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Lehnert J, Cha K, Halperin J, Yang K, Zheng DF, Khadra A, Cook EP, Krishnaswamy A. Visual attention to features and space in mice using reverse correlation. Curr Biol 2023; 33:3690-3701.e4. [PMID: 37611588 DOI: 10.1016/j.cub.2023.07.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/17/2023] [Accepted: 07/27/2023] [Indexed: 08/25/2023]
Abstract
Visual attention allows the brain to evoke behaviors based on the most important visual features. Mouse models offer immense potential to gain a circuit-level understanding of this phenomenon, yet how mice distribute attention across features and locations is not well understood. Here, we describe a new approach to address this limitation by training mice to detect weak vertical bars in a background of dynamic noise while spatial cues manipulate their attention. By adapting a reverse-correlation method from human studies, we linked behavioral decisions to stimulus features and locations. We show that mice deployed attention to a small rostral region of the visual field. Within this region, mice attended to multiple features (orientation, spatial frequency, contrast) that indicated the presence of weak vertical bars. This attentional tuning grew with training, multiplicatively scaled behavioral sensitivity, approached that of an ideal observer, and resembled the effects of attention in humans. Taken together, we demonstrate that mice can simultaneously attend to multiple features and locations of a visual stimulus.
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Affiliation(s)
- Jonas Lehnert
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada; Quantitative Life Sciences, McGill University, Montreal, QC H3A 1E3, Canada
| | - Kuwook Cha
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada
| | - Jamie Halperin
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada
| | - Kerry Yang
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada
| | - Daniel F Zheng
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada
| | - Anmar Khadra
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada; Quantitative Life Sciences, McGill University, Montreal, QC H3A 1E3, Canada; Centre for Applied Mathematics in Bioscience and Medicine, McGill University, Montreal, QC H3G 0B1, Canada
| | - Erik P Cook
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada; Quantitative Life Sciences, McGill University, Montreal, QC H3A 1E3, Canada; Centre for Applied Mathematics in Bioscience and Medicine, McGill University, Montreal, QC H3G 0B1, Canada.
| | - Arjun Krishnaswamy
- Department of Physiology, McGill University, Montreal, QC H3G 1Y6, Canada; Quantitative Life Sciences, McGill University, Montreal, QC H3A 1E3, Canada.
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Abadie B, Held M, Puri R, Krishnaswamy A, Yun J, Hanna M, Reed G, Kapadia S, Jaber W. Incidence and predictors of transthyretin cardiac amyloidosis in patients with degenerative aortic stenosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1619] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The approval of new therapies for treating transthyretin (TTR) cardiac amyloidosis has led to significant interest in identifying patients at high risk for this disease. Investigators have identified a correlation between severe degenerative aortic stenosis (AS) and TTR cardiac amyloidosis in older patients, with several studies finding up to 20% of patients who undergo transcatheter aortic valve replacement (TAVR) having TTR cardiac amyloidosis. These initial TAVR studies were conducted when TAVR was performed almost exclusively in high surgical risk populations. Therefore, the true incidence of TTR cardiac amyloidosis in an all-comers with severe degenerative AS referred for TAVR is unknown.
Purpose
To identify the true burden of TTR cardiac amyloidosis in a contemporary population of severe degenerative AS undergoing TAVR screening.
Methods
All patients ≥70 years with severe native valve degenerative AS seen in a multidisciplinary valve clinic were referred for technetium-99m pyrophosphate cardiac scintigraphy (PYP scan) for evaluation of cardiac amyloidosis. Diagnosis was made via combination of planar grade and heart to contralateral lung ratio, confirmed on single positron emission computed tomography/computed tomography (SPECT/CT). Patients with a positive PYP scan were referred to a heart failure clinic where they underwent testing for AL amyloidosis.
Results
Over a 10 month period, 247 patients seen in valve clinic underwent a PYP scan. Of this cohort, 203 patients ultimately underwent TAVR, 15 surgical aortic valve replacement, and 2 balloon valvuloplasty with 27 patients having not yet undergone a procedure. The positivity rate was 4% (10/247) with 1 patient having an equivocal result. The patients with a positive PYP scan had higher rate of low-flow low-gradient (LFLG) AS (64% vs 29%, p=0.006) and classical LFLG AS (27% vs 8%, p=0.02). Echocardiographic measures associated with a positive PYP scan include a lower global longitudinal strain (−10.0% vs −16.1%, p=0.008), lower average e' (4.5 vs 6.5, p=0.003), and an increased E/A ratio (1.8 vs 1.1, p=0.018).
Conclusions
The incidence of TTR amyloidosis in a contemporary, severe AS population ≥70 years undergoing TAVR screening appears much lower than previously described in the literature. Echocardiographic traits may be able to predict which patients with severe AS should undergo evaluation for TTR cardiac amyloidosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B Abadie
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - M Held
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - R Puri
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - J Yun
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - M Hanna
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - G Reed
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - S Kapadia
- Cleveland Clinic Foundation , Cleveland , United States of America
| | - W Jaber
- Cleveland Clinic Foundation , Cleveland , United States of America
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Lak H, Sammour Y, Chahine J, Chawla S, Kadri A, Popovic Z, Tarakji K, Svensson LG, Reed G, Puri R, Krishnaswamy A, Kapadia S. Impact of new-onset left bundle branch block on clinical and echocardiographic outcomes after TAVR with SAPIEN-3 valve. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2179] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
New left bundle branch block (LBBB) is a common finding after transcatheter aortic valve replacement (TAVR) that can result in worse outcomes after TAVR. We aim to investigate the impact of new-onset LBBB after TAVR using the SAPIEN-3 (S3) valve.
Methods
Consecutive patients who underwent transfemoral-TAVR with S3 valve between April 2015 and December 2018 were included. Exclusion criteria included pre-existing LBBB, right bundle branch block, left anterior hemiblock, left posterior hemiblock, wide QRS ≥120 msec, prior permanent pacemaker (PPM), and non-transfemoral access.
Results
Among 612 patients, 11.4% developed new-onset LBBB upon discharge. Implantation depth was the only predictor of new-onset LBBB (OR 1.294; 95% CI 1.121–1.493; p<0.001). The median (IQR) length of stay was longer with new-onset LBBB [3 (2–5) days vs. 2 (1–3) days; p<0.001]. New-onset LBBB was associated with higher thirty-day PPM requirement (18.6% vs. 5.4%; p<0.001) including those implanted after discharge (4.3% vs. 0.9%; p=0.02). There was no difference in 3-year all-cause mortality between both groups (30.9% vs. 30.6%; log-rank p=0.829). Further, new-onset LBBB was associated with lower left ventricular ejection fraction (LVEF) at both 30 days (55.9±11.4% vs. 59.3±9%; p=0.026) and 1 year (55±12% vs. 60.1±8.9%; p=0.002) despite no differences at baseline. These changes were still present when we stratified patients according to baseline LVEF (≥50% or <50%). We also noted higher mean LV end-diastolic volume index (51.4±18.6 vs. 46.4±15.1 ml/m2; p=0.036), and LV end-systolic volume index (23.2±14.1 vs. 18.9±9.7 ml/m2; p=0.009) with new-onset LBBB at 1 year. Lastly, there were significantly higher rates of heart failure readmissions at 1 year with new-onset LBBB (10.7% vs. 4.4%; log-rank p=0.033).
Conclusion
Among our cohort of S3 recipients, new-onset LBBB was associated with higher PPM requirement, worse LVEF, higher LV volumes and increased risk of heart failure hospitalizations. However, it did not affect mortality in the short-to-intermediate post-TAVR period.
Funding Acknowledgement
Type of funding sources: None. Figure 1. All-cause Survival
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Affiliation(s)
- H Lak
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - Y Sammour
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - J Chahine
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Chawla
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Kadri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - Z Popovic
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - K Tarakji
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - L G Svensson
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - G Reed
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Puri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic Foundation, Cleveland, United States of America
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Lak H, Sammour Y, Chawla S, Svensson LG, Yun J, Harb S, Reed GW, Puri R, Jaber W, Krishnaswamy A, Kapadia S. Impact of doppler velocity index after transcatheter aortic valve replacement using Sapien-3 valve – a single centre experience. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2178] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Little is known about the hemodynamic performance of Edwards Sapien-3 (S3) valve after Transcatheter Aortic Valve Replacement (TAVR). Doppler velocity index (DVI) is a better indicator of prosthetic valve function as it is independent of valve size and flow, unlike mean gradient and peak velocity which are flow-dependent.
Methods
In this study, we compare outcomes based on differences in DVI among a consecutive series of patients who underwent S3 TAVR between April 2015 and December 2018. Our institutional review board approved the study and informed consents were obtained from the subjects.
Results
Among 921 patients who had follow-up echocardiograms within 30 days after TAVR, 60.8% had DVI ≤0.5, while 39.2% had DVI >0.5. The median 30-day DVI was 0.47 with a standard deviation of 0.11 and mean 0.49 and interquartile range 0.41–0.55. The baseline clinical and procedural characteristics were similar between both groups with the exception of less post-dilation (36.8% vs. 47.4%; p=0.001) and greater implantation depth (2.59±1.99 vs. 2.31±1.9mm; p=0.031) with DVI ≤0.5. The rates of aortic valve calcification, pre dilation, pre-TAVR aortic regurgitation (AR) were similar. At baseline, there were no differences between both groups in mean or peak gradients or aortic velocity time integral (VTI). At 1 year, mean gradients were higher with DVI ≤0.5 (12.7±5.6 vs. 11.1±4.6 mmHg; p=0.001). DVI ≤0.5 was associated with higher peak gradients (24.2±10.2 vs. 21.4±8.7 mmHg; p=0.002), and aortic VTI (51.4±13.5 vs. 46.8±12.2 cm; p<0.001) at 1 year, especially with the 26mm and 29mm prostheses. Compared with DVI>0.5 group, patients in DVI<0.5 group had lower baseline left ventricular ejection fraction (LVEF) (54.5±12.2% vs. 58.9±11.2%; p<0.001), higher left ventricular end-diastolic volume index (LVEDVi) (54.3±20.9 vs. 49.4±17.4 ml/m2; p=0.001), higher LV end-systolic volume index (LVESVi) (25.2±16.5 vs. 21.3±12.7 ml/m2; p=0.001), and similar LV mass index (110.7±31.9 vs. 106.9±32.7 g/m2; p=0.134). 1-year mortality rates among patients who had DVI ≤0.5 compared to DVI >0.5 were lower (6.6% vs. 10.6%; log-rank p=0.033), however no difference was noted at both 2 years (17.3% vs. 20.1%; log-rank p=0.151), and 3 years after TAVR (30.7% vs. 31.2%; log-rank p=0.333).
Conclusions
DVI<0.5 was associated with higher peak gradients and lower baseline LVEF. DVI <0.5 group patients had lower 1-year mortality but similar mortality at 2 and 3-years of follow up.
Funding Acknowledgement
Type of funding sources: None. Figure 1. All-cause SurvivalFigure 2. Hemodynamic Data
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Affiliation(s)
- H Lak
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - Y Sammour
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Chawla
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - L G Svensson
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - J Yun
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Harb
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - G W Reed
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Puri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - W Jaber
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic Foundation, Cleveland, United States of America
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Abushouk AI, Abdelfattah O, Saad A, Gad MM, Reed GW, Puri R, Yun J, Vargo PR, Weiss A, Burns D, Popovic Z, Harb SC, Krishnaswamy A, Svensson LG, Kapadia SR. Late Clinical and Hemodynamic Outcomes in patients with degenerated bioprosthetic aortic valves undergoing transcatheter valve-in-valve implantation. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2200] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Clinical studies have shown promising early outcomes for valve-in-valve transcatheter aortic valve implantation (ViV-TAVI); however, the late outcomes of this procedure remain under-investigated.
Purpose
We performed the present analysis to assess the late clinical and hemodynamic outcomes of ViV-TAVI in patients with degenerated bioprosthetic aortic valves.
Methods
A comprehensive chart review was performed for eligible patients to retrieve data on procedural characteristics, admission details following the procedure, and echocardiographic parameters. Clinical outcomes included all-cause mortality, heart failure hospitalization and structural valve deterioration (SVD), as defined by VARC-II criteria, up to 5 years of follow-up. To assess the trends in mean and peak transvalvular gradients, data from the follow-up echocardiographic reports were analyzed using Syngo Dynamics imaging software.
Results
A total of 188 patients were included with a mean age of 75.8±10.4 years. Balloon- and self-expandable valves were used in 155 (82.4%) and 33 (17.6%) patients, respectively. At 30 days, 3 (1.6%) patients died and 8 (4.2%) required hospitalization for heart failure, while at 5 years, both events were recorded in 29 (15.4%) and 37 (19.7) patients, respectively. Kaplan-Meier survival analysis showed that patients with smaller surgical valves (internal diameter ≤21 mm) had a significantly higher mortality rate (log-rank p=0.021) than those with larger valves; however, no significant difference (log-rank p=0.59) was detected between different transcatheter valves (self vs. balloon-expandable). Three patients underwent re-intervention, performed via a transcatheter approach. Further, assessment of follow-up echocardiographic reports revealed 9 (4.8%) cases of SVD, as well as stable mean (16.3±6.9 at discharge and 16.9±11.3) and peak (30.3±12.1 at discharge and 30.7±18.4 at 5 years) transvalvular gradients. No difference (p>0.05) was observed based on transcatheter valve type or surgical valve internal diameter in terms of mean and peak transvalvular gradients throughout the follow-up period.
Conclusion
The present study showed good clinical outcomes among patients undergoing VIV-TAVI, with stable VIV performance over a five-year period. Future long-term studies are warranted to analyze the predictors of outcomes following ViV-TAVI and explore the role of this treatment option in the life-long management of aortic stenosis.
Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Jennifer and Robert McNeil Donation to the Heart, Thoracic, and Vascular Institute at Cleveland Clinic. Figure 1
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Affiliation(s)
- A I Abushouk
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - O Abdelfattah
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - A Saad
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - M M Gad
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - G W Reed
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - R Puri
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - J Yun
- Cleveland Clinic Foundation, Thoracic and Cardiovascular Surgery, Cleveland, United States of America
| | - P R Vargo
- Cleveland Clinic Foundation, Thoracic and Cardiovascular Surgery, Cleveland, United States of America
| | - A Weiss
- Cleveland Clinic Foundation, Thoracic and Cardiovascular Surgery, Cleveland, United States of America
| | - D Burns
- Cleveland Clinic Foundation, Thoracic and Cardiovascular Surgery, Cleveland, United States of America
| | - Z Popovic
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - S C Harb
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
| | - L G Svensson
- Cleveland Clinic Foundation, Thoracic and Cardiovascular Surgery, Cleveland, United States of America
| | - S R Kapadia
- Cleveland Clinic Foundation, Cardiovascular Medicine, Cleveland, United States of America
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Lak H, Sammour Y, Chawla S, Gajulapalli RD, Kumar A, Parikh P, Svensson LG, Harb S, Tarakji K, Wazni O, Reed GW, Puri R, Krishnaswamy A, Kapadia S. Impact of pacing-related differences on clinical and echocardiographic outcomes after TAVR with SAPIEN-3 valve. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2180] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Data regarding the impact of pacing on outcomes after transcatheter aortic valve replacement (TAVR) is evolving especially with regards to pre-existing PPM. We examined the impact of new and prior PPM on clinical and hemodynamic outcomes after SAPIEN-3 (S3) TAVR.
Methods
Consecutive patients who underwent transfemoral-TAVR using S3 valve between April 2015 and December 2018 at our Clinic were included.
Results
Among 1028 patients, 10.2% required new PPM within 30 days, while 14% had pre-existing PPM. The presence of either prior or new PPM had no impact on 3-year mortality (log-rank p=0.6), or 1-year major adverse cardiac and cerebrovascular event (MACCE) (log-rank p=0.65). New PPM was associated with lower left ventricular ejection fraction (LVEF) at both 30 days (54.4±11.3% vs. 58.4±10.1%; p=0.001), and 1 year (54.2±12% vs. 59.1±9.9%; p=0.009) compared to no PPM. Similarly, prior PPM was associated with worse LVEF at 30 days (53.6±12.3%; p<0.001) and 1 year (55.5±12.1%; p=0.006) compared to no PPM. Interestingly, new PPM was associated with lower 1-year mean gradient (11.4±3.8 vs. 12.6±5.6 mmHg; p=0.04), and peak gradient (21.3±6.5 vs. 24.1±10.4 mmHg; p=0.01) despite no baseline differences. Prior PPM was also associated with lower 1-year mean gradient (10.3±4.4 mmHg; p=0.001), and peak gradient (19.4±8 mmHg; p<0.001), and higher doppler velocity index (0.51±0.12 vs. 0.47±0.13; p=0.039). Moreover, 1-year LV end-systolic volume (LVESVi) was higher with new (23.2±16.1 vs. 20±10.8 ml/m2; p=0.038), and prior PPM (24.5±19.7; p=0.038) compared to no PPM. Prior PPM was associated with higher moderate-to-severe tricuspid regurgitation (35.3% vs. 17.7%; p<0.001). There were no differences with regards to the rest of the studied echocardiographic outcomes at 1 year.
Conclusion
In this S3 cohort, new and prior PPM did not affect 3-year mortality or 1-year MACCE, however they were associated with worse LVEF, higher LVESVi and lower mean and peak gradients on follow-up compared to no PPM.
Funding Acknowledgement
Type of funding sources: None. Figure 1. All-cause Survival
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Affiliation(s)
- H Lak
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - Y Sammour
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Chawla
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R D Gajulapalli
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Kumar
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - P Parikh
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - L G Svensson
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Harb
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - K Tarakji
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - O Wazni
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - G W Reed
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Puri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic Foundation, Cleveland, United States of America
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Lak H, Chawla S, Verma B, Vural A, Gad M, Shekhar S, Nair R, Yun J, Burns D, Puri R, Reed G, Harb S, Krishnaswamy A, Kapadia S. Outcomes of transfemoral-transcatheter aortic valve replacement with Sapien-3 valve in liver cirrhosis patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2177] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Little is known about the outcomes of liver cirrhosis patients with severe aortic stenosis (AS) who undergo transcatheter aortic valve replacement (TAVR).
Methods
We undertook a retrospective analysis of consecutive patients with severe symptomatic AS who underwent transfemoral-TAVR with Sapien-3 valve at our Clinic between April 2015 and December 2018, yielding 32 patients with liver cirrhosis on imaging including ultrasound and/or computed tomography. Their baseline characteristics, procedural and long-term outcomes after TAVR with the non-cirrhotic group were compared, along with their management strategies as per the hepatology team.
Results
Among 1028 patients, 32 were assigned to the cirrhosis, and 996 were assigned to the non-cirrhosis (control) group. Compared with the control group cirrhotic patients were slightly younger in age (74.5 vs 81.2 years), had a slightly higher BMI (31.3 vs 29.3), and had a higher incidence of prior history of myocardial infarction (38% vs 33%). Baseline variables including the history of smoking, hypertension, diabetes, and atrial fibrillation were comparable in both groups. Among cirrhotic patients (n=32), the most common etiologies were non-alcoholic steatohepatitis (NASH) (37.5%), Alcoholism (18.75%), and Hepatitis C (12.5%). The mean MELD-NA score was 11.8 and 67% of patients were Child PUGH Class A and 33% were Child PUGH Class B and all patients had a Child PUGH score of ≥5. 53% of patients (n=17) in the cirrhosis group were evaluated by Hepatology and 12.5% (n=4) were evaluated for a liver transplant but only 1 patient had a liver transplant post-TAVR. Compared with the control group cirrhotic patients had similar 1-year mortality (12% vs 12%, p=1), had a lower rate of 30-day new pacemaker post tavr (6% vs 9% p=0.85), had a higher rate of 1-year readmission for heart failure (12% vs 5% p=0.12) and similar 1-year major adverse cardiac and cerebrovascular event (MACCE) rate (15% vs 14% p=0.98)
Conclusion
Patients with severe AS undergoing TAVR with concomitant liver cirrhosis demonstrate comparable outcomes compared with their non- cirrhotic counterparts. NASH followed by alcoholic cirrhosis was found to be most common etiology.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- H Lak
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Chawla
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - B Verma
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Vural
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - M Gad
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Shekhar
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Nair
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - J Yun
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - D Burns
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - R Puri
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - G Reed
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Harb
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic Foundation, Cleveland, United States of America
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Rochon PL, Theriault C, Rangel Olguin AG, Krishnaswamy A. The cell adhesion molecule Sdk1 shapes assembly of a retinal circuit that detects localized edges. eLife 2021; 10:e70870. [PMID: 34545809 PMCID: PMC8514235 DOI: 10.7554/elife.70870] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/11/2021] [Indexed: 01/10/2023] Open
Abstract
Nearly 50 different mouse retinal ganglion cell (RGC) types sample the visual scene for distinct features. RGC feature selectivity arises from their synapses with a specific subset of amacrine (AC) and bipolar cell (BC) types, but how RGC dendrites arborize and collect input from these specific subsets remains poorly understood. Here we examine the hypothesis that RGCs employ molecular recognition systems to meet this challenge. By combining calcium imaging and type-specific histological stains, we define a family of circuits that express the recognition molecule Sidekick-1 (Sdk1), which include a novel RGC type (S1-RGC) that responds to local edges. Genetic and physiological studies revealed that Sdk1 loss selectively disrupts S1-RGC visual responses, which result from a loss of excitatory and inhibitory inputs and selective dendritic deficits on this neuron. We conclude that Sdk1 shapes dendrite growth and wiring to help S1-RGCs become feature selective.
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Rangel Olguin AG, Rochon PL, Krishnaswamy A. New Optical Tools to Study Neural Circuit Assembly in the Retina. Front Neural Circuits 2020; 14:44. [PMID: 32848633 PMCID: PMC7424070 DOI: 10.3389/fncir.2020.00044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/15/2020] [Accepted: 06/23/2020] [Indexed: 12/17/2022] Open
Abstract
During development, neurons navigate a tangled thicket of thousands of axons and dendrites to synapse with just a few specific targets. This phenomenon termed wiring specificity, is critical to the assembly of neural circuits and the way neurons manage this feat is only now becoming clear. Recent studies in the mouse retina are shedding new insight into this process. They show that specific wiring arises through a series of stages that include: directed axonal and dendritic growth, the formation of neuropil layers, positioning of such layers, and matching of co-laminar synaptic partners. Each stage appears to be directed by a distinct family of recognition molecules, suggesting that the combinatorial expression of such family members might act as a blueprint for retinal connectivity. By reviewing the evidence in support of each stage, and by considering their underlying molecular mechanisms, we attempt to synthesize these results into a wiring model which generates testable predictions for future studies. Finally, we conclude by highlighting new optical methods that could be used to address such predictions and gain further insight into this fundamental process.
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Kapadia S, Krishnaswamy A, Wierup P, Schoenhagen P, Harb S. Tricuspid Annulus Three-dimensional Geometry And Dimensions In Normal, Degenerative, And Functional Mitral Regurgitation. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.181] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Kapadia S, Krishnaswamy A, Wierup P, Schoenhagen P, Harb S. Mitral Annulus Three-dimensional Configuration And Size In Normal, Degenerative, And Functional Mitral Regurgitation. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.180] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Murugeppa A, Chandrashekara Murthy V, Krishnaswamy A, Sudha G, Prakash N, Shettar VK, Shridhar N, Raju NH. Synchronisation of Oestrous in Stall Fed Malnad Gidda Cattle: A Comparative Study. ACTA ACUST UNITED AC 2019. [DOI: 10.20546/ijcmas.2019.807.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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13
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- P, Krishnaswamy A, Honnappa T, Murthy V, Narayana Bhat M, Rangnath L. TOCODYNAMOMETRIC STUDY IN CASES OF PRIMARY UTERINE INERTIA IN DOGS. ACTA ACUST UNITED AC 2019. [DOI: 10.29005/ijcp.2019.11.1.038-041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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14
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Duan X, Krishnaswamy A, Laboulaye MA, Liu J, Peng YR, Yamagata M, Toma K, Sanes JR. Cadherin Combinations Recruit Dendrites of Distinct Retinal Neurons to a Shared Interneuronal Scaffold. Neuron 2018; 99:1145-1154.e6. [PMID: 30197236 DOI: 10.1016/j.neuron.2018.08.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [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: 01/23/2018] [Revised: 07/26/2018] [Accepted: 08/15/2018] [Indexed: 12/13/2022]
Abstract
Distinct neuronal types connect in complex ways to generate functional neural circuits. The molecular diversity required to specify this connectivity could be supplied by multigene families of synaptic recognition molecules, but most studies to date have assessed just one or a few members at a time. Here, we analyze roles of cadherins (Cdhs) in formation of retinal circuits comprising eight neuronal types that inform the brain about motion in four directions. We show that at least 15 classical Cdhs are expressed by neurons in these circuits and at least 6 (Cdh6-10 and 18) act individually or in combinations to promote specific connectivity among the cells. They act in part by directing the processes of output neurons and excitatory interneurons to a cellular scaffold formed by inhibitory interneurons. Because Cdhs are expressed combinatorially by many central neurons, similar interactions could be involved in patterning circuits throughout the brain.
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Affiliation(s)
- Xin Duan
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA 02138, USA; Departments of Ophthalmology and Physiology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Arjun Krishnaswamy
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA 02138, USA
| | - Mallory A Laboulaye
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA 02138, USA
| | - Jinyue Liu
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA 02138, USA
| | - Yi-Rong Peng
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA 02138, USA
| | - Masahito Yamagata
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA 02138, USA
| | - Kenichi Toma
- Departments of Ophthalmology and Physiology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Joshua R Sanes
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, MA 02138, USA.
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15
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Sato K, Sankaramangalam K, Krishnaswamy A, Mick S, Rodriguez L, Grimm R, Menon V, Kapadia S, Desai M, Svensson L, Griffin B, Popovic Z. 1139Prognostic impact of aortic valve replacement in contemporary low-gradient aortic stenosis patients with lack of contractile reserve. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.1139] [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: 11/14/2022] Open
Affiliation(s)
- K Sato
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - K Sankaramangalam
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - A Krishnaswamy
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - S Mick
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - L Rodriguez
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - R Grimm
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - V Menon
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - S Kapadia
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - M Desai
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - L Svensson
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - B Griffin
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
| | - Z Popovic
- Cleveland Clinic Foundation, Heart and Vascular Institute, Cleveland, United States of America
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16
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Liu J, Reggiani JDS, Laboulaye MA, Pandey S, Chen B, Rubenstein JLR, Krishnaswamy A, Sanes JR. Tbr1 instructs laminar patterning of retinal ganglion cell dendrites. Nat Neurosci 2018; 21:659-670. [PMID: 29632360 PMCID: PMC5920715 DOI: 10.1038/s41593-018-0127-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 02/20/2018] [Indexed: 12/20/2022]
Abstract
Visual information is delivered to the brain by >40 types of retinal ganglion cells (RGCs). Diversity in this representation arises within the inner plexiform layer (IPL), where dendrites of each RGC type are restricted to specific sublaminae, limiting the interneuronal types that can innervate them. How such dendritic restriction arises is unclear. We show that the transcription factor Tbr1 is expressed by four mouse RGC types with dendrites in the outer IPL and is required for their laminar specification. Loss of Tbr1 results in elaboration of dendrites within the inner IPL, while misexpression in other cells retargets their neurites to the outer IPL. Two transmembrane molecules, Sorcs3 and Cdh8, act as effectors of the Tbr1-controlled lamination program. However, they are expressed in just one Tbr1+ RGC type, supporting a model in which a single transcription factor implements similar laminar choices in distinct cell types by recruiting partially non-overlapping effectors.
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Affiliation(s)
- Jinyue Liu
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA.,Center for Brain Science, Harvard University, Cambridge, MA, USA.,Program in Neuroscience, Harvard Medical School, Boston, MA, USA
| | - Jasmine D S Reggiani
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA.,Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - Mallory A Laboulaye
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA.,Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - Shristi Pandey
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA.,Center for Brain Science, Harvard University, Cambridge, MA, USA
| | - Bin Chen
- Department of Molecular, Cell and Developmental Biology, University of California at Santa Cruz, Santa Cruz, CA, USA
| | - John L R Rubenstein
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Arjun Krishnaswamy
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA.,Center for Brain Science, Harvard University, Cambridge, MA, USA.,Department of Physiology, McGill University, Montreal, QC, Canada
| | - Joshua R Sanes
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA. .,Center for Brain Science, Harvard University, Cambridge, MA, USA.
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17
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Peng YR, Tran NM, Krishnaswamy A, Kostadinov D, Martersteck EM, Sanes JR. Satb1 Regulates Contactin 5 to Pattern Dendrites of a Mammalian Retinal Ganglion Cell. Neuron 2017; 95:869-883.e6. [PMID: 28781169 DOI: 10.1016/j.neuron.2017.07.019] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [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: 11/29/2016] [Revised: 06/16/2017] [Accepted: 07/19/2017] [Indexed: 12/13/2022]
Abstract
The size and shape of dendritic arbors are prime determinants of neuronal connectivity and function. We asked how ON-OFF direction-selective ganglion cells (ooDSGCs) in mouse retina acquire their bistratified dendrites, in which responses to light onset and light offset are segregated to distinct strata. We found that the transcriptional regulator Satb1 is selectively expressed by ooDSGCs. In Satb1 mutant mice, ooDSGC dendrites lack ON arbors, and the cells selectively lose ON responses. Satb1 regulates expression of a homophilic adhesion molecule, Contactin 5 (Cntn5). Both Cntn5 and its co-receptor Caspr4 are expressed not only by ooDSGCs, but also by interneurons that form a scaffold on which ooDSGC ON dendrites fasciculate. Removing Cntn5 from either ooDSGCs or interneurons partially phenocopies Satb1 mutants, demonstrating that Satb1-dependent Cntn5 expression in ooDSGCs leads to branch-specific homophilic interactions with interneurons. Thus, Satb1 directs formation of a morphologically and functionally specialized compartment within a complex dendritic arbor.
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Affiliation(s)
- Yi-Rong Peng
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Nicholas M Tran
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Arjun Krishnaswamy
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Dimitar Kostadinov
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Emily M Martersteck
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA
| | - Joshua R Sanes
- Center for Brain Science and Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, USA.
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18
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Affiliation(s)
- Arjun Krishnaswamy
- Department of Molecular and Cellular Biology and Center for Brain Science, Harvard University, Cambridge, Massachusetts 02138, USA.
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19
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Link T, Arpornsukant P, Chareddy A, Alluri A, Chyong D, Eshleman C, Hu M, Jain S, Kahn J, Kemelmakher H, Kepner A, Krishnaswamy A, Raman V, Sanders K, Stock G. CFTR: Structural Mishap by Mutation. FASEB J 2015. [DOI: 10.1096/fasebj.29.1_supplement.lb64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- T Link
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - P Arpornsukant
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - A Chareddy
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - A Alluri
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - D Chyong
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - C Eshleman
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - M Hu
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - S Jain
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - J Kahn
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - H Kemelmakher
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - A Kepner
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - A Krishnaswamy
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - V Raman
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - K Sanders
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
| | - G Stock
- ChemistryGeorgia Institute of TechnologyAtlantaGeorgiaUnited States
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20
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Duan X, Krishnaswamy A, De la Huerta I, Sanes JR. Type II cadherins guide assembly of a direction-selective retinal circuit. Cell 2014; 158:793-807. [PMID: 25126785 DOI: 10.1016/j.cell.2014.06.047] [Citation(s) in RCA: 143] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 05/10/2014] [Accepted: 06/20/2014] [Indexed: 01/02/2023]
Abstract
Complex retinal circuits process visual information and deliver it to the brain. Few molecular determinants of synaptic specificity in this system are known. Using genetic and optogenetic methods, we identified two types of bipolar interneurons that convey visual input from photoreceptors to a circuit that computes the direction in which objects are moving. We then sought recognition molecules that promote selective connections of these cells with previously characterized components of the circuit. We found that the type II cadherins, cdh8 and cdh9, are each expressed selectively by one of the two bipolar cell types. Using loss- and gain-of-function methods, we showed that they are critical determinants of connectivity in this circuit and that perturbation of their expression leads to distinct defects in visually evoked responses. Our results reveal cellular components of a retinal circuit and demonstrate roles of type II cadherins in synaptic choice and circuit function.
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Affiliation(s)
- Xin Duan
- Center for Brain Science, Harvard University, Cambridge, MA 02138, USA; Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138, USA
| | - Arjun Krishnaswamy
- Center for Brain Science, Harvard University, Cambridge, MA 02138, USA; Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138, USA
| | - Irina De la Huerta
- Center for Brain Science, Harvard University, Cambridge, MA 02138, USA; Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138, USA
| | - Joshua R Sanes
- Center for Brain Science, Harvard University, Cambridge, MA 02138, USA; Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA 02138, USA.
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21
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Jones BM, Kapadia SR, Smedira NG, Robich M, Tuzcu EM, Menon V, Krishnaswamy A. Ventricular septal rupture complicating acute myocardial infarction: a contemporary review. Eur Heart J 2014; 35:2060-8. [DOI: 10.1093/eurheartj/ehu248] [Citation(s) in RCA: 137] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Krishnaswamy A, Cooper E. Reactive oxygen species inactivate neuronal nicotinic acetylcholine receptors through a highly conserved cysteine near the intracellular mouth of the channel: implications for diseases that involve oxidative stress. J Physiol 2012; 590:39-47. [PMID: 21969449 PMCID: PMC3300044 DOI: 10.1113/jphysiol.2011.214007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Accepted: 10/02/2011] [Indexed: 11/08/2022] Open
Abstract
An intriguing feature of several nicotinic acetylcholine receptors (nAChRs) on neurons is that their subunits contain a highly conserved cysteine residue located near the intracellular mouth of the receptor pore. The work summarized in this review indicates that α3β4-containing and α4β2-containing neuronal nAChRs, and possibly other subtypes, are inactivated by elevations in intracellular reactive oxygen species (ROS). This review discusses a model for the molecular mechanisms that underlie this inactivation. In addition, we explore the implications of this mechanism in the context of complications that arise from diabetes. We review the evidence that diabetes elevates cytosolic ROS in sympathetic neurons and inactivates postsynaptic α3β4-containing nAChRs shortly after the onset of diabetes, leading to a depression of synaptic transmission in sympathetic ganglia, an impairment of sympathetic reflexes. These effects of ROS on nAChR function are due to the highly conserved Cys residues in the receptors: replacing the cysteine residues in α3 allow ganglionic transmission and sympathetic reflexes to function normally in diabetes. This example from diabetes suggests that other diseases involving oxidative stress, such as Parkinson's disease, could lead to the inactivation of nAChRs on neurons and disrupt cholinergic nicotinic signalling.
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23
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Davisson MT, Bronson RT, Tadenev ALD, Motley WW, Krishnaswamy A, Seburn KL, Burgess RW. A spontaneous mutation in contactin 1 in the mouse. PLoS One 2011; 6:e29538. [PMID: 22242131 PMCID: PMC3248457 DOI: 10.1371/journal.pone.0029538] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 11/30/2011] [Indexed: 01/06/2023] Open
Abstract
Mutations in the gene encoding the immunoglobulin-superfamily member cell adhesion molecule contactin1 (CNTN1) cause lethal congenital myopathy in human patients and neurodevelopmental phenotypes in knockout mice. Whether the mutant mice provide an accurate model of the human disease is unclear; resolving this will require additional functional tests of the neuromuscular system and examination of Cntn1 mutations on different genetic backgrounds that may influence the phenotype. Toward these ends, we have analyzed a new, spontaneous mutation in the mouse Cntn1 gene that arose in a BALB/c genetic background. The overt phenotype is very similar to the knockout of Cntn1, with affected animals having reduced body weight, a failure to thrive, locomotor abnormalities, and a lifespan of 2-3 weeks. Mice homozygous for the new allele have CNTN1 protein undetectable by western blotting, suggesting that it is a null or very severe hypomorph. In an analysis of neuromuscular function, neuromuscular junctions had normal morphology, consistent with previous studies in knockout mice, and the muscles were able to generate appropriate force when normalized for their reduced size in late stage animals. Therefore, the Cntn1 mutant mice do not show evidence for a myopathy, but instead the phenotype is likely to be caused by dysfunction in the nervous system. Given the similarity of CNTN1 to other Ig-superfamily proteins such as DSCAMs, we also characterized the expression and localization of Cntn1 in the retinas of mutant mice for developmental defects. Despite widespread expression, no anomalies in retinal anatomy were detected histologically or using a battery of cell-type specific antibodies. We therefore conclude that the phenotype of the Cntn1 mice arises from dysfunction in the brain, spinal cord or peripheral nervous system, and is similar in either a BALB/c or B6;129;Black Swiss background, raising a possible discordance between the mouse and human phenotypes resulting from Cntn1 mutations.
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Affiliation(s)
- Muriel T Davisson
- The Jackson Laboratory, Bar Harbor, Maine, United States of America.
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24
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Campanucci V, Krishnaswamy A, Cooper E. Diabetes depresses synaptic transmission in sympathetic ganglia by inactivating nAChRs through a conserved intracellular cysteine residue. Neuron 2010; 66:827-34. [PMID: 20620869 DOI: 10.1016/j.neuron.2010.06.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2010] [Indexed: 10/19/2022]
Abstract
Most people with diabetes develop severe complications of the autonomic nervous system; yet, the underlying causes of many diabetic-induced dysautonomias are poorly understood. Here we explore the idea that these dysautonomias results, in part, from a defect in synaptic transmission. To test this idea, we investigated cultured sympathetic neurons and show that hyperglycemia inactivates nAChRs through a mechanism involving an elevation in reactive oxygen species and an interaction with highly conserved cysteine residues located near the intracellular mouth of the nAChR channel. Consistent with this, we show that diabetic mice have depressed ganglionic transmission and reduced sympathetic reflexes, whereas diabetic mice expressing mutant postsynaptic nAChRs that lack the conserved cysteine residues on the alpha3 subunit have normal synaptic transmission in sympathetic ganglia and normal sympathetic reflexes. Our work suggests a new model for diabetic-induced dysautonomias and identifies ganglionic nAChRs as targets of hyperglycemia-induced downstream signals.
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Affiliation(s)
- Verónica Campanucci
- Department of Physiology, McGill University, Montreal, Quebec H3G 1Y6, Canada
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25
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Caffery PM, Krishnaswamy A, Sanders T, Liu J, Hartlaub H, Klysik J, Cooper E, Hawrot E. Engineering neuronal nicotinic acetylcholine receptors with functional sensitivity to alpha-bungarotoxin: a novel alpha3-knock-in mouse. Eur J Neurosci 2009; 30:2064-76. [PMID: 20128845 DOI: 10.1111/j.1460-9568.2009.07016.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We report here the construction of a novel knock-in mouse expressing chimeric alpha3 nicotinic acetylcholine receptor (nAChR) subunits with pharmacological sensitivity to alpha-bungarotoxin (alphaBTX). Sensitivity was generated by substituting five amino acids in the loop C (beta9-beta10) region of the mouse alpha3 subunit with the corresponding residues from the alpha1 subunit of the muscle type receptor from Torpedo californica. To demonstrate the utility of the underlying concept, expressed alpha3[5] subunits were characterized in the superior cervical ganglia (SCG) of homozygous knock-in mice, where the synaptic architecture of postsynaptic alpha3-containing nAChR clusters could now, for the first time, be directly visualized and interrogated by live-staining with rhodamine-conjugated alphaBTX. Consistent with the postsynaptic localization of ganglionic nAChRs, the alphaBTX-labeled puncta colocalized with a marker for synaptic varicosities. Following in vivo deafferentation, these puncta persisted but with significant changes in intensity and distribution that varied with the length of the recovery period. Compound action potentials and excitatory postsynaptic potentials recorded from SCG of mice homozygous for alpha3[5] were abolished by 100 nmalphaBTX, even in an alpha7 null background, demonstrating that synaptic throughput in the SCG is completely dependent on the alpha3-subunit. In addition, we observed that the genetic background of various inbred and outbred mouse lines greatly affects the functional expression of alpha3[5]-nAChRs, suggesting a powerful new approach for exploring the molecular mechanisms underlying receptor assembly and trafficking. As alphaBTX-sensitive sequences can be readily introduced into other nicotinic receptor subunits normally insensitive to alphaBTX, the findings described here should be applicable to many other receptors.
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Affiliation(s)
- Philip M Caffery
- Department of Molecular Pharmacology, Brown University, Providence, RI, USA
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26
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Manjunatha BM, Ravindra JP, Gupta PS, Devaraj M, Honnappa TG, Krishnaswamy A. Post-thaw development of in vitro produced buffalo embryos cryopreserved by cytoskeletal stabilization and vitrification. J Vet Sci 2009; 10:153-6. [PMID: 19461211 PMCID: PMC2801116 DOI: 10.4142/jvs.2009.10.2.153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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] [Indexed: 11/23/2022] Open
Abstract
The present study was conducted to examine post-thaw in vitro developmental competence of buffalo embryos cryopreserved by cytoskeletal stabilization and vitrification. In vitro produced embryos were incubated with a medium containing cytochalasin-b (cyto-b) in a CO2 incubator for 40 min for microfilament stabilization and were cryopreserved by a two-step vitrification method at 24℃ in the presence of cyto-b. Initially, the embryos were exposed to 10% ethylene glycol (EG) and 10% dimethylsulfoxide (DMSO) in a base medium for 4 min. After the initial exposure, the embryos were transferred to a 7 µl drop of 25% EG and 25% DMSO in base medium and 0.3 M sucrose for 45 sec. After warming, the embryos were cultured in vitro for 72 h. The post-thaw in vitro developmental competence of the cyto-b-treated embryos did not differ significantly from those vitrified without cyto-b treatment. The hatching rates of morulae vitrified without cyto-b treatment was significantly lower than the non-vitrified control. However, the hatching rate of cyto-b-treated vitrified morulae did not differ significantly from the non-vitrified control. This study demonstrates that freezing of buffalo embryos by cytoskeletal stabilization and vitrification is a reliable method for long-term preservation.
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Affiliation(s)
- B M Manjunatha
- Department of Animal Reproduction, Veterinary College, Karnataka Veterinary, Animal and Fishery Sciences University, Bangalore, India.
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27
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Krishnaswamy A, Cooper E. An activity-dependent retrograde signal induces the expression of the high-affinity choline transporter in cholinergic neurons. Neuron 2009; 61:272-86. [PMID: 19186169 DOI: 10.1016/j.neuron.2008.11.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2008] [Revised: 10/15/2008] [Accepted: 11/24/2008] [Indexed: 10/21/2022]
Abstract
A well-accepted view of developing circuits is that synapses must be active to mature and persist, whereas inactive synapses remain immature and are eventually eliminated. We question this long-standing view by investigating nonfunctional cholinergic nicotinic synapses in the superior cervical ganglia (SCG) of mice with a disruption in the alpha3 nicotinic receptor (nAChR) subunit gene, a gene essential for fast synaptic transmission in sympathetic ganglia. Using imaging and electrophysiology, we show that synapses persist for at least 2-3 months without postsynaptic activity; however, the presynaptic terminals lack high-affinity choline transporters (CHTs), and as a result, they are quickly depleted of transmitter. Moreover, we demonstrate with rescue experiments that CHT is induced by signals downstream of postsynaptic activity, converting immature terminals to mature terminals capable of sustaining transmitter release in response to high-frequency or continuous firing. Importantly, postsynaptic neurons must be continually active to maintain CHT in presynaptic terminals.
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Affiliation(s)
- Arjun Krishnaswamy
- Department of Physiology, McGill University, Montreal, H3G 1Y6 Quebec, Canada
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Rassadi S, Krishnaswamy A, Pié B, McConnell R, Jacob MH, Cooper E. A null mutation for the alpha3 nicotinic acetylcholine (ACh) receptor gene abolishes fast synaptic activity in sympathetic ganglia and reveals that ACh output from developing preganglionic terminals is regulated in an activity-dependent retrograde manner. J Neurosci 2006; 25:8555-66. [PMID: 16162937 PMCID: PMC6725660 DOI: 10.1523/jneurosci.1983-05.2005] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [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: 11/21/2022] Open
Abstract
In vertebrates, synaptic activity exerts an important influence on the formation of neural circuits, yet our understanding of its role in directing presynaptic and postsynaptic differentiation during synaptogenesis is incomplete. This study investigates how activity influences synaptic differentiation as synapses mature during early postnatal life. Specifically, we ask what happens to presynaptic terminals when synapses develop without functional postsynaptic receptors and without fast synaptic transmission. To address this issue, we investigated cholinergic nicotinic synapses in sympathetic ganglia of mice with a null mutation for the alpha3 nicotinic ACh receptor gene. Disrupting the alpha3 gene completely eliminates fast excitatory synaptic potentials on postganglionic sympathetic neurons, establishing a crucial role for alpha3-containing postsynaptic receptors in synaptic transmission. Interestingly, the preganglionic nerve terminals form morphologically normal synapses with sympathetic neurons, and these synapses persist without activity in postnatal animals. Surprisingly, when stimulating the preganglionic nerve at physiological rates, we discovered a significant decrease in ACh output from the presynaptic terminals in these alpha3(-/-) sympathetic ganglia. We show that this decrease in ACh output from the presynaptic terminals results, in part, from a lack of functional high-affinity choline transporters. We conclude the following: (1) fast synaptic transmission in mammalian SCG requires alpha3 expression; (2) in the absence of activity, the preganglionic nerve forms synapses that appear morphologically normal and persist for several weeks; and (3) to sustain transmitter release, developing presynaptic terminals require an activity-dependent retrograde signal.
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Affiliation(s)
- Siamak Rassadi
- Department of Physiology, McGill University, Montreal, Quebec, H3G 1Y6, Canada
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Baranoski GVG, Krishnaswamy A, Kimmel B. An investigation on the use of data-driven scattering profiles in Monte Carlo simulations of ultraviolet light propagation in skin tissues. Phys Med Biol 2005; 49:4799-809. [PMID: 15566176 DOI: 10.1088/0031-9155/49/20/010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Ultraviolet light can affect the appearance and medical condition of the human skin by triggering biophysical processes such as erythema, melanogenesis, photoaging and carcinogenesis. The evolution of these processes is related to the amount of ultraviolet light absorbed by skin pigments. This amount may vary with the wavelength and path length of the radiation that is propagated within the skin tissues. For many years, biomedical researchers have been investigating the propagation of ultraviolet light in skin tissues through Monte Carlo simulations. The scattering of the incident radiation by tissue internal structures, a key component in this process, is usually approximated by functions without a plausible connection with the underlying physical phenomena. In this paper, we examine the origins of such an approach, and question its generalized use with respect to wavelengths and biological materials for which there is no supporting data available. Furthermore, we perform comparisons to demonstrate that the accuracy and predictability of Monte Carlo simulations of ultraviolet propagation in skin tissues can be improved by using a data-driven approach to represent the scattering profile of these tissues.
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Affiliation(s)
- G V G Baranoski
- Natural Phenomena Simulation Group, School of Computer Science, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
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Gimber EA, Shields MD, Canawati HN, Sapico FL, Krishnaswamy A, El-Farra R, Maeder KN, Montgomerie JZ. Bacteriuria with Escherichia coli resistant to ciprofloxacin in patients with spinal-cord injury. Infect Control Hosp Epidemiol 1998; 19:85-6. [PMID: 9510103 DOI: 10.1086/647770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gupta RC, Sinha AK, Krishnaswamy A. Studies on the efficacy of some post-service intrauterine infusions on the conception rate of repeat breading cattle. Theriogenology 1983; 20:559-64. [PMID: 16725872 DOI: 10.1016/0093-691x(83)90079-1] [Citation(s) in RCA: 5] [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] [Received: 06/02/1983] [Accepted: 09/21/1983] [Indexed: 11/26/2022]
Abstract
The efficacy of post-insemination intrauterine infusion of Strep to-penicillin, Lugol's solution, one and two vials of Mastalone-U (Pfizer, Bombay, India, containing a combination of oxytetracycline hydrochloride, oleandomycin phosphate, neomycin sulphate, prednisolone and chlorpheniramine maleate) and distilled water was compared on the basis of conception rate with that of control in repeat breeder cows. The results indicated that there was no significant difference between the treated groups and the control, except that with two vials of Mastalone-U, the conception rate was significantly low (P<0.05). The results of the present trial suggest that intrauterine infusions for the treatment of repeat breeding cows should not be used indiscriminately.
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Affiliation(s)
- R C Gupta
- Department of Gynaecology & Obstetrics, College of Veterinary Sciences, Haryana Agricultural University, Hissar-125004, India
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Masters JR, Krishnaswamy A, Rigby CC, O'Donoghue EP. Quantitative organ culture: an approach to prediction of tumour response. Br J Cancer Suppl 1980; 4:199-202. [PMID: 6932927 PMCID: PMC2149186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Quantitative organ culture provides a simple in vitro method for assessing tumour responsiveness. The value of using 125IUdR incorporation as a reproducible index of DNA synthesis in organ culture has been investigated using human benign prostatic hyperplasia. From a study of the variables affecting the reproducibility, sensitivity and specificity of the method a simple technique was adopted. This method was applied to the study of the hormone-sensitivity of breast tumours, some of which showed a dose-response to 17 beta-estradiol. The criteria which must be applied to make such a test of clinical value are discussed.
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