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Miller CA, Felbaum DR, Liu AH, Mai J, Alfawaz A, Lynes J, Armonda R. Direct Vertebral Artery Access for Coil Embolization of a Partially Thrombosed Mid-Basilar Trunk Aneurysm: Technical Limitations. Oper Neurosurg (Hagerstown) 2021; 21:E381-E385. [PMID: 34133747 DOI: 10.1093/ons/opab186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/04/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND IMPORTANCE Partially thrombosed basilar aneurysms have a high morbidity from the rupture risk and mass effect prompting early treatment. Depending on the size and location, they pose a surgical challenge often requiring multiple endovascular treatment modalities. Here we present a partially thrombosed mid-basilar aneurysm successfully coil embolized with direct vertebral artery access and discuss the technical limitations of direct V1 access. CLINICAL PRESENTATION A 70-yr-old woman presented with acute onset headache, nausea, and vomiting. A computed tomography (CT) head demonstrated a hyperdense prepontine mass which was further characterized as a partially thrombosed basilar aneurysm on CT angiography. After multiple failed attempts to access the vertebral artery via femoral and radial access the patient was taken to the operating room (OR) for surgical exposure of the right V1 segment and direct cannulation of the vertebral artery. The aneurysm was successfully coiled and the vertebral artery closed primarily. The patient was discharged home without any neurological deficits. CONCLUSION Partially thrombosed mid-basilar aneurysms are difficult to treat both surgically and endovascularly. We present a case where endovascular access to the aneurysm was very challenging requiring direct exposure and cannulation of the V1 segment to successfully embolize with coils and discuss the technical limitations of this approach.
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Affiliation(s)
- Charles A Miller
- Division of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Daniel R Felbaum
- Department of Neurosurgery, Medstar Washington Hospital Center, Washington, District of Columbia, USA
| | - Ai-Hsi Liu
- Department of Neurosurgery, Medstar Washington Hospital Center, Washington, District of Columbia, USA
| | - Jeffrey Mai
- Department of Neurosurgery, Medstar Washington Hospital Center, Washington, District of Columbia, USA
| | - Abdullah Alfawaz
- Department of Vascular Surgery, Medstar Washington Hospital Center, Washington, District of Columbia, USA
| | - John Lynes
- Department of Neurosurgery, Medstar Washington Hospital Center, Washington, District of Columbia, USA
| | - Rocco Armonda
- Department of Neurosurgery, Medstar Washington Hospital Center, Washington, District of Columbia, USA
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2
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Shahjouei S, Tsivgoulis G, Farahmand G, Koza E, Mowla A, Vafaei Sadr A, Kia A, Vaghefi Far A, Mondello S, Cernigliaro A, Ranta A, Punter M, Khodadadi F, Naderi S, Sabra M, Ramezani M, Amini Harandi A, Olulana O, Chaudhary D, Lyoubi A, Campbell BCV, Arenillas JF, Bock D, Montaner J, Aghayari Sheikh Neshin S, Aguiar de Sousa D, Tenser MS, Aires A, Alfonso MDL, Alizada O, Azevedo E, Goyal N, Babaeepour Z, Banihashemi G, Bonati LH, Cereda CW, Chang JJ, Crnjakovic M, De Marchis GM, Del Sette M, Ebrahimzadeh SA, Farhoudi M, Gandoglia I, Gonçalves B, Griessenauer CJ, Murat Hanci M, Katsanos AH, Krogias C, Leker RR, Lotman L, Mai J, Male S, Malhotra K, Malojcic B, Mesquita T, Mir Ghasemi A, Mohamed Aref H, Mohseni Afshar Z, Moon J, Niemelä M, Rezai Jahromi B, Nolan L, Pandhi A, Park JH, Marto JP, Purroy F, Ranji-Burachaloo S, Carreira NR, Requena M, Rubiera M, Sajedi SA, Sargento-Freitas J, Sharma VK, Steiner T, Tempro K, Turc G, Ahmadzadeh Y, Almasi-Dooghaee M, Assarzadegan F, Babazadeh A, Baharvahdat H, Cardoso FB, Dev A, Ghorbani M, Hamidi A, Hasheminejad ZS, Hojjat-Anasri Komachali S, Khorvash F, Kobeissy F, Mirkarimi H, Mohammadi-Vosough E, Misra D, Noorian AR, Nowrouzi-Sohrabi P, Paybast S, Poorsaadat L, Roozbeh M, Sabayan B, Salehizadeh S, Saberi A, Sepehrnia M, Vahabizad F, Yasuda TA, Ghabaee M, Rahimian N, Harirchian MH, Borhani-Haghighi A, Azarpazhooh MR, Arora R, Ansari S, Avula V, Li J, Abedi V, Zand R. SARS-CoV-2 and Stroke Characteristics: A Report From the Multinational COVID-19 Stroke Study Group. Stroke 2021; 52:e117-e130. [PMID: 33878892 PMCID: PMC8078130 DOI: 10.1161/strokeaha.120.032927] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Supplemental Digital Content is available in the text. Background and Purpose: Stroke is reported as a consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in several reports. However, data are sparse regarding the details of these patients in a multinational and large scale. Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke, intracranial hemorrhage, and cerebral venous or sinus thrombosis among SARS-CoV-2–infected patients. We further investigated the risk of large vessel occlusion, stroke severity as measured by the National Institutes of Health Stroke Scale, and stroke subtype as measured by the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria among patients with acute ischemic stroke. In addition, we explored the neuroimaging findings, features of patients who were asymptomatic for SARS-CoV-2 infection at stroke onset, and the impact of geographic regions and countries’ health expenditure on outcomes. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least 1 eligible stroke patient. Of 432 patients included, 323 (74.8%) had acute ischemic stroke, 91 (21.1%) intracranial hemorrhage, and 18 (4.2%) cerebral venous or sinus thrombosis. A total of 183 (42.4%) patients were women, 104 (24.1%) patients were <55 years of age, and 105 (24.4%) patients had no identifiable vascular risk factors. Among acute ischemic stroke patients, 44.5% (126 of 283 patients) had large vessel occlusion; 10% had small artery occlusion according to the TOAST criteria. We observed a lower median National Institutes of Health Stroke Scale (8 [3–17] versus 11 [5–17]; P=0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; P<0.001) in countries with middle-to-high health expenditure when compared with countries with lower health expenditure. Among 380 patients who had known interval onset of the SARS-CoV-2 and stroke, 144 (37.8%) were asymptomatic at the time of admission for SARS-CoV-2 infection. Conclusions: We observed a considerably higher rate of large vessel occlusions, a much lower rate of small vessel occlusion and lacunar infarction, and a considerable number of young stroke when compared with the population studies before the pandemic. The rate of mechanical thrombectomy was significantly lower in countries with lower health expenditures.
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Affiliation(s)
- Shima Shahjouei
- Neurology Department, Neuroscience Institute, Geisinger Health System, PA (S. Shahjouei, A. Mowla, D.C., C.J.G., R.Z.)
| | - Georgios Tsivgoulis
- Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Greece (G. Tsivgoulis, A.H.K.)
| | - Ghasem Farahmand
- Iranian Center of Neurological Research, Neuroscience Institute (G.F., S.R.-B., M. Ghabaee, M.H.H.), Tehran University of Medical Sciences, Iran.,Neurology Department (G.F., A.V.F., M. Ghabaee), Tehran University of Medical Sciences, Iran
| | - Eric Koza
- Geisinger Commonwealth School of Medicine, Scranton, PA (E.K., O.O.)
| | - Ashkan Mowla
- Neurology Department, Neuroscience Institute, Geisinger Health System, PA (S. Shahjouei, A. Mowla, D.C., C.J.G., R.Z.).,Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, CA (A. Mowla, M.S.T.)
| | - Alireza Vafaei Sadr
- Department de Physique Theorique and Center for Astroparticle Physics, University Geneva, Switzerland (A.V.S.)
| | - Arash Kia
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, Institute for Healthcare Delivery Science, New York City, NY (A.K.)
| | - Alaleh Vaghefi Far
- Neurology Department (G.F., A.V.F., M. Ghabaee), Tehran University of Medical Sciences, Iran
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy (S. Mondello)
| | | | - Annemarei Ranta
- Department of Neurology, Wellington Hospital, New Zealand and Department of Medicine, University of Otago, New Zealand (A.R., M.P.)
| | - Martin Punter
- Department of Neurology, Wellington Hospital, New Zealand and Department of Medicine, University of Otago, New Zealand (A.R., M.P.)
| | - Faezeh Khodadadi
- PES University, Bangaluru, Karnataka, India (F. Khodadadi, A.D.)
| | - Soheil Naderi
- Department of Neurosurgery (S.N.), Tehran University of Medical Sciences, Iran
| | - Mirna Sabra
- Neurosciences Research Center, Lebanese University/Medical School, Beirut, Lebanon (M. Sabra, F. Kobeissy)
| | - Mahtab Ramezani
- Neurology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran (M. Ramezani, A.A.H.)
| | - Ali Amini Harandi
- Neurology Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran (M. Ramezani, A.A.H.)
| | - Oluwaseyi Olulana
- Geisinger Commonwealth School of Medicine, Scranton, PA (E.K., O.O.)
| | - Durgesh Chaudhary
- Neurology Department, Neuroscience Institute, Geisinger Health System, PA (S. Shahjouei, A. Mowla, D.C., C.J.G., R.Z.)
| | - Aicha Lyoubi
- Neurology Department, Delafontaine Hospital, Saint-Denis, France (A.L.)
| | - Bruce C V Campbell
- Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Australia (B.C.V.C.)
| | - Juan F Arenillas
- Department of Neurology, University of Valladolid, Spain (J.F.A., M.D.L.A.)
| | - Daniel Bock
- Department of Cardiology, Klinikum Frankfurt Höchst, Germany (D.B.)
| | - Joan Montaner
- Department of Neurology, Hospital Universitario Virgen Macarena, Sevilla, Spain (J. Montaner)
| | | | - Diana Aguiar de Sousa
- Department of Neurology (D.A.d.S.), Hospital de Santa Maria, University of Lisbon, Portugal.,Department of Neurology, Hospital de Santa Maria, University of Lisbon, Portugal (D.A.d.S.)
| | - Matthew S Tenser
- Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California, CA (A. Mowla, M.S.T.)
| | - Ana Aires
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal (A.A., E.A.).,Department of Medicine, University of Porto, Portugal (A.A., E.A.)
| | | | - Orkhan Alizada
- Neurosurgery Department, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Turkey (O.A., M.M.H.)
| | - Elsa Azevedo
- Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal (A.A., E.A.).,Department of Medicine, University of Porto, Portugal (A.A., E.A.)
| | - Nitin Goyal
- Department of Neurology, University of Tennessee (N.G., A.P., S.A.)
| | | | - Gelareh Banihashemi
- Imam Khomeini Hospital, and Neurology Department, Sina Hospital (G.B., F.V.), Tehran University of Medical Sciences, Iran
| | - Leo H Bonati
- Department of Neurology and Stroke Unit, University Hospital Basel, Switzerland (L.H.B.)
| | - Carlo W Cereda
- Stroke Center, Neurocenter of Southern Switzerland, Lugano (C.W.C.)
| | - Jason J Chang
- Department of Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC (J.J.C.)
| | - Miljenko Crnjakovic
- Intensive Care Unit, Department of Neurology, Clinical Hospital Dubrava, Zagreb, Croatia (M.C.)
| | - Gian Marco De Marchis
- Neurorehabilitation Unit, University Center for Medicine of Aging and Rehabilitation Basel, Felix Platter Hospital, University of Basel, Switzerland (G.D.M.)
| | | | | | - Mehdi Farhoudi
- Neurosciences Research Center, Tabriz University of Medical Sciences, Iran (M.F.)
| | | | - Bruno Gonçalves
- Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Université de Paris, INSERM U1266, France (B.G., G. Turc)
| | - Christoph J Griessenauer
- Neurology Department, Neuroscience Institute, Geisinger Health System, PA (S. Shahjouei, A. Mowla, D.C., C.J.G., R.Z.)
| | - Mehmet Murat Hanci
- Neurosurgery Department, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Turkey (O.A., M.M.H.)
| | - Aristeidis H Katsanos
- Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, "Attikon" University Hospital, Greece (G. Tsivgoulis, A.H.K.).,Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.H.K.)
| | - Christos Krogias
- Department of Neurology, St. Josef-Hospital, Ruhr University Bochum, Germany (C.K.)
| | - Ronen R Leker
- Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel (R.R.L.)
| | - Lev Lotman
- Department of Neurology, Albany Medical Center, NY (L.L., L.N., K.T.)
| | - Jeffrey Mai
- Department of Neurosurgery, Georgetown University and MedStar Washington Hospital Center, DC (J. Mai)
| | - Shailesh Male
- Department of Neurosurgery, Vidant Medical Center, Greenville, NC (S. Male)
| | - Konark Malhotra
- Department of Neurology, Allegheny Health Network, Pittsburgh, PA (K.M.)
| | - Branko Malojcic
- Department of Neurology, TIA Clinic, University Hospital Centre Zagreb, Zagreb School of Medicine, University of Zagreb, Croatia (B.M.)
| | - Teresa Mesquita
- Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (T.M., J.P.M.)
| | | | - Hany Mohamed Aref
- Department of Neurology, Ain Shams University, Cairo, Egypt (H.M.A.)
| | - Zeinab Mohseni Afshar
- Infection Disease Research Center, Kermanshah University of Medical Sciences, Iran (Z.M.A.)
| | - Jusun Moon
- Department of Neurology, National Medical Center, Seoul, South Korea (J. Moon)
| | - Mika Niemelä
- Department of Neurosurgery, Helsinki University and Helsinki University Hospital, Finland (M.N., B.R.J.)
| | - Behnam Rezai Jahromi
- Department of Neurosurgery, Helsinki University and Helsinki University Hospital, Finland (M.N., B.R.J.)
| | - Lawrence Nolan
- Department of Neurology, Albany Medical Center, NY (L.L., L.N., K.T.)
| | - Abhi Pandhi
- Department of Neurology, University of Tennessee (N.G., A.P., S.A.)
| | - Jong-Ho Park
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, South Korea (J.-H.P.)
| | - João Pedro Marto
- Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (T.M., J.P.M.)
| | - Francisco Purroy
- Department of Neurology, Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, Spain (F.P., N.R.C.)
| | - Sakineh Ranji-Burachaloo
- Iranian Center of Neurological Research, Neuroscience Institute (G.F., S.R.-B., M. Ghabaee, M.H.H.), Tehran University of Medical Sciences, Iran
| | - Nuno Reis Carreira
- Department of Internal Medicine (N.E.C.), Hospital de Santa Maria, University of Lisbon, Portugal.,Department of Neurology, Hospital Arnau de Vilanova, Institut de Recerca Biomèdica de Lleida, Universitat de Lleida, Spain (F.P., N.R.C.)
| | - Manuel Requena
- Stroke Unit, Department of Neurology, Hospital Vall d'Hebron Barcelona, Spain (M. Requena, M. Rubiera).,Department de Medicina, Universitat Autònoma de Barcelona, Spain (M. Requena, M. Rubiera)
| | - Marta Rubiera
- Stroke Unit, Department of Neurology, Hospital Vall d'Hebron Barcelona, Spain (M. Requena, M. Rubiera).,Department de Medicina, Universitat Autònoma de Barcelona, Spain (M. Requena, M. Rubiera)
| | - Seyed Aidin Sajedi
- Department of Neurology, Neuroscience Research Center, Golestan University of Medical Sciences, Iran (S.A.S.)
| | - João Sargento-Freitas
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal (J.S.-F.)
| | - Vijay K Sharma
- Division of Neurology, University Medicine Cluster, National University Health System, Singapore (V.K.S.)
| | - Thorsten Steiner
- Department of Neurology, Klinikum Frankfurt Höchst, Germany (T.S.).,Department of Neurology, Heidelberg University Hospital, Germany (T.S.)
| | - Kristi Tempro
- Department of Neurology, Albany Medical Center, NY (L.L., L.N., K.T.)
| | - Guillaume Turc
- Department of Neurology, GHU Paris Psychiatrie et Neurosciences, Université de Paris, INSERM U1266, France (B.G., G. Turc)
| | | | - Mostafa Almasi-Dooghaee
- Divisions of Vascular and Endovascular Neurosurgery (M.A.-D., M. Ghorbani), Firoozgar Hospital, Iran University of Medical Sciences, Tehran.,Neurology (M.A.-D.), Firoozgar Hospital, Iran University of Medical Sciences, Tehran.,Divisions of Vascular and Endovascular Neurosurgery (M.A.-D.), Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran.,Neurology (M.A.-D.), Rasoul-Akram Hospital, Iran University of Medical Sciences, Tehran
| | | | - Arefeh Babazadeh
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Iran (A.B.)
| | - Humain Baharvahdat
- Neurosurgical Department, Ghaem Hospital, Mashhad University of Medical Sciences, Iran (H.B.)
| | | | - Apoorva Dev
- PES University, Bangaluru, Karnataka, India (F. Khodadadi, A.D.)
| | - Mohammad Ghorbani
- Divisions of Vascular and Endovascular Neurosurgery (M.A.-D., M. Ghorbani), Firoozgar Hospital, Iran University of Medical Sciences, Tehran
| | - Ava Hamidi
- Neurology Ward, Gheshm Hospital, Iran (A.H.)
| | - Zeynab Sadat Hasheminejad
- Department of Neurology, Imam Hosein Hospital, Shahid Beheshti Medical University, Tehran, Iran (Z.S.H., M. Sepehrnia)
| | | | - Fariborz Khorvash
- Neurology Department, Isfahan University of Medical Sciences, Iran (F. Khorvash)
| | - Firas Kobeissy
- Neurosciences Research Center, Lebanese University/Medical School, Beirut, Lebanon (M. Sabra, F. Kobeissy).,Program of Neurotrauma, Neuroproteomics and Biomarker Research, University of Florida (F. Kobeissy)
| | | | | | - Debdipto Misra
- Steele Institute of Health and Innovation, Geisinger Health System, PA (D.M.)
| | - Ali Reza Noorian
- Department of Neurology, Southern California Permanente Medical Group, Irvine, CA (A.R.N.)
| | | | - Sepideh Paybast
- Department of Neurology, Bou Ali Hospital, Qazvin University of Medical Sciences, Iran (S.P.)
| | - Leila Poorsaadat
- Department of Neurology, Arak University of Medical Sciences, Iran (L.P.)
| | - Mehrdad Roozbeh
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran (M. Roozbeh)
| | - Behnam Sabayan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (B.S.)
| | - Saeideh Salehizadeh
- Neurology Department, Salahadin Ayubi Hospital, Baneh, Iran (S. Salehizadeh)
| | - Alia Saberi
- Neurology Department, Poursina Hospital, Rasht, Guilan, Iran (S.A.S.N., A.S.)
| | - Mercedeh Sepehrnia
- Department of Neurology, Imam Hosein Hospital, Shahid Beheshti Medical University, Tehran, Iran (Z.S.H., M. Sepehrnia)
| | - Fahimeh Vahabizad
- Imam Khomeini Hospital, and Neurology Department, Sina Hospital (G.B., F.V.), Tehran University of Medical Sciences, Iran
| | | | - Mojdeh Ghabaee
- Iranian Center of Neurological Research, Neuroscience Institute (G.F., S.R.-B., M. Ghabaee, M.H.H.), Tehran University of Medical Sciences, Iran.,Neurology Department (G.F., A.V.F., M. Ghabaee), Tehran University of Medical Sciences, Iran
| | - Nasrin Rahimian
- Department of Neurology, Yasrebi Hospital, Kashan, Iran (N.R.)
| | - Mohammad Hossein Harirchian
- Iranian Center of Neurological Research, Neuroscience Institute (G.F., S.R.-B., M. Ghabaee, M.H.H.), Tehran University of Medical Sciences, Iran
| | | | | | - Rohan Arora
- Department of Neurology, Long Island Jewish Forest Hills, Queens, NY (R.A.)
| | - Saeed Ansari
- Department of Neurology, University of Tennessee (N.G., A.P., S.A.)
| | - Venkatesh Avula
- Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA (V. Avula, V. Abedi, J.L.)
| | - Jiang Li
- Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA (V. Avula, V. Abedi, J.L.).,Biocomplexity Institute, Virginia Tech, Blacksburg, VA (J.L., V. Abedi)
| | - Vida Abedi
- Department of Molecular and Functional Genomics, Geisinger Health System, Danville, PA (V. Avula, V. Abedi, J.L.).,Biocomplexity Institute, Virginia Tech, Blacksburg, VA (J.L., V. Abedi)
| | - Ramin Zand
- Neurology Department, Neuroscience Institute, Geisinger Health System, PA (S. Shahjouei, A. Mowla, D.C., C.J.G., R.Z.)
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Katsanos AH, Krogias C, Lioutas VA, Goyal N, Zand R, Sharma VK, Varelas P, Malhotra K, Paciaroni M, Sharaf A, Chang J, Karapanayiotides T, Kargiotis O, Pappa A, Mai J, Tsantes A, Boviatsis E, Lambadiari V, Shoamanesh A, Mitsias PD, Selim MH, Alexandrov AV, Tsivgoulis G. The prognostic utility of ICH-score in anticoagulant related intracerebral hemorrhage. J Neurol Sci 2019; 409:116628. [PMID: 31862517 DOI: 10.1016/j.jns.2019.116628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 11/26/2022]
Abstract
Although intracerebral hemorrhage (ICH) score is used to provide an estimate on the probability of mortality following spontaneous ICH of any cause, its utility has not been exclusively tested in ICH patients with history of treatment with vitamin K antagonists (VKAs) or non-vitamin K oral anticoagulants (NOACs). The aim of the present report is to investigate the utility of ICH score for mortality prognostication of VKA-ICH and NOAC-ICH patients. We used receiver operating characteristic curve analyses to estimate the accuracy parameters for the different values of ICH score in the prognosis of mortality within 30-days after the onset of NOAC-ICH or VKA-ICH. We analyzed data from 108 NOAC-ICH and 241 VKA-ICH patients (median age 76 years, 58% males, median NIHSS score 11 points, median ICH-score 2 points). ICH score of 4 points was uncovered to be the most favorable threshold for the prediction of 30-day mortality both after NOAC-ICH (sensitivity: 57.7%, specificity: 98.8%) or VKA-ICH (sensitivity: 42.1%, specificity: 92.6%). However, comparison of the areas under the curve (AUC) suggested a cumulatively higher (p = .001) predictive value of ICH-score in the prognostication of 30-day mortality after ICH related to the use of NOACs (AUC: 0.92, 95%CI: 0.86-0.98) compared to the ICH related to the use of VKAs (AUC: 0.77, 95%CI: 0.70-0.83). In conclusion, ICH score seems to have an adequate predictive utility in the prognostication of 30-day mortality following an ICH related to the use of oral anticoagulants, with better yield in ICH cases associated with the use of NOACs.
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Affiliation(s)
- Aristeidis H Katsanos
- Division of Neurology, McMaster University, Population Health Research Institute, Hamilton, ON, Canada.
| | - Christos Krogias
- Department of Neurology, St. Josef-Hospital, Ruhr University of Bochum, Bochum, Germany
| | | | - Nitin Goyal
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Ramin Zand
- Department of Neurology, Geisinger Medical Center, Danville, PA, USA
| | - Vijay K Sharma
- Division of Neurology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | | | - Maurizio Paciaroni
- Stroke Unit, Division of Cardiovascular Medicine, University of Perugia, Italy
| | | | - Jason Chang
- Department of Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC, USA
| | - Theodore Karapanayiotides
- Second Department of Neurology, AHEPA University Hospital, Aristotelian University of Thessaloniki, Thessaloniki, Greece
| | | | - Alexandra Pappa
- Department of Neurology, University of Thessaly, Larissa, Greece
| | - Jeffrey Mai
- Department of Neurosurgery, Georgetown University, Washington, DC, USA
| | - Argyrios Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Efstathios Boviatsis
- Department of Neurosurgery, "Attikon" Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Vaia Lambadiari
- Second Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ashkan Shoamanesh
- Division of Neurology, McMaster University, Population Health Research Institute, Hamilton, ON, Canada
| | - Panayiotis D Mitsias
- Department of Neurology, Henry Ford Hospital, Detroit, MI, USA; Department of Neurology, School of Medicine, University of Crete, Crete, Greece
| | - Magdy H Selim
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Andrei V Alexandrov
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Georgios Tsivgoulis
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA; Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
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Lioutas VA, Goyal N, Katsanos AH, Krogias C, Zand R, Sharma VK, Varelas P, Malhotra K, Paciaroni M, Sharaf A, Chang J, Karapanayiotides T, Kargiotis O, Pappa A, Mai J, Pandhi A, Schroeder C, Tsantes A, Mehta C, Kerro A, Khan A, Mitsias PD, Selim MH, Alexandrov AV, Tsivgoulis G. Clinical Outcomes and Neuroimaging Profiles in Nondisabled Patients With Anticoagulant-Related Intracerebral Hemorrhage. Stroke 2019; 49:2309-2316. [PMID: 30355114 DOI: 10.1161/strokeaha.118.021979] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background and Purpose- The aim of this study was to prospectively validate our prior findings of smaller hematoma volume and lesser neurological deficit in nonvitamin K oral anticoagulant (NOAC) compared with Vitamin K antagonist (VKA)-related intracerebral hemorrhage (ICH). Methods- Prospective 12-month observational study in 15 tertiary stroke centers in the United States, Europe, and Asia. Consecutive patients with premorbid modified Rankin Scale score of <2 with acute nontraumatic anticoagulant-related ICH divided into 2 groups according to the type of anticoagulant: NOAC versus VKA. We recorded baseline ICH volume, significant hematoma expansion (absolute [12.5 mL] or relative [>33%] increase), neurological severity measured by National Institutes of Health Stroke Scale score, 90-day mortality, and functional status (modified Rankin Scale score). Results- Our cohort comprised 196 patients, 62 NOAC related (mean age, 75.0±11.4 years; 54.8% men) and 134 VKA related (mean age, 72.3±10.5; 73.1% men). There were no differences in vascular comorbidities, antiplatelet, and statin use; NOAC-related ICH patients had lower median baseline hematoma volume (13.8 [2.5-37.6] versus 19.5 [6.6-52.0] mL; P=0.026) and were less likely to have severe neurological deficits (National Institutes of Health Stroke Scale score of >10 points) on admission (37% versus 55.3%, P=0.025). VKA-ICH were more likely to have significant hematoma expansion (37.4% versus 17%, P=0.008). NOAC pretreatment was independently associated with smaller baseline hematoma volume (standardized linear regression coefficient:-0.415 [95% CI, -0.780 to -0.051]) resulting in lower likelihood of severe neurological deficit (odds ratio, 0.44; 95% CI, 0.22-0.85) in multivariable-adjusted models. Conclusions- Patients with NOAC-related ICH have smaller baseline hematoma volumes and lower odds of severe neurological deficit compared with VKA-related ICH. These findings are important for practicing clinicians making anticoagulation choices.
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Affiliation(s)
- Vasileios-Arsenios Lioutas
- From the Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (V.-A.L., M.H.S.)
| | - Nitin Goyal
- Department of Neurology, University of Tennessee Health Science Center, Memphis (N.G., A.P., A.K., A.V.A., G.T.)
| | - Aristeidis H Katsanos
- Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (A.H.K., G.T.).,Department of Neurology, University of Ioannina School of Medicine, Greece (A.H.K.)
| | - Christos Krogias
- Department of Neurology, St Josef-Hospital, Ruhr University of Bochum, Germany (C.K., C.S.)
| | - Ramin Zand
- Department of Neurology, Geisinger Medical Center, Danville, PA (R.Z., A.K.)
| | - Vijay K Sharma
- Division of Neurology, Yong Loo Lin School of Medicine, National University of Singapore (V.K.S.)
| | - Panayiotis Varelas
- Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., C.M., P.D.M.)
| | - Konark Malhotra
- Department of Neurology, West Virginia University Charleston Division (K.M.)
| | - Maurizio Paciaroni
- Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Italy (M.P.)
| | - Aboubakar Sharaf
- Department of Neurology, Essentia Health-Duluth Clinic, MN (A.S.)
| | - Jason Chang
- Department of Critical Care Medicine, MedStar Washington Hospital Center, DC (J.C.)
| | - Theodore Karapanayiotides
- Second Department of Neurology, AHEPA University Hospital, Aristotelian University of Thessaloniki, Greece (T.K.)
| | | | - Alexandra Pappa
- Department of Neurology, University of Tennessee Health Science Center, Memphis (N.G., A.P., A.K., A.V.A., G.T.).,Department of Neurology, University of Thessaly, Larissa, Greece (A.P.)
| | - Jeffrey Mai
- Department of Neurosurgery Georgetown University, Washington, DC (J.M.)
| | | | - Christoph Schroeder
- Department of Neurology, St Josef-Hospital, Ruhr University of Bochum, Germany (C.K., C.S.)
| | - Argyrios Tsantes
- Laboratory of Haematology and Blood Bank Unit, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (A.T.)
| | - Chandan Mehta
- Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., C.M., P.D.M.)
| | - Ali Kerro
- Department of Neurology, University of Tennessee Health Science Center, Memphis (N.G., A.P., A.K., A.V.A., G.T.)
| | - Ayesha Khan
- Department of Neurology, Geisinger Medical Center, Danville, PA (R.Z., A.K.)
| | - Panayiotis D Mitsias
- Department of Neurology, Henry Ford Hospital, Detroit, MI (P.V., C.M., P.D.M.).,Department of Neurology, School of Medicine, University of Crete, Greece (P.D.M.)
| | - Magdy H Selim
- From the Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (V.-A.L., M.H.S.)
| | - Andrei V Alexandrov
- Department of Neurology, University of Tennessee Health Science Center, Memphis (N.G., A.P., A.K., A.V.A., G.T.)
| | - Georgios Tsivgoulis
- Department of Neurology, University of Tennessee Health Science Center, Memphis (N.G., A.P., A.K., A.V.A., G.T.).,Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece (A.H.K., G.T.)
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Negre H, Pinte L, Manduke R, Cunningham A, Anderson H, Richard S, Khelladi R, Mai J, Chow S, Kelley M, Daley H, Sturtevant O, Nikiforow S, Ritz J. Personnel environmental monitoring during manufacture of manipulated cell therapy products. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Liu X, Nie Z, Chen J, Guo X, Ou Y, Chen G, Mai J, Gong W, Wu Y, Gao X, Qu Y, Bell E, Lin S, Zhuang J. 1193Maternal environmental tobacco smoke interacted with other factors on cardiovascular defects in a population case-control study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.1193] [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: 11/13/2022] Open
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Qu Y, Liu X, Bell E, Chen J, Han F, Pan W, Cen J, Ou Y, Wen S, Mai J, Nie Z, Gao X, Wu Y, Lin S, Zhuang J. P6209Perinatal outcome of fetus with prenatal diagnosed congenital heart defects, results of a cohort study from China. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6209] [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: 11/13/2022] Open
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Alqahtani SA, Stemer AB, McCullough MF, Bell RS, Mai J, Liu AH, Armonda RA. Endovascular Management of Stroke Patients with Large Vessel Occlusion and Minor Stroke Symptoms. Cureus 2017; 9:e1355. [PMID: 28721323 PMCID: PMC5510978 DOI: 10.7759/cureus.1355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Endovascular mechanical thrombectomy for stroke patients with large vessel occlusion (LVO) in the anterior circulation has become the standard of care based on several major randomized clinical trials. The successful result reported by these trials constitutes what may be the largest achievement in the history of neurological sciences. However, most of these mechanical thrombectomy trials (except for the multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands, i.e., MR CLEAN and Extending the Time for Thrombolysis in Emergency Neurological Deficits–Intra-Arterial, i.e., EXTEND-IA) excluded stroke patients with minor to mild stroke symptoms with National Institutes of Health Stroke Scale (NIHSS) scores of six to eight or lower. The median NIHSS score for patients who underwent acute endovascular thrombectomy was approximately 15 to 17 in all trials. To date, the evidence is lacking to support the mechanical thrombectomy in patients with acute stroke and LVO with minor to mild severity on NIHSS score. The purpose of this review was to assess the current data, safety and clinical outcomes in stroke patients with minor to mild symptoms who were treated with endovascular thrombectomy.
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Affiliation(s)
| | | | | | - Randy S Bell
- Department of Neurosurgery, Walter Reed Army Medical Center, Washington D.C
| | - Jeffrey Mai
- Neurosurgery, Medstar Georgetown University Hospital
| | - Ai-Hsi Liu
- Neurointerventional Radiology, Medstar Washington Hospital Center
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Ferrari M, Xu R, Zhang G, Mai J, Shen H. Abstract P3-06-06: Development of iNPG-pDox for metastatic breast cancer treatment. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-06-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
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Affiliation(s)
- M Ferrari
- Houston Methodist Research Institute, Houston, TX; Huazhong University of Science and Technology, Wuhan, China
| | - R Xu
- Houston Methodist Research Institute, Houston, TX; Huazhong University of Science and Technology, Wuhan, China
| | - G Zhang
- Houston Methodist Research Institute, Houston, TX; Huazhong University of Science and Technology, Wuhan, China
| | - J Mai
- Houston Methodist Research Institute, Houston, TX; Huazhong University of Science and Technology, Wuhan, China
| | - H Shen
- Houston Methodist Research Institute, Houston, TX; Huazhong University of Science and Technology, Wuhan, China
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10
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Xu J, Hsu D, Mai J, Lo S. Utility of Transthoracic Echocardiogram (TTE) to Guide Eculizumab Treatment in Adult Onset Atypical Haemolytic Uraemic Syndrome (aHUS) with Severe Cardiac Involvement. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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11
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Guo L, Yang J, Mai J, Du X, Guo Y, Li P, Yue Y, Tang D, Lu C, Zhang WH. Prevalence and associated factors of myopia among primary and middle school-aged students: a school-based study in Guangzhou. Eye (Lond) 2016; 30:796-804. [PMID: 26965016 DOI: 10.1038/eye.2016.39] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 02/04/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo estimate the prevalence of myopia among primary and middle school-aged students in Guangzhou and to explore the potentially contributing factors to myopia.MethodsThis cross-sectional study was based on a sample of students in grades 1-6 and grades 7-9. Data were collected from refractive error measurements and a structured questionnaire.ResultsA total of 3055 participants were involved in this analysis, and the overall prevalence of myopia was 47.4% (95% confidence interval (CI)= 45.6-49.2%). The prevalence of myopia in students increased along with the growth of grade level; the prevalence of myopia in students in grade 1 was only 0.2%, as it increased to 38.8% in students in grade 3, and the rate was the highest (68.4%) in students in grade 9. Girls were at a higher risk of myopia than boys (adjusted odds ratio=1.22, 95% CI=1.04-1.44). Both male and female students whose distance of reading was longer than 25 cm were less likely to have myopia and who have one or two myopic parents were at a higher risk of myopia. In addition, reading for pleasure more than 2 h per day (adjusted odds ratio=1.84, 95% CI=1.09-3.12) was only positively associated with myopia in boys and spending time watching television per week was only positively associated with myopia in girls.ConclusionMyopia in students is a significant public health problem in Guangzhou. Female gender, higher grade, longer time spent for near work, shorter distance of near work, and parental myopia were shown to be associated with the increasing risk of myopia in children.
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Affiliation(s)
- L Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.,Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Brussel, Belgium
| | - J Yang
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, People's Republic of China
| | - J Mai
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, People's Republic of China
| | - X Du
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, People's Republic of China
| | - Y Guo
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, People's Republic of China
| | - P Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Y Yue
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - D Tang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - C Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - W-H Zhang
- Epidemiology, Biostatistics and Clinical Research Centre, School of Public Health, Université Libre de Bruxelles (ULB), Brussel, Belgium
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Affiliation(s)
- Jeffrey Mai
- Department of Neurosurgery, George Washington University,Washington, D.C
| | - James Ecklund
- Department of Neurosurgery, George Washington University,Washington, D.C
| | - Michelle Feinberg
- Department of Neurosurgery, George Washington University,Washington, D.C
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Xu K, He L, Mai J. Characteristic of surface myoelectric signals on maximum isometric voluntary contraction of wrist flexors and extensors in children with hemiplegic cerebral palsy. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Shen H, Xu R, Mai J, Huang Y, Ferrari M. Abstract P6-13-02: Overcoming therapy resistance of metastatic breast cancer by enhanced tumor delivery of polymeric doxorubicin. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p6-13-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Metastatic breast cancers are treated with chemotherapy drugs in clinic. However, patients usually develop therapy resistance quickly due to intrinsic and acquired mechanisms. Poor drug delivery to tumor cells may also contribute to therapy resistance. To address both biological and mass transport barriers to effective therapy, we developed a new doxorubicin-based formulation, polymeric doxorubicin (pDox), to be delivered using a porous silicon drug carrier, the multistage vector (MSV). We show the novel, rationally designed MSV/pDox drug enriches in tumor tissues and has considerable therapeutic efficacy in two animal models of triple negative breast cancer lung metastasis, conferring a significant survival advantage to animals treated with MSV/pDox over all other control groups (80% survival for the MSV/pDox group at 24 weeks post treatment vs. 0% survival for all others, log-rank test, p < 0.001). Mechanistically, pDox is released from the MSV as nanoparticles by controlled, sustained kinetics, and enters tumor cells by vesicular transport. The active doxorubicin is released in the acidic environment in lysosomes, exits vesicles in the perinuclear region, and enters the nucleus for drug action. This effective mass transport mechanism kills both the bulk and therapy resistant cells, but avoids cardiac damage. As a result, this new nanodrug has a significantly higher therapeutic window over doxorubicin and Doxil.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-13-02.
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Affiliation(s)
- H Shen
- The Methodist Hospital Research Institute, Houston, TX
| | - R Xu
- The Methodist Hospital Research Institute, Houston, TX
| | - J Mai
- The Methodist Hospital Research Institute, Houston, TX
| | - Y Huang
- The Methodist Hospital Research Institute, Houston, TX
| | - M Ferrari
- The Methodist Hospital Research Institute, Houston, TX
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Kalfas F, Ramanathan D, Mai J, Schwartz S, Sekhar LN. Petrous bone epidermoid cyst caused by penetrating injury to the external ear: Case report and review of literature. Asian J Neurosurg 2012; 7:93-7. [PMID: 22870161 PMCID: PMC3410170 DOI: 10.4103/1793-5482.98656] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Epidermoid cysts are histologically benign, slow-growing congenital neoplasms of the central nervous system that may arise from retained ectodermal implants. The epidermoid lesions are generally caused during the 3rd to 5th week of gestation by an incomplete cleavage of the neural tissue from the cutaneous ectoderm, though it can also happen later in life due to introduction of skin elements by skin puncture, trauma or surgery. We present this unique case of a petromastoid epidermoid cyst associated with ipsilateral cerebellar abscesses, presenting 20 years after a penetrating trauma to the external auditory canal. Radical excision of both lesions and revision of the previous fistulous tract was performed. We present the diagnostic challenge and the operative treatment of this unique case, which to our knowledge is the first where an epidermoid cyst and an adjacent brain abscess occurred as a result of a single traumatic event.
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Affiliation(s)
- Fotios Kalfas
- Department of Neurological Surgery, University of Washington, Seattle, USA
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Huff W, Mai J, Kuhn J, Lenartz D, Klosterkoetter J, Sturm V. Response to Dr. Mavridis' and Dr. Anagnostopoulos' letter. Clin Neurol Neurosurg 2010; 113:258-9. [PMID: 21163570 DOI: 10.1016/j.clineuro.2010.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 11/01/2010] [Indexed: 11/30/2022]
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Abstract
OBJECTIVE To examine the association between internet addiction and self-injurious behaviour (SIB) in adolescence. METHODS Population-based cross-sectional survey of 1618 high school students aged 13-18 years in Guangzhou city, Guangdong Province, PR China. Deliberate SIB was measured using self-reported questionnaire; internet addiction was assessed using the Internet Addiction Test (IAT). RESULTS 263 (16.3%) participants reported having committed some form of SIB in the past 6 months. 73 (4.5%) had committed SIB 6 times or more, and 157 (9.7%) 1-5 times. The majority of respondents were classified as normal users of the internet (n = 1392, 89.2%), with 158 (10.2%) moderately and 10 (0.6%) severely addicted to the internet. After adjusting for potential confounders, the odds ratio for SIB was 2.0 (95% CI 1.1 to 3.7) for those who were classified as moderately and severely addicted to the internet when compared to the normal group. CONCLUSIONS SIB is common in adolescence in the study population in China. Addiction to the internet is detrimental to mental health and increases the risk of self-injury among adolescents. Clinicians need to be aware of potential co-morbidities of other addictions among adolescent self-injured patients.
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Affiliation(s)
- L T Lam
- Discipline of Paediatric and Child Health, The University of Sydney, Australia.
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Yin Y, Yan Y, Jiang X, Mai J, Chen NC, Wang H, Yang XF. Inflammasomes are differentially expressed in cardiovascular and other tissues. Int J Immunopathol Pharmacol 2009; 22:311-22. [PMID: 19505385 DOI: 10.1177/039463200902200208] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
To determine the expression of components in Toll-like receptors (TLRs)/Nod-like receptors (NLRs)/inflammasome/caspase-1/interleukin (IL-1)-beta pathway, we examined the expression profiles of those genes by analyzing the data from expression sequence tag cDNA cloning and sequencing. We made several important findings: firstly, among 11 tissues examined, vascular tissues and heart express fewer types of TLRs and NLRs than immune and defense tissues including blood, lymph nodes, thymus and trachea; secondly, brain, lymph nodes and thymus do not express proinflammatory cytokines IL-1beta and IL-18 constitutively, suggesting that these two cytokines need to be upregulated in the tissues; and thirdly, based on the expression data of three characterized inflammasomes (NALP1, NALP3 and IPAF inflammasome), the examined tissues can be classified into three tiers: the first tier tissues including brain, placenta, blood and thymus express inflammasome(s) in constitutive status; the second tier tissues have inflammasome(s) in nearly-ready expression status (with the requirement of upregulation of one component); the third tier tissues, like heart and bone marrow, require upregulation of at least two components in order to assemble functional inflammasomes. Our original model of three-tier expression of inflammasomes would suggest a new concept of tissue inflammation privilege, and provides an insight to the differences among tissues in initiating acute inflammation in response to stimuli.
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Affiliation(s)
- Y Yin
- Department of Pharmacology and Cardiovascular Research Center, Temple University School of Medicine, Philadelphia, PA, USA
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Affiliation(s)
- J. Mai
- Universitätslaboratorium, Heidelberg
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22
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Affiliation(s)
- J. Mai
- Universitätslaboratorium, Heidelberg
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23
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Affiliation(s)
- J. Mai
- Anorganisch‐chemisches Laboratorium der Universität, Bern
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Kermer P, Krajewska M, Zapata JM, Takayama S, Mai J, Krajewski S, Reed JC. Bag1 is a regulator and marker of neuronal differentiation. Cell Death Differ 2002; 9:405-13. [PMID: 11965493 DOI: 10.1038/sj.cdd.4400972] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [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: 06/10/2001] [Accepted: 10/10/2001] [Indexed: 11/08/2022] Open
Abstract
Bag 1 acts as a co-chaperone for Hsp70/Hsc70. We report here that stable over-expression of Bag1 in immortalized neuronal CSM14.1 cells prevents death following serum deprivation. Bag1 over-expression slowed the proliferative rate of CSM14.1 cells, resulted in increased levels of phospo-MAP kinases and accelerated neuronal differentiation. Immunocytochemistry revealed mostly nuclear localization of Bag1 protein in these cells. However, during differentiation in vitro, Bag1 protein shifted from predominantly nuclear to mostly cytosolic in CSM14.1 cells. To explore in vivo parallels of these findings, we investigated Bag1 expression in the developing mouse nervous system using immunohistochemical methods. Early in brain development, Bag1 was found in nuclei of neuronal precursor cells, whereas cytosolic Bag1 staining was observed mainly after completion of neuronal precursor migration and differentiation. Taken together, these findings raise the possibility that the Bag1 protein is expressed early in neurogenesis in vivo and is capable of modulating neuronal cell survival and differentiation at least in part from a nuclear location.
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Affiliation(s)
- P Kermer
- The Burnham Institute, Program on Apoptosis and Cell Death Research, 10901 N. Torrey Pines Road, La Jolla, California, CA 92037, USA
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Mai J, Erickson B, Rownd J, Gillin M. Comparision of four different dose specification methods for high-dose-rate intracavitary radiation for treatment of cervical cancer. Int J Radiat Oncol Biol Phys 2001; 51:1131-41. [PMID: 11704338 DOI: 10.1016/s0360-3016(01)01771-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [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: 10/18/2022]
Abstract
PURPOSE To compare the dose delivered to target tissues and dose-limiting structures as defined by specific dose points with high-dose-rate intracavitary brachytherapy using tandem and ring or tandem and ovoids applicators, and to provide a reasonable approach to dose optimization. METHODS AND MATERIALS Dosimetry was obtained using four different dose specifications: (1) 100% of the dose prescribed in a tapered fashion along the tandem and 140% at the ovoid/ring surface, (2) 100% of the dose prescribed along the tandem and 100% at the ovoid/ring surface, (3) 100% of the dose prescribed to point A without any additional applicator specification points, and (4) nonoptimized plan using relative dwell weighting to simulate classic Fletcher low-dose-rate (LDR) loading with the dose specified at point A. Point doses were recorded at A, B, and T (cervical tumor point), ICRU rectum, and ovoid/ring surface. RESULTS For the tandem and ovoids applicators, significant differences were found among the four different dose specification methods for point T and vaginal mucosal doses. When the dose was optimized to point A alone, the ovoid dwell weights were reduced, resulting in higher point T doses and underdosing of the vaginal mucosa. Fixed weighting based on Fletcher LDR loading specifications resulted in higher vaginal mucosa doses. For the tandem and ring applicators, significant differences were observed for vaginal mucosal doses and the ICRU rectal dose. Optimization to point A alone resulted in widely varying dosimetric distributions and vaginal mucosa doses up to 632% of the prescription dose. With nonoptimized fixed weighting, the vaginal wall dose and ICRU rectal dose were increased. CONCLUSION Prescribing to dose optimization points in a tapered fashion along the tandem and at the ovoid/ring surface results in a pear-shaped dose distribution resembling classic LDR systems. The other dose specification methods may result in underdosing of important target tissues or overdosing of adjacent dose-limiting structures.
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Affiliation(s)
- J Mai
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI 53226, USA
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Luo R, Mai J, Chen Q, Yang S, Zhong J. [Evaluation of sensorineural hearing loss in childhood]. Zhonghua Er Bi Yan Hou Ke Za Zhi 2001; 36:346-51. [PMID: 12761942] [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: 03/02/2023]
Abstract
OBJECTIVE To explore the clinical and audiological characteristics of sensorineural hearing loss (SHL) with pathological changes both in cochlea and retrocochlear in children and evaluate the relationship between SHL and the lesions in the central nervous system (CNS). METHODS Three hundred and ten cases (500 ears) of SHL accepted between 1998 and 2000 were studied. The age of patients was ranged from 1 month to 6 years old. According to the evaluation of function of CNS by pediatric neurologist, all cases were divided into two groups: SHL with CNS disease and SHL without CNS disease. Some same age children without hearing loss were subjected as control group. All children were tested using both auditory brainstem responses (ABR) and distortion product otoacoustic emissions (DPOAE). RESULTS 1. The rate of SHL accompanied with CNS diseases was very high in these children. 2. Patients with kernicterus-cerebral palsy usually had serious hearing loss caused by acoustic nerve lesion at retrocochlear, but their cochlea function was injured slightly. Patients with external hydrocephalus had only slight acoustic nerve lesion at retrocochlear, and patients with other CNS diseases usually had no change for their cochlea function. 3. In the group of SHL caused by cochlea lesion, amplitudes of DPOAE decreased obviously when the threshold of wave V of ABR was up to 60 dB nHL, and amplitudes of DPOAE seriously decreased or disappeared when the threshold of wave V was up to above 70 dB nHL. CONCLUSION The patients with SHL are usually accompanied with CNS diseases in childhood, and their hearing loss appears very difference from audiological characteristics. We suggest that it is necessary to test both ABR and DPOAE in these patients, and it is important that pediatric neurologist join in audiologist team for our clinical study.
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Affiliation(s)
- R Luo
- Department of Otorhinolaryngology, Guangzhou Children Hospital, Guangzhou Medical College, Guangzhou 510120, China.
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Mai J, Sokolov IM, Blumen A. Directed particle diffusion under "burnt bridges" conditions. Phys Rev E Stat Nonlin Soft Matter Phys 2001; 64:011102. [PMID: 11461220 DOI: 10.1103/physreve.64.011102] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2000] [Indexed: 05/23/2023]
Abstract
We study random walks on a one-dimensional lattice that contains weak connections, so-called "bridges." Each time the walker crosses the bridge from the left or attempts to cross it from the right, the bridge may be destroyed with probability p; this restricts the particle's motion and directs it. Our model, which incorporates asymmetric aspects in an otherwise symmetric hopping mechanism, is very akin to "Brownian ratchets" and to front propagation in autocatalytic A+B-->2A reactions. The analysis of the model and Monte Carlo simulations show that for large p the velocity of the directed motion is extremely sensitive to the distribution of bridges, whereas for small p the velocity can be understood based on a mean-field analysis. The single-particle model advanced by us here allows an almost quantitative understanding of the front's position in the A+B-->2A many-particle reaction.
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Affiliation(s)
- J Mai
- Theoretische Polymerphysik, Universität Freiburg, Hermann-Herder-Strasse 3, D-79104 Freiburg, Germany
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Liu X, Mai J, Rao X, Gao X. [Dietary intake of antioxidant vitamins and personal demographic characteristics of Guangdong residents]. Wei Sheng Yan Jiu 2001; 30:107-10. [PMID: 11321943] [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: 02/19/2023]
Abstract
The study aim at revealing the associations between the intake of dietary antioxidant vitamins and personal characteristics on age, sex, education, working status and household gross income etc. The intake of antioxidant vitamins in a population of Guangdong Province was studied. A total of 418 males and 503 females, aged 25-84 year were interviewed, and questionnaires on socio-demography and on a 12-month food intake frequency (FFQ) were completed in 1995. The daily average intake of antioxidant vitamins and energy was higher in male than in female. Older subjects consumed lesser antioxidant vitamins. The vitamin E intake of higher education persons as well as high family income females (> 15001RMB) was higher. Individual business owners and farmers consumed lesser antioxidant vitamins than the other counterparts. The highest vitamin E intake was found in the currently unemployed men and retired women. BMI was positively associated with the intake of antioxidant vitamins excepted for the obesity group. The result suggests that the consumption of antioxidant vitamins varies with characteristics of socio-demographic status. Health promotion programs, such as suggestions on eating more fruits and vegetables should be targeted at the elderly, the less educated, lower income families and rural community.
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Affiliation(s)
- X Liu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangzhou 510100, China
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Moin K, Demchik L, Mai J, Duessing J, Peters C, Sloane BF. Observing proteases in living cells. Cellular Peptidases in Immune Functions and Diseases 2 2001; 477:391-401. [PMID: 10849765 DOI: 10.1007/0-306-46826-3_40] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The lysosomal cysteine protease cathepsin B has been implicated in tumor progression and metastasis in part due to its altered trafficking. In order to analyze the trafficking of cathepsin B in living cells, we utilized enhanced green fluorescent protein (EGFP) fused to various cathepsin B constructs for transfecting two cell lines: an invasive human breast adenocarcinoma cell line (BT20) and a cathepsin B deficient mouse embryonic fibroblast cell line (MEF T -/-). The cells were transiently transfected with four cathepsin B-EGFP fusion constructs: full-length preprocathepsin B-EGFP, cathepsin B preregion-EGFP, cathepsin B prepro region-EGFP, and cathepsin B prepro region-EGFP with a mutation of the glycosylation site in the pro region. The full length construct showed vesicular distribution throughout the cells in both cell lines. In both BT20 and MEF T -/- cells, preregion-EGFP was localized in a ring tightly associated with the cell nucleus, suggesting distribution to the endoplasmic reticulum. The distribution of the prepro region-EGFP construct was similar except that it also included some patchy areas adjacent to the nucleus. This suggested that the cathepsin B prepro region-EGFP might have entered the Golgi. Distribution of the mutated cathepsin B prepro region-EGFP was similar to that of wild-type prepro region-EGFP in the MEF T -/-. In the invasive BT20 cells, however, the mutated prepro region-EGFP showed a vesicular distribution throughout the cytoplasm and in cell processes. This distribution is similar to that of endogenous cathepsin B in these cells. Our results suggest that: 1) tumor cells have an alternative mechanism for trafficking of cathepsin B which is independent of the mannose-6-phosphate receptor pathway, and 2) the pro region of cathepsin B may contain the sorting sequence necessary for its trafficking via this pathway.
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Affiliation(s)
- K Moin
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, Michigan 48201, USA
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Robbins P, Mi Z, Lu X, Mai J, Ghivizanni S, Evans C, Oligino T. Arthritis Res 2001; 3:P22. [DOI: 10.1186/ar348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Mai J, Robbins PD. Targeting gene therapy for transplantation with venom. Transplantation 2000; 70:1553-4. [PMID: 11152214 DOI: 10.1097/00007890-200012150-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- J Mai
- Department of Molecular Genetics and Biochemistry, University of Pittsburgh School of Medicine, PA 15261, USA
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Abstract
Long-term follow-up (>10 years) after vertical banded gastroplasty (VBG) is almost nonexistent. The aim of this study was to determine long-term outcome after VBG in a group of 71 patients studied prospectively. Seventy-one consecutive patients with morbid obesity (54 women and 17 men; mean age 40 years [range 22 to 71 years]) underwent VBG from 1985 to 1989 and were followed prospectively. Follow-up was obtained in 70 (99%) of the 71 patients. Weight (mean +/- standard error of the mean) preoperatively was 138 +/- 3 kg and decreased to 108 +/- 2 kg 10 or more years postoperatively. Body mass index decreased from 49 +/-1 to 39 +/- 1. Only 14 (20%) of 70 patients lost and maintained the loss of at least half of their excess body weight with the VBG anatomy. Vomiting one or more times per week continues to occur in 21% and heartburn in 16%. Fourteen patients have undergone conversion from VBG to Roux-en-Y gastric bypass (11 patients) or other procedures (3 patients) because of a combination of inadequate weight loss in 13 patients, gastroesophageal reflux in five, and frequent vomiting in four. Only 26% of patients after VBG have maintained a weight loss of at least 50% of their excess body weight; 17% underwent bariatric reoperation with good results. Thus VBG is not an effective, durable bariatric operation.
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Affiliation(s)
- B M Balsiger
- Department of Surgery, Mayo Clinic, Rochester, Minn. 55905, USA
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Abstract
Upon orthostatic stress after a period of rest, the heart rate increases rapidly to maintain cardiac output and minimize the fall in arterial pressure. Pacemaker patients are often prone to a deficient response to orthostatic stress. This may cause lightheadedness and, in rare patients with autonomic dysfunction, syncope. To alleviate these undesirable consequences, an enhanced rate response algorithm was developed using an accelerometer. The pacemaker generates two signals from its accelerometer: instantaneous activity level (Act) and long-term change in activity level (ActVar). Low values of both Act and ActVar indicate a resting state. An increase in Act while ActVar remains low indicates the onset of motion after prolonged rest. Upon detecting this transition, the algorithm increases the pacing rate to a programmable orthostatic compensation rate for a programmable duration. A taped-on pacemaker with this algorithm was evaluated in three healthy women and two healthy men, 36 +/- 8 years of age. Electrocardiogram and ventricular pacing pulses were recorded by a 24-hour ambulatory system. Each trigger of the orthostatic compensation rate was verified against a > 10 beats/min increase in heart rate, a response classified as appropriate. The overall specificity of the algorithm among the five subjects was 78%. The nocturnal specificity (10 PM to 7 AM) was 98%, considerably higher than during daytime (72%). In conclusion, a pacing algorithm to alleviate orthostatic stress was developed, which was highly specific during the night hours.
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Affiliation(s)
- J Mai
- St. Jude Medical CRMD, 15900 Valley View Ct., Sylmar, CA 91354, USA.
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Mi Z, Mai J, Lu X, Robbins PD. Characterization of a class of cationic peptides able to facilitate efficient protein transduction in vitro and in vivo. Mol Ther 2000; 2:339-47. [PMID: 11020349 DOI: 10.1006/mthe.2000.0137] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.5] [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: 11/22/2022] Open
Abstract
Protein transduction domains (PTDs), such as the third helix of the Drosophila Antennapedia homeobox gene (Antp) and the HIV TAT PTD, possess a characteristic positive charge on the basis of their enrichment for arginine and lysine residues. To determine whether cationic peptides are able to function as protein transduction domains, 12-mer peptide sequences from an M13 phage library were selected for synthesis on the basis of their varying cationic charge content. In addition, polylysine and polyarginine peptides were synthesized in order to assess the effect of charge contribution in protein transduction. Coupling of the biotinylated peptides to avidin-beta-galactosidase facilitated transduction in a wide variety of cell lines and primary cells, including islet beta-cells, synovial cells, polarized airway epithelial cells, dendritic cells, myoblasts, and tumor cells. Two of the peptides, PTD-4 and PTD-5, mediated transduction nearly 600-fold more efficiently than a random control peptide, but with an efficiency similar to the TAT PTD and the 12 mers of polylysine and polyarginine. Furthermore, confocal analysis of biotinylated peptide-streptavidin-Cy3 conjugates demonstrated that the internalized PTDs are found in both the nuclei and the cytoplasm of treated cells. When tested in vivo, the PTDs were able to facilitate efficient and rapid protein delivery into rabbit synovium and mouse solid tumors following intraarticular and intratumoral administration, respectively. These novel PTDs can be used to transfer therapeutic proteins and DNA for the treatment of a wide variety of diseases, including arthritis and cancer.
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Affiliation(s)
- Z Mi
- Department of Molecular Genetics and Biochemistry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15261, USA
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Mai J, Sokolov IM, Blumen A. Front propagation in one-dimensional autocatalytic reactions: the breakdown of the classical picture at small particle concentrations. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 2000; 62:141-5. [PMID: 11088445 DOI: 10.1103/physreve.62.141] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2000] [Indexed: 04/15/2023]
Abstract
The autocatalytic scheme A+B-->2A in a discrete particle system is studied in one dimension via Monte Carlo simulations. We find considerable differences in the results for the front velocities and front forms compared to the classical, continuous picture, which is only valid in the limit of very small reaction probabilities p. Interestingly, we also obtain front propagation velocities fairly below the classical minimal velocity.
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Affiliation(s)
- J Mai
- Theoretische Polymerphysik, Universitat Freiburg, Hermann-Herder Strasse 3, D-79104 Freiburg im Breisgau, Germany
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Abstract
Symptomatic gastroesophageal reflux disease is common in our experience after vertical banded gastroplasty. Our aim was to determine the safety and efficacy of Roux-en-Y gastric bypass in the treatment of symptomatic gastroesophageal reflux disease complicating vertical banded gastroplasty. We evaluated prospectively collected data on 25 patients who underwent revisional bariatric surgery because of severe gastroesophageal reflux disease after vertical banded gastroplasty. Only 4 of 25 patients had gastroesophageal reflux disease symptoms prior to vertical banded gastroplasty. Endoscopic findings in 24 patients included esophagitis (58%), Barrett's esophagus (28%), pouchitis (29%), and gastritis (21%);7 (28%) of 25 patients had evidence of stenosis at the pouch outlet. Mean follow-up (complete in all 25) after Roux-en-Y gastric bypass was 37 +/- 7 months (range 3 to 102 months). There were no deaths. Postoperative complications occurred in six patients: pneumonia in two, wound infection in two, prolonged drainage of the defunctionalized stomach via gastrostomy in one, and fever in one. Median hospitalization was 7 days (range 5 to 43 days). At follow-up (37 +/- 7 months), 24 (96%) of 25 are completely or almost completely symptom free. Body mass index was 33 +/- 2 kg/m(2) before and 28 +/- 2 kg/m(2) after Roux-en-Y gastric bypass (P = 0. 001). Symptoms of gastroesophageal reflux disease are common after vertical banded gastroplasty. Conversion to Roux-en-Y gastric bypass is safe, relieves gastroesophageal reflux disease, and promotes further weight loss. Moreover, maladaptive eating (vomiting, and so forth) induced by vertical banded gastroplasty is relieved.
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Affiliation(s)
- B M Balsiger
- Department of Surgery and the Gastroenterology Research Unit, Mayo Clinic, Rochester, MN, USA
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Abstract
To study potential roles of plasma membrane-associated extracellular cathepsin B in tumor cell invasion and metastasis, we used the yeast two-hybrid system to screen for proteins that interact with human procathepsin B. The annexin II light chain (p11), one of the two subunits of the annexin II tetramer, was one of the proteins identified. We have confirmed that recombinant human procathepsin B interacts with p11 as well as with the annexin II tetramer in vitro. Furthermore, procathepsin B could interact with the annexin II tetramer in vivo as demonstrated by coimmunoprecipitation. Cathepsin B and the annexin II tetramer were shown by immunofluorescent staining to colocalize on the surface of human breast carcinoma and glioma cells. Taken together, our results indicate that the annexin II tetramer can serve as a binding protein for procathepsin B on the surface of tumor cells, an interaction that may facilitate tumor invasion and metastasis.
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Affiliation(s)
- J Mai
- Department of Pharmacology, Wayne State University, School of Medicine, Detroit, Michigan 48201, USA
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Abstract
The cysteine protease cathepsin B is upregulated in a variety of tumors, particularly at the invasive edges. Cathepsin B can degrade extracellular matrix proteins, such as collagen IV and laminin, and can activate the precursor form of urokinase plasminogen activator (uPA), perhaps thereby initiating an extracellular proteolytic cascade. Recently, we demonstrated that procathepsin B interacts with the annexin II heterotetramer (AIIt) on the surface of tumor cells. AIIt had previously been shown to interact with the serine proteases: plasminogen/plasmin and tissue-type plasminogen activator (tPA). The AIIt binding site for cathepsin B differs from that for either plasminogen/plasmin or tPA. AIIt also interacts with extracellular matrix proteins, e.g., collagen I and tenascin-C, forming a structural link between the tumor cell surface and the extracellular matrix. Interestingly, cathepsin B, plasminogen/plasmin, t-PA and tenascin-C have all been linked to tumor development. We speculate that colocalization through AIIt of proteases and their substrates on the tumor cell surface may facilitate: (1) activation of precursor forms of proteases and initiation of proteolytic cascades; and (2) selective degradation of extracellular matrix proteins. The recruitment of proteases to specific regions on the cell surface, regions where potential substrates are also bound, could well function as a 'proteolytic center' to enhance tumor cell detachment, invasion and motility.
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Affiliation(s)
- J Mai
- Department of Pharmacology, Wayne State University, School of Medicine, 540 East Canfield, Detroit, MI 48201, USA
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Abstract
We examined occurrence of carpal tunnel syndrome in 48 patients with Down syndrome clinically and electrophysiologically. In the median nerve the distal latency to the abductor pollicis brevis muscle and the distal sensory nerve conduction velocity to digit II and III were recorded. As a control, we examined the ulner nerve. In the median nerve, a distal latency above 4.3 msec and sensory nerve conduction velocity below 50 m/sec were considered indicative of Carpal tunnel syndrome. Twenty seven patients (56%) had normal findings, 13 (27%) had both prolonged distal motor latency and reduced distal sensory nerve conduction velocity, and 8 patients (17%) had one of these signs, a much higher frequency than expected. Results show that prevalence of electrophysiological carpal tunnel syndrome is high in individuals with Down syndrome.
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Affiliation(s)
- J E Christensen
- Klinisk Neurofysiologisk AFD, Rigshospitalet, Copenhagen, Denmark
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Abstract
AIMS Vigabatrin is a new antiepileptic medication consisting of a racemic mixture of 50% active S enantiomer and 50% inactive R enantiomer. Since patients suffering from epilepsy may become pregnant, it is important to understand the extent of placental transfer of such medication. METHODS During steady-state, vigabatrin enantiomer concentrations were measured in maternal and umbilical blood and in breast milk of two patients. RESULTS The concentration ratios from the umbilical vein to maternal plasma were R:0.068, S:0.16; 4h25 min after drug administration (case 1) and R: 1.39, S: 0.91; 9h after drug administration (case 2). The milk: plasma concentration ratio was lower than 1 at pre dose sampling in both cases, as well as 3 and 6 h post dose in one case. An estimate of the maximum amount of R and S enantiomers of vigabatrin that a suckling infant would ingest in a day is 3.6% and 1% of the weight-adjusted daily dose respectively. CONCLUSIONS These results would suggest a slow placental transfer of the vigabatrin enantiomers and that the quantity ingested through milk is small.
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Affiliation(s)
- A Tran
- Department de pharmacologie Périnatale et Pédiatrique, Hôpital St Vincent de Paul, Paris, France
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Wu Y, Vollmer WM, Buist AS, Tsai R, Cen R, Wu X, Chen P, Li Y, Guo C, Mai J, Davis CE. Relationship between lung function and blood pressure in Chinese men and women of Beijing and Guangzhou. PRC-USA Cardiovascular and Cardiopulmonary Epidemiology Research Group. Int J Epidemiol 1998; 27:49-56. [PMID: 9563693 DOI: 10.1093/ije/27.1.49] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [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: 02/07/2023] Open
Abstract
BACKGROUND Previous studies of western populations have shown an inverse association between lung function and blood pressure. METHODS As part of a People's Republic of China-United States cardiopulmonary epidemiology study, we investigated the cross-sectional relationship between lung function and blood pressure in 6757 Chinese men and women, aged 35-54, from Beijing and Guangzhou, China. We also evaluated the longitudinal association between lung function and incident hypertension among 4818 initially normotensive subjects followed up between 2 and 4 years later. RESULTS In our cross-sectional analyses of baseline data, lung function varied inversely with baseline systolic (SBP) and diastolic blood pressure (DBP) in all women and in Beijing men. This association held for absolute and height-standardized forced vital capacity (FVC) and one-second forced expiratory volume (FEV1) (correlations: 0.10, -0.18, P < 0.0001), but was weaker after adjustment for age (correlations: -0.02, -0.11). The longitudinal follow-up showed that lower initial lung function levels were associated with a higher incidence of hypertension (SBP > or = 140 mmHg or DBP > or = 90 mmHg or currently using antihypertensive medications), but only among women in Guangzhou. Relative risks for hypertension incidence for those in the two lowest quintiles for FEV1 and FVC, compared to those in the two highest quintiles, ranged from 1.9 to 2.3 for Guangzhou women and from 0.9 to 1.4 for all other gender-city subgroups. Logistic regression analyses adjusting for age, baseline SBP, body mass index, smoking, education, and urban versus rural setting generally confirmed these patterns. CONCLUSIONS These results suggest a statistically significant, though weak, inverse relationship between lung function and blood pressure in Chinese men and women. This association is largely attributable to age and is present prospectively only in women.
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Affiliation(s)
- Y Wu
- Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences, Beijing, PRC
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Lash LH, Shivnani A, Mai J, Chinnaiyan P, Krause RJ, Elfarra AA. Renal cellular transport, metabolism, and cytotoxicity of S-(6-purinyl)glutathione, a prodrug of 6-mercaptopurine, and analogues. Biochem Pharmacol 1997; 54:1341-9. [PMID: 9393677 DOI: 10.1016/s0006-2952(97)00401-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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]
Abstract
The disposition of S-(6-purinyl)glutathione (6-PG) and its metabolites, including the antitumor agent 6-mercaptopurine (6-MP), was characterized in freshly isolated renal cortical cells from male F344 rats to assess the ability of the kidney to convert 6-PG to 6-MP. The intracellular transport and accumulation of 6-PG and 6-MP, the metabolism of 6-PG to 6-MP, and the potential cytotoxicity of 6-MP, 6-thioxanthine (6-ThXan), and 6-thioguanine (6-ThGua) were determined. 6-PG and 6-MP were accumulated by renal cortical cells by time- and concentration-dependent processes, reaching maximal levels of 14.2 and 1.52 nmol/10(6) cells, respectively, with 1 mM concentrations of each compound. Treatment with acivicin, an inhibitor of 6-PG metabolism by gamma-glutamyltransferase, increased accumulation of 6-PG, and treatment with alpha-keto-gamma-methiolbutyrate, a keto acid cosubstrate that stimulates activity of the cysteine conjugate beta-lyase (beta-lyase), which generates 6-MP, decreased accumulation of 6-PG. Incubation of renal cells with 10 mM 6-PG generated 6-MP at a rate of 2.4 nmol/min per 10(6) cells, demonstrating that the beta-lyase pathway forms the desired product from the prodrug within the intact renal cell. Preincubation of cells with acivicin or aminooxyacetic acid, an inhibitor of the beta-lyase, decreased the net formation of 6-MP, demonstrating further the function of the beta-lyase. 6-MP, 6-ThXan, and 6-ThGua exhibited approximately equivalent cytotoxicity (45-55% release of lactate dehydrogenase with 1 mM at 2 hr) in isolated renal cells. Based on the known antitumor potency of these agents, this suggests that cytotoxicity and antitumor activity occur by distinct mechanisms. The high amount of accumulation of 6-PG and its subsequent metabolism to 6-MP, as compared with the relatively low amount of accumulation of 6-MP, in renal cells suggest that 6-PG can function as a prodrug and is a more effective delivery vehicle for 6-MP to renal cells than 6-MP itself. Administration of 6-PG may be an effective means of treating renal tumors or suppressing renal transplant rejection.
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Affiliation(s)
- L H Lash
- Department of Pharmacology, Wayne State University School of Medicine, Detroit, MI 48201, USA.
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Dennis BH, Zhou B, Liu X, Yang J, Mai J, Cao T, Ni G, Zhao L, Stamler J. Changes in food, nutrient and energy intake in People's Republic of China samples of urban and rural north and south adults surveyed in 1983-84 and resurveyed in 1987-88. Asia Pac J Clin Nutr 1997; 6:277-286. [PMID: 24394788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Dietary patterns were assessed in a prospective study of cardiovascular disease (CVD) risk factors in four Chinese populations: Beijing urban (BJ-U) and rural (BJ-R), Guangzhou urban (GZ-U) and rural (GZ-R). A total of 10,076 men and women 35-54 years old were surveyed in 1983-84 and resurveyed in 1987-88. Dietary data were obtained in a subsample of about 10% (n=169 BJ-U, 178 BJ-R, 198 GZ-U, 230 GZ-R). Three 24-hr recalls were collected on each participant in each survey. Comparison of mean intakes in the two periods showed increases in meat, poultry, fish (except GZ-R), eggs (rural only), milk (except BJ-R) and alcoholic beverages. The largest shifts were in meat intake (29%-39%), alcoholic beverages (71%-104%) and fats in the urban samples (33%-35%). These changes are reflected in increased mean intakes of animal protein, fat, saturated fatty acids (SFA) and higher Keys scores. Mean total fat intake now exceeds the PRC recommended range of 20-25% of energy in three of the four samples. During this period BMI increased in all samples especially among men (3% - 6%). These surveys, conducted during a period of rapid economic development in China, show that such changes promote shifts in dietary patterns and energy balance towards increased risk of cardiovascular disease.
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Affiliation(s)
- B H Dennis
- University of North Carolina, Chapel Hill, North Carolina, USA
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Garkavtsev I, Boland D, Mai J, Wilson H, Veillette C, Riabowol K. Specific monoclonal antibody raised against the p33ING1 tumor suppressor. Hybridoma (Larchmt) 1997; 16:537-40. [PMID: 9455706 DOI: 10.1089/hyb.1997.16.537] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
An IgG1 mouse monoclonal antibody (CAb1) was produced against human recombinant p33ING1. The antibody is able to recognize native and denatured antigen in ELISA and Western blot protocols, respectively. CAb1 can be used to specifically detect the p33ING1 protein in dot blot and Western immunoblot protocols of both human and mouse cell lysates. In addition, this antibody is also useful for cellular localization of native and ectopically overexpressed p33ING1 protein by indirect immunofluorescence.
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Affiliation(s)
- I Garkavtsev
- Department of Medical Biochemistry, University of Calgary, Alberta, Canada
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Mai J, Sokolov IM, Blumen A. Exact enumeration of all conformations of a heteropolymer chain in a prescribed, non-compact volume. J Chem Phys 1997. [DOI: 10.1063/1.473741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Affiliation(s)
- K Fogh
- Department of Dermatology, Aarhus University Hospital, Denmark
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Mai J, Liang Y, Li M. [Clinical analysis of diagnosis and treatment of 44 cases with intraspinal lipoma]. Zhonghua Wai Ke Za Zhi 1996; 34:735-6. [PMID: 9590774] [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: 02/07/2023]
Abstract
44 cases of intraspinal lipoma were confirmed by pathologic examination. We excised the lipomas totally or partly. After surgery, 8 cases improved greatly, 19 cases improved, 18 not improved. CT scan and MRI are the key methods for diagnosis of intraspinal lipoma, most of intraspinal lipomas are adherent to the spine and root of nerves tightly and difficult to be dissected. So it's not easy to excise the lipoma entirely. But if we use microsurgery we can get better results.
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Affiliation(s)
- J Mai
- Department of Neurosurgery, Gaozhou People's Hospital, Guangdong
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Mai J, Sokolov IM, Blumen A. Front Propagation and Local Ordering in One-Dimensional Irreversible Autocatalytic Reactions. Phys Rev Lett 1996; 77:4462-4465. [PMID: 10062544 DOI: 10.1103/physrevlett.77.4462] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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