.5 mm Hg (95% CIs, - 3.09 to 0.17 mm Hg; P = 0.08) for diastolic blood pressure in the soy isoflavones-treated group compared to placebo. Meta-regression and subgroup analyses indicated that blood pressure status was a significant predictor of heterogeneity for the effect of soy isoflavones on blood pressure. Subgroup analysis of hypertensive subjects revealed that a greater blood pressure reduction was identified in the soy isoflavone-treated group compared to placebo (5 trials; SBP: - 5.94, 95% CIs [- 10.55, - 1.34] mm Hg, P = 0.01; DBP: - 3.35, 95% CIs [- 6.52, - 0.19] mm Hg, P = 0.04). In contrast, treatment with soy isoflavones did not lead to a significant reduction in blood pressure in normotensive subjects (6 trials; SBP: 0.29, 95% CIs [- 2.39, 2.97] mm Hg, P = 0.83; DBP: - 0.43, 95% CIs [- 1.66, 0.81] mm Hg, P = 0.50). CONCLUSION Soy isoflavones had an effect of lowering blood pressure in hypertensive subjects, but not in normotensive subjects. Larger trials need to be carried out to confirm the present findings.
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Affiliation(s)
- X X Liu
- The Key Laboratory of Clinical Cardiovascular Genetics, Ministry of Education and Sino-German Laboratory for Molecular Medicine, Beijing, PR China
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Chen JZ, Ye JY, Zhang HY, Jiang XJ, Zhang YX, Liu ZL. Freshwater toxic cyanobacteria induced DNA damage in apple (Malus pumila), rape (Brassica napus) and rice (Oryza sativa). J Hazard Mater 2011; 190:240-244. [PMID: 21497440 DOI: 10.1016/j.jhazmat.2011.03.030] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 02/21/2011] [Accepted: 03/10/2011] [Indexed: 05/30/2023]
Abstract
Cyanobacteria in freshwater ecosystems can present a harmful effect on growth and development of plants through irrigation with contaminated water. In this study, the effects of microcystins (MCs)-containing cyanobacteria extract (CE) on DNA damage of apple, rape and rice were investigated to explore the phytotoxic mechanism of MCs through DNA fragmentation and RAPD analysis. Determination of DNA fragmentation by fluorescent dye DAPI showed that significant DNA damage was observed in rice seedlings after exposure to CE while DNA fragmentation in rape seedlings and apple cultures did not differ significantly between treatment and control groups. Qualitative characterization of genomic DNA fragmentation by agarose gel electrophoresis supported the quantitative determination using DAPI. The main changes in RAPD profiles of rape seedlings following exposure of lower doses of CE were variation in band intensity for the primers F03 and S01, while higher doses of CE caused loss of normal bands and appearance of new bands except band intensity changes. The data presented here demonstrate that DNA damage in plants occurs following exposure of microcystins, and the polymorphic RAPDs may be used as an investigation tool for environmental toxicology and as a useful biomarker for the detection of genotoxic effects of microcystins on plants.
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Affiliation(s)
- J Z Chen
- School of Life Science, Huzhou University, Huzhou 313000, PR China.
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Abstract
INTRODUCTION The diagnosis of long segment Hirschsprung's disease (LSHD) is frequently delayed. Our purpose was to: 1) summarize contrast enema (CE) findings in patients with LSHD, and 2) evaluate the utility of CE by comparing LSHD patients managed with/without pre-biopsy CE. METHODS All LSHD cases (transition zone [TZ] proximal to the splenic flexure) treated between 1984 and 2009 were stratified according to whether a pre-biopsy CE was done (Group 1) or not (Group 2). CE were reviewed by a single pediatric radiologist, and the original reports were categorized as "helpful", "inconclusive" or "misleading". Group comparisons included elapsed days from admission to diagnostic rectal biopsy/first operation and initial hospitalization length of stay (LOS). RESULTS 29 patients (16 in Group 1; 13 in Group 2) were identified. CE review revealed TZ in 7/16 (44%); and of these, 6 (86%) underestimated the actual aganglionic segment length. 6/16 (38%) original CE reports were "misleading". Overall, Group 1 patients experienced a significant delay in time to biopsy (p=0.047), first operation (p=0.005), and showed a trend towards prolonged LOS. CONCLUSIONS Pre-biopsy CE offers little to the diagnosis of LSHD and may contribute to diagnosis/treatment delays. Even if a TZ is recognized in biopsy proven HD, the predicted aganglionic segment length should not guide the operative planning.
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Affiliation(s)
- J Z Chen
- BC Children's Hospital, Pediatric General Surgery, Vancouver, Canada
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Ferenczi K, Ohtola J, Aubert P, Kessler M, Sugiyama H, Somani AK, Gilliam AC, Chen JZ, Yeh I, Matsuyama S, McCormick TS, Cooper KD. Malignant T cells in cutaneous T-cell lymphoma lesions contain decreased levels of the antiapoptotic protein Ku70. Br J Dermatol 2010; 163:564-71. [PMID: 20408834 DOI: 10.1111/j.1365-2133.2010.09812.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Malignant T cells in primary cutaneous T-cell lymphoma (CTCL) are genetically unstable and exhibit prolonged lifespans potentially explained by dysregulation of apoptosis, yet are responsive to apoptosis-inducing therapies. The heterodimeric protein Ku70/80 is known to play a role in DNA repair (Ku70 and Ku80) and inhibition of apoptosis (Ku70 only). OBJECTIVES To investigate the expression of Ku70/80 in CD3+ T cells derived from skin and blood in patients with CTCL and normal samples, as well as benign dermatoses. METHODS Normal (n=10), CTCL (n=9) and benign dermatoses (n=13) skin samples were stained for confocal imaging of Ku70/80 and CD3 and analysed using imaging software. Circulating CD4+ T cells in normal and CTCL peripheral blood were analysed by flow cytometry and Western blot for Ku70/80 expression (n=6). RESULTS Ku70 and Ku80 were significantly diminished in T cells of CTCL lesions relative to T cells of control skin. Decreased T-cell Ku70 expression was not a feature of the benign dermatoses psoriasis and contact dermatitis, suggesting that loss of Ku70/80 in CTCL is not simply the result of cutaneous inflammation. Reduced Ku70 was also noted in circulating CD4+ T cells in patients with CTCL with peripheral blood involvement. CONCLUSIONS Deficient expression or lack of Ku70/80 may result in genomic instability and play a role in tumorigenesis, as well as account for the increased susceptibility of malignant T cells to apoptosis-inducing treatment modalities in the setting of intrinsic resistance to apoptosis.
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Affiliation(s)
- K Ferenczi
- Department of Dermatology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
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Chen JZ, Lukas B, Dar AR, Bzdusek K, Karnas S, Yartsev S. Sci-Thurs PM: Planning-01: Evaluation of Real-Time Dose-Adaptation Process for Intensity-Modulated Radiation Therapy. Med Phys 2009. [DOI: 10.1118/1.3244172] [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: 11/07/2022] Open
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Wang XX, Zhang FR, Zhu JH, Xie XD, Chen JZ. Up-Regulation of CXC Chemokine Receptor 4 Expression in Chronic Atrial Fibrillation Patients with Mitral Valve Disease May Be Attenuated by Renin–Angiotensin System Blockers. J Int Med Res 2009; 37:1145-51. [PMID: 19761697 DOI: 10.1177/147323000903700419] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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] Open
Abstract
This study characterized CXC chemokine receptor 4 (CXCR4) expression in patients with mitral valve disease and chronic atrial fibrillation (AF). Forty-eight patients with chronic AF formed two groups based on whether they were treated with or without renin–angiotensin system (RAS) blockers (AF + RAS group; n = 25, or AF – RAS group; n = 23). The controls comprised 17 mitral valve disease patients with sinus rhythm (SR group). CXCR4 mRNA and protein levels in the left atria were significantly higher in the AF – RAS and AF + RAS groups than in the SR group. CXCR4 expression was significantly lower in the AF + RAS group than the AF – RAS group. More CD34+ cells expressed CXCR4 in the AF – RAS and AF + RAS groups than in the SR group. Angiotensin II, collagen I and left atrial diameter significantly positively correlated with CXCR4 expression in the AF – RAS group. These results suggest that CXCR4 expression is up-regulated in chronic AF patients with mitral valve disease, is associated with atrial remodelling, and that these effects are attenuated by RAS blockers.
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Affiliation(s)
- XX Wang
- Department of Cardiology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
| | - FR Zhang
- Department of Cardiology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
| | - JH Zhu
- Department of Cardiology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
| | - XD Xie
- Department of Cardiology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
| | - JZ Chen
- Department of Cardiology, The First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
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Qie YQ, Wang JL, Liu W, Shen H, Chen JZ, Zhu BD, Xu Y, Zhang XL, Wang HH. More vaccine efficacy studies on the recombinant Bacille Calmette-Guerin co-expressing Ag85B, Mpt64 and Mtb8.4. Scand J Immunol 2009; 69:342-50. [PMID: 19284499 DOI: 10.1111/j.1365-3083.2009.02231.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The immunogenicity of the recombinant Bacille Calmette-Guerin: rBCG-Ag85B-Mpt64(190-198)-Mtb8.4 (rBCG-AMM) was evaluated in our previous study. This paper compares the protective efficacy of rBCG-AMM, rBCG-A which overexpresses Ag85B and BCG in C57BL/6 mice. There was no significant difference in proliferation characteristics among rBCG-AMM, rBCG-A and BCG. The growth characteristics of rBCG-AMM in host tissue were identical to control BCG, suggesting the improved protective efficacy was directly related to the expression of the Ag85B-Mpt64(190-198)-Mtb8.4 fusion protein. The protective experiment demonstrated that rBCG-AMM could confer similar or even better protective efficacy against Mycobacterium tuberculosis infection compared with BCG or rBCG-A as evaluated by bacterial organ loads, lung histopathology and net weight gain or loss. The results suggested that the recombinant BCG: rBCG-Ag85B-Mpt64(190-198)-Mtb8.4 is a potential vaccine candidate for further study.
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Affiliation(s)
- Y Q Qie
- State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Science, Fudan University, Shanghai, China
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Xu ZX, Chen JZ, Yue YB, Zhang JQ, Li ZH, Feng DM, Ruan ZC, Tian L, Xue JL, Wang QJ, Jia W. A 16-bp RBE element mediated Rep-dependent site-specific integration in AAVS1 transgenic mice for expression of hFIX. Gene Ther 2009; 16:589-95. [DOI: 10.1038/gt.2009.9] [Citation(s) in RCA: 15] [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: 11/09/2022]
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Xia L, Wang XX, Hu XS, Guo XG, Shang YP, Chen HJ, Zeng CL, Zhang FR, Chen JZ. Resveratrol reduces endothelial progenitor cells senescence through augmentation of telomerase activity by Akt-dependent mechanisms. Br J Pharmacol 2008; 155:387-94. [PMID: 18587418 DOI: 10.1038/bjp.2008.272] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND PURPOSE Recent studies have shown that resveratrol increased endothelial progenitor cells (EPCs) numbers and functional activity. However, the mechanisms remain to be determined. Previous studies have demonstrated that increased EPC numbers and activity were associated with the inhibition of EPC senescence, which involves activation of telomerase. Therefore, we investigated whether resveratrol inhibits the onset of EPC senescence through telomerase activation, leading to potentiation of cellular activity. EXPERIMENTAL APPROACH After prolonged in vitro cultivation, EPCs were incubated with or without resveratrol. The senescence of EPCs were determined by acidic beta-galactosidase staining. The bromo-deoxyuridine incorporation assay or a modified Boyden chamber assay were employed to assess proliferative or migratory capacity, respectively. To further examine the underlying mechanisms of these effects, we measured telomerase activity and the phosphorylation of Akt by western blotting. KEY RESULTS Resveratrol dose dependently prevented the onset of EPCs senescence and increased the proliferation and migration of EPCs. The effect of resveratrol on senescence could not be abolished by eNOS inhibitor or by an oestrogenic receptor antagonist. Resveratrol significantly increased telomerase activity and Akt phosphorylation. Pre-treatment with the PI3K inhibitor, LY294002, significantly attenuated resveratrol-induced telomerase activity. CONCLUSIONS AND IMPLICATIONS Resveratrol delayed the onset of EPC senescence and this effect was accompanied by activation of telomerase through the PI3K-Akt signalling pathway. The inhibition of EPCs senescence by resveratrol might protect EPCs against dysfunction induced by pathological factors in vivo and improve EPC functional activities in a way that may be important for cell therapy.
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Affiliation(s)
- L Xia
- Department of Cardiovascular Diseases, the First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, PR China
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Zhu JH, Chen JZ, Wang XX, Xie XD, Sun J, Zhang FR. Homocysteine accelerates senescence and reduces proliferation of endothelial progenitor cells. J Mol Cell Cardiol 2006; 40:648-52. [PMID: 16600290 DOI: 10.1016/j.yjmcc.2006.01.011] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [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] [Received: 08/16/2005] [Revised: 01/01/2006] [Accepted: 01/12/2006] [Indexed: 12/13/2022]
Abstract
Our previous studies showed that homocysteine (Hcy) reduces endothelial progenitor cell (EPC) numbers and impairs functional activity. However, the mechanisms by which Hcy reduces EPCs numbers and activity remain to be determined. Recent studies have demonstrated that reduced EPCs numbers and activity was associated with EPCs senescence which involved telomerase activity. Therefore, we investigated whether Hcy accelerates the onset of EPCs senescence through telomerase inactivation, leading to cellular dysfunction. EPCs were isolated from peripheral blood and characterized. After ex vivo cultivation, EPCs became senescent as determined by acidic beta-galactosidase staining. Hcy dose-dependently accelerated the onset of EPCs senescence in culture. Moreover, Hcy decreased proliferation of EPCs as assessed by BrdU incorporation assay and colony-forming capacity. To get further insights into the underlying mechanisms of these effects induced by Hcy, we measured telomerase activity and determined the phosphorylation of Akt by using western blot. Hcy significantly diminished telomerase activity and Akt phosphorylation. Taken together, the results of the present study demonstrated that Hcy accelerated the onset of EPCs senescence, leading to cellular dysfunction. The effect of Hcy might be dependent on telomerase inactivation, and Akt dephosphorylation also appeared to play a major role. In addition, atorvastatin had a preventative effect against Hcy-induced EPCs senescence.
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Affiliation(s)
- J H Zhu
- Department of Cardiology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Abstract
The aim of this investigation is to determine whether rapamycin treatment has any effect on endothelial progenitor cells (EPCs). Total mononuclear cells (MNCs) were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. After 7 days in culture, attached cells were stimulated with rapamycin (in a series of final concentrations: 0.1, 1.0, 2.0 and 5.0 g/ml) for 6, 12, 24 and 48 h. EPCs were characterized as adherent cells, double positive for DiLDL uptake and lectin binding by direct fluorescence staining. EPC proliferation and migration were determined using the MTT assay and a modified version of the Boyden chamber assay, respectively. An EPC adhesion assay was performed by replating the cells on fibronectin-coated dishes; adherent cells were then counted. Tube formation activity was assayed by using a tube formation assay kit and endothelial nitric oxide synthase (eNOS) was assayed by Western blot analysis. Incubation of isolated human MNCs with rapamycin decreased the number of EPCs present; rapamycin also decreased EPCs proliferative, migratory, adhesive, tube formation capacity and eNOS production in a concentration- and time-dependent manner. Rapamycin was found to decrease the number, proliferative, migratory, adhesive and tube formation capacities of the EPCs, and also was found to decreases eNOS in the EPCs.
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Affiliation(s)
- T-G Chen
- Department of Cardiovascular Disease, First Affiliated Hospital, Medical School of Zhejiang University, Hangzhou, China
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Goldman SP, Chen JZ, Battista JJ. Feasibility of a fast inverse dose optimization algorithm for IMRT via matrix inversion without negative beamlet intensities. Med Phys 2005; 32:3007-16. [PMID: 16266115 DOI: 10.1118/1.2030427] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A fast optimization algorithm is very important for inverse planning of intensity modulated radiation therapy (IMRT), and for adaptive radiotherapy of the future. Conventional numerical search algorithms such as the conjugate gradient search, with positive beam weight constraints, generally require numerous iterations and may produce suboptimal dose results due to trapping in local minima. A direct solution of the inverse problem using conventional quadratic objective functions without positive beam constraints is more efficient but will result in unrealistic negative beam weights. We present here a direct solution of the inverse problem that does not yield unphysical negative beam weights. The objective function for the optimization of a large number of beamlets is reformulated such that the optimization problem is reduced to a linear set of equations. The optimal set of intensities is found through a matrix inversion, and negative beamlet intensities are avoided without the need for externally imposed ad-hoc constraints. The method has been demonstrated with a test phantom and a few clinical radiotherapy cases, using primary dose calculations. We achieve highly conformal primary dose distributions with very rapid optimization times. Typical optimization times for a single anatomical slice (two dimensional) (head and neck) using a LAPACK matrix inversion routine in a single processor desktop computer, are: 0.03 s for 500 beamlets; 0.28 s for 1000 beamlets; 3.1 s for 2000 beamlets; and 12 s for 3000 beamlets. Clinical implementation will require the additional time of a one-time precomputation of scattered radiation for all beamlets, but will not impact the optimization speed. In conclusion, the new method provides a fast and robust technique to find a global minimum that yields excellent results for the inverse planning of IMRT.
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Affiliation(s)
- S P Goldman
- Department of Physics & Astronomy, University of Western Ontario, London, Ontario N6A 3K7, Canada.
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Wong E, D'Souza DP, Chen JZ, Lock M, Rodrigues G, Coad T, Trenka K, Mulligan M, Bauman GS. Intensity-modulated arc therapy for treatment of high-risk endometrial malignancies. Int J Radiat Oncol Biol Phys 2005; 61:830-41. [PMID: 15708263 DOI: 10.1016/j.ijrobp.2004.06.253] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2004] [Revised: 06/14/2004] [Accepted: 06/30/2004] [Indexed: 11/18/2022]
Abstract
PURPOSE We developed an intensity-modulated arc therapy (IMAT) technique for the treatment of women with high-risk endometrial malignancies. In the context of multimodality therapy, nodal and tumor bed irradiation was delivered while respecting tolerance doses for critical structures. METHODS AND MATERIALS Five patients were planned and treated with the IMAT technique after hysterectomy. Computed tomographic (CT) scans for treatment planning were acquired with the tumor bed contoured as the clinical target volume (CTV(tumor_bed)) and the iliac and presacral vessels contoured as the gross tumor volume (GTV). In 2 patients the lower para-aortic nodes were included into the GTV. The small bowel, iliac crests, femoral heads, bladder, and rectum were contoured as critical organs. For the nodes, a CTV(nodes) was generated with a 7-10-mm margin around the vessels, and the planning target volume (PTV(nodes)) was generated by a further 5-mm expansion. For the tumor bed, the PTV(tumor_bed) was generated with a margin of 7-10 mm around CTV(tumor_bed). Planning constraints included adequate coverage of the tumor bed (>95% receiving > or =45 Gy) and nodes (> or =95% receiving > or =40 Gy). Arc combinations with different extents were tested, and the final plan was generated based on the balance between complexity (number of arcs), PTV coverage, and critical structure sparing. Conventional and 8-field intensity-modulated radiation therapy (IMRT) plans were generated for each patient for comparison purposes. All patients were treated with IMAT. RESULTS We found that two anterior intensity-modulated arcs (300 degrees to 30 degrees and 330 degrees to 60 degrees ) adequately treated the PTVs. Furthermore, this IMAT technique allowed sparing of small bowel and the iliac crests (marrow space) to a similar degree as the 8-field IMRT. The 8-field IMRT yielded better dose uniformity than IMAT in the target volumes; however, neither technique was as uniform as the conventional plan. In the 5 patients, IMAT treatment was well tolerated and completed as planned. CONCLUSIONS We successfully piloted an optimized intensity-modulated arc technique to treat 5 high-risk endometrial cancer patients undergoing multimodality treatment. This allowed a significant reduction in dose to bone marrow and small bowel compared with conventional techniques and was simpler to deliver than multifield IMRT.
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Affiliation(s)
- Eugene Wong
- Department of Oncology, University of Western Ontario, and London Regional Cancer Centre, 790 Commissioners Road East, London, Ontario N6A 4L6, Canada.
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Kron T, Grigorov G, Yu E, Yartsev S, Chen JZ, Wong E, Rodrigues G, Trenka K, Coad T, Bauman G, Van Dyk J. Planning evaluation of radiotherapy for complex lung cancer cases using helical tomotherapy. Phys Med Biol 2005; 49:3675-90. [PMID: 15446797 DOI: 10.1088/0031-9155/49/16/014] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Lung cancer treatment is one of the most challenging fields in radiotherapy. The aim of the present study was to investigate what role helical tomotherapy (HT), a novel approach to the delivery of highly conformal dose distributions using intensity-modulated radiation fan beams, can play in difficult cases with large target volumes typical for many of these patients. Tomotherapy plans were developed for 15 patients with stage III inoperable non-small-cell lung cancer. While not necessarily clinically indicated, elective nodal irradiation was included for all cases to create the most challenging scenarios with large target volumes. A 2 cm margin was used around the gross tumour volume (GTV) to generate primary planning target volume (PTV2) and 1 cm margin around elective nodes for secondary planning target volume (PTV1) resulting in PTV1 volumes larger than 1000 cm3 in 13 of the 15 patients. Tomotherapy plans were created using an inverse treatment planning system (TomoTherapy Inc.) based on superposition/convolution dose calculation for a fan beam thickness of 25 mm and a pitch factor between 0.3 and 0.8. For comparison, plans were created using an intensity-modulated radiation therapy (IMRT) approach planned on a commercial treatment planning system (TheraplanPlus, Nucletron). Tomotherapy delivery times for the large target volumes were estimated to be between 4 and 19 min. Using a prescribed dose of 60 Gy to PTV2 and 46 Gy to PTV1, the mean lung dose was 23.8+/-4.6 Gy. A 'dose quality factor' was introduced to correlate the plan outcome with patient specific parameters. A good correlation was found between the quality of the HT plans and the IMRT plans with HT being slightly better in most cases. The overlap between lung and PTV was found to be a good indicator of plan quality for HT. The mean lung dose was found to increase by approximately 0.9 Gy per percent overlap volume. Helical tomotherapy planning resulted in highly conformal dose distributions. It allowed easy achievement of two different dose levels in the target simultaneously. As the overlap between PTV and lung volume is a major predictor of mean lung dose, future work will be directed to control of margins. Work is underway to investigate the possibility of breath-hold techniques for tomotherapy delivery to facilitate this aim.
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Affiliation(s)
- Tomas Kron
- London Regional Cancer Centre, Departments of Radiation Oncology and Physics and Engineering, London Ontario N6A 4L6, Canada.
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Abstract
In the present study, we examined the effect of interleukin-2 (IL-2) on cardiomyocyte Ca(2+) handling. The effects of steady-state and transient changes in stimulation frequency on the intracellular Ca(2+) transient were investigated in isolated ventricular myocytes by spectrofluorometry. In the steady state (0.2 Hz) IL-2 (200 U/ml) decreased the amplitude of Ca(2+) transients induced by electrical stimulation and caffeine. At 1.25 mM extracellular Ca(2+) concentration ([Ca(2+)](o)), when the stimulation frequency increased from 0.2 to 1.0 Hz, diastolic Ca(2+) level and peak intracellular Ca(2+) concentration ([Ca(2+)](i)), as well as the amplitude of the transient, increased. The positive frequency relationships of the peak and amplitude of [Ca(2+)](i) transients were blunted in the IL-2-treated myocytes. The effect of IL-2 on the electrically induced [Ca(2+)](i) transient was not normalized by increasing [Ca(2+)](o) to 2.5 mM. IL-2 inhibited the frequency relationship of caffeine-induced Ca(2+) release. Blockade of sarcoplasmic reticulum (SR) Ca(2+)-ATPase with thapsigargin resulted in a significant reduction of the amplitude-frequency relationship of the transient similar to that induced by IL-2. The restitutions were not different between control and IL-2 groups at 1.25 mM [Ca(2+)](o), which was slowed in IL-2-treated myocytes when [Ca(2+)](o) was increased to 2.5 mM. There was no difference in the recirculation fraction (RF) between control and IL-2-treated myocytes at both 1.25 and 2.5 mM [Ca(2+)](o). The effects of IL-2 on frequency relationship, restitution, and RF may be due to depressed SR functions and an increased Na(+)-Ca(2+) exchange activity, but not to any change in L-type Ca(2+) channels.
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Affiliation(s)
- C M Cao
- Department of Physiology, Zhejiang University School of Medicine, 353 Yan'an Road, Hangzhou 310031, China
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Darhuber AA, Chen JZ, Davis JM, Troian SM. A study of mixing in thermocapillary flows on micropatterned surfaces. Philos Trans A Math Phys Eng Sci 2004; 362:1037-1058. [PMID: 15306483 DOI: 10.1098/rsta.2003.1361] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The recent introduction of actuation mechanisms for microfluidic transport based on free surface flows raises a number of interesting questions involving efficient mixing configurations, especially in systems with small aspect ratios. This work investigates the characteristics of convective and diffusive mixing in continuous-mode streaming of thermocapillary microflows on chemically micropatterned surfaces. Mixing times and mixing lengths relevant to chemical microreactors or gas sensors are investigated for various geometries and parameter ranges. Scaling arguments and full numerical solutions are presented to extract optimal operating conditions. Confocal fluorescence microscopy measurements of the interfacial diffusive broadening in adjacent flowing streams confirm numerical predictions. Three important mixing regimes, based on analogues of purely diffusive dynamics, Rhines-Young shear-augmented diffusion and Taylor-Aris dispersion are identified and investigated for use in free surface flows with large surface-to-volume ratios.
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Affiliation(s)
- A A Darhuber
- Microfluidic Research and Engineering Laboratory, Department of Chemical Engineering, Princeton University, Princeton, NJ 08544, USA.
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Bauman G, Gete E, Chen JZ, Wong E. Simplified intensity-modulated arc therapy for dose escalated prostate cancer radiotherapy. Med Dosim 2004; 29:18-25. [PMID: 15023389 DOI: 10.1016/j.meddos.2003.09.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2003] [Accepted: 09/20/2003] [Indexed: 11/25/2022]
Abstract
Simplified intensity-modulated arc therapy (SIMAT) employs forward planned, conformal, and avoidance arc combinations with dynamic multileaf collimation (MLC) as a simpler alternative to other forms of intensity-modulated radiotherapy (IMRT). In this work, we compare SIMAT with 4-field (4F) and 6-field (6F) 3D conformal radiation therapy (CRT) for prostate cancer treatment. Prostate, seminal vesicle, bladder, and rectum were contoured on the CT images of 10 patients being planned for radiotherapy. Two planning target volumes (PTV) were defined: PTV1 (prostate + seminal vesicles + 1.0-cm margin) and PTV2 (prostate + 1.0-cm margin). SIMAT, 4F, and 6F plans were generated with a prescription dose of 78 Gy to prostate and 54 Gy to the seminal vesicles. Differences in the 3 techniques in terms of target and rectal coverage were compared. In addition, dose distributions of the SIMAT plans were verified with measurements in a phantom. Mean dose to PTV2 (4F, 76 Gy; 6F, 78 Gy; SIMAT, 76 Gy) and the dose delivered to 95% of the target volume (D(95)) were similar between the 3-techniques. Target conformity was better with SIMAT. Mean dose and calculated NTCP for the rectum were lower for SIMAT than those for 4F and 6F plans (4F 55.6 Gy vs. 6F 49.0 Gy vs. SIMAT 42.7 Gy). Mean dose to femoral heads was lower for the 4F technique vs. 6F and SIMAT techniques (4F 44.5 Gy vs. 6F 48.9 Gy vs. SIMAT 49.5 Gy). In-phantom measurement demonstrated good agreement between the plans and SIMAT treatments delivered in phantom. We concluded that SIMAT demonstrates advantages over 4F and 6F in terms of target conformity mean rectal dose and NTCP with good reproducibility in phantom. On the basis of this analysis, we have commenced a clinical pilot study of SIMAT for prostate cancer radiotherapy.
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Affiliation(s)
- G Bauman
- Departments of Radiation Oncology, London Regional Cancer Centre and the University of Western Ontario, London, Ontario, Canada.
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