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Guo HH, Song BY, Wang XR, Cui JX, Zhang ZB, Wang BY, Liu Y, Tan BB, Zhao Q. [A case of diaphragmatic hemangioma misdiagnosed as gastrointestinal stromal tumor of stomach]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:1194-1195. [PMID: 38110283 DOI: 10.3760/cma.j.cn441530-20230613-00204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
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Park NJ, Hiniker SM, Guo HH, Advani RH, Hoppe RT, Binkley MS. Investigating PET Responses to Treatment in Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:e480. [PMID: 37785523 DOI: 10.1016/j.ijrobp.2023.06.1699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) There is no standard treatment for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). Although response by positron emission tomography (PET) for classic Hodgkin lymphoma (cHL) has allowed for response-adapted treatment, similar approaches for NLPHL have not been developed. This is in part due to the lack of data for PET response to treatment. Therefore, we sought to investigate PET responses to management for NLPHL. MATERIALS/METHODS We retrospectively identified 47 patients who were diagnosed with or treated for NLPHL between 2001-2018 at a single institution and underwent a staging PET. We recorded clinical data and PET metrics for patients who received various forms of management, including chemotherapy (CT), radiation therapy (RT), combined modality therapy (CMT = CT+RT, with rituximab in a subset), rituximab monotherapy, and observation after excision. Metabolic response was scored according to the Deauville 5-point scale criteria, with complete metabolic response defined as a score 1-3. RESULTS We identified 47 patients with median age of 26 (IQR = 17-50). They predominantly were male (74.5%) and had early stage (23.4% I, 36.2% II) versus advanced stage (29.8% III, 10.5% IV) NLPHL. The majority of patients had their immunoarchitectural pattern scored (n = 36, 76.6%), with typical pattern (A/B) being the most frequent type (58.3%). The median follow-up was 5.7 years (IQR = 2.3-9.3). Overall survival was 100% at 5 years and 92.3% at 10 years. Primary management included CMT (n = 10, 21.3%; with rituximab in a subset n = 1, 10.0%), CT alone (n = 22, 46.8%; with rituximab in a subset n = 5, 22.7%), RT alone (n = 8, 17.0%), rituximab alone (n = 3, 6.4%), and observation after excision (n = 4, 8.5%). On baseline PET, median SUVmax was 10.7 (range = 1.7-35.4). Of the 10 patients who received CMT, the complete metabolic response rates were 42.9% at interim-chemotherapy PET and 75% at post-chemotherapy PET, which improved to 100% after consolidative radiotherapy. There was no difference in complete metabolic response rate to chemotherapy for typical versus variant pattern (P = 0.60). Of the 22 patients who received CT alone, 66.7% had a complete metabolic response at the interim PET and 72.7% at the end of chemotherapy. For RT, rituximab alone, and observation, the complete metabolic response rates at median 3 months (range 1-5 months) after treatment were 87.5%, 66.7%, 75.0%, respectively. CONCLUSION Based on our cohort, we found that patients with NLPHL had a lower complete metabolic response to CT (∼75%) compared to cHL (∼85-90%) and PET-response was improved following RT for those receiving CMT. There was no significant difference in PET-response for those with variant versus typical immunoarchitectural patterns. Our findings will allow for the development of PET response-adapted therapy for NLPHL.
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Affiliation(s)
- N J Park
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - S M Hiniker
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - H H Guo
- Department of Nuclear Medicine, Stanford University School of Medicine, Stanford, CA
| | - R H Advani
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA
| | - R T Hoppe
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - M S Binkley
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Ning HY, Cai HJ, Ma TT, Fan CE, Wu DD, Gao FY, Kong F, Zhang FJ, Wang R, Guo HH, Ma RL, Zheng CY, Hao B, Wang HT, Zhang JJ, Zhang L, Wang XY. [Investigation and analysis of airborne allergenic pollen in 4 districts and 5 counties of Hohhot City]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1364-1372. [PMID: 37743296 DOI: 10.3760/cma.j.cn112150-20230116-00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm2 and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.
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Affiliation(s)
- H Y Ning
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - H J Cai
- Allergy Center, Hohhot First Hospital, Hohhot 010030, China
| | - T T Ma
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - C E Fan
- Allergy Center, Hohhot First Hospital, Hohhot 010030, China
| | - D D Wu
- Department of Primary Health Care, Hohhot Health Committee, Hohhot 010010, China
| | - F Y Gao
- Department of Allergy, Qingshuihe County Hospital, Hohhot 011600, China
| | - F Kong
- Department of Allergy, Hohhot Huimin District Hospital, Hohhot 010030, China
| | - F J Zhang
- Department of Clinical Laboratory, Ying Xin Road Office East Community Health Service Centre, Hohhot 010000, China
| | - R Wang
- Department of Clinical Laboratory, Daxuexi Road Community Health Service Centre, Hohhot 010018, China
| | - H H Guo
- Department of Allergy and Department of Clinical Laboratory, Tumotezuoqi People's Hospital, Hohhot 010100, China
| | - R L Ma
- Department of Allergy, Tuoketuo County Hospital, Hohhot 010200, China
| | - C Y Zheng
- Department of Allergy, Helingeer County Hospital, Hohhot 011500, China
| | - B Hao
- Department of Allergy, Wuchuan County Hospital, Hohhot 011700, China
| | - H T Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
| | - J J Zhang
- Allergy Center, Hohhot First Hospital, Hohhot 010030, China
| | - L Zhang
- Department of Otorhinolaryngology Head and Neck Surgery and Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Beijing Key Laboratory of Allergic Diseases, Beijing Institute of Otorhinolaryngology, Beijing 100005, China
| | - X Y Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China Allergy Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
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Parker WA, Vigneault DM, Yang I, Bratt A, Marquardt AC, Sharifi H, Guo HH. Opportunistic Screening for Atrial Fibrillation on Routine Chest Computed Tomography. J Thorac Imaging 2023; 38:270-277. [PMID: 36917506 DOI: 10.1097/rti.0000000000000702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
PURPOSE Quantitative biomarkers from chest computed tomography (CT) can facilitate the incidental detection of important diseases. Atrial fibrillation (AFib) substantially increases the risk for comorbid conditions including stroke. This study investigated the relationship between AFib status and left atrial enlargement (LAE) on CT. MATERIALS AND METHODS A total of 500 consecutive patients who had undergone nongated chest CTs were included, and left atrium maximal axial cross-sectional area (LA-MACSA), left atrium anterior-posterior dimension (LA-AP), and vertebral body cross-sectional area (VB-Area) were measured. Height, weight, age, sex, and diagnosis of AFib were obtained from the medical record. Parametric statistical analyses and receiver operating characteristic curves were performed. Machine learning classifiers were run with clinical risk factors and LA measurements to predict patients with AFib. RESULTS Eighty-five patients with a diagnosis of AFib were identified. Mean LA-MACSA and LA-AP were significantly larger in patients with AFib than in patients without AFib (28.63 vs. 20.53 cm 2 , P <0.000001; 4.34 vs. 3.5 cm, P <0.000001, respectively), both with area under the curves (AUCs) of 0.73. Multivariable logistic regression analysis including age, sex, and VB-Area with LA-MACSA improved the AUC for predicting AFib (AUC=0.77). An LA-MACSA threshold of 30 cm 2 demonstrated high specificity for AFib diagnosis at 92% and sensitivity of 48%, and LA-AP threshold at 4.5 cm demonstrated 90% specificity and 42% sensitivity. A Bayesian machine learning model using age, sex, height, body surface area, and LA-MACSA predicted AFib with an AUC of 0.743. CONCLUSIONS LA-MACSA or LA-AP can be rapidly measured from routine chest CT, and when >30 cm 2 and >4.5 cm, respectively, are specific indicators to predict patients at increased risk for AFib.
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Affiliation(s)
| | | | - Issac Yang
- Stanford University School of Medicine, Stanford, CA
| | - Alex Bratt
- Stanford and Mayo Clinic Hospital, Rochester, MN
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Guo HH, Hu YY, Tian Y, Yang PG, Ding PA, Wang D, Zhang ZD, Zhao XF, Liu Y, Li Y, Zhao Q. [Da Vinci robotic surgery for synchronous gastric and colorectal primary tumors: 8 cases]. Zhonghua Wei Chang Wai Ke Za Zhi 2023; 26:787-789. [PMID: 37574296 DOI: 10.3760/cma.j.cn441530-20221029-00440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
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Wang ZY, Chang QG, Guo HH, Du X, Liu YH, Yin DT. [Establishment and validation of a nomogram model for evaluating the metastasis of lymph nodes posterior to the right recurrent laryngeal nerve in papillary thyroid carcinoma]. Zhonghua Yi Xue Za Zhi 2023; 103:2175-2182. [PMID: 37482730 DOI: 10.3760/cma.j.cn112137-20221107-02336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Objective: To explore the related factors of lymph nodes posterior to the right recurrent laryngeal nerve (LN-prRLN) metastasis in papillary thyroid carcinoma (PTC) and establish a nomogram model for evaluating LN-prRLN metastasis. Methods: The clinical data of patients with PTC who underwent surgery in the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2021 were retrospectively analyzed. Multivariate logistic regression was used to analyze the related factors of LN-prRLN metastasis and construct a nomogram model for evaluating LN-prRLN metastasis. Meanwhile, the data of 120 patients from January to June 2022 were also collected for external verification. Results: A total of 466 patients with PTC were enrolled, including 106 males and 360 females, and aged 44 (33, 53) years. There were 280 cases in the training group and 186 cases in the internal validation group, respectively. Multivariate logistic regression analysis showed that age (OR=0.966, 95%CI: 0.938-0.996, P=0.027), tumor size (OR=1.048, 95%CI: 1.001-1.098, P=0.043), multifocality (OR=2.459, 95%CI: 1.268-4.767, P=0.008), right central lymph node metastasis reported by ultrasound (OR=3.099, 95%CI: 1.255-7.651, P=0.014), extrathyroid extension (OR=3.561, 95%CI: 1.255-10.102, P=0.017) and serum thyroglobulin level (OR=1.010, 95%CI: 1.001-1.018, P=0.032) were related factors for LN-prRLN metastasis. The area under the curve (AUC) values of receiver operating characteristic (ROC) curves of the training group, internal validation group and external validation group were 0.765 (95%CI: 0.691-0.840), 0.747 (95%CI: 0.657-0.837) and 0.754 (95%CI: 0.639-0.869), respectively. Conclusion: Dissection of the LN-prRLN is recommended for young PTC patients with large tumor size, multifocality, right central lymph node metastasis reported by ultrasound, extrathyroid extension and high serum thyroglobulin level.
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Affiliation(s)
- Z Y Wang
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Q G Chang
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - H H Guo
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - X Du
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y H Liu
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - D T Yin
- Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Yang SY, Deng WW, Zhao RZ, Long XP, Wang DM, Guo HH, Jiang LX, Chen WM, Shi B. Exosomes Derived from Endothelial Cells Inhibit Neointimal Hyperplasia Induced by Carotid Artery Injury in Rats via ROS-NLRP3 Inflammasome Pathway. Bull Exp Biol Med 2023; 174:762-767. [PMID: 37162629 DOI: 10.1007/s10517-023-05788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Indexed: 05/11/2023]
Abstract
This study attempted to investigate whether exosomes derived from rat endothelial cells (EC-Exo) attenuate intimal hyperplasia after balloon injury using hematoxylin and eosin staining, immunohistochemistry, immunofluorescence staining, Evans blue staining, and Western blotting. The results indicated that EC-Exo inhibited intimal hyperplasia in the carotid artery after balloon injury, promoted re-endothelialization, and reduced vascular inflammation and ROS-NLRP3-mediated cell pyroptosis. Thus, EC-Exo can inhibit neointimal hyperplasia after carotid artery injury in rats presumably by inhibiting the ROS-NLRP3 inflammasome and phenotypic transformation of vascular smooth muscle cells.
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Affiliation(s)
- S Y Yang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - W W Deng
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - R Z Zhao
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - X P Long
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - D M Wang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - H H Guo
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - L X Jiang
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - W M Chen
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - B Shi
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China.
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Gopalan D, Riley JY, Leong K, Guo HH, Zamanian RT, Hsi A, Auger W, Lindholm P. Pulmonary Vein Sign on Computed Tomography Pulmonary Angiography in Proximal and Distal Chronic Thromboembolic Pulmonary Hypertension With Hemodynamic Correlation. J Thorac Imaging 2023; 38:159-164. [PMID: 36919975 PMCID: PMC10128904 DOI: 10.1097/rti.0000000000000706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Pulmonary vein sign (PVS) indicates abnormal pulmonary venous flow on computed tomography pulmonary angiography (CTPA) is a frequent finding in proximal chronic thromboembolic pulmonary hypertension (CTEPH). PVS's occurrence in distal CTEPH and correlation to disease severity is unknown. Using right heart catheterization data, we evaluated the relationship between PVS and CTEPH disease distribution and severity. MATERIALS AND METHOD A total of 93 consecutive CTEPH cases with both CTPA and right heart catheterization were identified in this retrospective multi-institutional study. After excluding 17 cases with suboptimal CTPA, there were 52 proximal and 24 distal CTEPH cases. Blood flow in the major pulmonary veins was graded qualitatively. Subgroup analysis of PVS was performed in 38 proximal CTEPH cases before and after pulmonary endarterectomy. RESULTS PVS was more frequent in proximal (79%) than distal CTEPH (29%) ( P <0.001). No significant difference was noted in invasive mean pulmonary artery pressure (46±11 and 41±12 mm Hg) or pulmonary vascular resistance (9.4±4.5 and 8.4±4.8 WU) between the 2 groups. In the subgroup analysis, PVS was present in 29/38 patients (76%) before surgery. Postoperatively, 33/38 cases (87%, P <0.001) had normal venous flow (mean pulmonary artery pressure 46±11 and 25; pulmonary vascular resistance 9.2±4.3 and 2.6 WU preop and postop, respectively). CONCLUSION PVS is a common feature in proximal but infrequent findings in distal CTEPH. PVS does not correlate with hemodynamic severity. PVS resolution was seen in the majority of patients following successful endarterectomy.
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Affiliation(s)
- Deepa Gopalan
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
- Department of Radiology, Imperial College Hospital NHS Trust, London, UK
| | | | - Kai’en Leong
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
| | | | - Roham T. Zamanian
- Division of Pulmonary, Allergy, & Critical Care Medicine
- Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University School of Medicine
| | - Andrew Hsi
- Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford University School of Medicine
| | | | - Peter Lindholm
- Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
- Department of Emergency Medicine, University of California, San Diego, CA
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Song H, Guja KE, Yang EJ, Guo HH. 64Cu-DOTATATE Uptake in a Pulmonary Hamartoma. Clin Nucl Med 2023; 48:58-60. [PMID: 36469060 DOI: 10.1097/rlu.0000000000004390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
ABSTRACT DOTATATE PET/CT is frequently used to evaluate indeterminant pulmonary nodules suspected to be pulmonary carcinoid. We report an unexpected case of pulmonary hamartoma demonstrating 64Cu-DOTATATE uptake in a 43-year-old woman with a slowly enlarging pulmonary nodule. Histopathological staining showed somatostatin receptor 2 expression on vascular endothelial cells and a proportion of cartilage and smooth muscle cells within the hamartoma.
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Affiliation(s)
- Hong Song
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging
| | - Kip E Guja
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging
| | - Eric J Yang
- Department of Pathology, Stanford University and Hospital, Stanford, CA
| | - Haiwei Henry Guo
- From the Department of Radiology, Division of Nuclear Medicine and Molecular Imaging
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Ding PA, Yang PG, Tian Y, Li F, Guo HH, Liu Y, Zhang ZD, Wang D, Li Y, Zhao Q. [The clinical value of further accurate staging of pT2 gastric cancer based on the depth of invasion]. Zhonghua Zhong Liu Za Zhi 2021; 43:1197-1202. [PMID: 34794224 DOI: 10.3760/cma.j.cn112152-20200309-00189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the clinical value of pT2 gastric cancer staging pT2a and pT2b according to the depth of muscularis propria invasion in evaluating the prognosis of gastric cancer. Methods: According to the 8th edition of TNM staging system for gastric cancer proposed by the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC), patients with gastric cancer who underwent radical surgery in the Fourth Hospital of Hebei Medical University from January 1, 2008 to January 1, 2015 were selected and divided into pT2a and pT2b stage group according to the depth of tumor invasion. The 5-year overall survival (OS) and disease-free survival (DFS) were compared between the two groups. Results: The median follow-up time of 1 411 patients with postoperative pathological pT2 stage was 68.8 months, and 1 347 patients (95.46%) received complete follow-up data. The 5-year OS rate was 65.85%, and the 5-year DFS rate was 67.83 %. The 5-year OS rate and 5-year DFS rate of 709 pT2a patients were 72.50% and 73.91%, respectively. The 5-year OS rate and 5-year DFS rate of 638 pT2b patients were 58.46% and 61.13%, respectively, significantly different from those of the pT2a group (P<0.001). Hierarchical analysis was performed according to N staging. The 5-year OS rates of pT2aN0M0 (274 cases), pT2aN1M0 (192 cases), pT2aN2M0 (147 cases), pT2aN3aM0 (59 cases) and pT2aN3bM0 (37 cases) were 83.58 %, 72.40 %, 68.71 %, 54.24 % and 35.12 %, respectively. The 5-year DFS rates were 84.67 %, 77.08 %, 67.35 %, 54.24 % and 35.14 %, respectively. In the pT2b group, the 5-year OS rates of pT2bN0M0 (209 cases), pT2bN1M0 (166 cases), pT2bN2M0 (127 cases), pT2bN3aM0 (78 cases) and pT2bN3bM0 (58 cases) were 76.08%, 62.05%, 56.69%, 37.18% and 17.24%, respectively, and the 5-year DFS rates were 80.86%, 69.28%, 54.33%, 35.90% and 15.52%, respectively. Under the same N stage, the OS rates of patients in the pT2a group were better than those in the pT2b group (P values were 0.023, 0.034, 0.034, 0.043 and 0.018, respectively). When the N stage was N0 and N1, there was no significant difference in the 5-year DFS rate between the pT2a group and the pT2b group (P values were 0.199 and 0.090, respectively). When the N stages were N2, N3a and N3b, the difference between the pT2a stage group and the pT2b stage group was statistically significant (P values were 0.027, 0.022 and 0.025, respectively). Conclusions: In the 8th edition of AJCC/UICC gastric cancer staging system, pT2 stage can be divided into pT2a stage (invasion of superficial muscularis) and pT2b stage (invasion of deep muscularis) according to the infiltration depth of muscularis propria. There are significant differences in prognosis between the two groups. Combined with the number of lymph node metastasis, the prognosis of patients with pT2 gastric cancer can be more accurately evaluated.
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Affiliation(s)
- P A Ding
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P G Yang
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Tian
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - F Li
- Department of Pathology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - H H Guo
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Liu
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Z D Zhang
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - D Wang
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Li
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Q Zhao
- Department of External Medicine, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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Fairchild RM, Horomanski A, Mar DA, Triant GR, Lu R, Lu D, Guo HH, Baker MC. Prevalence and significance of pulmonary disease on lung ultrasonography in outpatients with SARS-CoV-2 infection. BMJ Open Respir Res 2021; 8:8/1/e000947. [PMID: 34385149 PMCID: PMC8361701 DOI: 10.1136/bmjresp-2021-000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/21/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The majority of patients with SARS-CoV-2 infection are diagnosed and managed as outpatients; however, little is known about the burden of pulmonary disease in this setting. Lung ultrasound (LUS) is a convenient tool for detection of COVID-19 pneumonia. Identifying SARS-CoV-2 infected outpatients with pulmonary disease may be important for early risk stratification. OBJECTIVES To investigate the prevalence, natural history and clinical significance of pulmonary disease in outpatients with SARS-CoV-2. METHODS SARS-CoV-2 PCR positive outpatients (CV(+)) were assessed with LUS to identify the presence of interstitial pneumonia. Studies were considered positive based on the presence of B-lines, pleural irregularity and consolidations. A subset of patients underwent longitudinal examinations. Correlations between LUS findings and patient symptoms, demographics, comorbidities and clinical outcomes over 8 weeks were evaluated. RESULTS 102 CV(+) patients underwent LUS with 42 (41%) demonstrating pulmonary involvement. Baseline LUS severity scores correlated with shortness of breath on multivariate analysis. Of the CV(+) patients followed longitudinally, a majority showed improvement or resolution in LUS findings after 1-2 weeks. Only one patient in the CV(+) cohort was briefly hospitalised, and no patient died or required mechanical ventilation. CONCLUSION We found a high prevalence of LUS findings in outpatients with SARS-CoV-2 infection. Given the pervasiveness of pulmonary disease across a broad spectrum of LUS severity scores and lack of adverse outcomes, our findings suggest that LUS may not be a useful as a risk stratification tool in SARS-CoV-2 in the general outpatient population.
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Affiliation(s)
- Robert M Fairchild
- Department of Immunology & Rheumatology, Stanford University, Stanford, California, USA
| | - Audra Horomanski
- Department of Immunology & Rheumatology, Stanford University, Stanford, California, USA
| | - Diane A Mar
- Department of Immunology & Rheumatology, Stanford University, Stanford, California, USA
| | - Gabriela R Triant
- Department of Immunology & Rheumatology, Stanford University, Stanford, California, USA
| | - Rong Lu
- Quantitative Sciences Unit, Division of Biomedical Informatics Research, Stanford University, Stanford, California, USA
| | - Di Lu
- Quantitative Sciences Unit, Division of Biomedical Informatics Research, Stanford University, Stanford, California, USA
| | - Haiwei Henry Guo
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Matthew C Baker
- Department of Immunology & Rheumatology, Stanford University, Stanford, California, USA
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12
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Ding PA, Yang PG, Tian Y, Lin XC, Li F, Zhang ZD, Wang D, Guo HH, Liu Y, Li Y, Zhao Q. [The effect of cancer nodules on survival prognosis of gastric cancer patients]. Zhonghua Zhong Liu Za Zhi 2021; 43:194-201. [PMID: 33601484 DOI: 10.3760/cma.j.cn112152-20200408-00323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the relationship between cancer nodules and clinicopathological characteristics of gastric cancer, and analyze its impact on survival prognosis of gastric cancer patients. Methods: A retrospective analysis of 2 386 patients with gastric cancer who underwent radical surgery from January 1, 2012 to January 1, 2015 in the Third Surgery Department of the Fourth Hospital of Hebei Medical University was performed. The relationship between cancer nodules and clinicopathological characteristics of gastric cancer and its impact on survival prognosis of gastric cancer patients were analyzed. Results: Among the 2 386 patients, there were 459 cases (19.24%) with cancer nodules, and 1 927 cases (80.76%) without cancer nodules. Logistic multivariate analysis showed that pT staging (P=0.036), pN staging (P=0.024), pTNM staging (P=0.032), Borrmann classification (P=0.008), vascular tumor thrombus (P=0.001) were independent risk factors for cancer nodules. The complete follow-up date of 2 273 cases (95.26%) of 2 386 patients with gastric cancer were obtained. A total of 1 259 patients relapsed and 1 152 died during the follow-up period. The 5-years overall survival (OS) rate was 49.32%, and the 5-years disease-free survival (DFS) rate was 44.61%. Among them, the 5-years OS rate and DFS rate of those with cancer nodules were 26.76% and 24.94%, while the 5-years OS rate and DFS rate of those without cancer nodules were 54.75% and 49.34%, respectively (P<0.001). Patients with positive cancer nodules were divided into 3 groups according to the number of cancer nodules: 1 (115 cases), 2 to 3 (202 cases), and more than 4 (124 cases). The 5-years OS rates of 3 groups were 41.74%, 30.69% and 10.48%, respectively (P<0.001). The 5-years DFS rates were 40.00%, 28.22% and 9.68%, respectively (P<0.001). Cox multivariate analysis showed that histological type (P=0.004), pT staging (P=0.007), pN staging (P=0.004), pTNM staging (P=0.002), vascular tumor thrombus (P=0.034), cancer nodules (P=0.005) and the number of cancer nodules (P=0.001) were independent risk factors for the prognosis of gastric cancer patients, and postoperative adjuvant chemotherapy (P=0.043) was a protective factor for the prognosis of gastric cancer patients. Conclusion: Cancer nodules are closely related to the tumor stage and prognosis of gastric cancer patients. The number of cancerous nodules is an independent risk factor for the prognosis of gastric cancer patients.
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Affiliation(s)
- P A Ding
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - P G Yang
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Tian
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - X C Lin
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - F Li
- Department of Pathology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Z D Zhang
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - D Wang
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - H H Guo
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Liu
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Y Li
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
| | - Q Zhao
- The Third Department of Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
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13
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Lui NS, Guo HH, Sung AW, Peterson A, Kulkarni VN. Single-Lumen Endotracheal Tube and Bronchial Blocker for Airway Management During Tracheobronchoplasty for Tracheobronchomalacia: A Case Report. A A Pract 2020; 13:236-239. [PMID: 31385817 PMCID: PMC6749959 DOI: 10.1213/xaa.0000000000001076] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We present a case of a 69-year-old man who underwent tracheobronchoplasty for tracheobronchomalacia using a single-lumen endotracheal tube and a Y-shaped bronchial blocker for airway management. Tracheobronchoplasty is performed by sewing mesh to plicate the posterior, membranous wall of the distal trachea and main bronchi through a right posterolateral thoracotomy. The goals of airway management include continuous left-lung ventilation and lung protection from aspiration. Ideally, only conventional airway management tools are used. This case demonstrates that a single-lumen endotracheal tube with a bronchial blocker can be a straightforward strategy for airway management during tracheobronchoplasty.
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Affiliation(s)
| | | | | | - Ashley Peterson
- Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California
| | - Vivekanand N Kulkarni
- Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California
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14
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Christou S, Chatziathanasiou T, Angeli S, Koullapis P, Stylianou F, Sznitman J, Guo HH, Kassinos SC. Anatomical variability in the upper tracheobronchial tree: sex-based differences and implications for personalized inhalation therapies. J Appl Physiol (1985) 2020; 130:678-707. [PMID: 33180641 DOI: 10.1152/japplphysiol.00144.2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The morphometry of the large conducting airways is presumed to have a strong effect on the regional deposition of inhaled aerosol particles. Nevertheless, sex-based differences have not been fully quantified and are still largely ignored in designing inhalation therapies. To this end, we retrospectively analyzed high-resolution computed tomography scans for 185 individuals (90 women, 95 men) in the age range of 12-89 yr to determine airway luminal areas, airway lengths, and bifurcation angles. Only subjects free of chronic airway disease were considered. In men, luminal areas of the upper conducting airways were, on average, ∼30%-50% larger when compared with those in women, with the largest differences found in the trachea (289.72 ± 54.25 vs. 193.50 ± 42.37 mm2 for men and women, respectively). The ratio of the largest luminal area in men to the smallest luminal area in women (in any given segment) ranged between 4.5 and 8.6, the largest differences being found in the lobar bronchi. Sex-based differences were minor in the case of bifurcation angles (e.g., average main bifurcation angle: 93.04 ± 9.58° vs. 91.03 ± 9.81° for men and women, respectively), but large intersubject variability was found irrespective of sex (e.g., range of main bifurcation angle: 65.04°-122.01° vs. 69.46°-113.94° for men and women, respectively). Bronchial segments were shorter by ∼5%-20% in women relative to men, the largest differences being located in the upper lobes. False discovery rate analysis revealed statistically significant associations among morphometric measures of the right lung in women (but not in men), suggesting two phenotypes among women that we attribute to the smaller female thoracic volume.NEW & NOTEWORTHY We found significant sex-based morphometric differences in the central airways of healthy men and women that were only mildly attenuated in subsets matched for lung volume. Lumen areas were significantly larger in men (∼30%-50%). Large variability (∼75%-87%) in airway bifurcation angles (60°-122°) was found irrespective of sex. The branching pattern of the right main and right upper bronchi in women (but not in men) follows two phenotypes modulated by lung volume.
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Affiliation(s)
- Simoni Christou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Thanasis Chatziathanasiou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | | | - Pantelis Koullapis
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Fotos Stylianou
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
| | - Josué Sznitman
- Department of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Haiwei Henry Guo
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Stavros C Kassinos
- Computational Sciences Laboratory (UCY-CompSci), Department of Mechanical and Manufacturing Engineering, University of Cyprus, Nicosia, Cyprus
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15
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Ding PA, Liu Y, Guo HH, Yang PG, Tian Y, Fan LQ, Tan BB, Li Y, Zhao Q. [Application of laparoscopic exploration combined with abdominal exfoliative cytology in the diagnosis and treatment of locally advanced gastric cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:170-176. [PMID: 32074798 DOI: 10.3760/cma.j.issn.1671-0274.2020.02.013] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the clinical significance of laparoscopic exploration combined with abdominal exfoliative cytology in the diagnosis and treatment of patients with locally advanced gastric cancer. Methods: Inclusion criteria: (1) cancer confirmed by gastroscopy and pathology without preoperative anti-tumor treatment; (2) no distant metastases found in preoperative imaging examinations; (3) patients without surgical contraindications and being tolerant to surgery; (4) patients were willing to undergo laparoscopic exploration and abdominal exfoliative cytology examination, and signed informed consent. A retrospective cohort study method was used to collect and analyze the clinicopathological data of 225 patients with advanced gastric cancer based on the above inclusion criteria from a prospective, multicenter, open, randomized controlled phase III clinical trial (registration No. NCT01516944) conducted between February 2012 and December 2018 in The Fourth Hospital of Hebei Medical University, including 162 males and 63 females with age ranged from 23 to 78 years old. Forty-five patients (20.0%) were classified as Borrmann type I to II, and 180 (80.0%) were classified as type III to IV. All the patients underwent laparoscopy and peritoneal lavage cytology under general anesthesia. Laparoscopic exploration sequence: left and right diaphragm→liver and spleen→parietal peritoneum→pelvic cavity→greater omentum, small intestine, mesentery→transverse colon mesentery →stomach. Contents of exploration: (1) with or without ascites; (2) whether metastatic lesions existed in the peritoneum, mesentery, omentum and Douglas pouch; (3) whether metastasis existed on the liver surface; (4) whether the gastric lymph nodes were swollen; (5) whether infiltration occurred on the gastric serosa surface; (6) whether gastric wall was stiff. The left and right subphrenic, the abdominal and pelvic peritoneum, and the mesentery were rinsed with 500 ml of sterilized normal saline. Position of the reverse Trendelenburg was used in the Douglas pouch. The peritoneal lavage fluid under the liver and spleen fossa was collected. Cytological examination was carried out for exfoliative tumor cells. Evaluation criteria: (1) peritoneal metastasis (P): P0 meant no peritoneal metastasis, P1 meant peritoneal metastasis; (2) free peritoneal cancer cells (CY): CY0 meant no cancer cells in peritoneal lavage fluid cytology, CY1 meant cancer cells in peritoneal lavage fluid cytology. The results of patients undergoing laparoscopic exploration combined with abdominal exfoliative cytology, treatment options and prognosis were analyzed. Kaplan-Meier method was used to calculate the survival rate and a survival curve was drawn. Log-rank test was used for survival analysis. Results: After laparoscopic exploration in 225 patients, clinical staging was corrected in 68 (30.2%) patients, of whom 7 (3.1%) downstaged and 61 (27.1%) increased in staging. Of 164 patients evaluated as P0CY0 after the first laparoscopy and peritoneal cytology examination, 126 underwent radical D2 surgery, and the other 38 patients were found to have later local lesions or extensive fusion of local lymph nodes, so then received neoadjuvant chemotherapy. Twenty-nine patients evaluated as P1CY0 or P1CY1 and 32 patients as P0CY1 underwent intraperitoneal hyperthermic chemotherapy+conversion therapy, and then a second laparoscopic exploration was performed to determine the treatment plan. In total, the original treatment regimens were changed after laparoscopic exploration in 99(44.0%) cases. The follow-up period ended in January 2019. The overall 2-year survival rate of 225 patients was 64.0%. As for those who were evaluated as P0CY0, P0CY1 and P1CY0-1 after the first laparoscopic exploration, the 2-year overall survival rate was 70.7%, 65.6% and 24.1%, respectively (P=0.002). The stratified analysis showed that among 180 patients with stage III tumor, after laparoscopic exploration combined with abdominal exfoliative cytology, 125 patients were found to be P0CY0, 28 were P0CY1, and 27 were P1CY0-1, whose 2-year overall survival rates were 70.4%, 64.3%, and 29.6% respectively, and the difference among these 3 groups was statistically significant (P=0.009). Conclusion: Laparoscopic exploration combined with abdominal exfoliative cytology in patients with locally advanced gastric cancer has important clinical guiding significance in improving accurate staging, treatment options and prognosis evaluation, and can avoid non-therapeutic open-close abdominal surgery.
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Affiliation(s)
- P A Ding
- The Third Department of Surgery, The Fourth Hospital, Hebei Medical University, Shijiazhuang 050017, China
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16
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Lai YK, Holmes B, Guo HH. A Young Woman With a Rapidly Growing Thoracic Tumor. Chest 2020; 155:e145-e148. [PMID: 31060712 DOI: 10.1016/j.chest.2018.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 11/14/2018] [Accepted: 12/19/2018] [Indexed: 10/26/2022] Open
Abstract
CASE PRESENTATION A 38-year-old woman presented with 2 months of dry cough, progressive shortness of breath, central chest pain, nausea, vomiting, and dizziness. She was previously healthy and was not taking any medications. She denied fever, night sweats, or weight loss. She had a two pack-year smoking history and had quit smoking at 27 years of age. She denied drug use and had no recent travel history. Family history was pertinent for ovarian cancer, breast cancer, and colon cancer.
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Affiliation(s)
- Yu Kuang Lai
- Department of Medicine, Division of Pulmonary and Critical Care, Stanford, CA.
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17
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Lai YK, Lindholm P, Guo HH. The Intralobular Gradient as Seen in Re-Expansion Pulmonary Edema. Radiol Cardiothorac Imaging 2019; 1:e190084. [PMID: 33778531 DOI: 10.1148/ryct.2019190084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/24/2019] [Accepted: 08/05/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Yu Kuang Lai
- Department of Medicine, Division of Pulmonary and Critical Care (Y.K.L.) and Department of Radiology and Thoracic Imaging (P.L., H.H.G.), Stanford University School of Medicine, 300 Pasteur Dr, Room S-074A, Stanford, CA 94305; and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (P.L.)
| | - Peter Lindholm
- Department of Medicine, Division of Pulmonary and Critical Care (Y.K.L.) and Department of Radiology and Thoracic Imaging (P.L., H.H.G.), Stanford University School of Medicine, 300 Pasteur Dr, Room S-074A, Stanford, CA 94305; and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (P.L.)
| | - Haiwei Henry Guo
- Department of Medicine, Division of Pulmonary and Critical Care (Y.K.L.) and Department of Radiology and Thoracic Imaging (P.L., H.H.G.), Stanford University School of Medicine, 300 Pasteur Dr, Room S-074A, Stanford, CA 94305; and Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (P.L.)
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18
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Ning N, Guo HH, Iagaru A, Mittra E, Fowler M, Witteles R. Serial Cardiac FDG-PET for the Diagnosis and Therapeutic Guidance of Patients With Cardiac Sarcoidosis. J Card Fail 2019; 25:307-311. [DOI: 10.1016/j.cardfail.2019.02.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 02/10/2019] [Accepted: 02/22/2019] [Indexed: 11/29/2022]
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Mirza AA, Robinson TE, Gifford K, Guo HH. 3D Printing and the Cystic Fibrosis Lung. J Cyst Fibros 2018; 18:278-279. [PMID: 30361143 DOI: 10.1016/j.jcf.2018.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/15/2018] [Accepted: 09/16/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Alicia A Mirza
- Stanford University, 300 Pasteur Drive, 94305 Palo Alto, CA, United States.
| | - Terry E Robinson
- Stanford University, 300 Pasteur Drive, 94305 Palo Alto, CA, United States
| | - Kyle Gifford
- Stanford University, 300 Pasteur Drive, 94305 Palo Alto, CA, United States
| | - Haiwei Henry Guo
- Stanford University, 300 Pasteur Drive, 94305 Palo Alto, CA, United States.
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20
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Moradzadeh N, Hwang G, Nair V, Guo HH. Methyl Methacrylate Mimicking a Retained Guide Wire. J Vasc Interv Radiol 2017; 27:1906. [PMID: 27886956 DOI: 10.1016/j.jvir.2016.07.020] [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] [Received: 07/13/2016] [Revised: 07/21/2016] [Accepted: 07/21/2016] [Indexed: 10/20/2022] Open
Affiliation(s)
- Nathaniel Moradzadeh
- Department of Radiology, Stanford University School of Medicine, 300 Pasteur Dr., H3630, Stanford, CA 94305-5642.
| | - Gloria Hwang
- Divisions of Interventional Radiology, Stanford University School of Medicine, 300 Pasteur Dr., H3630, Stanford, CA 94305-5642
| | - Viswam Nair
- Pulmonary and Critical Care Medicine, Stanford University School of Medicine, 300 Pasteur Dr., H3630, Stanford, CA 94305-5642
| | - Haiwei Henry Guo
- (d)Thoracic Radiology, Stanford University School of Medicine, 300 Pasteur Dr., H3630, Stanford, CA 94305-5642
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21
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Aviram G, Rozenbaum Z, Ziv-Baran T, Berliner S, Topilsky Y, Fleischmann D, Sung YK, Zamanian RT, Guo HH. Identification of Pulmonary Hypertension Caused by Left-Sided Heart Disease (World Health Organization Group 2) Based on Cardiac Chamber Volumes Derived From Chest CT Imaging. Chest 2017; 152:792-799. [PMID: 28506612 DOI: 10.1016/j.chest.2017.04.184] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 01/14/2017] [Revised: 04/07/2017] [Accepted: 04/29/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Evaluations of patients with pulmonary hypertension (PH) commonly include chest CT imaging. We hypothesized that cardiac chamber volumes calculated from the same CT scans can yield additional information to distinguish PH related to left-sided heart disease (World Health Organization group 2) from other PH subtypes. METHODS Patients who had PH confirmed by right heart catheterization and contrast-enhanced chest CT studies were enrolled in this retrospective multicenter study. Cardiac chamber volumes were calculated using automated segmentation software and compared between group 2 and non-group 2 patients with PH. RESULTS This study included 114 patients with PH, 27 (24%) of whom were classified as group 2 based on their pulmonary capillary wedge pressure. Patients with group 2 PH exhibited significantly larger median left atrial (LA) volumes (118 mL vs 63 mL; P < .001), larger median left ventricular (LV) volumes (90 mL vs 76 mL; P = .02), and smaller median right ventricular (RV) volumes (173 mL vs 210 mL; P = .005) than did non-group 2 patients. On multivariate analysis adjusted for age, sex, and mean pulmonary arterial pressure, group 2 PH was significantly associated with larger median LA and LV volumes (P < .001 and P = .008, respectively) and decreased volume ratios of RA/LA, RV/LV, and RV/LA (P = .001, P = .004, and P < .001, respectively). Enlarged LA volumes demonstrated a high discriminatory ability for group 2 PH (area under the curve, 0.92; 95% CI, 0.870-0.968). CONCLUSIONS Volumetric analysis of the cardiac chambers from nongated chest CT scans, particularly with findings of an enlarged left atrium, exhibited high discriminatory ability for identifying patients with PH due to left-sided heart disease.
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Affiliation(s)
- Galit Aviram
- Department of Radiology, Tel Aviv Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Zach Rozenbaum
- Department of Internal Medicine "D" and "E", Tel Aviv Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Ziv-Baran
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomo Berliner
- Department of Internal Medicine "D" and "E", Tel Aviv Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yan Topilsky
- Department of Cardiology, Tel Aviv Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dominik Fleischmann
- Department of Radiology, Stanford Health Care, Stanford University School of Medicine Stanford, CA
| | - Yon K Sung
- Department of Pulmonary and Critical Care Medicine, Stanford Health Care, Stanford University School of Medicine Stanford, CA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Health Care, Stanford University School of Medicine Stanford, CA
| | - Roham T Zamanian
- Department of Pulmonary and Critical Care Medicine, Stanford Health Care, Stanford University School of Medicine Stanford, CA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford Health Care, Stanford University School of Medicine Stanford, CA
| | - Haiwei Henry Guo
- Department of Radiology, Stanford Health Care, Stanford University School of Medicine Stanford, CA
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Abstract
BACKGROUND Coccidioidomycosis, commonly called "valley fever," "San Joaquin fever," "desert fever," or "desert rheumatism," is a multi-system illness caused by infection with Coccidioides fungi (C. immitis or C. posadasii). This organism is endemic to the desert Southwest regions of the United States and Mexico and to parts of South America. The manifestations of infection occur along a spectrum from asymptomatic to mild self-limited fever to severe disseminated disease. METHODS Review of the English-language literature. RESULTS There are five broad indications for surgical intervention in patients with coccidioidomycosis: Tissue diagnosis in patients at risk for co-existing pathology, perforation, bleeding, impingement on critical organs, and failure to resolve with medical management. As part of a multidisciplinary team, surgeons may be responsible for the care of infected patients, particularly those with severe disease. CONCLUSION This review discusses the history, microbiology, epidemiology, pathology, diagnosis, and treatment of coccidioidomycosis, focusing on situations that may be encountered by surgeons.
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Affiliation(s)
| | - Haiwei Henry Guo
- 2 Department of Radiology, Stanford University , Stanford, California
| | - Thomas G Weiser
- 1 Department of Surgery, Stanford University , Stanford, California
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Chaudhuri AA, Binkley MS, Rigdon J, Carter JN, Aggarwal S, Dudley SA, Qian Y, Kumar KA, Hara WY, Gensheimer M, Nair VS, Maxim PG, Shultz DB, Bush K, Trakul N, Le QT, Diehn M, Loo BW, Guo HH. Pre-treatment non-target lung FDG-PET uptake predicts symptomatic radiation pneumonitis following Stereotactic Ablative Radiotherapy (SABR). Radiother Oncol 2016; 119:454-60. [PMID: 27267049 DOI: 10.1016/j.radonc.2016.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/09/2016] [Accepted: 05/16/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE To determine if pre-treatment non-target lung FDG-PET uptake predicts for symptomatic radiation pneumonitis (RP) following lung stereotactic ablative radiotherapy (SABR). METHODS We reviewed a 258 patient database from our institution to identify 28 patients who experienced symptomatic (grade ⩾ 2) RP after SABR, and compared them to 57 controls who did not develop symptomatic RP. We compared clinical, dosimetric and functional imaging characteristics between the 2 cohorts including pre-treatment non-target lung FDG-PET uptake. RESULTS Median follow-up time was 26.9 months. Patients who experienced symptomatic RP had significantly higher non-target lung FDG-PET uptake as measured by mean SUV (p < 0.0001) than controls. ROC analysis for symptomatic RP revealed area under the curve (AUC) of 0.74, with sensitivity 82.1% and specificity 57.9% with cutoff mean non-target lung SUV > 0.56. Predictive value increased (AUC of 0.82) when mean non-target lung SUV was combined with mean lung dose (MLD). We developed a 0-2 point model using these 2 variables, 1 point each for SUV > 0.56 or MLD > 5.88 Gy equivalent dose in 2 Gy per fraction (EQD2), predictive for symptomatic RP in our cohort with hazard ratio 10.01 for score 2 versus 0 (p < 0.001). CONCLUSIONS Patients with elevated pre-SABR non-target lung FDG-PET uptake are at increased risk of symptomatic RP after lung SABR. Our predictive model suggests patients with mean non-target lung SUV > 0.56 and MLD > 5.88 Gy EQD2 are at highest risk. Our predictive model should be validated in an external cohort before clinical implementation.
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Affiliation(s)
- Aadel A Chaudhuri
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Michael S Binkley
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Joseph Rigdon
- Quantitative Sciences Unit, Stanford University School of Medicine, United States
| | - Justin N Carter
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Sonya Aggarwal
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Sara A Dudley
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Yushen Qian
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Kiran A Kumar
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Wendy Y Hara
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States
| | - Michael Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Viswam S Nair
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, United States
| | - Peter G Maxim
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States
| | - David B Shultz
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Canada
| | - Karl Bush
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Nicholas Trakul
- Department of Radiation Oncology, University of Southern California School of Medicine, United States
| | - Quynh-Thu Le
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States
| | - Maximilian Diehn
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, United States.
| | - Billy W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States.
| | - Haiwei Henry Guo
- Department of Radiology and Nuclear Medicine, Stanford University School of Medicine, United States.
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Sun SX, Guo HH, Zhang J, Yu B, Sun KN, Jin QH. BMP-2 and titanium particles synergistically activate osteoclast formation. ACTA ACUST UNITED AC 2014; 47:461-9. [PMID: 24820069 PMCID: PMC4086172 DOI: 10.1590/1414-431x20132966] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 01/18/2013] [Accepted: 11/25/2013] [Indexed: 02/06/2023]
Abstract
A previous study showed that BMP-2 (bone morphogenetic protein-2) and wear debris can
separately support osteoclast formation induced by the receptor activator of NF-κB
ligand (RANKL). However, the effect of BMP-2 on wear debris-induced osteoclast
formation is unclear. In this study, we show that neither titanium particles nor
BMP-2 can induce osteoclast formation in RAW 264.7 mouse leukemic monocyte macrophage
cells but that BMP-2 synergizes with titanium particles to enhance osteoclast
formation in the presence of RANKL, and that at a low concentration, BMP-2 has an
optimal effect to stimulate the size and number of multinuclear osteoclasts,
expression of osteoclast genes, and resorption area. Our data also clarify that the
effects caused by the increase in BMP-2 on phosphorylated SMAD levels such as c-Fos
expression increased throughout the early stages of osteoclastogenesis. BMP-2 and
titanium particles stimulate the expression of p-JNK, p-P38, p-IkB, and P50 compared
with the titanium group. These data suggested that BMP-2 may be a crucial factor in
titanium particle-mediated osteoclast formation.
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Affiliation(s)
- S X Sun
- Department of Orthopedics, Affiliated Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - H H Guo
- Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - J Zhang
- Institute of Pathology, Xi'an Jiaotong University, Xi'an Shaanxi, China
| | - B Yu
- Ningxia Medical University, Ningxia Hui Autonomous Region, China
| | - K N Sun
- Department of Orthopedics, Affiliated Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Q H Jin
- Department of Orthopedics, Affiliated Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
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25
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Guo HH, Yu CC, Sun SX, Ma XJ, Yang XC, Sun KN, Jin QH. Adenovirus-mediated siRNA targeting TNF-α and overexpression of bone morphogenetic protein-2 promotes early osteoblast differentiation on a cell model of Ti particle-induced inflammatory response in vitro. Braz J Med Biol Res 2013; 46:831-8. [PMID: 24141610 PMCID: PMC3854310 DOI: 10.1590/1414-431x20133092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 03/07/2013] [Accepted: 07/01/2013] [Indexed: 11/21/2022] Open
Abstract
Wear particles are phagocytosed by macrophages and other inflammatory cells,
resulting in cellular activation and release of proinflammatory factors, which
cause periprosthetic osteolysis and subsequent aseptic loosening, the most
common causes of total joint arthroplasty failure. During this pathological
process, tumor necrosis factor-alpha (TNF-α) plays an important role in
wear-particle-induced osteolysis. In this study, recombination adenovirus (Ad)
vectors carrying both target genes [TNF-α small interfering RNA (TNF-α-siRNA)
and bone morphogenetic protein 2 (BMP-2)] were synthesized and transfected into
RAW264.7 macrophages and pro-osteoblastic MC3T3-E1 cells, respectively. The
target gene BMP-2, expressed on pro-osteoblastic MC3T3-E1 cells and silenced by
the TNF-α gene on cells, was treated with titanium (Ti) particles that were
assessed by real-time PCR and Western blot. We showed that recombinant
adenovirus (Ad-siTNFα-BMP-2) can induce osteoblast differentiation when treated
with conditioned medium (CM) containing RAW264.7 macrophages challenged with a
combination of Ti particles and Ad-siTNFα-BMP-2 (Ti-ad CM) assessed by alkaline
phosphatase activity. The receptor activator of nuclear factor-κB ligand was
downregulated in pro-osteoblastic MC3T3-E1 cells treated with Ti-ad CM in
comparison with conditioned medium of RAW264.7 macrophages challenged with Ti
particles (Ti CM). We suggest that Ad-siTNFα-BMP-2 induced osteoblast
differentiation and inhibited osteoclastogenesis on a cell model of a Ti
particle-induced inflammatory response, which may provide a novel approach for
the treatment of periprosthetic osteolysis.
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Affiliation(s)
- H H Guo
- Affiliated Hospital of Ningxia Medical University, Department of Orthopedic Surgery, Yinchuan, China
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26
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Huai RC, Yi CL, Ru LB, Chen GH, Guo HH, Luo L. Traumatic carotid cavernous fistula concomitant with pseudoaneurysm in the sphenoid sinus. Interv Neuroradiol 2008; 14:59-68. [PMID: 20557787 PMCID: PMC3313707 DOI: 10.1177/159101990801400108] [Citation(s) in RCA: 13] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2007] [Accepted: 02/29/2008] [Indexed: 11/16/2022] Open
Abstract
SUMMARY This study was designed to elucidate the generating mechanism, diagnosis and treatment of traumatic carotid cavernous fistula (tCCF) concomitant with pseudoaneurysm in the sphenoid sinus. Six cases of tCCF concomitant with pseudoaneurysm in the sphenoid sinus were analyzed in this study. Clinical history, neurological examination, CT and MRI scans, pre- and postembolization cerebral angiograms and follow-up data were included. All patients presented with massive epistaxis and symptoms of tCCF. The pseudoaneurysms and fistulas were occluded with detachable balloons, and preservation of the parent artery in two cases. One patient also had indirect carotid cavernous fistula (CCF) on the contralateral side embolized by transfacial vein approach with microcoils. Complete symptom resolution was achieved in all cases, without procedure related complications. During the follow-up period all patients returned to work. Falling from a high speed motorcycle without wearing a helmet may be one of the main causes of this disease. The site of impact during the accident mostly localizes in the frontal and lateral of the orbit. Intracavernous sinus hypertension of tCCF combining with fracture of the lateral wall of the sphenoid may lead to the formation of a pseudoaneurysm in the sphenoid sinus. MRI scan is very helpful in the diagnosis of this disease before the patient receives angiography. Detachable balloon occlusion of the pseudoaneurysm and fistula is a safe and efficient treatment.
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Affiliation(s)
- R C Huai
- Department of Neurosurgery, Changzheng Hospital, the Shanghai Neurosurgical Institute, Shanghai China -
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27
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ten Tije AJ, Wieman TJ, Taber SW, Tseng MT, Cerrito PB, Jansen JM, Guo HH, Fingar VH. Analysis of pulmonary microvasculature changes after photodynamic therapy delivered to distant sites. Photochem Photobiol 1999; 69:494-9. [PMID: 10212583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Photodynamic therapy (PDT) can exert local damage by direct tumor cytotoxicity, by disruption of the microvasculature or by a combination of these effects. Although systemic effects after PDT of small tissue areas (< 1% total body surface area) are unlikely, treatment of larger areas may result in an accumulated effect leading to toxicity. Several investigators have described animal death after high dose PDT to tumors on the hind limb of animals and hypothesized that a toxic shock syndrome caused by vasoactive agents released after PDT is responsible. Because one of the most vulnerable organs to toxic shock injury is the lung, we studied the systemic effects of local PDT to this organ by intravital microscopy using a pulmonary window chamber. The PDT treatment conditions (25 mg/kg Photofrin, 24 h, 150 J/cm2 630 nm, maximum area 6.28 cm2) were chosen that produce systemic toxicity and lethality in rats. Adhesion of leukocytes in the lung was monitored in vivo using anti-CD-13-labeled microspheres. The progression of pulmonary edema was assessed by monitoring the leakage of rhodamine-labeled albumin and by wet-to-dry lung weight ratios. Although an increased leukocyte adherence was observed and a significant number of animals died after the extensive PDT treatment, no biologically significant lung edema could be demonstrated. These data indicate that lung edema and acute respiratory distress syndrome is not the cause of death in these animals and that the toxicity is related to other mechanisms including circulatory shock after extensive muscle damage.
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Affiliation(s)
- A J ten Tije
- Department of Internal Medicine, St. Clara Hospital, Rotterdam, The Netherlands
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28
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Fingar VH, Guo HH, Lu ZH, Peiper SC. Expression of chemokine receptors by endothelial cells: detection by intravital microscopy using chemokine-coated fluorescent microspheres. Methods Enzymol 1997; 288:148-58. [PMID: 9356993 DOI: 10.1016/s0076-6879(97)88013-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
MESH Headings
- Animals
- Antigens, CD/analysis
- Antigens, CD/biosynthesis
- Endothelium, Vascular/cytology
- Endothelium, Vascular/metabolism
- Escherichia coli
- Gene Expression/genetics
- Interleukin-8/isolation & purification
- Interleukin-8/metabolism
- Microscopy, Fluorescence/methods
- Microscopy, Video
- Microspheres
- Rats
- Rats, Sprague-Dawley
- Receptors, Chemokine/analysis
- Receptors, Chemokine/biosynthesis
- Receptors, Interleukin/analysis
- Receptors, Interleukin/biosynthesis
- Receptors, Interleukin-8A
- Recombinant Fusion Proteins/isolation & purification
- Recombinant Fusion Proteins/metabolism
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Affiliation(s)
- V H Fingar
- Department of Surgery, University of Louisville, Kentucky 40292, USA
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29
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Affiliation(s)
- Z X Wang
- Department of Biochemistry and Molecular Biology, Henry Vogt Cancer Research Institute, James Graham Brown Cancer Center, University of Louisville, Kentucky 40292, USA
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30
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Doranz BJ, Lu ZH, Rucker J, Zhang TY, Sharron M, Cen YH, Wang ZX, Guo HH, Du JG, Accavitti MA, Doms RW, Peiper SC. Two distinct CCR5 domains can mediate coreceptor usage by human immunodeficiency virus type 1. J Virol 1997; 71:6305-14. [PMID: 9261347 PMCID: PMC191903 DOI: 10.1128/jvi.71.9.6305-6314.1997] [Citation(s) in RCA: 169] [Impact Index Per Article: 6.3] [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] [Indexed: 02/05/2023] Open
Abstract
The chemokine receptor CCR5 is the major fusion coreceptor for macrophage-tropic strains of human immunodeficiency virus type 1 (HIV-1). To define the structures of CCR5 that can support envelope (Env)-mediated membrane fusion, we analyzed the activity of homologs, chimeras, and mutants of human CCR5 in a sensitive gene reporter cell-cell fusion assay. Simian, but not murine, homologs of CCR5 were fully active as HIV-1 fusion coreceptors. Chimeras between CCR5 and divergent chemokine receptors demonstrated the existence of two distinct regions of CCR5 that could be utilized for Env-mediated fusion, the amino-terminal domain and the extracellular loops. Dual-tropic Env proteins were particularly sensitive to alterations in the CCR5 amino-terminal domain, suggesting that this domain may play a pivotal role in the evolution of coreceptor usage in vivo. We identified individual residues in both functional regions, Asp-11, Lys-197, and Asp-276, that contribute to coreceptor function. Deletion of a highly conserved cytoplasmic motif rendered CCR5 incapable of signaling but did not abrogate its ability to function as a coreceptor, implying the independence of fusion and G-protein-mediated chemokine receptor signaling. Finally, we developed a novel monoclonal antibody to CCR5 to assist in future studies of CCR5 expression.
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Affiliation(s)
- B J Doranz
- Department of Pathology, University of Pennsylvania, Philadelphia 19104, USA
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31
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Rana S, Besson G, Cook DG, Rucker J, Smyth RJ, Yi Y, Turner JD, Guo HH, Du JG, Peiper SC, Lavi E, Samson M, Libert F, Liesnard C, Vassart G, Doms RW, Parmentier M, Collman RG. Role of CCR5 in infection of primary macrophages and lymphocytes by macrophage-tropic strains of human immunodeficiency virus: resistance to patient-derived and prototype isolates resulting from the delta ccr5 mutation. J Virol 1997; 71:3219-27. [PMID: 9060685 PMCID: PMC191454 DOI: 10.1128/jvi.71.4.3219-3227.1997] [Citation(s) in RCA: 159] [Impact Index Per Article: 5.9] [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] [Indexed: 02/03/2023] Open
Abstract
The alpha-chemokine receptor fusin (CXCR-4) and beta-chemokine receptor CCR5 serve as entry cofactors for T-cell (T)-tropic and macrophage (M)-tropic human immunodeficiency virus type 1 (HIV-1) strains, respectively, when expressed with CD4 in otherwise nonpermissive cells. Some M-tropic and dual-tropic strains can also utilize other beta-chemokine receptors, such as CCR2b and CCR3. A mutation of CCR5 (delta ccr5) was recently found to be common in certain populations and appears to confer protection against HIV-1 in vivo. Here, we show that this mutation results in a protein that is expressed intracellularly but not on the cell surface. Primary CD4 T cells from delta ccr5 homozygous individuals were highly resistant to infection with prototype M-tropic HIV-1 strains, including an isolate (YU-2) that uses CCR5 and CCR3, but were permissive for both a T-tropic strain (3B) and a dual-tropic variant (89.6) that uses CXCR-4, CCR5, CCR3, or CCR2b. These cells were also resistant to M-tropic patient isolates but were readily infected by T-tropic patient isolates. Primary macrophages from delta ccr5 homozygous individuals were also resistant to infection with M-tropic strains, including YU-2, but the dual-tropic strain 89.6 was able to replicate in them even though macrophages are highly resistant to CXCR-4-dependent T-tropic isolates. These data show that CCR5 is the essential cofactor for infection of both primary macrophages and T lymphocytes by most M-tropic strains of HIV-1. They also suggest that CCR3 does not function for HIV-1 entry in primary lymphocytes or macrophages, but that a molecule(s) other than CCR5 can support entry into macrophages by certain virus isolates. These studies further define the cellular basis for the resistance to HIV-1 infection of individuals lacking functional CCR5.
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MESH Headings
- CD4 Antigens/immunology
- CD8 Antigens/immunology
- Cells, Cultured
- HIV-1/immunology
- HIV-1/physiology
- Humans
- Lymphocytes/cytology
- Lymphocytes/virology
- Macrophages/cytology
- Macrophages/virology
- Mutagenesis
- Receptors, CCR3
- Receptors, CCR5
- Receptors, Chemokine
- Receptors, Cytokine/genetics
- Receptors, Cytokine/immunology
- Receptors, Cytokine/physiology
- Receptors, HIV/genetics
- Receptors, HIV/immunology
- Receptors, HIV/physiology
- Species Specificity
- Virus Replication
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Affiliation(s)
- S Rana
- Division of Pulmonary and Critical Care, University of Pennsylvania School of Medicine, Philadelphia 19104, USA
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32
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Guo HH, Zhou LF. [Further experience in the diagnosis and treatment of sphenoidal ridge meningioma]. Zhonghua Wai Ke Za Zhi 1994; 32:740-2. [PMID: 7774425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
72 cases with sphenoidal ridge meningioma operated on in recent 12 years in our department were reported. In the microsurgical group and non-microsurgical group, the rate of total removal of medial tumors was 65% and 20% respectively (P < 0.01); lateral tumors was 100% and 77% respectively (P > 0.05); the mortality was 6.7% and 11.9% respectively (P > 0.05); the rate of neurological impaired was 33.3% and 64.3% respectively (P < 0.001); good rate of following up for a long time was 87.5% and 16.7% in medial group respectively (P < 0.05); 66.7% and 75% in lateral group respectively (P > 0.05). It is believed that application of CT and angiography and microsurgical technique is helpful to the diagnosis and treatment of sphenoidal ridge meningioma.
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Affiliation(s)
- H H Guo
- Huashan Hospital, Shanghai Medical University
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33
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Guo HH, Pan YH, Zhou LF, Shi YQ. Research on hemodynamics of cerebral arteriovenous malformation by Doppler ultrasound. Chin Med J (Engl) 1993; 106:351-6. [PMID: 8404277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Combined extracranial and transcranial Doppler (TCD) instruments were used to study the hemodynamics of 20 patients with cerebral arteriovenous malformation (AVM) proved angiographically. It was discovered that the flow velocities in AVM-feeding arteries and their proximal arteries were increased; the increase of flow velocities in feeding arteries close to AVM was more remarkable than that in feeding-arteries proximal to extracranial internal carotid artery far from AVM; pulsating indexes of AVM-feeding arteries were decreased; increase of flow velocities in AVM-feeding arteries was related to the decrease of pulsating index; the flow velocities of nontapering feeding arteries were faster than those of tapering arteries; the greater the size of AVM, the faster the velocity in feeding artery; and the flow velocities and pulsating indexes of AVM-feeding arteries were gradually recovered to normal 3-5 weeks after resection of AVM. It is believed that increase of flow velocity in AVM-feeding artery is associated with distention and decreased resistance of flow in AVM-feeding artery. TCD combined with CT scans are helpful to the diagnosis of AVM. Combination of TCD and cerebral angiography (CAG) to evaluate comprehensively the preoperative hemodynamics of AVM and to monitor postoperative changes is helpful to detecting cerebral steal due to steal leakage in circle of Willis and preventing the hazardous postoperative complications caused by pressure breakthrough of normal perfusion.
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Affiliation(s)
- H H Guo
- Institute of Neurology, Shanghai Medical University
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