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Springer A, Dreher A, Reimers J, Kaiser L, Bahlmann E, van der Schalk H, Wohlmuth P, Gessler N, Hassan K, Wietz J, Bein B, Spangenberg T, Willems S, Hakmi S, Tigges E. Gender disparities in patients undergoing extracorporeal cardiopulmonary resuscitation. Front Cardiovasc Med 2024; 10:1265978. [PMID: 38292453 PMCID: PMC10824923 DOI: 10.3389/fcvm.2023.1265978] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/30/2023] [Indexed: 02/01/2024] Open
Abstract
Introduction The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in extracorporeal cardiopulmonary resuscitation (eCPR) has emerged as a treatment option for selected patients who are experiencing refractory cardiac arrest (CA). In the light of increasing availability, the analyses of outcome-relevant predisposing characteristics are of growing importance. We evaluated the prognostic influence of gender in patients presenting with out-of-hospital cardiac arrest (OHCA) treated with eCPR. Methods We retrospectively analysed the data of 377 consecutive patients treated for OHCA using eCPR in our cardiac arrest centre from January 2016 to December 2022. The primary outcome was defined as the survival of patients until they were discharged from the hospital, with a favourable neurological outcome [cerebral performance category (CPC) score of ≤2]. Statistical analyses were performed using baseline comparison, survival analysis, and multivariable analyses. Results Out of the 377 patients included in the study, 69 (21%) were female. Female patients showed a lower prevalence rate of pre-existing coronary artery disease (48% vs. 75%, p < 0.001) and cardiomyopathy (17% vs. 34%, p = 0.01) compared with the male patients, while the mean age and prevalence rate of other cardiovascular risk factors were balanced. The primary reason for CA differed significantly (female: coronary event 45%, pulmonary embolism 23%, cardiogenic shock 17%; male: coronary event 70%, primary arrhythmia 10%, cardiogenic shock 10%; p = 0.001). The prevalence rate of witnessed collapse (97% vs. 86%; p = 0.016) and performance of bystander CPR (94% vs. 85%; p = 0.065) was higher in female patients. The mean time from collapse to the initiation of eCPR did not differ between the two groups (77 ± 39 min vs. 80 ± 37 min; p = 0.61). Overall, female patients showed a higher percentage of neurologically favourable survival (23% vs. 12%; p = 0.027) despite a higher prevalence of procedure-associated bleeding complications (33% vs. 16%, p = 0.002). The multivariable analysis identified a shorter total CPR duration (p = 0.001) and performance of bystander CPR (p = 0.03) to be associated with superior neurological outcomes. The bivariate analysis showed relevant interactions between gender and body mass index (BMI). Conclusion Our analysis suggests a significant survival benefit for female patients who obtain eCPR, possibly driven by a higher prevalence of witnessed collapse and bystander CPR. Interestingly, the impact of patient age and BMI on neurologically favourable outcome was higher in female patients than in male patients, warranting further investigation.
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Affiliation(s)
- A. Springer
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - A. Dreher
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - J. Reimers
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - L. Kaiser
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - E. Bahlmann
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - H. van der Schalk
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | | | - N. Gessler
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
- Asklepios ProResearch, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - K. Hassan
- Department of Cardiac Surgery, Asklepios Clinic St. Georg, Hamburg, Germany
| | - J. Wietz
- Department of Emergency Medicine, Asklepios Clinic St. Georg, Hamburg, Germany
| | - B. Bein
- Department of Anaesthesiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - T. Spangenberg
- Department of Cardiology and Critical Care, Asklepios Clinic Altona, Hamburg, Germany
| | - S. Willems
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Semmelweis-University, Budapest, Hungary
| | - S. Hakmi
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiac Surgery, Asklepios Clinic St. Georg, Hamburg, Germany
| | - E. Tigges
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
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Springer A, Dreher A, Reimers J, Kaiser L, Bahlmann E, van der Schalk H, Wohlmuth P, Gessler N, Hassan K, Wietz J, Bein B, Spangenberg T, Willems S, Hakmi S, Tigges E. Prognostic influence of mechanical cardiopulmonary resuscitation on survival in patients with out-of-hospital cardiac arrest undergoing ECPR on VA-ECMO. Front Cardiovasc Med 2024; 10:1266189. [PMID: 38274309 PMCID: PMC10808304 DOI: 10.3389/fcvm.2023.1266189] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) in extracorporeal cardiopulmonary resuscitation (ECPR) in selected patients after out-of-hospital cardiac arrest (OHCA) is an established method if return of spontaneous circulation cannot be achieved. Automated chest compression devices (ACCD) facilitate transportation of patients under ongoing CPR and might improve outcome. We thus sought to evaluate prognostic influence of mechanical CPR using ACCD in patients presenting with OHCA treated with ECPR including VA-ECMO. Methods We retrospectively analyzed data of 171 consecutive patients treated for OHCA using ECPR in our cardiac arrest center from the years 2016 to 2022. A Cox proportional hazards model was used to identify characteristics related with survival. Results Of the 171 analyzed patients (84% male, mean age 56 years), 12% survived the initial hospitalization with favorable neurological outcome. The primary reason for OHCA was an acute coronary event (72%) followed by primary arrhythmia (9%) and non-ischemic cardiogenic shock (6.7%). In most cases, the collapse was witnessed (83%) and bystander CPR was performed (83%). The median time from collapse to VA-ECMO was 81 min (Q1: 69 min, Q3: 98 min). No survival benefit was seen for patients resuscitated using ACCD. Patients in whom an ACCD was used presented with overall longer times from collapse to ECMO than those who were resuscitated manually [83 min (Q1: 70 min, Q3: 98 min) vs. 69 min (Q1: 57 min, Q3: 84 min), p = 0.004]. Conclusion No overall survival benefit of the use of ACCD before ECPR is established was found, possibly due to longer overall CPR duration. This may arguably be because of the limited availability of ACCD in pre-clinical paramedic service at the time of observation. Increasing the availability of these devices might thus improve treatment of OHCA, presumably by providing efficient CPR during transportation and transfer.
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Affiliation(s)
- A. Springer
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - A. Dreher
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - J. Reimers
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - L. Kaiser
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - E. Bahlmann
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - H. van der Schalk
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | | | - N. Gessler
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
- Asklepios ProResearch, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
| | - K. Hassan
- Department of Cardiac Surgery, Asklepios Clinic St. Georg, Hamburg, Germany
| | - J. Wietz
- Department of Emergency Medicine, Asklepios Clinic St. Georg, Hamburg, Germany
| | - B. Bein
- Department of Anaesthesiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
| | - T. Spangenberg
- Department of Cardiology and Critical Care, Asklepios Clinic Altona, Hamburg, Germany
| | - S. Willems
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Semmelweis-University, Budapest, Hungary
| | - S. Hakmi
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
- Department of Cardiac Surgery, Asklepios Clinic St. Georg, Hamburg, Germany
| | - E. Tigges
- Department of Cardiology and Critical Care, Asklepios Clinic St. Georg, Hamburg, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany
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Mondal E, Karim MR, Begum A, Hassan K, Noor SM, Khan MM, Khan KH, Ashrafuzzaman SM. Clinical and Liver Enzymes among the Patients with Metabolic Syndrome with or without Non Alcoholic Fatty Liver Disease attending a Tertiary Care Hospital. Mymensingh Med J 2023; 32:338-347. [PMID: 37002743] [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: 04/04/2023]
Abstract
Metabolic syndrome is characterized by central obesity, dyslipidemia, raised blood pressure and impaired blood sugar levels. Patients with metabolic syndrome are at increased risk of type 2 diabetes and atherosclerotic cardiovascular disease. This cross-sectional observational study was carried out from January 2019 to December 2019 at the inpatient and outpatient department of BIRDEM General Hospital, Dhaka, Bangladesh. Adult subjects aged ≥18 years with metabolic syndrome (IDF criteria, 2006) were included and purposive sampling was done. A total of 242 participants were included and the mean age was 40.2±14.1 years ranging from 18-70 years. Among them, 140(57.85%) were female and 102(42.15%) were male. Out of 242 participants, 170(70.25%) subjects had Metabolic Syndrome (MetS) with Non-Alcoholic Fatty Liver (NAFLD) and 72(29.75%) subjects had metabolic syndrome without NAFLD. In the male participants, the mean waist-hip ratio (WHR) of MetS with NAFLD and MetS without NAFLD was 1.01±0.07 vs. 0.96±0.08 respectively (p-value 0.003). In female subjects, the mean waist-hip ratio (WHR) of MetS with NAFLD and MetS without NAFLD group was 0.90±0.10 vs. 0.86±0.08 respectively (p-value 0.026). MetS with NAFLD subjects were more hypertensive than MetS without NAFLD subjects (61.2% vs. 42.7%). In the MetS with NAFLD group (n=170), 11.8% was normoglycemic, 43.5% was prediabetic and 44.7% was diabetic. In the MetS without NAFLD group (n=72), 19.5% was normoglycemic, 50% was prediabetic and 30.5% was diabetic. SGPT value was significantly raised in MetS with NAFLD subjects (56.4%) than MetS without NAFLD (38.9%) subjects (p-value 0.038). SGOT value was significantly raised in MetS with NAFLD subjects (58.8%) than MetS without NAFLD subjects (41.7%); (p-value 0.005). Mean Total Cholesterol and Triglyceride were significantly raised in MetS with NAFLD subjects than MetS without NAFLD subjects (p-value 0.01). In Subjects with grade I fatty liver, mean SGPT and SGOT were 42.27±22.31 vs. 39.59±16.93 respectively. In Subjects with grade II fatty liver, mean SGPT and SGOT were 62.13±32.42 vs. 52.45±28.56 respectively. In grade III fatty liver, mean SGPT and SGOT were 51.50±32.19 vs. 41.00±17.52 respectively (p value <0.001). More than two-third of participants with metabolic syndrome had non-alcoholic fatty liver disease (NAFLD) and a significant elevation of liver enzymes than metabolic syndrome without NAFLD participants. About 85.0% of metabolic syndrome participants had glucose intolerance in the form of prediabetes and diabetes.
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Affiliation(s)
- E Mondal
- Dr Ershad Mondal, Medical Officer, Department of Medicine, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
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Abd Elhameed M, Hassan K, Metwally A, Sabry M. Assessment of WALANT Anaesthesia in Flexor Tendon Repair of the Hand. Minia Journal of Medical Research 2023; 0:0-0. [DOI: 10.21608/mjmr.2023.191725.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Hassan K, Bruening T, Bein B, Caspary M, Wohlmuth P, Geidel S, Schmoeckel M. Hemadsorption treatment for antithrombotic drug removal in emergency cardiac surgery – cost-benefit analysis comparing patient outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Intraoperative hemadsorption is indicated for ticagrelor and rivaroxaban removal in patients undergoing urgent cardiac surgery and has been previously shown to reduce bleeding complications. However, whether this application is cost effective is currently unknown.
Methods
Between June 2017 and June 2021, we evaluated the outcomes of 72 consecutive patients (age 65±11 years) with acute coronary syndrome (ACS) pretreated with ticagrelor who underwent urgent coronary artery bypass grafting (CABG) at our institution. Intraoperative hemoadsorption (IH) was used in all cases (IH-Pat). We estimated the mean cost per patient, and a bootstrap analysis was performed based on individual data from the case series. We compared the results with “historical patients” who were operated under the same conditions between June 2015 and June 2017 but without IH (n=22).
Results
Bilateral internal mammary artery (BIMA) was used in 67.7% of all cases. Use of IH was associated with significantly shorter operation times (277±65 min vs. 320±75 min; P=0.014) and significantly less postoperative 24-hours chest tube drainage (277±65 mL vs. 866±262 mL; P<0.001). Only two rethoracotomies (2.8%) had to be performed. In addition, patients operated without IH required significantly more blood products and had a significantly higher rate of rethoracotomy, resulting in longer ICU stays. The variable that had the highest impact on the level of cost savings was the operation duration. The overall cost saving with IH were calculated at over 4200±1100€ with operation time, ICU stay and blood product costs being the top contributors.
Conclusions
The results suggest that the clinical benefits derived from IH in ticagrelor-treated patients requiring urgent cardiac surgery patients could result in significant cost savings of over 4200±1100 € per patient.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Hassan
- Asklepios Clinic St. Georg, Cardiac Surgery , Hamburg , Germany
| | - T Bruening
- Asklepios Clinic St. Georg, Cardiac Surgery , Hamburg , Germany
| | - B Bein
- Asklepios Clinic St. Georg, Department of Anesthesiology and Intensive Care Medicine , Hamburg , Germany
| | - M Caspary
- Asklepios Clinic St. Georg, Department of Anesthesiology and Intensive Care Medicine , Hamburg , Germany
| | - P Wohlmuth
- Asklepios Clinic St. Georg, ProResearch Institute , Hamburg , Germany
| | - S Geidel
- Asklepios Clinic St. Georg, Cardiac Surgery , Hamburg , Germany
| | - M Schmoeckel
- Asklepios Clinic St. Georg, Cardiac Surgery , Hamburg , Germany
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Blanchard T, Lecomte P, Melon M, Simon L, Hassan K, Nicol R. Experimental acoustic scene analysis using One-Eighth spherical fraction microphone array. J Acoust Soc Am 2022; 151:180. [PMID: 35105033 DOI: 10.1121/10.0009230] [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] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
This paper investigates the performance of one-eighth Spherical Fraction Microphone Array through experimental measurement to analyze acoustic scenes in one-eighth of space. The array geometry is designed to be placed in a room corner at the junction of three acoustically rigid walls. Two prototypes are built with 8 and 16 microphones, respectively. The sampling strategy is discussed and a spatial aliasing analysis is carried out both analytically and by numerical simulations. The array performances are evaluated through Spherical Fraction Beamforming (SFB). This approach is based on the decomposition of the acoustic pressure field in a rigid bounded domain. The localization angular error and Directivity Index criterion are evaluated for both arrays. In a first experiment, the arrays are mounted in an eighth of space built inside an anechoic room. The results are compared with simulation and show consistency. The theoretical limitations of SFB in a rigid bounded one-eighth of space are retrieved experimentally. These limitations are also observed in a real configuration: an office room. Further investigations on SFB are also conducted in the case of a virtual scene constructed with two sound sources.
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Affiliation(s)
- T Blanchard
- Laboratoire d'Acoustique de l'Université du Mans (LAUM), UMR 6613, Institut d'Acoustique - Graduate School (IA-GS), CNRS, Le Mans Université, France
| | - P Lecomte
- University of Lyon, Université Claude Bernard Lyon 1, CNRS, Ecole Centrale Lyon, INSA Lyon, LMFA, UMR5509, 69622 Villeurbanne, France
| | - M Melon
- Laboratoire d'Acoustique de l'Université du Mans (LAUM), UMR 6613, Institut d'Acoustique - Graduate School (IA-GS), CNRS, Le Mans Université, France
| | - L Simon
- Laboratoire d'Acoustique de l'Université du Mans (LAUM), UMR 6613, Institut d'Acoustique - Graduate School (IA-GS), CNRS, Le Mans Université, France
| | - K Hassan
- Laboratoire d'Acoustique de l'Université du Mans (LAUM), UMR 6613, Institut d'Acoustique - Graduate School (IA-GS), CNRS, Le Mans Université, France
| | - R Nicol
- Orange Labs, 2 Avenue Pierre Marzin, 22307 Lannion Cedex, France
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Alamri A, Alharbi K, Hassan K, Alhakami S, Alosaimi M, Rofidi K, Ahmed I. Frequency of Neuropathic Sensory Symptoms Among Patients With Uncontrolled Diabetes Mellitus in Security Forces Hospital, Riyadh, Saudi Arabia. Cureus 2021; 13:e17528. [PMID: 34603896 PMCID: PMC8476209 DOI: 10.7759/cureus.17528] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background Diabetic peripheral neuropathy (DPN) is a chronic sensorimotor length-dependent and symmetrical polyneuropathy. Some peripheral neuropathies have painful presentations, and some are painless. DPN can have a potential impact on the patient's life. Objectives This study was conducted in order to investigate the frequency of neuropathic sensory symptoms among patients with uncontrolled diabetes mellitus. Methods This is a cross-sectional study conducted in the Security Forces hospital using the Neuropathy Total Symptom Score-6 (NTSS-6) questionnaire. The questionnaire was administered by contacting patients through the phone. Patients with uncontrolled diabetes (HbA1C >9) were included in the study. Results This study included 285 participants; 58.9% had type II diabetes and 41.1% had type I diabetes, 156 (54.7%) were females, and 129 (45.3%) were males. Most of the patients (51.1%) were 45-64 years old and the majority were non-smokers (77.9%). Patients with neuropathic pain were 182 (63.9%); 79 (43.4%) of them were males and 103 (56.6%) were females. The prevalence of neuropathic symptoms was much higher in females than in males. Conclusion The prevalence of painful DPN is high among patients with long-term uncontrolled diabetes mellitus. Older, unemployed, and low-educated patients are at higher risk of developing painful DPN. Proper glycemic control and lifestyle modifications are essential in preventing the progression of this condition.
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Affiliation(s)
| | - Khalid Alharbi
- Surgery, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Khaled Hassan
- Internal Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Salem Alhakami
- Internal Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Khalid Rofidi
- Family Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Ibrahim Ahmed
- Family Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Moharam I, Sultan H, Hassan K, Ibrahim M, Shany S, Shehata AA, Abo-ElKhair M, Pfaff F, Höper D, EL Kady M, Beer M, Harder T, Hafez H, Grund C. Emerging infectious bronchitis virus (IBV) in Egypt: Evidence for an evolutionary advantage of a new S1 variant with a unique gene 3ab constellation. Infect Genet Evol 2020; 85:104433. [PMID: 32622080 PMCID: PMC7327463 DOI: 10.1016/j.meegid.2020.104433] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/05/2020] [Accepted: 06/16/2020] [Indexed: 12/21/2022]
Abstract
Infectious bronchitis virus (IBV), a gamma-coronavirus, causes infectious bronchitis (IB), a major respiratory disease of chicken. Its high mutation rate in conjunction with recombination of the RNA genome constantly creates IBV variants that are difficult to control by currently available vaccines. In this study, we addressed the question whether small-scale holdings might harbor IBV variants that serve as a reservoir for newly emerging variants. Egyptian IBV isolate EGY/NR725/2016 (NR725/16) from a small-scale broiler farm was assigned to genotype I, clade 23 (S1:GI-23), based on partial S1 gene sequences and corroborated by full genome sequencing. Analysis of the S1 gene established three subclades for historical IBV strains (S1:GI-23.1, S1:GI-23.2.1 and S1:GI-23.2.2) and confirmed NR725/16 as being part of a separate fourth subclade (S1:GI-23.3). Samples from the years 2018 and 2019 revealed that the new subclade prevails in Egypt, carrying fixed mutations within the hypervariable regions (HVR) 1-3 of the S1 protein that affect two neutralization sensitive epitopes at sites 294F, 297S and 306Y (48.2) and 329R (62.1). In addition, recombination was recognized in isolate NR 725/16, with intra-subtype mixing for the entire genes 3ab and E and inter-subtype mixing for the entire gene 6b with a close match to QX like viruses of genotype GI-19. Further analysis of gene 3ab detected the homologous gene pool to NR725/16 in samples from 2013 (3ab:C) and closely related 3ab genotypes in IBV Egyptian isolates from 2016, 2018 and 2019. These data prove a flourishing exchange between poultry holdings with a common gene pool. The continued circulation of viruses harboring genes S1:GI-23.3 and 3ab:C indicates an evolutionary advantage of this combination possibly by combining antigenic escape with modulated pathogenicity to facilitate IBV spread in the vaccinated poultry population in Egypt.
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Affiliation(s)
- Ibrahim Moharam
- Institute of Diagnostic Virology Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Germany,Department of Birds and Rabbits Medicine, University of Sadat City, Monufia, Egypt
| | - Hesham Sultan
- Department of Birds and Rabbits Medicine, University of Sadat City, Monufia, Egypt
| | - K. Hassan
- Institute of Diagnostic Virology Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Germany,Department of Poultry Diseases, Beni-Suef University, Beni-Suef, Egypt
| | - Mahmoud Ibrahim
- Department of Birds and Rabbits Medicine, University of Sadat City, Monufia, Egypt
| | - Salama Shany
- Department of Poultry Diseases, Beni-Suef University, Beni-Suef, Egypt
| | - Awad A. Shehata
- Department of Birds and Rabbits Medicine, University of Sadat City, Monufia, Egypt
| | | | - Florian Pfaff
- Institute of Diagnostic Virology Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Germany
| | - Dirk Höper
- Institute of Diagnostic Virology Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Germany
| | - Magdy EL Kady
- Department of Poultry Diseases, Beni-Suef University, Beni-Suef, Egypt
| | - Martin Beer
- Institute of Diagnostic Virology Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Germany
| | - Timm Harder
- Institute of Diagnostic Virology Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Germany
| | - Hafez Hafez
- Institute of Poultry Disease, Freie Universität Berlin, Germany
| | - Christian Grund
- Institute of Diagnostic Virology Institute of Diagnostic Virology, Friedrich-Loeffler-Institut, Germany.
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mahrous M, Hassan K, Abdelrahman A, Helmy AEH. Prognostic value of serum lactate during anesthesia for cardiac surgery. Sohag Medical Journal 2020; 24:163-171. [DOI: 10.21608/smj.2020.21163.1085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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mahrous M, Hassan K, Abdelrahman A, Helmy AEH. Prognostic value of central venous oxygen saturation during anesthesia for cardiac surgery. Sohag Medical Journal 2020; 24:33-39. [DOI: 10.21608/smj.2020.21279.1086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Hassan K, Stoeck M, Brüning T, Bein B, Caspary M, Schmoeckel M, Geidel S. Budget Impact Analysis of Sorbent Hemadsorption during Emergency Cardiac Surgery in Ticagrelor-Loaded Patients. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Geidel S, Hassan K, Alessandrini H, Wohlmuth P, Caspary M, Bein B, Schmoeckel M. Mid-Term Results of Surgery in Patients with Unsuccessful MitraClip Implants for Degenerative Mitral Valve Disease. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hassan K, Brüning T, Radtke A, Kannmacher J, Bein B, Schmoeckel M, Geidel S. Low Bleeding after Emergency CABG Using CytoSorb Adsorption of Ticagrelor: A 2-Year Clinical Experience. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Doubell J, Kyriakakis C, Weich H, Herbst P, Pecoraro A, Moses J, Griffiths B, Snyman HW, Kabwe L, Du Toit R, Joubert L, Hassan K, Doubell A. P6518Radial artery dilatation to improve access and lower complication rates during coronary angiography (RADIAL): a randomized controlled trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Transradial catheterization has become the preferred access site for coronary angiography. The transradial approach is however not without challenges and complications. Cannulation is technically challenging and may require multiple cannulation attempts or access may fail. Local access site complications may occur postprocedurally.
Purpose
To explore the use of prolonged occlusion flow mediated dilatation (PO-FMD) to dilate the radial artery prior to cannulation to reduce puncture attempts, increase cannulation success and reduce access site complications in transradial coronary angiography.
Methods
1156 patients undergoing transradial coronary angiography were randomized into PO-FMD and sham PO-FMD groups. PO-FMD was achieved by a 10 minute inflation of a blood pressure cuff on the arm to above systolic pressure, followed by deflation with resultant radial artery dilation. In the sham PO-FMD group the cuff was not inflated. The operators were blinded to the intervention.
Results
580 patients were randomized to the sham PO-FMD group and 576 to the PO-FMD group. The number of puncture attempts were reduced with the use of PO-FMD, with a median number of attempts of 1 in the PO-FMD group and 2 in the sham PO-FMD group (p<0.001). Cannulation failure was reduced with PO-FMD FMD with cannulation failure rates of 2.7% in the PO-FMD group and 5.8% in the sham PO-FMD group (p=0.01). Radial artery pulsation loss (RAPL) was reduced with PO-FMD with 1.4% in the PO-FMD group and 3.8% in the sham PO-FMD group (p=0.02).
Conclusion
PO-FMD decreases puncture attempts, reduces cannulation failure rates and decreases RAPL during transradial coronary angiography.
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Affiliation(s)
- J Doubell
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - C Kyriakakis
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - H Weich
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - P Herbst
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - A Pecoraro
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - J Moses
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - B Griffiths
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - H W Snyman
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - L Kabwe
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - R Du Toit
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - L Joubert
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - K Hassan
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - A Doubell
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
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Hassan K, Hosni A, Hewidy M, Abd El razik A. MICROPROPAGATION AND EVALUATION OF GENETIC STABILITY OF FOXGLOVE TREE (Paulownia tomentosa). Arab Universities Journal of Agricultural Sciences 2019; 26:2287-2296. [DOI: 10.21608/ajs.2018.35343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Agnesi C, Da Lio B, Cozzolino D, Cardi L, Ben Bakir B, Hassan K, Della Frera A, Ruggeri A, Giudice A, Vallone G, Villoresi P, Tosi A, Rottwitt K, Ding Y, Bacco D. Hong-Ou-Mandel interference between independent III-V on silicon waveguide integrated lasers. Opt Lett 2019; 44:271-274. [PMID: 30644878 DOI: 10.1364/ol.44.000271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/05/2018] [Indexed: 06/09/2023]
Abstract
The versatility of silicon photonic integrated circuits has led to a widespread usage of this platform for quantum information-based applications, including quantum key distribution (QKD). However, the integration of simple high-repetition-rate photon sources is yet to be achieved. The use of weak-coherent pulses (WCPs) could represent a viable solution. For example, measurement device independent QKD (MDI-QKD) envisions the use of WCPs to distill a secret key immune to detector side channel attacks at large distances. Thus, the integration of III-V lasers on silicon waveguides is an interesting prospect for quantum photonics. Here we report the experimental observation of Hong-Ou-Mandel interference with 46±2% visibility between WCPs generated by two independent III-V on silicon waveguide integrated lasers. This quantum interference effect is at the heart of many applications, including MDI-QKD. This Letter represents a substantial first step towards an implementation of MDI-QKD fully integrated in silicon and could be beneficial for other applications such as standard QKD and novel quantum communication protocols.
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Doubell J, Kyriakakis C, Weich H, Herbst P, Pecoraro A, Griffiths B, Snyman HW, Moses J, Kabwe L, Du Toit R, Joubert L, Hassan K, Doubell A. P5519Radial artery dilatation to improve access and lower complication rates during coronary angiography (RADIAL): a randomized controlled trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Doubell
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - C Kyriakakis
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - H Weich
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - P Herbst
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - A Pecoraro
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - B Griffiths
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - H W Snyman
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - J Moses
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - L Kabwe
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - R Du Toit
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - L Joubert
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - K Hassan
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
| | - A Doubell
- University of Stellenbosch, Division of Cardiology, Department of Medicine, Cape Town, South Africa
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Kadi NE, Davis A, Cooke A, Wang L, Korkaya H, Kalemkerian G, Hassan K. Abstract 5836: Activation Induced Cytosine Deamination, AICDA, is induced after EGFR TKI exposure leading to secondary resistant mutations in lung adenocarcinoma. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-5836] [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
Background: Epidermal growth factor receptor (EGFR) activation mutations occur in 10-50% of lung adenocarcinomas. This leads to constitutive activation of EGFR, which triggers multiple downstream survival and proliferation pathways. EGFR tyrosine kinase inhibitors (TKIs) are the mainstay of treatment for stage IV non-small cell lung cancer (NSCLC) patients with EGFR mutations. Acquired EGFR mutations are the main mechanism of on-target resistance to TKIs. T790M mutation that occurs after first line TKI treatment, is a cytosine to thymine (C>T) single nucleotide transition leading to a threonine to methionine amino acid change at position 790 (i.e. T790M). Interestingly, treatment with Osimertinib, that overcomes the T790M mutation, leads to other acquired resistant mutations, C797S, G796S/R and L792F/H. Our data suggest that resistant mutations are acquired events secondary to cytosine deamination through Activation Induced Cytosine Deamination enzyme (AICDA).
Results: Sub clones of the lung adenocarcinoma cell line PC9 with no evidence of T790M mutation by droplet digital PCR (ddPCR) at baseline, were treated with EGFR TKI. After serially increasing the treatment dose, T790M mutation was detected by ddPCR associated with a significant increase in AICDA expression. Knocking down AICDA by shRNA, decreases the development of T790M in PC9 cell lines after TKI exposure. Similarly, when the resistant T790M PC9 clones were treated with Osimertinib, the expression of AICDA was also induced. Using mass spectrometry, we established that cytosine at codon 790 is methylated; thus, deamination of 5-methylcytosine leads to thymine directly, explaining the T790M C>T mutation. In addition, using ChIP assay and pharmacological inhibition we confirm that upon TKI exposure, NFĸB binds AICDA promoter and induces its expression. In a mouse xenograft model, the induction of NFĸB and AICDA after EGFR TKI exposure is abrogated by concurrent use of an NFĸB inhibitor. Finally, patients treated with EFR TKI had an increased expression of AICDA upon progression.
Conclusion: In EGFR driven lung adenocarcinoma, NFĸB pathway is activated upon exposure to EGFR TKIs which induces AICDA expression. AICDA deaminates cytosine into other nucleotides leading to treatment resistance.
Citation Format: Najwa El Kadi, April Davis, Alexander Cooke, Luo Wang, Hasan Korkaya, Gregory Kalemkerian, Khaled Hassan. Activation Induced Cytosine Deamination, AICDA, is induced after EGFR TKI exposure leading to secondary resistant mutations in lung adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5836.
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Affiliation(s)
| | | | | | - Luo Wang
- 1University of Michigan, Ann Arbor, MI
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Abstract
Summary
Objectives:
Hospitals and medical centers are producing more and more data that need to be processed. Those data are confidential, heterogeneous, and limited to the geographic site where they have been produced. Unless properly anonymized, they cannot be distributed on wide area networks.
Methods:
Grid technologies allow the globalization of storage and processing resources, and enable large-scale experimentations on distributed data. They constitute a promising tool to treat the different data and analyze the knowledge they contain, while offering secured access and high-performance computing capacities to the different users. Our aim is to evaluate the possibilities of grid technologies for handling medical data.
Results and Conclusions:
In this paper, we focus on a breast cancer diagnosis assistance tool, based on distributed and incremental knowledge construction and a content-based image retrieval system. We analyze the different scenarios of uses of such a tool. We further propose an algorithm that indexes mammographic images for content-based query purposes. This algorithm is tested on images of different resolutions in order to reduce the indexation time and we analyze its performance with experiments on the grid.
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Abdelzaher M, Mahmoud H, Abd El-Mabood A, Hassan K. Comparative study between Tramadol and Midazolam as an admixture to bupivacaine inUltrasound guided supraclavicular brachial plexus block. Sohag Medical Journal 2018; 22:243-250. [DOI: 10.21608/smj.2018.41680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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El Kadi N, Wang L, Davis A, Brown N, Kalemkerian G, Hassan K. MA 11.10 EGFR TKI Treatment Induces Active Deamination of 5-Methylcytosine and Leads to Acquired T790M Resistant Mutation. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.549] [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: 11/26/2022]
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Hassan K, Kadi NE, Davis A, Kalemkerian G, Wang L, Korkaya H. Abstract 4119: The development of EGFR resistant mutation, T790M, in lung adenocarcinoma is acquired through a specific cytosine deamination mechanism. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4119] [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
EGFR resistant mutation, T790M, in lung adenocarcinoma is acquired through a specific cytosine deamination mechanism.
Background: Epidermal growth factor receptor (EGFR) activation mutations occur in 15% of lung adenocarcinomas. This leads to constitutive activation of EGFR, which triggers multiple downstream survival and proliferation pathways. Currently, EGFR tyrosine kinase inhibitors (TKIs) are first line therapy for stage IV non-small cell lung cancer (NSCLC) patients with EGFR mutations. Despite initial significant response to TKIs, most tumors develop resistance. The main mechanism of resistance detected in 50-60% of cases is a cytosine to thymine (C>T) single nucleotide transition mutation at position 2369. This causes a threonine to methionine amino acid change at position 790 (i.e. T790M). Our data suggests that the C>T mutation is an acquired event secondary to cytosine deamination by Activation Induced Cytosine Deamination enzyme (AICDA).
Results: Single cell clones of lung adenocarcinoma cell line, PC9, were treated with EGFR TKI. At baseline, these clones have EGFR exon 19 deletion but no evidence of T790M mutation by digital droplet PCR (ddPCR). However, after treatment with a serial increasing dose of EGFR TKI, T790M mutation was detected by ddPCR. Assessing whether cytosine deamination enzymes were altered by this treatment, a significant increase in AICDA expression was seen. Furthermore, recombinant AICDA protein could deaminate cytosine at position 2369 in vitro. In addition, using mass spectrometry and methylation specific primers, we determined that cytosine at position 2369 is in fact methylated. This further supports our hypothesis since 5-methyl cytosine is deaminated into thymine directly. Since in germinal center B-lymphocytes, AICDA is activated through a non-canonical NFkB mechanism, we assessed NFkB pathway in PC9 cell line. RelB and p52 expression were significantly increased after TKI treatment. In addition direct interaction between RelB and AICDA promoter was confirmed by ChIP Assay. These findings were also seen in a mouse PC9 xenograft model. Daily oral gavage of EGFR TKI caused significant increase in the expression of RelB as well as AICDA. Adding NFkB inhibitor twice weekly inhibited the expression of RelB and AICDA. Finally, knocking down AICDA by shRNA prevented the development of T790M mutation in PC9 cell lines after TKI exposure.
Conclusion: Our data suggest that the T790M mutation could be actively acquired after TKI treatment through a cytosine deamination process by AICDA. This would have significant implications for treatment with targeted therapy. In fact, Imatinib resistance in CML and GIST tumors have a similar C>T single nucleotide transition mutation.
Citation Format: Khaled Hassan, Najwa El Kadi, April Davis, Gregory Kalemkerian, Luo Wang, Hasan Korkaya. The development of EGFR resistant mutation, T790M, in lung adenocarcinoma is acquired through a specific cytosine deamination mechanism [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4119. doi:10.1158/1538-7445.AM2017-4119
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Affiliation(s)
| | | | | | | | - Luo Wang
- 1University of Michigan, Ann Arbor, MI
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Katheria AC, Brown MK, Hassan K, Poeltler DM, Patel DA, Brown VK, Sauberan JB. Hemodynamic effects of sodium bicarbonate administration. J Perinatol 2017; 37:518-520. [PMID: 28206993 DOI: 10.1038/jp.2016.258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 11/09/2016] [Accepted: 12/13/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe the hemodynamic changes that occur with sodium bicarbonate (NaHCO3) administration in premature neonates. STUDY DESIGN This retrospective study included premature neonates 23 to 31+6 weeks of gestational age who underwent continuous cardiac and cerebral monitoring as participants in prospective trials at our institution, and who received NaHCO3 infused over 30 min in the first 24 h of life. Blood pressure (BP), heart rate, cardiac output (CO), SpO2 and cerebral oximetry (StO2) were captured every 2 s. A baseline was established for all continuous data and averaged over the 10 min before NaHCO3 administration. Baseline was compared with measurements over 10 min epochs until 80 min after administration. Arterial blood gases before and within 1 h of administration were also compared. Significance was set at P<0.05. RESULTS A total of 36 subjects received NaHCO3 (1.3±0.3 mEq kg-1) in the first 24 h (14±8.5 h) of life. NaHCO3 administration increased pH (7.23 vs 7.28, P<0.01) and decreased base deficit (-8.9 vs -6.8, P<0.01) and PaCO2 (45 vs 43 mm Hg, P<0.05). There was a transient but significant (P<0.05) decrease in systemic BP coinciding with an increase in cerebral oxygenation without an increase in oxygen extraction. CO did not change. CONCLUSION Early postnatal NaHCO3 administration does not acutely improve CO but does cause transient fluctuations in cerebral and cardiovascular hemodynamics in extremely premature infants.
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Affiliation(s)
- A C Katheria
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
| | - M K Brown
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
| | - K Hassan
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
| | - D M Poeltler
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
| | - D A Patel
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
| | - V K Brown
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
| | - J B Sauberan
- Neonatal Research Institute, Sharp Mary Birch Hospital for Women and Newborns, San Diego, CA, USA
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Oberhoffer M, Hülskötter M, Helm E, Hassan K, Rad A, Betzold M, Geidel S, Schmoeckel M. Reduction of Sternal Wound Infections with Combined Chlorhexidine–Isopropyl Alcohol Skin Disinfection in Patients Undergoing Bilateral Mammarian Artery Bypass Surgery. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M. Oberhoffer
- Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany
| | - M. Hülskötter
- Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany
| | - E. Helm
- Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany
| | - K. Hassan
- Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany
| | - A. Rad
- Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany
| | - M. Betzold
- Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany
| | - S. Geidel
- Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany
| | - M. Schmoeckel
- Herzchirurgie, Asklepios Klinik St. Georg, Hamburg, Germany
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Abd El Rahman A, Hassan K, Mohamed M. Comparative Study Between Dexmedetomidine And Magnesium sulfate Added to Bupivacaine In Spinal Anesthesia For Postoperative Analgesia In Patients Undergoing Perianal Surgeries. Sohag Medical Journal 2017; 21:183-189. [DOI: 10.21608/smj.2017.40543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Abstract
INTRODUCTION Though insulin has no upper limit in dosage, we do not encounter very high dose requirements too often. The reported case is the first in Bangladesh to require more than 1000 international units (IU) of subcutaneous insulin per day. CASE PRESENTATION A 44-year old male diabetic patient from Bangladesh presented with unusually uncontrolled diabetes mellitus due to extreme insulin resistance. Despite dramatic increase in insulin step by step up to 1110 IU of concomitant short and intermediate acting insulin per day by subcutaneous route, his blood glucose remained over 12 mmol/L persistently, in all the fasting, pre-prandial, postprandial and random samples. He was also treated with several oral hypoglycemic agents including metformin, vildagliptin, glimepiride, pioglitazone and miglitol along with insulin but blood glucose levels remained almost unchanged. However, intravenous infusion of insulin over 4 hours caused a plummet in the glucose level. His blood test for insulin autoantibody was negative. CONCLUSION This paper provides a scope to review literatures on extreme subcutaneous insulin resistance and its management. It also reveals the limitations of management due to lack of facilities in an underdeveloped country, which hinders proper exploration to many medical issues.
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Affiliation(s)
- Zuhayer Ahmed
- Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Indrajit Prasad
- Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Hafizur Rahman
- Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Jalil Ansari
- Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | - Khaled Hassan
- Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
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Kong F, Ten Haken R, Schipper M, Hayman J, Ramnath N, Hassan K, Matuszak M, Ritter T, Bi N, Wang W, Orringer M, Cease K, Lawrence T, Kalemkerian G. A Phase II Trial of Midtreatment PET-CT Adapted Radiation Therapy With Concurrent Chemotherapy in Patients With Inoperable/Unresectable Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1735] [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: 10/20/2022]
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Nobili F, Rodriguez G, Malfatto L, Celestino MA, Hassan K, Francione S, Marenco S, Rosadini G. Correlates of contralateral hypoperfusion in chronic stroke patients. Neurol Res 2016; 14:125-6. [PMID: 1355866 DOI: 10.1080/01616412.1992.11740029] [Citation(s) in RCA: 1] [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: 10/21/2022]
Affiliation(s)
- F Nobili
- Department of Motor Science-Neurophysiopathology, University and Center for Cerebral Neurophysiology (CNR), Genova, Italy
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Okoye O, Okonkwo O, Oderinlo O, Hassan K, Ijasan A. Bilateral concomitant intravitreal anti-vascular endothelial growth factor injection: Experience in a Nigerian tertiary private eye care facility. Niger J Clin Pract 2016; 19:544-8. [PMID: 27251975 DOI: 10.4103/1119-3077.183313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the indication and safety profile of same-session bilateral intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF). METHODS This is a retrospective case series of all the patients that received same-session bilateral intravitreal anti-VEGF in Eye Foundation Hospital, Ikeja, Lagos, from March 2013 to March 2015. Data retrieved from the patients' medical records includes demographics, indications for injections, complications, and systemic comorbidities. RESULTS During the study period, a total of 442 injections were performed on 126 eyes of 63 patients (M:F ratio; 1.4:1) whose mean age was 55.7 ± 15.6 standard deviation years. The modal age group was 51-70 years. All the patients received injection Bevacizumab (Avastin; Genentech Inc., South San Francisco, California, USA-1.25 mg). The most common primary indication for initiating bilateral intravitreal therapy was diabetic macular edema 23 (36.5%). Mean follow-up period was 40.6 days (range: 1-364 days). A combined diabetes mellitus and hypertension accounted for most of the systemic comorbidities 28 (44.4%). Subconjunctival hemorrhage was the only complication seen in these patients with 6 (9.5%) occurring intraoperatively and 9 (14.3%) postoperatively. There was no association between intraoperative complication and age (P = 0.66) or gender (P = 0.96). Furthermore, there exist no association between postoperative complication and age (P = 0.49) or gender (P = 0.99). CONCLUSIONS No major systemic or ocular adverse events were noted. Given that there are potentially serious complications following anti-VEGF injection, further study with a larger number of patients will be necessary to definitively prove the safety of this treatment modality.
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Affiliation(s)
- O Okoye
- Department of Ophthalmology, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - O Okonkwo
- Eye Foundation Hospital and Laser Center, Retina Institute, Ikeja, Lagos, Nigeria
| | - O Oderinlo
- Eye Foundation Hospital and Laser Center, Retina Institute, Ikeja, Lagos, Nigeria
| | - K Hassan
- Eye Foundation Hospital and Laser Center, Retina Institute, Ikeja, Lagos, Nigeria
| | - A Ijasan
- Eye Foundation Hospital and Laser Center, Retina Institute, Ikeja, Lagos, Nigeria
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Solus JF, Hassan K, Lee SJ, Hsi AC, Rosman IS, Dehmeri S, Schaffer A. Cutaneous squamous cell carcinoma progression is associated with decreased GATA-3 immunohistochemical staining. J Cutan Pathol 2016; 43:347-53. [PMID: 26762870 DOI: 10.1111/cup.12667] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 05/20/2015] [Revised: 11/30/2015] [Accepted: 01/10/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND The GATA family of transcription factors is an essential regulator of cellular proliferation and differentiation. In the skin, GATA-3 is critical for epidermal stratification and maintenance of barrier function. A role for GATA-3 in the development of human cutaneous squamous cell carcinoma (SCC) is not known. Here, we investigated GATA-3 immunohistochemical staining in premalignant and invasive cutaneous SCC from sun-exposed and sun-protected skin. METHODS GATA-3 immunohistochemistry was performed on actinic keratoses (AK) (n = 19), in situ squamous cell carcinomas with actinic [SCCIS (A)] (n = 9) or bowenoid features [SCCIS (B)] (n = 17), well-, moderately and poorly differentiated SCC (n = 36), Bowenoid papulosis of the perineum (n = 15) and penile SCC (pSCC) (n = 10). RESULTS We found that GATA-3 immunohistochemical staining is progressively lost in sun-exposed skin as neoplasia progresses from pre-cancerous AK to SCCIS (A), and ultimately, to SCC, which shows near absent GATA-3 staining. This reduction in GATA-3 staining is independent of histological grade in SCC. Only slight down-regulation of GATA-3 was seen in all cases of SCCIS (B) and Bowenoid papulosis, while near absent GATA-3 expression was seen in pSCC. CONCLUSION We propose that decreased GATA-3 immunohistochemical staining is associated with cutaneous SCC progression on both sun-exposed and sun-protected sites.
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Affiliation(s)
- Jason F Solus
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Khaled Hassan
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Sena J Lee
- Internal Medicine Division of Dermatology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Andy C Hsi
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Ilana S Rosman
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.,Internal Medicine Division of Dermatology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Shadmehr Dehmeri
- Internal Medicine Division of Dermatology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - András Schaffer
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.,Internal Medicine Division of Dermatology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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Hassan K, Hassan F, Hassan D, Edgem R, Hassan S. Do diabetic patients receiving conventional dialysis solutions benefit from peritoneal dialysis? MINERVA UROL NEFROL 2015; 67:365-374. [PMID: 26329754] [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: 06/05/2023]
Abstract
AIM The study aimed to evaluate the impact of glucose-based peritoneal dialysis solutions (GBPDS) on diabetic patients on maintenance peritoneal dialysis. METHODS In this cross-sectional study we compared the influence of long term use of GBPDS on sixteen parameters related to the peritoneal glucose load, hydration status, inflammation, blood pressure, lipid profile and left ventricular mass in 45 stable PD patients (20 diabetic and 25 non-diabetic) receiving GBPDS. RESULTS At 24 months HbA1c, peritoneal glucose load index (PGLI), fluid overload (FO), plasma BNP, hsCRP and IL-6 levels, WBC count, blood pressure, triglycerides, LDL-C and left ventricular mass index (LVMI) were higher in diabetic patients compared to non-diabetic subjects (P ≤ 0.04). Of 16 tested variables, 14 had deteriorated at 24 months in diabetic patients. PGLI values > 3 g/kg/day or FO > 1.0 L were associated with abnormal values of HbA1c, plasma BNP, CRP and plasma IL-6 levels. 60% of diabetic patients had PGLI > 3g/kg/day compared to 32% of non-diabetic patients (P < 0.001). Seventy per cent of diabetic patients had FO > 1.0 L compared to 28% of non-diabetic patients (P < 0.001). Only 12% of diabetic patients had nocturnal blood pressure dipping compared to 45% of non-diabetics (P = 0.03). 57.8% of the studied patients had increased LVMI. Diabetic patients had higher LVMI values compared to non-diabetics (P < 0.001). The presence of DM was found to be the most powerful predictor for the development of LVH (P < 0.001). CONCLUSION Utilization of GBPDS in diabetic PD patients may be associated with substantial adverse consequences affecting glycemic control, hydration status, lipid profile, inflammation, blood pressure control and LVM.
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Affiliation(s)
- K Hassan
- Faculty of Medicine in the Galilee, Bar‑Ilan University, Safed, Israel -
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te Wildt B, Hassan K, Steinbüchel T, Dieris-Hirche J, Rojas S, Hillemacher T, Löber S, Münte T, Mohammadi B, Szycik G. Abhängigkeitsphänomene, Aggressivität und Empathie bei exzessiven Nutzern von Computerspielen vom First-Person-Shooter-Typ. Suchttherapie 2015. [DOI: 10.1055/s-0035-1564214] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- B. te Wildt
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum Bochum der Ruhr-Universität Bochum
| | - K. Hassan
- Klinikum Herford, Klinik für Kardiologie
| | - T. Steinbüchel
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum Bochum der Ruhr-Universität Bochum
| | | | - S. Rojas
- Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Medizinische Hochschule Hannover
| | - T. Hillemacher
- Zentrum für Seelische Gesundheit, Medizinische Hochschule Hannover
| | - S. Löber
- Lehrstuhl für Klinische Psychologie und Psychotherapie, Universität Bamberg
| | - T. Münte
- Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Lübeck
| | | | - G. Szycik
- Institut für Verhaltenstherapie und Verhaltensmedizin (AVVM), Zentrum für Seelische Gesundheit, Medizinische Hochschule Hannover
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Mostafa A, Hassan K. Energy Harvesting Aware Clustering and Opportunistic Transmission with Fuzzy Petri Net Reasoning. EAI Endorsed Transactions on Industrial Networks and Intelligent Systems 2015. [DOI: 10.4108/eai.17-9-2015.150283] [Citation(s) in RCA: 1] [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: 11/05/2022] Open
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Elnady B, El-Sharkawi M, El-Meshtawy M, Adam F, Hassan K. High Density Pedicle Screws through Posterior Only Approach for Surgical Correction of Severe Adolescent Idiopathic Scoliosis > 70o. Egyptian Spine Journal 2015. [DOI: 10.21608/esj.2015.3973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Elyan D, Wasfy M, El Mohammady H, Hassan K, Monestersky J, Noormal B, Oyofo B. Non-bacterial etiologies of diarrheal diseases in Afghanistan. Trans R Soc Trop Med Hyg 2014; 108:461-5. [PMID: 24942900 DOI: 10.1093/trstmh/tru096] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Microbial diarrheal diseases are one of the leading causes of child morbidity and mortality in developing countries. This study aimed to identify the main causes of non-bacterial diarrhea in Afghanistan. METHODS A total of 699 stools were collected from children aged under 5 years who presented with diarrhea at Indira Gandhi and Kandahar hospitals. Frozen aliquots were preserved for screening against rotavirus, astrovirus, adenovirus, norovirus, Cryptosporidium and Giardia, when bacterial cultures tested negative. Tests were performed at the hospitals after laboratory staff were trained and provided with enzyme-immunoassays and equipment. Results were confirmed at the U.S. Naval Medical Research Unit No. 3, Cairo, Egypt. RESULTS Of the samples tested, 71.9% (503/699) were infected with one or more pathogens. However, the majority (85.8%; 432/503) showed single infections: rotavirus (72.2%; 329/432), Cryptosporidium (14.1%; 61/432), Giardia (5.1%; 22/432), astrovirus (2.3%; 10/432), adenovirus (1.6%; 7/432) and norovirus (0.7%; 3/432). The remaining 14% (71/503) showed mixed infections of the tested pathogens. CONCLUSIONS Non-bacterial pathogens were identified that could enable health officials to adopt more effective treatment and control measures for diarrhea in Afghanistan.
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Affiliation(s)
- Diaa Elyan
- U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt
| | - Momtaz Wasfy
- U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt
| | - Hanan El Mohammady
- U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt
| | - Khaled Hassan
- U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt
| | - Jesse Monestersky
- U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt
| | - Bashir Noormal
- Afghanistan Public Health Institute (APHI) - Ministry of Public Health (MoPH), Islamic Republic of Afghanistan
| | - Buhari Oyofo
- U.S. Naval Medical Research Unit No. 3 (NAMRU-3), PSC 452, Box 5000, FPO AE 09835-0007, Cairo, Egypt
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Fotheringham J, Campbell MJ, Wilkie M, Lopes Barreto D, Sampimon DE, Struijk DG, Krediet RT, Portoles J, Janeiro D, Tato AM, Lopez P, Castellano I, Del Peso G, Rivera M, Fernandez-Reyes MJ, Ortega M, Martinez De Miguel P, Caparros G, Selgas R, Sarmento-Dias M, Santos-Araujo C, Poinhos R, Soares Silva I, Simoes Silva L, Sousa MJ, Correia F, Pestana M, Kang SH, Cho KH, Park JW, Yoon KW, Do JY, Ponce D, Banin V, Bueloni T, Caramori J, Balbi A, Barretti P, Virzi GM, Na HY, Kim YB, Jo YI, Griva K, Yu Z, Foo M, Chang KY, Kim YK, Kim YO, Song HC, Yang CW, Kim SH, Kim YL, Kim YS, Kang SW, Kim NH, Kim HW, Waniewski J, Poleszczuk J, Antosiewicz S, Baczy ski D, Pietribiasi M, Wankowicz Z, Alhwiesh A, Nasreldin MA, Saeed I, Braide M, Milan Manani S, I{middle dot}Nal S, Okyay GU, Ulu MS, Kidir V, Altuntas A, Ahsen A, Unverdi S, Yuksel S, Duranay M, Sezer MT, Mushahar L, Lim WM, Mohd Yusuf WS, Sivathasan S, Ancarani P, Parodi D, Terrile O, Scofferi S, Lenzora G, Martins AR, Vizinho R, Branco PQ, Gaspar MA, Barata JD, Dimkovic N, Lazarevic T, Zdenka M, Pljesa S, Marinkovic J, Djukanovic L, Ahbap E, Kara E, Sahutoglu T, Basturk T, Koc Y, Sakaci T, Sevinc M, Akgol C, Unsal A, Vlahu CA, De Graaff M, Vink H, Struijk DG, Krediet RT, Zeiler M, Marani M, Agostinelli RM, Monteburini T, Marinelli R, Di Luca M, Santarelli S, Moreiras-Plaza M, Blanco-Garcia R, Martin-Baez I, Fernandez-Fleming F, Beato-Coo L, Chang JH, Ro H, Jung JY, Lee HH, Moon SJ, Chung W, Hassan K, Hassan D, Shturman A, Hassan F, Rubinchik I, Hassan S, Atar S, Witoon R, Matsuda A, Tayama Y, Ogawa T, Kogure Y, Okazaki S, Hatano M, Kiba T, Iwashita T, Shimizu T, Hasegawa H, Mitarai T, Rroji ( Molla) M, Seferi S, Burazeri G, Thereska N, Theodoridis M, Gioka T, Bounta T, Kriki P, Mourvati E, Thodis E, Roumeliotis A, Passadakis P, Vargemezis V, Bek S, Eren N, Eraldemir FC, Batman A, Derviso lu E. PERITONEAL DIALYSIS 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu154] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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Hassan K, Leroy F, Colas-des-Francs G, Weeber JC. Dihedron dielectric loaded surface plasmon athermal polarization converter. Opt Lett 2014; 39:697-700. [PMID: 24487902 DOI: 10.1364/ol.39.000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We investigate numerically a novel plasmonic polarization converter relying on the excitation of a so-called dihedron dielectric loaded plasmon polariton. The dihedron dielectric loaded waveguide consists of a dielectric ridge implemented at the inner corner of a metal-coated dielectric step. For a dielectric ridge with a square cross section, the plasmon polariton modes supported by each side of the metallized step hybridize to create supermodes with crossed polarizations. We show that the two supermodes can be operated in a dual-mode interferometer configuration to perform an efficient (24 dB) TE-TM/TM-TE polarization conversion over typical distances below 30 μm at telecommunications wavelengths. In addition, on the basis of the thermo-optical properties of our device, we find that the dihedron plasmonic polarization converter is temperature insensitive.
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Weeber JC, Bernardin T, Nielsen MG, Hassan K, Kaya S, Fatome J, Finot C, Dereux A, Pleros N. Nanosecond thermo-optical dynamics of polymer loaded plasmonic waveguides. Opt Express 2013; 21:27291-27305. [PMID: 24216953 DOI: 10.1364/oe.21.027291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The thermo-optical dynamics of polymer loaded surface plasmon waveguide (PLSPPW) based devices photo-thermally excited in the nanosecond regime is investigated. We demonstrate thermo-absorption of PLSPPW modes mediated by the temperature-dependent ohmic losses of the metal and the thermally controlled field distribution of the plasmon mode within the metal. For a PLSPPW excited by sub-nanosecond long pulses, we find that the thermo-absorption process leads to modulation depths up to 50% and features an activation time around 2 ns whereas the relaxation time is around 800 ns, four-fold smaller than the cooling time of the metal film itself. Next, we observe the photo-thermal activation of PLSPPW racetrack shaped resonators at a time scale of 300 ns followed however by a long cooling time (18 μs) attributed to the poor heat diffusivity of the polymer. We conclude that nanosecond excitation combined to high thermal diffusivity materials opens the way to high speed thermo-optical plasmonic devices.
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Kaya S, Weeber JC, Zacharatos F, Hassan K, Bernardin T, Cluzel B, Fatome J, Finot C. Photo-thermal modulation of surface plasmon polariton propagation at telecommunication wavelengths. Opt Express 2013; 21:22269-22284. [PMID: 24104119 DOI: 10.1364/oe.21.022269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We report on photo-thermal modulation of thin film surface plasmon polaritons (SPP) excited at telecom wavelengths and traveling at a gold/air interface. By operating a modulated continuous-wave or a Q-switched nanosecond pump laser, we investigate the photo-thermally induced modulation of SPP propagation mediated by the temperature-dependent ohmic losses in the gold film. We use a fiber-to-fiber characterization set-up to measure accurately the modulation depth of the SPP signal under photo-thermal excitation. On the basis of these measurements, we extract the thermo-plasmonic coefficient of the SPP mode defined as the temperature derivative of the SPP damping constant. Next, we introduce a figure of merit which is relevant to characterize the impact of temperature onto the properties of bounded or weakly leaky SPP modes supported by a given metal at a given wavelength. By combining our measurements with tabulated values of the temperature-dependent imaginary part of gold dielectric function, we compute the thermo-optical coefficients (TOC) of gold at telecom wavelengths. Finally, we investigate a pulsed photo-thermal excitation of the SPP in the nanosecond regime. The experimental SPP depth of modulation obtained in this situation are found to be in fair agreement with the modulation depths computed by using our values of gold TOC.
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Hassan K, Wang L, Korkaya H, O'Dowd P, Dubaisi S, Kadi R, Nasr R, Zhang B, Davis A, Kalemkerian G, Wicha M. Abstract 960: Blocking the Notch pathway induces mesenchymal-to-epithelial transition in lung adenocarcinoma: A novel approach to overcoming chemoresistance. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-960] [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
Backgroung: The Epithelial-Mesenchymal Transition (EMT) is a key developmental program that is often activated during cancer invasion and metastasis. EMT cells possess the characteristics of cell motility, invasiveness, and have stem cells properties. EMT expression profile correlates with resistance to chemotherapy and poor outcome in multiple tumors and there is evidence suggesting an integral role of Notch pathway in mediating an EMT status. In this study, we investigated Notch activity and EMT status and the correlation with chemoressitance in lung adenocarcinoma.
Results: Transduction of multiple lung adenocarcinoma cell lines, NCI-H1299, NCI-H460, NCI-H358, NCI-H441 with a Notch GFP-reporter construct identified a subset of cells with high Notch activity (GFP-positive). We compared cell migration capacity of GFP-positive and -negative cells utilizing a transwell invasion assay. Cells with high Notch activity, as evidenced by GFP expression, had a significantly higher migration capability as compared to GFP-negative cells. To evaluate resistance to chemotherapy, we treated GFP-pos and GFP-neg cells with docetaxel or cisplatin and measured apoptosis by Annexin V expression with flow cytometry. GFP-pos cells showed major resistance to both agents as compared to GFP-neg cells. When GFP-pos cells were exposed to a Notch activity blocker, gamma secretase inhibitor (GSI), these cells were rendered sensitive to cisplatin or docetaxel exposure as evident by an increase in Annexin V expression. Using RNA microarray analysis and RT-PCR assays, there was an increased expression of EMT related genes (Vimentin, N-Cadherin, Snail-1,….) in GFP-pos cells as compared to GFP-neg cells. Furthermore, NOD/SCID mice with subcutaneous primary lung tumor xenografts treated with GSI showed decreased expression of downstream effectors of Notch as as well as vimentin. Mice treated with combination of GSI and docetaxel had better tumor control as compared to those treated with GSI and docetaxel as single agents.
Conclusion: These studies suggest that the Notch pathway is an important regulator of EMT status and that its inhibition induces mesenchymal to epithelial transition overcoming chemoresistnace. Notch inhibitors in combination with standard chemotherapy present a potential effective approach to achieve better disease control in lung cancer.
Citation Format: Khaled Hassan, Luo Wang, Hasan Korkaya, Paige O'Dowd, Sarah Dubaisi, Rayyan Kadi, Rawad Nasr, Binghui Zhang, April Davis, Gregory Kalemkerian, Max Wicha. Blocking the Notch pathway induces mesenchymal-to-epithelial transition in lung adenocarcinoma: A novel approach to overcoming chemoresistance. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 960. doi:10.1158/1538-7445.AM2013-960
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Affiliation(s)
| | - Luo Wang
- University of Michigan, Ann Arbor, MI
| | | | | | | | | | | | | | | | | | - Max Wicha
- University of Michigan, Ann Arbor, MI
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Geidel S, Schäfer U, Hassan K, Oberhoffer M, Bader R, Kuck KH, Schmoeckel M. Hybrid approach for redo mitral valve surgery with safe intermittent catheter balloon occlusion of a patent arterial T-graft. Herz 2013; 38:736-7. [PMID: 23430090 DOI: 10.1007/s00059-013-3760-z] [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: 11/01/2012] [Revised: 12/04/2012] [Accepted: 01/11/2013] [Indexed: 11/28/2022]
Affiliation(s)
- S Geidel
- Abteilung für Herzchirurgie, Asklepios Klinik St. Georg, Lohmühlenstr. 5, 20099, Hamburg, Germany,
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Shah JN, Pokhrel Y, Hassan K, Thapa G, Manandhar K, Maharjan SB. Is routine hospital visit after day case inguinal hernia surgery in children necessary? J Nepal Health Res Counc 2013; 11:35-39. [PMID: 23787523] [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: 06/02/2023]
Abstract
BACKGROUND To observe the prospects of day case inguinal hernia surgery in children without routine postoperative hospital visits. The aim was to access the advantages, acceptability and safety of this change in practice in low resource country like Nepal. METHODS This was a cross-sectional study in a tertiary care general teaching hospital. Thirty children aged 6 months to 14 years who had elective day case Inguinal Hernia surgery from May 2011 to Oct 2011 were prospectively observed. Children with obstructed hernia, un-descended testis were excluded. Parents were counseled for omission of routine hospital visit after surgery. Main outcome measures were to observe unplanned hospital visit, reasons for visit, post-operative pain, wound infection and overall satisfaction of parents interviewed by telephone. Study was approved by institutional review committee. RESULTS There were 28 boys and two girls. Average age was five years. Right Inguinal Hernia patients were 19 in number while 11 patients had left sided hernia. None of the children visited health facility for pain or wound problem. Two children were brought to outpatient because they were mistakenly given appointment slip. Mother noticed recurrence and brought one child to surgical outpatient. All 30 parents responded to telephone enquiry and were satisfied. CONCLUSIONS Routine follow up visit after day care Inguinal Hernia surgery in children is not necessary. This practice is safe, economic and well accepted by children and parents.
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Affiliation(s)
- J N Shah
- Department of surgery, Patan Hospital, Patan Academy of Health Sciences, Kathmandu, Nepal.
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Mansour AM, Abd Elkhalek R, Shaheen HI, El Mohammady H, Refaey S, Hassan K, Riddle M, Sanders JW, Sebeny PJ, Young SYN, Frenck R. Burden of Aeromonas hydrophila-associated diarrhea among children younger than 2 years in rural Egyptian community. J Infect Dev Ctries 2012; 6:842-6. [PMID: 23276737 DOI: 10.3855/jidc.2390] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 02/08/2012] [Accepted: 02/11/2012] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Between 2004 and 2007, a birth cohort of Egyptian children was analysed to evaluate the epidemiology of enteric diseases. METHODOLOGY A stool sample was collected from the study children every two weeks as well as whenever they experienced diarrhea. Samples were tested for routine bacterial pathogens as well as enteropathogenic viruses and parasites. A secondary goal of the study was to evaluate the burden of less commonly reported pathogens including Aeromonas hydrophila. RESULTS Of the 348 study subjects, 79 had A. hydrophila isolated from their stool at some point during the study. Thirty-six children had exclusively symptomatic (S) infections while 33 had exclusively asymptomatic (AS) infections. However, 10 children had both S and AS infections. Among symptomatic cases, A. hydrophila was the sole pathogen isolated 36% of the time. An important aspect of A. hydrophila associated diarrhea was the high level of resistance to cephalosporins. CONCLUSION Although relatively uncommon, A. hydrophila was found to be associated with diarrhea among children living in Egypt and was frequently multi-drug resistant.
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Weeber JC, Hassan K, Saviot L, Dereux A, Boissière C, Durupthy O, Chaneac C, Burov E, Pastouret A. Efficient photo-thermal activation of gold nanoparticle-doped polymer plasmonic switches. Opt Express 2012; 20:27636-27649. [PMID: 23262712 DOI: 10.1364/oe.20.027636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We report on the photo-thermal activation of dielectric loaded plasmonic switches comprised of gold nanoparticle-doped polymer deposited onto a gold film. The plasmonic switches rely on a multi-mode interferometer design and are fabricated by electron beam lithography applied to a positive resin doped with gold nanoparticles at a volume ratio of 0.52%. A cross-bar switching is obtained at telecom wavelengths by pumping the devices with a visible beam having a frequency within the localized surface plasmon resonance band of the embedded nanoparticles. By comparing the switching performances of doped and undoped devices, we show that for the modest doping level we consider, the power needed to activate the doped switches is reduced by a factor 2.5 compared to undoped devices. The minimization of activation power is attributed to enhanced light-heat conversion and optimized spatial heat generation for doped devices and not to a change of the thermo-optic coefficient of the doped polymer.
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Affiliation(s)
- J-C Weeber
- Laboratoire Interdisciplinaire Carnot de Bourgogne, UMR 6303 CNRS-Université de Bourgogne, Dijon, France.
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Zehtabchi S, Berwald N, Hassan K, Khan F, Viswanathan N, Ardolic B. 128 The Role of Antibiotic Prophylaxis for Prevention of Wound Infection in Emergency Department Patients With Simple Hand Laceration: A Feasibility Pilot Study. Ann Emerg Med 2012. [DOI: 10.1016/j.annemergmed.2012.06.105] [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: 11/28/2022]
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Hassan K, Rubinchik I, Hassan F, Ron E, Hassan S. Unusual Cause of Late Peritoneal Dialysate Leakage. Perit Dial Int 2012; 32:360-1. [DOI: 10.3747/pdi.2011.00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- K. Hassan
- Nephrology and Hypertension Department Western Galilee Hospital Nahariya, Israel
- Ruth and Bruce Rappaport Faculty of Medicine Technion, Haifa, Israel
| | - I. Rubinchik
- Nephrology and Hypertension Department Western Galilee Hospital Nahariya, Israel
| | - F. Hassan
- Sackler Faculty of Medicine Tel Aviv University Tel Aviv, Israel
| | - E. Ron
- Nephrology and Hypertension Department Western Galilee Hospital Nahariya, Israel
| | - S. Hassan
- Internal Medicine Department Carmel Medical Center Haifa, Israel
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Hasan K, Kim G, Malik F, Davis A, Paulson AK, Quraishi AA, D'Angelo RC, Tawakkol N, Liu S, Hassan K, Clouthier SG, Wicha MS. Abstract 3349: Transformation of mammary epithelial cells by inactivation of p53 and PTEN generates cancer stem cells driven by an IL-6/TGF-beta inflammatory loop. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-3349] [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
The PTEN and p53 tumor suppressor genes, frequently inactivated in human breast cancers have been shown to be regulators of normal and malignant breast stem cell self-renewal. In addition, inactivation of tumor suppressors in preneoplastic lesions are implicated in tumor progression from ductal situ in carcinoma (DCIS) to invasive ductal carcinoma. To determine the relationship between stem cell self-renewal and carcinogenesis, we examined the effects of PTEN and p53 knockdown on normal mammary epithelial cells obtained from reduction mammoplasties, as well as in the non-transformed mammary cell line MCF10A. Simultaneous knockdown of PTEN and p53 in normal mammary epithelial cells generated hyperplastic and DCIS-like lesions when these cells were transplanted into the humanized mammary fat pads of NOD/SCID mice. In MCF10A cells knockdown of PTEN and p53 synergized to expand the stem cell compartment transforming these cells and generating highly metastatic tumors in NOD/SCID mice. Stem cell expansion was driven by activation of an inflammatory loop involving both IL-6 and TGF-b. This inflammatory loop was mediated by both AKT/b-Catenin and Stat3/NF-kB pathways. Conversely collective inhibition of these pathways including TGF-b, IL-6 and Wnt/b-Catenin and Stat3/NF-kB was necessary to revert back this stem cell phenotype. This may suggest that synergistic activity of these pathways may contribute to the expansion and transformation of mammary stem cells. The expanded cancer stem cells were highly metastatic and invasive and displayed properties of EMT. The IL6-R antibody tocilizumab blocked this loop resulting in a reduction of CSCs and thus inhibiting tumor growth in mouse xenografts. These studies suggest that loss of PTEN and p53 transforms mammary epithelial cells by activating an inflammatory loop mediated by IL-6 and TGF-b, generating CSCs with an EMT phenotype. Since CSCs drive tumor growth and metastasis, targeting the self-renewal by interfering with this CSC, inflammatory loop represents a rational strategy for breast cancer prevention and therapy.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3349. doi:1538-7445.AM2012-3349
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Affiliation(s)
| | - Gwangil Kim
- 2Department of Pathology, CHA Bundang Medical Center, CHA University, Gyeonggi, Republic of Korea
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Kalavrouziotis D, Papaioannou S, Giannoulis G, Apostolopoulos D, Hassan K, Markey L, Weeber JC, Dereux A, Kumar A, Bozhevolnyi SI, Baus M, Karl M, Tekin T, Tsilipakos O, Pitilakis A, Kriezis EE, Avramopoulos H, Vyrsokinos K, Pleros N. 0.48Tb/s (12x40Gb/s) WDM transmission and high-quality thermo-optic switching in dielectric loaded plasmonics. Opt Express 2012; 20:7655-7662. [PMID: 22453444 DOI: 10.1364/oe.20.007655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We demonstrate Wavelength Division Multiplexed (WDM)-enabled transmission of 480Gb/s aggregate data traffic (12x40Gb/s) as well as high-quality 1x2 thermo-optic tuning in Dielectric-Loaded Surface Plasmon Polariton Waveguides (DLSPPWs). The WDM transmission characteristics have been verified through BER measurements by exploiting the heterointegration of a 60 μm-long straight DLSPPW on a Silicon-on-Insulator waveguide platform, showing error-free performance for six out of the twelve channels. High-quality thermo-optic tuning has been achieved by utilizing Cycloaliphatic-Acrylate-Polymer as an efficient thermo-optic polymer loading employed in a dual-resonator DLSPPW switching structure, yielding a 9 nm wavelength shift and extinction ratio values higher than 10 dB at both output ports when heated to 90°C.
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Affiliation(s)
- D Kalavrouziotis
- National Technical University of Athens – School of Electrical Engineering and Computer Engineering 9 Iroon Polytechniou Street, Zografou 15780 –Athens, Greece.
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50
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Geidel S, Schneider C, Lass M, Hassan K, Pape A, Krause K, Boczor S, Kuck KH, Schmoeckel M. Concomitant three-dimensional prosthetic ring annuloplasty for functional tricuspid valve disease in patients with chronic ischemic mitral regurgitation. Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297653] [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: 10/14/2022]
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