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Peripheral Indicators of Dysbiosis in Heart Transplant Recipients (PoD-HTR). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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714 ‘Administration of Tranexamic Acid in Traumatic Brain Injury in a Major London Trauma Centre’. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Aim
Traumatic brain injury contributes to worldwide death and disability more than any other traumatic insult. CRASH-3 demonstrated tranexamic acid is safe in mild to moderate traumatic brain injury and head injury-related death was reduced when given within 3 hours of injury. This project aims to review adherence to the recommendations at a major trauma centre and implement changes with the view of improving outcomes.
Method
Patients presenting at St Mary's Hospital with a traumatic head injury over a 6-month period were identified. Data collection included: timings of injury and tranexamic acid administration, Glasgow Coma Scale at the scene and admission, and bolus vs. bolus and infusion. Results presented at the regional trauma network meeting with summary poster designed for display in the department. A second cycle of data collection was completed over 2 months following the interventions.
Results
There was an increase in the proportion of patients who received tranexamic acid from 29% in cycle 1 to 51% in cycle 2. The proportion of patients receiving both the initial bolus and infusion also increased from 25% in cycle 1 to 45% in cycle 2. The average time from injury to first dose of tranexamic acid was reduced from 2 hours 16 minutes to 1 hour 33 minutes.
Conclusions
The interventions implemented between cycles 1 and 2 led to an overall improvement in the major trauma unit's adherence to the CRASH-3 recommendations. Decisions where tranexamic acid is withheld are down to clinical judgement however it is recommended that the reasoning is also documented.
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Poke Not Prod: First Canadian Experience Using Donor-Derived Cell Free DNA to Replace Endomyocardial Biopsy During COVID-19. J Heart Lung Transplant 2022. [PMCID: PMC8988591 DOI: 10.1016/j.healun.2022.01.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose After a heart transplant (HT), non-invasive methods for rejection surveillance minimize the need for endomyocardial biopsies (EMBx). We describe the first experience with combined use of genetic expression profiling (GEP) and donor-derived cell-free DNA (dd-cfDNA) testing in Canada as part of a quality improvement project to minimize patient risk during the COVID pandemic. Methods Adult outpatients at least 6 months after HT were screened from May 2021 to July 2021 to have their routine EMBx replaced by a combination of GEP and dd-cfDNA. Demographics, modification of immunosuppression (IS) and outcomes (hospital admission, rejection, and need for EMBx) were collected. Results Among 90 patients, 31 (33%) were enrolled, and 37 non-invasive tests were performed. The median time after HT was 2 years and patients were predominantly Caucasian (52%) and male (68%). 53% had a history of acute cellular rejection during the first year and 32% had cardiac allograft vasculopathy. Of the tests performed, 23 (60%) were - GEP / - dd-cfDNA, 10 (27%) were + GEP / - dd-cfDNA, 4 (11%) were - GEP / + dd-cfDNA and none were + GEP / + dd-cfDNA. Being bridged with a VAD (OR = 5.5, p=0.034) and a history of a previously treated CMV (OR = 16.0, p=0.003) were associated with a positive GEP and a negative dd-cfDNA result. Having received a COVID vaccine in the last 3 months did not affect GEP results (GEP was positive in 23.8% after vaccination vs 33.3% in non-vaccinated patients, p=0.690; average GEP score 29.8 vs 30.7, p=0.673). The 4 patients with a + dd-cfDNA (range 0.19 - 0.81%) underwent an EMBx with no significant cellular or antibody mediated rejection, thus avoiding 89% of the EMBx. No unscheduled clinic visits, emergency department or hospital admissions were recorded. After non-invasive testing, the IS was reduced in 16 cases (43.2%). IS was reduced in in 59% of patients with negative concordant tests (- GEP / - dd-cfDNA), 30% in patients with + GEP / - dd-cfDNA and no reduction in IS occurred in those with + dd-cfDNA. Conclusion The combination of GEP and dd-cfDNA for rejection surveillance allowed for a marked reduction in EMBx (89%) and for a personalized downtitration of IS without adverse events in the short term. The use of non-invasive rejection surveillance testing was an effective strategy to avoid hospital contact for HT recipients during the COVID-19 pandemic.
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Poke Not Prod: Improving Quality of Life Through Non-Invasive Rejection Surveillance for Heart Transplant Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Perioperative intravenous contrast administration and the incidence of acute kidney injury after major gastrointestinal surgery: prospective, multicentre cohort study. Br J Surg 2020; 107:1023-1032. [PMID: 32026470 DOI: 10.1002/bjs.11453] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/21/2019] [Accepted: 11/08/2019] [Indexed: 01/14/2023]
Abstract
BACKGROUND This study aimed to determine the impact of preoperative exposure to intravenous contrast for CT and the risk of developing postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. METHODS This prospective, multicentre cohort study included adults undergoing gastrointestinal resection, stoma reversal or liver resection. Both elective and emergency procedures were included. Preoperative exposure to intravenous contrast was defined as exposure to contrast administered for the purposes of CT up to 7 days before surgery. The primary endpoint was the rate of AKI within 7 days. Propensity score-matched models were adjusted for patient, disease and operative variables. In a sensitivity analysis, a propensity score-matched model explored the association between preoperative exposure to contrast and AKI in the first 48 h after surgery. RESULTS A total of 5378 patients were included across 173 centres. Overall, 1249 patients (23·2 per cent) received intravenous contrast. The overall rate of AKI within 7 days of surgery was 13·4 per cent (718 of 5378). In the propensity score-matched model, preoperative exposure to contrast was not associated with AKI within 7 days (odds ratio (OR) 0·95, 95 per cent c.i. 0·73 to 1·21; P = 0·669). The sensitivity analysis showed no association between preoperative contrast administration and AKI within 48 h after operation (OR 1·09, 0·84 to 1·41; P = 0·498). CONCLUSION There was no association between preoperative intravenous contrast administered for CT up to 7 days before surgery and postoperative AKI. Risk of contrast-induced nephropathy should not be used as a reason to avoid contrast-enhanced CT.
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Can concordance between actual care received and a pathway map be measured on a population level in Ontario? A pilot study. ACTA ACUST UNITED AC 2020; 27:e27-e33. [PMID: 32218665 DOI: 10.3747/co.27.5349] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Clinical pathways are associated with improved adherence to clinical guidelines; however, most studies have evaluated pathways for a single intervention at a single institution. The objective of the present study was to develop and evaluate a method of measuring concordance with a population-based clinical pathway map to determine if that method could be feasible for assessing overall health system performance. Methods Patients with stage ii or iii colon cancer diagnosed in 2010 were identified, and clinical data were obtained through linkages to administrative databases. Pathway concordance was defined a priori based on receipt of key elements of the Ontario Health (Cancer Care Ontario) colorectal pathway maps. For stages ii and iii colon cancer alike, concordance was reported as the proportion of patients receiving care that followed the predefined key elements of the pathway map. Regression analysis was used to identify predictors of concordant care. Results Our study identified 816 patients with stage ii and 800 patients with stage iii colon cancer. Of the patients with stage ii disease, 70% (n = 571) received concordant care. Of the patients with stage iii disease, results showed high concordance for all key elements except receipt of chemotherapy, leading to an overall concordance rate of 39% for that cohort. Conclusions Our method of measuring concordance was feasible on a population-based level, but future studies to validate it and to develop more sophisticated methods to measure concordance in larger cohorts and various disease sites are necessary. Measurement of clinical pathway concordance on a population-based level has the potential to be a useful tool for assessing system performance.
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TP1-9 Vestibular dysfunction in acute traumatic brain injury. Journal of Neurology, Neurosurgery and Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesVestibular dysfunction following traumatic brain injury (TBI) is a major cause of morbidity and unemployment and has impact on the patient’s ability to rehabilitate. Chronically, up to a quarter of TBI cases have cryptogenic dizziness and imbalance, possibly due to chronic brain adaptation that masks the diagnosis. Establishing the spectrum of vestibular diagnoses in acute TBI – when they may be more obvious – may aid diagnosis in chronic TBI cases.DesignProspective audit of referrals to specialist neuro-otology team.SubjectsConsecutive Major Trauma Ward TBI in-patients admitted between June 2014 and May 2015.MethodsAll cases were screened by the therapists for vestibular symptoms and/or signs and referred for specialist neuro-otology review.ResultsOf 111 patients screened, 96 had features of vestibular dysfunction. Of 96 cases, SYMPTOMS (i.e. subjective report) included: – imbalance (58.3%) – headache (50%) -dizziness (40%) Of 96 cases, SIGNS (i.e. examination) included: – gait ataxia (75.5%) – broken smooth pursuit (61.2%) – positive Hallpike (51%) – positive head impulse test (18%). The data indicate that BPPV affects 49% and headache with migraine-like features affect 40.8%. Acute peripheral unilateral vestibular loss affects 18% TBI cases.ConclusionsVestibular dysfunction in TBI is common, typically involving peripheral and central structures, often in the same case, and requires specialist neuro-otological management.
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P108 Acetazolamide for obstructive hydrocephalus in the pregnant female: a case report and literature review. J Neurol Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesThis study presents a case report and literature review of acetazolamide use in the pregnant patient to further delineate its role and controversies in the treatment of symptomatic hydrocephalus. Here we present a case from our neurosurgical service which demonstrated safe use and efficacy of acetazolamide in refractory hydrocephalus secondary to a space-occupying lesion.DesignCase report and literature review.Subjects33-year-old, primigravid female treated at Charing Cross Hospital, London.MethodsAdaptation of the PRISMA guideline to facilitate an initial PubMed database search for all available full-text, peer-reviewed publications in English. Papers were screened for relevance to pregnant patients with hydrocephalus receiving acetazolamide therapy, as well as relevant papers describing related disorders of cerebrospinal fluid flow.ResultsThere exist no prospective, randomised-controlled trials for the use of acetazolamide to treat hydrocephalus in pregnancy. Retrospective data in patients with related conditions suggest no significant link between acetazolamide use and teratogenicity in humans.ConclusionsAcetazolamide can be a safe and efficacious therapy in the pregnant patient with refractory hydrocephalus as a bridge to delivery. We agree with the consensus and its appropriate use in the pregnant neurosurgical patient.
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TP1-8 Decompressive craniectomy for paediatric traumatic brain injury: a systematic review. Journal of Neurology, Neurosurgery and Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesManaging raised intracranial pressure (ICP) in traumatic brain injury (TBI) has been the centre of debate. Recent publications (such as RescueICP) have helped our understanding of the role of decompressive craniectomy (DC) in adults but no such data is available for the paediatric population. We aim to assess the current literature on the role of DC in this group of patients.DesignSystematic review of this subject.Subjects260 paediatric patients within 12 studies were included within our criteria.MethodsA comprehensive search of the MEDLINE and EMBASE databases led to the screening of 212 studies, with 12 studies included. We collected data on age, GCS at presentation, treatment protocols and their short- and long-term outcomes.ResultsNine studies looked at ICP as an outcome and these all reported that it was successfully controlled by DC (69.4%–100% reduction, p<0.05). Only two studies looked at mortality, both found that it was lower in the DC group (p<0.05). The 6–12 month outcome, based on the Extended Glasgow Outcome Scale (GOS-E) and a range of other pre-defined daily activities, were overall positive, or superior to those of medically treated (p<0.05) in 10 of the studies. One study suggested no difference in outcome.ConclusionsThe currently available evidence appears to supports the beneficial role of DC in the treatment of children with refractory high ICP (>20 mmHg) and a GCS score of <8 at the time of presentation. However the quality of each of these studies is poor and further research is required.
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New approach to the reconstruction of defects deep in the orbital roof. Br J Oral Maxillofac Surg 2018; 56:559-560. [DOI: 10.1016/j.bjoms.2018.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 05/02/2018] [Indexed: 11/25/2022]
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The relationship between 18 F-FDG-PETCT-derived markers of tumour metabolism and systemic inflammation in patients with recurrent disease following surgery for colorectal cancer. Colorectal Dis 2018; 20:407-415. [PMID: 29178362 DOI: 10.1111/codi.13973] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 10/30/2017] [Indexed: 12/12/2022]
Abstract
AIM 18 F-fluorodeoxyglucose positron emission tomography-computed tomography (18 F-FDG-PETCT)-derived markers of tumour metabolism have been reported to have prognostic significance in a variety of tumours. Host inflammation is also recognized to have prognostic significance. The aim of the present study was to investigate the relationship between these markers and host systemic inflammation in patients undergoing elective surgery for colorectal cancer. METHOD Patients with histologically confirmed colorectal cancer who underwent elective surgery between 2008 and 2015 and also underwent 18 F-FDG-PETCT at a single centre were included (n = 103). The neutrophil-lymphocyte ratio (NLR) and modified Glasgow Prognostic Score (mGPS) were derived from routine blood tests. The maximum standardized uptake (SUVmax), peak standardized uptake (SUVpeak), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) were measured. RESULTS There was no association between 18 F-FDG-PETCT measures of tumour metabolism and systemic inflammation in the 33 patients who underwent preoperative imaging. Of the 70 patients with recurrent disease who underwent 18 F-FDG-PETCT during follow-up, patients with NLR ≥ 5 had a significantly higher SUVmax (20 vs 7, P = 0.002), SUVpeak (14 vs 5, P < 0.001), MTV (29 g vs 2 g, P = 0.001) and TLG (338 g vs 9 g, P < 0.001). Similarly, patients with a mGPS of 1-2 at the time of 18 F-FDG-PETCT had a significantly higher median SUVmax (11 vs 6, P = 0.048), SUVpeak (8 vs 4, P = 0.046), MTV (13 ml vs 2 ml, P = 0.005) and TLG (146 g vs 10 g, P = 0.004). CONCLUSION The present study reports a direct association between 18 F-FDG-PETCT-derived measures of tumour metabolism and systemic inflammation in patients with recurrent colorectal cancer.
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Evidence based treatment for unstable slipped upper femoral epiphysis: Systematic review and exploratory patient level analysis. Surgeon 2018; 16:46-54. [DOI: 10.1016/j.surge.2016.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/13/2016] [Indexed: 11/29/2022]
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Treatment of stable slipped capital femoral epiphysis: systematic review and exploratory patient level analysis. J Orthop Traumatol 2017; 18:379-394. [PMID: 28831651 PMCID: PMC5685987 DOI: 10.1007/s10195-017-0469-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/13/2017] [Indexed: 01/29/2023] Open
Abstract
Background Several aspects of slipped capital femoral epiphysis (SCFE) treatment remain controversial. Loder’s work has been instrumental in changing our understanding and approach to the management of the condition when he introduced the concept of “slip instability” and showed that avascular necrosis (AVN) developed in 47% of unstable slips but none of the stable slips. As the two types of SCFE behave differently in terms of presentation, progress and complications, we approached them as two different conditions to highlight these differences. This paper focuses on treatments of stable SCFE. Materials and methods An extensive literature search was carried out from multiple databases. One thousand six hundred and twenty-three citations were screened. Three hundred and sixteen full publications were obtained for further scrutiny. Fifty-eight studies (2262 hips) were included in the review. These studies evaluated 6 interventions. AVN was chosen as a surrogate for bad outcome. Secondary outcomes were chondrolysis (CL), femoro-acetabular impingement (FAI), osteoarthritis (OA) and patients’ reported outcomes. The latter were pooled when they met our predefined criteria. Results The type of surgical intervention was an important risk factor. Pinning in situ (PIS) was associated with the lowest AVN rate (1.4%). Moreover, the CL, FAI and OA rates were relatively low in patients who underwent PIS. These were not translated into high patient satisfaction rates among these patients, with only 47% reporting an “excellent” outcome. In contrast, 87% of patients who underwent Ganz surgical dislocation reported an “excellent” outcome. The Ganz surgical dislocation was associated with an AVN rate of 3.3%; double that observed in pinning in situ. Conclusion Pinning in situ is the best treatment for mild and moderate stable slip. Ganz surgical dislocation gives higher patient satisfaction for severe stable slip but the risk of AVN is doubled compared with pinning in situ. Devices that allow continued growth may be better than standard screws. Level of evidence Level III.
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Hematopoietic neoplasms in Prkar2a-deficient mice. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2015; 34:143. [PMID: 26608815 PMCID: PMC4660639 DOI: 10.1186/s13046-015-0257-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 11/11/2015] [Indexed: 12/22/2022]
Abstract
Background Protein kinase A (PKA) is a holoenzyme that consists of a dimer of regulatory subunits and two inactive catalytic subunits that bind to the regulatory subunit dimer. Four regulatory subunits (RIα, RIβ, RIIα, RIIβ) and four catalytic subunits (Cα, Cβ, Cγ, Prkx) have been described in the human and mouse genomes. Previous studies showed that complete inactivation of the Prkar1a subunit (coding for RIα) in the germline leads to embryonic lethality, while Prkar1a–deficient mice are viable and develop schwannomas, thyroid, and bone neoplasms, and rarely lymphomas and sarcomas. Mice with inactivation of the Prkar2a and Prkar2b genes (coding for RIIα and RIIβ, respectively) are also viable but have not been studied for their susceptibility to any tumors. Methods Cohorts of Prkar1a+/−, Prkar2a+/−, Prkar2a−/−, Prkar2b+/− and wild type (WT) mice have been observed between 5 and 25 months of age for the development of hematologic malignancies. Tissues were studied by immunohistochemistry; tumor-specific markers were also used as indicated. Cell sorting and protein studies were also performed. Results Both Prkar2a−/− and Prkar2a+/− mice frequently developed hematopoietic neoplasms dominated by histiocytic sarcomas (HS) with rare diffuse large B cell lymphomas (DLBCL). Southern blot analysis confirmed that the tumors diagnosed histologically as DLBCL were clonal B cell neoplasms. Mice with other genotypes did not develop a significant number of similar neoplasms. Conclusions Prkar2a deficiency predisposes to hematopoietic malignancies in vivo. RIIα’s likely association with HS and DLBCL was hitherto unrecognized and may lead to better understanding of these rare neoplasms.
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THE IMPACT-CABG TRIAL: A CANADIAN RCT OF CD133+ STEM CELL THERAPY FOR ISCHEMIC CARDIOMYOPATHY. Can J Cardiol 2015. [DOI: 10.1016/j.cjca.2015.07.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Abstract
INTRODUCTION Spondylodiscitis refers to the infection of the intervertebral disc and osteomyelitis of the adjacent endplates, and it is uncommon in the developed world. Broad consensus indicates its incidence is on the rise. METHODS The aim of this retrospective study was twofold. First, we sought to give an up-to-date incidence estimate by comparing case presentation over two time periods (1995-1999 and 2008-2011). Data from the England and Wales census in 2001 and 2011 were used for incidence estimation. The second part of this study aimed to generate management guidance from data from medical and radiographic records of the 2008-2011 patient cohort. RESULTS The incidence of adult spontaneous spondylodiscitis in the local region between 2008 and 2011 was 3.67/100,000 per year, representing a 150% increase from the incidence in 1995-1999. Our data demonstrate that methicillin sensitive Staphylococcus aureus remains the most common offending pathogen of spontaneous spondylodiscitis. The mean C-reactive protein (CRP) level remained at >30mg/l after a month of starting antibiotic treatment in both medically and surgically managed groups. CONCLUSIONS Evidence suggests that the incidence of spondylodiscitis is on the rise. A review of our case series has demonstrated the effectiveness of intravenous antibiotic therapy. While no official guidance exists for when to switch from intravenous to oral antibiotics, our study shows that CRP at 1 month is >30mg/l and we recommend 6 weeks of intravenous therapy, followed by 6 further weeks of oral therapy.
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Haploinsufficiency for either one of the type-II regulatory subunits of protein kinase A improves the bone phenotype of Prkar1a+/- mice. Hum Mol Genet 2015; 24:6080-92. [PMID: 26246497 DOI: 10.1093/hmg/ddv320] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 07/31/2015] [Indexed: 01/01/2023] Open
Abstract
Carney Complex (CNC), a human genetic syndrome predisposing to multiple neoplasias, is associated with bone lesions such as osteochondromyxomas (OMX). The most frequent cause for CNC is PRKAR1A deficiency; PRKAR1A codes for type-I regulatory subunit of protein kinase A (PKA). Prkar1a(+/-) mice developed OMX, fibrous dysplasia-like lesions (FDL) and other tumors. Tumor tissues in these animals had increased PKA activity due to an unregulated PKA catalytic subunit and increased PKA type II (PKA-II) activity mediated by the PRKAR2A and PRKAR2B subunits. To better understand the effect of altered PKA activity on bone, we studied Prkar2a and Prkar2b knock out (KO) and heterozygous mice; none of these mice developed bone lesions. When Prkar2a(+/-) and Prkar2b(+/-) mice were used to generate Prkar1a(+/-)Prkar2a(+/-) and Prkar1a(+/-)Prkar2b(+/-) animals, bone lesions formed that looked like those of the Prkar1a(+/-) mice. However, better overall bone organization and mineralization and fewer FDL lesions were found in both double heterozygote groups, indicating a partial restoration of the immature bone structure observed in Prkar1a(+/-) mice. Further investigation indicated increased osteogenesis and higher new bone formation rates in both Prkar1a(+/-)Prkar2a(+/-) and Prkar1a(+/-)Prkar2b(+/-) mice with some minor differences between them. The observations were confirmed with a variety of markers and studies. PKA activity measurements showed the expected PKA-II decrease in both double heterozygote groups. Thus, haploinsufficiency for either of PKA-II regulatory subunits improved bone phenotype of mice haploinsufficient for Prkar1a, in support of the hypothesis that the PRKAR2A and PRKAR2B regulatory subunits were in part responsible for the bone phenotype of Prkar1a(+/-) mice.
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PROGRESSIVE AORTIC DILATATION IS REGULATED BY THE MIR-17 CLUSTER. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Heparin is the Anticoagulant of Choice for a Busy Cardiology Unit? Heart Lung Circ 2013. [DOI: 10.1016/j.hlc.2013.05.515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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577 Aged Cardiac Patients Show Impaired Mesenchymal Stem Cell Differentiation to a Myogenic Phenotype Due to Depressed WNT/β-Catenin Signaling. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract 1360: A mouse model of double heterozygosity for protein kinase A regulatory subunits promotes osteoblastic differentiation of cAMP-induced bone tumors. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-1360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Carney Complex (CNC) is a multiple neoplasia syndrome inherited in an autosomal dominant manner and causing various endocrine and bone tumors. The PRKAR1A gene coding for the regulatory subunit type 1A of protein kinase A (PKA) is mutated in CNC patients, but tumorogenesis mechanisms are not well understood. Regulatory subunits suppress activity of catalytic subunits of PKA responsible for cAMP signaling and cell differentiation and maturation. Mice with a deleted prkar1a allele develop a variety of tumors overlapping those of CNC patients. Deletion of a catalytic subunit allele prkaca+/− on the prkar1a+/ background unexpectedly increased the numer and aggressiveness of bone tumors without development of schwannomas or thyroid lesions. Cells from prkar1a+/−prkaca+/ tumors have more type II PKA complexes, indicating that unbalanced expression of type II and type I regulatory subunits may also dysregulates PKA catalytic activity, potentially increasing tumorigenesis. Methods: To explore this hypothesis, single mice with single alleles of prkar1a, prkar2a and prkar2b were crossed to generate heterozygous mice for double heterozygotes prkar1a+/−/prkar2a+/− or prkar1a+/−/prkar2b+/− and double knockouts. The resulting mice of 3,6,9,12,18 month age were phenotyped and compared to prkar1a+/−. Tumor specimens were examined by histology, polarized microscopy and confocal Raman micro-spectroscopy. Results: Mice with both alleles prkar1a+/+ did not develop any tumors. Double heterozygotes developed bone tumors whose onset age was delayed to 9 months in prkar1a+/−/prkar2b+/− mice compared to 3-6 months in the others. However, the mean number of tumors per animal became similar for prkar1a+/− and double heterozygotes by 12 months. Histology of the bone tumors showed abnormal proliferation of a fibroblastoid-like cell with better osteogenic differentiation in the lesions from double heterozygous mice. Polarized microscopy and Raman micro-spectroscopy revealed that bone material growing in tumors was immature and poorly organized in prkar1a+/− mice (disorganized collagen and osteocytes and undermineralized matrix). Prkar2α+/− deletion on the prkar1α+/− background rescued local organization and mineralization but worsened global organization of cortical tumor bone. The prkar1a+/−/prkar2b+/− deletion rescued both global and local organization and mineralization, resulting in formation of mature bone. Conclusion: Prkar1a haploinsufficiency requires both prkar2a and prkar2b for tumorigenesis in most tissues except bone. In bone, however, prkar1a is the major tumor-suppressor gene. Unexpectedly, Prkar2b or prkar2a deficiencies in addition to prkar1a lead to better differentiation of bone tumors, indicating a compensating role for the type II regulatory subunits in bone tumirogenesis.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1360. doi:1538-7445.AM2012-1360
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In vitro studies of novel PRKAR1A mutants that extend the predicted RIα protein sequence into the 3'-untranslated open reading frame: proteasomal degradation leads to RIα haploinsufficiency and Carney complex. J Clin Endocrinol Metab 2012; 97:E496-502. [PMID: 22205709 PMCID: PMC3319211 DOI: 10.1210/jc.2011-2220] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Carney complex (CNC) is a multiple endocrine neoplasia syndrome due to inactivating mutations in the PRKAR1A gene that codes for type Iα regulatory (RIα) subunit of protein kinase A. Most PRKAR1A mutations are subject to nonsense mRNA decay (NMD) and, thus, lead to haploinsufficiency. METHODS AND SETTING Patient phenotyping for CNC features and DNA, RNA, protein, and transfection studies were carried out at a research center. RESULTS We describe in unrelated kindreds with CNC four naturally occurring PRKAR1A mutations (1055del4, 1067del4ins5, 1076delTTins13, and 1142del4) that are predicted to escape NMD because they are located in the last coding exon of the gene. The phenotype of CNC was not different from that in other patients with the condition, although the number of patients was small. Each of the mutations caused a frameshift that led to a new stop codon into the 3' untranslated open reading frame, predicting an elongated protein that, however, was absent in patient-derived cells. After site-directed mutagenesis, in vitro transcription, and cell-free translation experiments, the expected size mutant proteins were present. However, when the mutant constructs were transfected in adrenal (NCI-295), testicular (N-TERA), and embryonic (HEK293) cells and despite the presence of the mutant mRNA, Western blot analysis indicated that there were no longer proteins. The subsequent application of proteasome inhibitors to cells transfected with the mutant constructs led to the detection of the aberrant proteins, although a compound that affects protein folding had no effect. The wild-type protein was also decreased in both patient-derived cells and/or tissues as well as in the in vitro systems used in this study. CONCLUSIONS This was the first demonstration of proteasomal degradation of RIα protein variants leading to PRKAR1A haploinsufficiency and CNC, adding protein surveillance to NMD in the cellular mechanisms overseeing RIα synthesis. In agreement with the molecular data, CNC patients bearing PRKAR1A defects that extend the open reading frame did not have a different phenotype, although this has to be confirmed in a larger number of patients.
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Efficient derivation and genetic modifications of human pluripotent stem cells on engineered human feeder cell lines. Stem Cells Dev 2012; 21:2298-311. [PMID: 22225458 DOI: 10.1089/scd.2011.0688] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Derivation of pluripotent stem cells (iPSCs) induced from somatic cell types and the subsequent genetic modifications of disease-specific or patient-specific iPSCs are crucial steps in their applications for disease modeling as well as future cell and gene therapies. Conventional procedures of these processes require co-culture with primary mouse embryonic fibroblasts (MEFs) to support self-renewal and clonal growth of human iPSCs as well as embryonic stem cells (ESCs). However, the variability of MEF quality affects the efficiencies of all these steps. Furthermore, animal sourced feeders may hinder the clinical applications of human stem cells. In order to overcome these hurdles, we established immortalized human feeder cell lines by stably expressing human telomerase reverse transcriptase, Wnt3a, and drug resistance genes in adult mesenchymal stem cells. Here, we show that these immortalized human feeders support efficient derivation of virus-free, integration-free human iPSCs and long-term expansion of human iPSCs and ESCs. Moreover, the drug-resistance feature of these feeders also supports nonviral gene transfer and expression at a high efficiency, mediated by piggyBac DNA transposition. Importantly, these human feeders exhibit superior ability over MEFs in supporting homologous recombination-mediated gene targeting in human iPSCs, allowing us to efficiently target a transgene into the AAVS1 safe harbor locus in recently derived integration-free iPSCs. Our results have great implications in disease modeling and translational applications of human iPSCs, as these engineered human cell lines provide a more efficient tool for genetic modifications and a safer alternative for supporting self-renewal of human iPSCs and ESCs.
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Mutations and polymorphisms in the gene encoding regulatory subunit type 1-alpha of protein kinase A (PRKAR1A): an update. Hum Mutat 2010; 31:369-79. [PMID: 20358582 DOI: 10.1002/humu.21178] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PRKAR1A encodes the regulatory subunit type 1-alpha (RIalpha) of the cyclic adenosine monophosphate (cAMP)-dependent protein kinase (PKA). Inactivating PRKAR1A mutations are known to be responsible for the multiple neoplasia and lentiginosis syndrome Carney complex (CNC). To date, at least 117 pathogenic variants in PRKAR1A have been identified (online database: http://prkar1a.nichd.nih.gov). The majority are subject to nonsense mediated mRNA decay (NMD), leading to RIalpha haploinsufficiency and, as a result, activated cAMP signaling. Recently, it became apparent that CNC may be caused not only by RIalpha haploinsufficiency, but also by the expression of altered RIalpha protein, as proven by analysis of expressed mutations in the gene, consisting of amino acid substitutions and in-frame genetic alterations. In addition, a new subgroup of mutations that potentially escape NMD and result in CNC through altered (rather than missing) protein has been analyzed-these are frame-shifts in the 3' end of the coding sequence that shift the stop codon downstream of the normal one. The mutation detection rate in CNC patients is recently estimated at above 60%; PRKAR1A mutation-negative CNC patients are characterized by significant phenotypic heterogeneity. In this report, we present a comprehensive analysis of all presently known PRKAR1A sequence variations and discuss their molecular context and clinical phenotype.
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Abstract
A 9-month-old p53-null female mouse was found dead in its cage. At necropsy, a large thymic mass encompassed the heart. Microscopically, the mass was composed of numerous varying-sized cysts lined with simple squamous epithelial cells to columnar ciliated cells. Also present within this mass was a large aggregate of loosely arranged fusiform-shaped cells. These cells also were found in smaller numbers in the connective tissue surrounding the cysts. The larger aggregate of fusiform cells was positive for desmin and S-100 and negative for smooth muscle actin. Electron microscopy revealed well-formed Z lines and I bands of skeletal muscle phenotype. A diagnosis of rhabdomyoma within a congenital multilocular thymic cyst was made. The thymus contains a small population of myoid cells, which should be taken in consideration when evaluating thymic tumors.
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Ultrasound-guided lumbar plexus block through the acoustic window of the lumbar ultrasound trident. Br J Anaesth 2008; 100:533-7. [DOI: 10.1093/bja/aen026] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ultrasound-guided sciatic nerve block: description of a new approach at the subgluteal space. Br J Anaesth 2007; 98:390-5. [PMID: 17307781 DOI: 10.1093/bja/ael364] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Sciatic nerve block is frequently used for anaesthesia or analgesia during orthopaedic foot surgery and there are several different approaches to the sciatic nerve. This report describes a new approach to the sciatic nerve using ultrasound. Local anesthetic was injected into the 'subgluteal space' under ultrasound guidance which was effective in producing sciatic nerve block in a small series of five patients. The anatomy, sonographic features, technique of identifying the subgluteal space, and potential advantages of this approach to the sciatic nerve are discussed.
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Abstract
2512 Background: The vast majority of carcinomas express either MUC-1 or CEA. Preclinical and clinical studies have demonstrated that induction of T-cell responses directed against CEA and MUC-1 can lead to anti-tumor activity without toxicity. Two novel vaccines have been developed: (a) PANVAC-V (V) a recombinant vaccinia virus containing CEA and MUC-1 with modified agonist epitopes and 3 costimulatory molecule transgenes, and (b) PANVAC-F (F) a similar recombinant fowlpox virus. Methods: This pilot study enrolled 25 pts with metastatic carcinoma who had progressive disease after chemotherapy. Pts received V priming followed by F boosts every 2 weeks × 3 then monthly with restaging scans every 2 months while on study. All vaccines were given with sargramostim at the vaccine site. The primary endpoint was safety. Class I and class II immune responses to CEA were analyzed. Class I responses were assayed by ELISPOT, intracellular cytokine, and tetramer binding; and class II responses were assayed by ELISA using CEA protein and class II peptides. Results: Treatment was well tolerated with 135 cycles given. Only one grade 3 toxicity (syncope during a flu-like illness) was possibly related to vaccine. Apart from injection site reactions, only 9 cycles (7%) were associated with transient grade 2 toxicity (generally flu-like syndromes). Class I and class II immunologic responses were demonstrated. A pt with metastatic breast cancer and 5 large liver metastasis had a 24% decrease in unidimensional measurement of disease for 6 months. A pt with metastatic gastric cancer had stable disease for 5 months. Furthermore, a pt with metastatic clear cell ovarian cancer s/p chemotherapy had complete disappearance of large volume, symptomatic ascites accompanied by marked improvement in the appearance of mesenteric stranding and a CA-125 reduction from 281 U/mL to continued sustained normal values (< 20 U/mL). Conclusions: This vaccine can be given safely and can generate therapy specific immunologic responses. In addition 1 pt with metastatic ovarian cancer had a dramatic clinical response. Based on this, we have initiated a pilot study specifically for ovarian cancer pts to gain more information on which to base a large clinical endpoint trial. No significant financial relationships to disclose.
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P-290 Manganese superoxide dismutase and catalase geneticpolymorphisms, activity levels and lung cancer risk in Chinese in Hong Kong. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80784-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
BACKGROUND Body mass index (BMI) is frequently related to percentage body fat. Nevertheless the relationship between BMI and fat mass/height2 (FM/H2), theoretically, should be more appropriate. AIM This study seeks to evaluate the relationship between BMI and both percentage body fat and FM/H2 in a group of Chinese Australian females. SUBJECTS AND METHODS Forty subjects took part in the study and all were Chinese females resident in Brisbane, Australia. Body mass index was calculated from height and weight. Percentage body fat and fat mass were calculated from measurements of total body water. RESULTS The use of BMI to predict FM/H2 accounted for double the variance of that found when BMI was used to predict percentage body fat. CONCLUSIONS As a consequence, it is possible that the use of BMI to predict FM/H2 and not percentage body fat in the first instance may prove to be more useful in a number of adult populations. Nevertheless, with a relatively small sample size it is difficult, if not impossible, to test the developed equations on a validation group and further investigation into the findings described in this paper needs to be undertaken.
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The prediction of body composition in Chinese Australian females. Int J Obes (Lond) 2001; 25:286-91. [PMID: 11410833 DOI: 10.1038/sj.ijo.0801473] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/1999] [Revised: 07/26/2000] [Accepted: 08/07/2000] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine the efficacy of applying specific body composition techniques to, and assess the relationship between body mass index (BMI) and body fat levels for Chinese Australian females. DESIGN Statistical comparative analysis of body composition techniques. SUBJECTS Australian resident females of Chinese extraction (n=40) (aged 18-45 y, mean 32.5+/-8.0; BMI range 15.7-30.9 kg/m2, mean 21.7+/-3.1 kg/m2, median 20.8 kg/m2). MEASUREMENTS Body composition determined using bio-electrical impedance analysis (BIA), the skin-fold equations of Durnin and Womersley (D&W) and a deuterium dilution technique. Body size was calculated as the body mass index (BMI) weight/height(2) (kg/m2). RESULTS With a median BMI of 20.8, range 15.7-30.9, an acceptable BMI existed for 87.5% of the subjects (mean (s.d.) 21.7+/-3.1 kg/m2). Percentage fat mass (%FM) from the deuterium dilution technique (mean (s.d.) 35.6+/-6.4) suggested 75% were overweight or obese. %FM from the D&W equation (mean (s.d.) 28.0+/-3.9) and BIA (mean (s.d.) 29.4+/-5.1) also indicated a tendency towards overweight or obese. The deuterium technique was significantly correlated and significantly different to the D&W eqn, r=0.71 P=0.001; and BIA, r=0.77, P=0.001. Bland and Altman analysis indicated that bias existed between the techniques (BIA mean (s.d.)-6.7+/-4.1) and D&W equation mean (s.d.)-6+/-4.5) when compared to the deuterium method. CONCLUSIONS Despite a low mean BMI, body fat levels determined by the three methods suggested that, overall, an unsatisfactory body composition existed. The levels of overweight and obesity (%FM>30) were higher than reported in previous research despite a mean BMI lower than the Australian national average. Comparative analysis suggested that the body fat prediction techniques used may be precise but not accurate. Comparative results obtained for the BIA and D&W equation techniques suggest an overestimation of body fat levels for leaner individuals and under estimation for overfat individuals. The results support the notion that accurate determination of body composition and the determination of appropriate body size may require equations developed for specific ethnic populations.
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Effective treatment of high-grade lymphoproliferative disorder after renal transplantation using autologous lymphocyte activated killer cell therapy. Am J Kidney Dis 1998; 32:813-9. [PMID: 9820452 DOI: 10.1016/s0272-6386(98)70138-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Posttransplantation lymphoproliferative disorders (PTLD) is not uncommon and can occur in 2% to 5% of solid organ recipients on immunosuppression. Epstein-Barr virus (EBV) infection or reactivation and intensive anti-T lymphocyte treatment are important pathogenetic factors for a large proportion of these disorders. Nonclonal lesions with polymorphous histology have a potential for regressing when the immunosuppressants are reduced or stopped. Clonal tumors with a monomorphous histology carry a poor prognosis, and the mortality rate for monoclonal lymphoma has been reported as high as 80%. We report a renal transplant recipient who developed high-grade monoclonal lymphoma only 4 months after a live-donor transplantation. The tumor was EBV positive. Reduction of immunosuppressants resulted in minimal regression of the tumor. The patient was treated with adoptive immunotherapy using ex vivo generation of autologous lymphocyte activated killer (LAK) cells. She had leukapheresis, and autologous peripheral blood mononuclear cells were obtained and cultured in interleukin-2 (IL-2)-rich medium for 9 to 10 days. The IL-2-activated LAK cells were reinfused into the patient without any systemic administration of IL-2. The patient experienced no side effects during the infusion. There was no rejection episode, and the renal function of the patient remained stable after treatment. Computed tomography scan performed 2 months after the infusion showed marked regression of the lesions in the liver and spleen. Five months later, magnetic resonance imaging showed complete resolution of the tumor lesions. Ultrasonography 13 months after the LAK cell infusion showed no lesion. The allograft function was not affected after treatment. Adoptive immunotherapy using IL-2-activated autologous LAK cells was effective in treating this renal transplant patient with EBV-positive high-grade lymphoma. The patient's kidney allograft functioned well without any rejection.
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Modelling cortical cataractogenesis XX. In vitro effect of alpha-lipoic acid on glutathione concentrations in lens in model diabetic cataractogenesis. BIOCHEMISTRY AND MOLECULAR BIOLOGY INTERNATIONAL 1998; 46:585-95. [PMID: 9818098 DOI: 10.1080/15216549800204112] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In previous studies stereospecific protection against lens opacity was consistent with specific reduction of R-alpha-lipoic acid(R-alpha-LA) in mitochondria of the vulnerable cells at the lens equator where the first globular degeneration is seen in glucose cataract. In this study two further possible explanations of this effect were investigated: (1) increased glucose uptake by the lens, leading to increased glycolysis and release of lactate into the incubation medium and/or (2) maintenance of glutathione levels by the R-alpha-LA. The data did not support 1, but was consistent with 2, after 24 hr incubation. The concentrations of glutathione in normal lenses or lenses incubated with R- or racemic alpha-LA were not significantly different, but the concentration of glutathione in lenses incubated with S-alpha-LA was significantly lower than the R-alpha-LA-incubated lenses.
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Abstract
To evaluate ozone damage to hairless mouse skin, two parameters of oxidative damage, vitamin E depletion and malondialdehyde (MDA) production, were measured in vitamin E-enriched and in control skin from mice exposed to ozone (10 ppm). A 5% vitamin E solution (tocotrienol-rich fraction, TRF) in polyethylene glycol (PEG) was applied to 2 sites on the back of hairless mice, PEG to 2 sites. After 2 h, the sites were washed, one of each pair of sites covered and the mice exposed ozone for 2 h. Ozone exposure (compared with covered sites) increased epidermal MDA in PEG-treated sites, while vitamin E was unchanged. In contrast, ozone exposure significantly depleted vitamin E in TRF-treated sites, while significant MDA accumulation was prevented. This is the first demonstration that ozone exposure causes damage to cutaneous lipids, an effect which can be attenuated by vitamin E application.
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In vivo exposure to ozone depletes vitamins C and E and induces lipid peroxidation in epidermal layers of murine skin. Free Radic Biol Med 1997; 23:385-91. [PMID: 9214574 DOI: 10.1016/s0891-5849(96)00617-x] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To evaluate skin susceptibility to ozone (O3) and to localize possible oxidative damage within the skin layers, hairless mice were exposed to 10 ppm O3 or air (0 ppm O3) for 2 h. The mice were euthanized, the skin removed and frozen. Three skin layers (upper epidermis, lower epidermis/papillary dermis, and dermis) were separated, antioxidant concentrations (alpha-tocopherol and ascorbic acid) and the lipid peroxidation product malondialdehyde (MDA) measured. In the upper epidermis, O3 significantly depleted alpha-tocopherol (22%; p < .05) and ascorbic acid (55%; p < .01). These antioxidants were unchanged by O3 in the lower skin layers. More remarkably, MDA increased ten-fold in the upper epidermis (p < .001) and two-fold in the lower epidermis/papillary epidermis (p < .05); it was unchanged in the dermis. Thus, exposure to O3 in vivo depletes ascorbic acid and alpha-tocopherol and strongly induces lipid peroxidation in skin. High MDA concentrations measured in the upper epidermis suggest that O3 reacts directly with fatty acids on the skin surface layers. These results further suggest that chronic exposure to lower O3 concentrations found in urban smog could potentially have implications for skin health.
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Thalidomide-responsive chronic pulmonary GVHD. Bone Marrow Transplant 1997; 19:95-6. [PMID: 9012941 DOI: 10.1038/sj.bmt.1700613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Cell mediated cytotoxicity of human colon carcinoma cells by a monoclonal antibody (R4) recognizing the carcinoembryonic antigen (CEA) and CEA-related molecules. Int J Oncol 1996; 8:1127-35. [DOI: 10.3892/ijo.8.6.1127] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Primary lymphoma of the kidney in the acquired immunodeficiency syndrome. Arch Pathol Lab Med 1994; 118:10. [PMID: 8285827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Primary lymphoma of the kidney in the acquired immunodeficiency syndrome. Arch Pathol Lab Med 1993; 117:541-3. [PMID: 8489348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
An increased incidence of lymphoma has been reported in patients with the acquired immunodeficiency syndrome. Malignant lymphomas that develop within this setting of impaired immune surveillance have distinctive clinical, histologic, and molecular biologic characteristics. Histologically, the majority of these lymphomas are small noncleaved cell or immunoblastic lymphomas, and are B-cell phenotype by immunophenotypic and immunoglobulin gene rearrangement studies. In contrast with malignant lymphoma occurring in the general population, extranodal origin is common in acquired immunodeficiency syndrome-related non-Hodgkin's lymphomas, with the central nervous system, bone marrow, gastrointestinal tract, and liver being the most common sites. To the best of our knowledge, there has been no description in the literature of primary renal lymphoma occurring in patients with the acquired immunodeficiency syndrome. We report an unusual case of primary non-Hodgkin's lymphoma (diffuse B-cell immunoblastic type) of the kidney in a patient with the acquired immunodeficiency syndrome.
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Vascular proliferation of the thyroid. A complication of fine-needle aspiration. Arch Pathol Lab Med 1992; 116:1040-2. [PMID: 1417444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Fine-needle aspiration (FNA) of the thyroid has a low morbidity rate, with hematoma formation being the most commonly encountered complication. We describe two cases of exuberant vascular proliferation within the thyroid gland, one resembling a cavernous hemangioma and the other with similar changes but with areas of papillary endothelial hyperplasia. Both lesions occurred in patients with a recent history of FNA prior to the thyroidectomy procedure. The vascular proliferation was interpreted as organizational changes in a hematoma secondary to the FNA. These cases, in conjunction with a recent case of Masson's vegetant intravascular hemangioendothelioma complicating thyroid FNA, expand the literature on vascular proliferations that may develop subsequent to thyroid FNA.
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Oxygen partial-density-of-states change in the YBa2Cu3Ox compounds for x. PHYSICAL REVIEW. B, CONDENSED MATTER 1989; 39:4796-4799. [PMID: 9948859 DOI: 10.1103/physrevb.39.4796] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Electronic structure of the icosahedral and other phases of aluminum-manganese alloys studied by soft-x-ray emission spectroscopy. PHYSICAL REVIEW. B, CONDENSED MATTER 1988; 37:8594-8597. [PMID: 9944219 DOI: 10.1103/physrevb.37.8594] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Al L2,3 and Mg double-ionization emission spectra of dilute Al in Mg alloys. PHYSICAL REVIEW. B, CONDENSED MATTER 1988; 37:2401-2407. [PMID: 9944784 DOI: 10.1103/physrevb.37.2401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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Soft x-ray absorption and emission spectra and the electronic structure of the Ba2YCu3O7-x superconductor. PHYSICAL REVIEW. B, CONDENSED MATTER 1988; 37:2293-2296. [PMID: 9944757 DOI: 10.1103/physrevb.37.2293] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
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