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Larson A, Weisfeld-Adams JD, Benke TA, Bonnen PE. Cerebrotendinous Xanthomatosis Presenting with Infantile Spasms and Intellectual Disability. JIMD Rep 2016; 35:1-5. [PMID: 27858369 DOI: 10.1007/8904_2016_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/15/2016] [Accepted: 09/20/2016] [Indexed: 01/05/2023] Open
Abstract
Cerebrotendinous xanthomatosis (CTX) is an inborn error of metabolism leading to progressive multisystem disease. Symptoms often begin in the first decade of life with chronic diarrhea, cataracts, developmental delay, intellectual disability, and cerebellar or pyramidal dysfunction. Later manifestations include tendon xanthomas, polyneuropathy, and abnormal neuroimaging. Pathogenic biallelic variants in CYP27A1 leading to compromised function of sterol 27-hydroxylase result in accumulation of detectable toxic intermediates of bile acid synthesis rendering both genetic and biochemical testing effective diagnostic tools. Effective treatment with chenodeoxycholic acid is available, making early diagnosis critical for patient care. Here we report a new patient with CTX and describe the early signs of disease in this patient. Initial symptoms included infantile spasms, which have not previously been reported in CTX. Developmental delay, mild intellectual disability with measured cognitive decline in childhood, was also observed. These clinical signs do not traditionally compel testing for CTX, and we highlight the need to consider this rare but treatable disorder among the differential diagnosis of children with similar clinical presentation. Increased awareness of early signs of CTX is important for improving time to diagnosis for this patient population.
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Gordon A, White S, Gates V, Procissi D, Li W, Harris K, Kim D, Omary R, Zhang Z, Salem R, Lewandowski R, Larson A. 90Y radiation lobectomy in the rodent model: dose-dependent induction of radiation fibrosis and hepatic volume changes in normal liver. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.071] [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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KIM Y, Kim D, Jeon M, Gordon A, Larson A, Chung J. Intraarterial targeted delivery of porous magnetic nano-clusters combined with iodinated oil in a liver cancer model. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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54
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Kern E, Lin D, Larson A, Yang GY, Taft T, Zalewski A, Gonsalves N, Hirano I. Prospective assessment of the diagnostic utility of esophageal brushings in adults with eosinophilic esophagitis. Dis Esophagus 2016; 29:48-53. [PMID: 25515533 DOI: 10.1111/dote.12304] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patients with eosinophilic esophagitis (EoE) undergo multiple endoscopies with biopsy for both diagnosis and assessment of treatment response, which is inconvenient and costly. Brush cytology has been examined in Barrett's esophagus to reduce the need for repeated endoscopic biopsies. The aim of this pilot study was to evaluate the ability of brush cytology to detect mucosal eosinophilia in patients with EoE. This prospective study included adults with untreated and treated esophageal eosinophilia undergoing endoscopy at a tertiary care center. Patients received paired brushings and biopsies at the proximal and distal esophagus. A blinded pathologist quantified the number of eosinophils and epithelial cells per high-power field (hpf) on the cytology slides. The ratio of eosinophils/epithelial cells was used to normalize the cytology specimens for density of cells collected. The main outcome measures were sensitivity and specificity of brush cytology, and correlation between cytology and histology. Twenty-eight patients enrolled. The average age of the cohort was 37.7 ± 10.4 years; 75% of subjects were male. The sensitivity of cytology was 67-69% at the proximal esophagus and 70-72% at the distal esophagus. The specificity was 61-67% proximally and 70-75% distally. Histology was not significantly correlated with the max ratio of eosinophils/epithelial cells per hpf or the absolute number of eosinophils on cytology slides. Cytology using esophageal brushing has limited sensitivity and specificity for the detection of esophageal mucosal eosinophilia. The presence of exudates on endoscopy increased the detection of eosinophilia, which could make cytology useful in pediatric EoE, which often has a more exudative presentation. Diagnostic yield may improve with alternative acquisition techniques or the incorporation of eosinophil degranulation proteins.
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Larson A, Nokoff NJ, Meeks NJL. Genetic causes of pituitary hormone deficiencies. DISCOVERY MEDICINE 2015; 19:175-183. [PMID: 25828521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In recent decades, dozens of genes that cause isolated and combined pituitary hormone deficiencies have been discovered. We will review the clinically relevant genes known to cause isolated and combined pituitary hormone deficiencies in humans. This review will address genetic causes of adrenocorticotropic hormone deficiency, thyroid stimulating hormone deficiency, growth hormone deficiency, hypogonadotropic hypogonadism, and diabetes insipidus. Additionally, we will discuss genetic causes of combined pituitary hormone deficiency, septo-optic dysplasia, holoprosencephaly, and multisystemic syndromes in which hypopituitarism is a significant component. With the widespread clinical availability of next generation sequencing and ongoing identification of new disease causing genes, genetic diagnoses are determined for increasing numbers of patients. With new insights into mechanisms of disease resulting from multiple gene interactions, an increasingly nuanced understanding of the underlying genetic etiology of pituitary hormone deficiencies is possible.
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Saldívar-Ramírez MMG, Sánchez-Torres CG, Cortés-Hernández DA, Escobedo-Bocardo JC, Almanza-Robles JM, Larson A, Reséndiz-Hernández PJ, Acuña-Gutiérrez IO. Study on the efficiency of nanosized magnetite and mixed ferrites in magnetic hyperthermia. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2014; 25:2229-2236. [PMID: 24573458 DOI: 10.1007/s10856-014-5187-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 02/18/2014] [Indexed: 06/03/2023]
Abstract
Magnetic materials, which have the potential for application in heating therapy by hyperthermia, were prepared. This alternative treatment is used to eliminate cancer cells. Magnetite, magnesium-calcium ferrites and manganese-calcium ferrites were synthesized by sol-gel method followed by heat treatment at different temperatures for 30 min in air. Materials with superparamagnetic behavior and nanometric sizes were obtained in all the cases. Thus, these nanopowders may be suitable for their use in human tissue. The average sizes were 14 nm for magnetite, 10 nm for both Mg(0.4)Ca(0.6)Fe(2)O(4) and Mg(0.6)Ca(0.4)Fe(2)O(4) and 11 nm for Mn(0.2)Ca(0.8)Fe(2)O(4). Taking into account that the Mg(0.4)Ca(0.6)Fe(2)O(4) and Mg(0.6)Ca(0.4)Fe(2)O(4) treated at 350 °C showed the lower coercivity values, these nanoparticles were selected for heating tests and cell viability. Heating curves of Mg(0.4)Ca(0.6)Fe(2)O(4) subjected to a magnetic field of 195 kHz and 10 kA/m exhibited a temperature increase up to 45 °C in 15 min. A high human osteosarcoma cell viability of 90-99.5% was displayed. The human osteosarcoma cell with magnesium-calcium ferrites exposed to a magnetic field revealed a death cell higher than 80% in all the cases.
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Larson A, Tebbe H, Loschky L. The Time-Course of Scene and Action Categorization in Dynamic Videos. J Vis 2014. [DOI: 10.1167/14.10.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Loschky L, Larson A, Magliano J, Smith T. What Would Jaws Do? The tyranny of film and the relationship between gaze and higher-level comprehension processes for narrative film. J Vis 2014. [DOI: 10.1167/14.10.761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Coy A, Ringer R, Larson A, Luczak M, Loschky L. Investigating visual crowding of objects in complex scene images. J Vis 2014. [DOI: 10.1167/14.10.779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Wangler MF, Gonzaga-Jauregui C, Gambin T, Penney S, Moss T, Chopra A, Probst FJ, Xia F, Yang Y, Werlin S, Eglite I, Kornejeva L, Bacino CA, Baldridge D, Neul J, Lehman EL, Larson A, Beuten J, Muzny DM, Jhangiani S, Gibbs RA, Lupski JR, Beaudet A. Heterozygous de novo and inherited mutations in the smooth muscle actin (ACTG2) gene underlie megacystis-microcolon-intestinal hypoperistalsis syndrome. PLoS Genet 2014; 10:e1004258. [PMID: 24676022 PMCID: PMC3967950 DOI: 10.1371/journal.pgen.1004258] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 02/04/2014] [Indexed: 12/15/2022] Open
Abstract
Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a rare disorder of enteric smooth muscle function affecting the intestine and bladder. Patients with this severe phenotype are dependent on total parenteral nutrition and urinary catheterization. The cause of this syndrome has remained a mystery since Berdon's initial description in 1976. No genes have been clearly linked to MMIHS. We used whole-exome sequencing for gene discovery followed by targeted Sanger sequencing in a cohort of patients with MMIHS and intestinal pseudo-obstruction. We identified heterozygous ACTG2 missense variants in 15 unrelated subjects, ten being apparent de novo mutations. Ten unique variants were detected, of which six affected CpG dinucleotides and resulted in missense mutations at arginine residues, perhaps related to biased usage of CpG containing codons within actin genes. We also found some of the same heterozygous mutations that we observed as apparent de novo mutations in MMIHS segregating in families with intestinal pseudo-obstruction, suggesting that ACTG2 is responsible for a spectrum of smooth muscle disease. ACTG2 encodes γ2 enteric actin and is the first gene to be clearly associated with MMIHS, suggesting an important role for contractile proteins in enteric smooth muscle disease.
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Larson A, Ringer R, Hutson J, Peterson J, Walton T, O'Dea C, Akao K, Strouts P, Loschky L. Do Scenes Facilitate Action Categorization? J Vis 2013. [DOI: 10.1167/13.9.1051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Larson A, Hendry J, Loschky L. Scene Gist Meets Event Perception: The Time Course of Scene Gist and Event Recognition. J Vis 2012. [DOI: 10.1167/12.9.1077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Loschky L, Ringer R, Larson A, Hughes G, Dean K, Weiser J, Flippo L, Johnson A, Neider M, Kramer A. Developing a New Measure of the Useful Field of View for Use in Dynamic Real-World Scene Viewing. J Vis 2012. [DOI: 10.1167/12.9.564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Bellande B, Winicur Z, Gallo B, Turner M, Saulino M, Heath S, Bennett S, Nelson ME, Reese C, Larson A, Dawidowicz S, Boche J, Cox K. Competency-Based Curricula in DBS and ITB Therapies for Movement Disorders (P06.022). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Larson A, Mandelbaum DE. Association of Head Circumference and Shoulder Dystocia in Macrosomic Neonates. Matern Child Health J 2012; 17:501-4. [DOI: 10.1007/s10995-012-1013-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Larson A, Wallace C, McQuade M, Badke C, Loschky L. The Impact of Scrambling the Order of Episode Components on Perceived Events and Recognition Memory for a Picture Story. J Vis 2011. [DOI: 10.1167/11.11.1132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Loschky L, Hansen B, Fintzi A, Bjerg A, Ellis K, Freeman T, Hilburn S, Larson A. Basic level scene categorization is affected by unrecognizable category-specific image features. J Vis 2010. [DOI: 10.1167/9.8.948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Larson A, Loschky L, Pollock W, Bjerg A, Hilburn S, Smerchek S. Variation in scene gist recognition over time in central versus peripheral vision. J Vis 2010. [DOI: 10.1167/9.8.967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Larson A, Loschky L, Ringer R, Kridner C. Attention modulates gist performance between central and peripheral vision. J Vis 2010. [DOI: 10.1167/10.7.1250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
To identify the forces directing organismal evolution, a general analytical system is developed to synthesize structuralist and Darwinian traditions in an explicitly historical framework. Morphological features of lungless salamanders are examined to identify hierarchical systems of developmental and functional constraint on evolution and their interactions with processes at the genic and populational levels. Characteristic patterns of change occur repeatedly in the evolutionary history of this group.
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Loschky L, Larson A, Smerchek S, Finan S. The superordinate natural/man-made distinction is perceived before basic level distinctions in scene gist recognition. J Vis 2010. [DOI: 10.1167/8.6.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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72
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Larson A, Loschky L, Matz E, Smerchek S, Weber P, Berger L. The roles of central versus peripheral visual information in recognizing scene gist. J Vis 2010. [DOI: 10.1167/8.6.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Chung J, Sato K, Omary R, Larson A, Wang D. Abstract No. 99: 4D TRIP-MRI monitoring of radiofrequency ablation of VX2 tumors in rabbit livers. J Vasc Interv Radiol 2010. [DOI: 10.1016/j.jvir.2009.12.250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Noren DP, Johnson AH, Rehder D, Larson A. Close approaches by vessels elicit surface active behaviors by southern resident killer whales. ENDANGER SPECIES RES 2009. [DOI: 10.3354/esr00205] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Barrett M, Larson A, Carville K, Ellis I. Challenges faced in implementation of a telehealth enabled chronic wound care system. Rural Remote Health 2009; 9:1154. [PMID: 19705955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION In the rural Midwest region of Western Australia (WA), wound care is a major burden on the healthcare system. Optimal wound care was found to be impeded by issues that included the involvement of multiple healthcare providers, incomplete and inconsistent documentation, and limited access to expert review. A telehealth solution was trailed in 2007. OBJECTIVE To describe the systemic barriers encountered in implementing a telehealth program in rural WA and to provide recommendations for future telehealth initiatives. METHODS This study trialled the use of a shared electronic wound imaging and reporting system in combination with an expert remote wound consultation service for the management of patients with chronic wounds in the Midwest of WA. The trial sites included rural hospital out-patient clinics, a private domiciliary nursing service, residential aged care facilities, general practices and a podiatry clinic. The implementation conformed to accepted best practice in introducing telehealth initiatives. RESULTS During the trial 12 sites had the relevant software installed and were able to access a central server. Although a total of 41 patients with chronic wounds were enrolled, four sites did not enroll any patients and only two sites successfully incorporated the system into regular practice. Major obstacles were workforce issues and significant delays in installing the software at some sites. Only 47% of the healthcare providers trained to use the software at the beginning of the trial were still employed when the trial ended. Prolonged periods of vacant positions at one remote clinic and an aged care facility made it impossible for the remaining providers to allocate time for using the wound care software. CONCLUSION The disease burden of the patient group, funding models and workforce shortages frustrated the successful adoption of an evidence based strategy that was known to improve health outcomes.
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