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Johnson MD, Palmisciano P, Yamani AS, Hoz SS, Prestigiacomo CJ. A Systematic Review and Meta-Analysis of 3-Dimensional Morphometric Parameters for Cerebral Aneurysms. World Neurosurg 2024; 183:214-226.e5. [PMID: 38160907 DOI: 10.1016/j.wneu.2023.12.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Imaging modalities with increased spatial resolution have allowed for more precise quantification of cerebral aneurysm shape in 3-dimensional (3D) space. We conducted a systematic review and meta-analysis to assess the correlation of individual 3D morphometric measures with cerebral aneurysm rupture status. METHODS Two independent reviewers performed a PRISMA (preferred reporting items of systematic reviews and meta-analysis)-guided literature search to identify articles reporting the association between 3D morphometric measures of intracranial aneurysms and rupture status. RESULTS A total of 15,122 articles were identified. After screening, 39 studies were included. We identified 17 3D morphometric measures, with 11 eligible for the meta-analysis. The meta-analysis showed a significant association with rupture status for the following measures: nonsphericity index (standardized mean difference [SMD], 0.66; 95% confidence interval [CI], 0.53-0.79; P < 0.0001; I2 = 55.2%), undulation index (SMD, 0.55; 95% CI, 0.26-0.85; P = 0.0017; I2 = 68.1%), ellipticity index (SMD, 0.53; 95% CI, 0.29-0.77; P = 0.0005; I2 = 70.8%), volume (SMD, 0.18; 95% CI, 0.02-0.35; P = 0.0320; I2 = 82.3%), volume/ostium ratio (SMD, 0.43; 95% CI, 0.16-0.71; P = 0.0075; I2 = 90.4%), elongation (SMD, -0.94; 95% CI, -1.12 to -0.76; P = 0.0005; I2 = 0%), flatness (SMD, -0.87; 95% CI, -1.04 to -0.71; P = 0.0005; I2 = 0%), and sphericity (SMD, -0.62; 95% CI, -1.06 to -0.17; P = 0.0215; I2 = 67.9%). A significant risk of publication bias was estimated for the ellipticity index (P = 0.0360) and volume (P = 0.0030). CONCLUSIONS Based on the results of a meta-analysis containing 39 studies, the nonsphericity index, undulation index, elongation, flatness, and sphericity demonstrated the most consistent correlation with rupture status.
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Affiliation(s)
- Mark D Johnson
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA.
| | - Paolo Palmisciano
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Ali S Yamani
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Samer S Hoz
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA
| | - Charles J Prestigiacomo
- College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA; Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, USA
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Johnson MD, Ventre GJ, Kaye J, Patel HB, Naveed A, Prestigiacomo CJ, Ngwenya LB. Evaluating mortality and 6-month functional outcomes of patients with dural venous sinus thrombosis in traumatic brain injury. J Neurosurg 2023:1-10. [PMID: 38157533 DOI: 10.3171/2023.10.jns231158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/12/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Patients with dural venous sinus thrombosis (DVST) in select populations following traumatic brain injury (TBI), including those with blunt mechanism or depressed skull fractures, have been shown to have an increased risk of mortality. The purpose of this study was to assess these findings in a mixed population of head trauma patients. METHODS The authors performed a case-control study using propensity score matching by reviewing 17 years (2004-2021) of data from their institutional trauma registry. Patients with imaging-confirmed DVST were matched to a control group of TBI patients without identified DVST based on age, sex, postresuscitation Glasgow Coma Scale (GCS) score, and Injury Severity Score. All age groups and injury mechanisms were included with a head Abbreviated Injury Scale score ≥ 3. Data on demographics, injury and radiographic characteristics, and patient outcomes were collected. Multivariable logistic regression was performed to identify predictors of inpatient mortality. An additional subgroup analysis of patients with concurrent DVST and blunt cerebrovascular injury (BCVI) was planned a priori. RESULTS The authors identified 9875 patients who presented to their institution over the study period with TBIs, with a 1.64% incidence of DVST. Concurrent BCVI was diagnosed in 23.5% of patients with a DVST. Following matching, the presence of DVST itself was not significantly associated with inpatient mortality (OR 0.68, 95% CI 0.24-1.88). On regression analysis, penetrating injuries (8.19, 95% CI 1.21-80.0) and lower postresuscitation GCS scores (0.69, 95% CI 0.53-0.84) were independently associated with inpatient mortality for patients with traumatic DVST. Significantly worse functional outcomes were observed in those with DVST at 3 months, with no significant difference at 6 months. CONCLUSIONS The authors observed a prevalence of traumatic DVST of 1.64% in a mixed population of head-injured patients, with 23.5% of patients with DVST having concurrent BCVI. Traumatic DVST alone was not associated with a significantly increased risk of inpatient mortality.
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Affiliation(s)
- Mark D Johnson
- 1College of Medicine, University of Cincinnati
- 2Department of Neurosurgery, University of Cincinnati; and
| | | | - Joel Kaye
- 1College of Medicine, University of Cincinnati
- 2Department of Neurosurgery, University of Cincinnati; and
| | | | - Asad Naveed
- 1College of Medicine, University of Cincinnati
- 2Department of Neurosurgery, University of Cincinnati; and
| | - Charles J Prestigiacomo
- 1College of Medicine, University of Cincinnati
- 2Department of Neurosurgery, University of Cincinnati; and
| | - Laura B Ngwenya
- 1College of Medicine, University of Cincinnati
- 3Department of Neurology & Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio
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Yang HW, Lee S, Berry BC, Yang D, Zheng S, Carroll RS, Park PJ, Johnson MD. A role for mutations in AK9 and other genes affecting ependymal cells in idiopathic normal pressure hydrocephalus. Proc Natl Acad Sci U S A 2023; 120:e2300681120. [PMID: 38100419 PMCID: PMC10743366 DOI: 10.1073/pnas.2300681120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is an enigmatic neurological disorder that develops after age 60 and is characterized by gait difficulty, dementia, and incontinence. Recently, we reported that heterozygous CWH43 deletions may cause iNPH. Here, we identify mutations affecting nine additional genes (AK9, RXFP2, PRKD1, HAVCR1, OTOG, MYO7A, NOTCH1, SPG11, and MYH13) that are statistically enriched among iNPH patients. The encoded proteins are all highly expressed in choroid plexus and ependymal cells, and most have been associated with cilia. Damaging mutations in AK9, which encodes an adenylate kinase, were detected in 9.6% of iNPH patients. Mice homozygous for an iNPH-associated AK9 mutation displayed normal cilia structure and number, but decreased cilia motility and beat frequency, communicating hydrocephalus, and balance impairment. AK9+/- mice displayed normal brain development and behavior until early adulthood, but subsequently developed communicating hydrocephalus. Together, our findings suggest that heterozygous mutations that impair ventricular epithelial function may contribute to iNPH.
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Affiliation(s)
- Hong Wei Yang
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA01655
| | - Semin Lee
- Brigham and Women’s Hospital, Boston, MA02115
- Harvard Medical School, Boston, MA02115
| | - Bethany C. Berry
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA01655
| | - Dejun Yang
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA01655
| | - Shaokuan Zheng
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA01655
| | - Rona S. Carroll
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA01655
- Brigham and Women’s Hospital, Boston, MA02115
- Harvard Medical School, Boston, MA02115
| | - Peter J. Park
- Brigham and Women’s Hospital, Boston, MA02115
- Harvard Medical School, Boston, MA02115
| | - Mark D. Johnson
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, MA01655
- Department of Neurological Surgery, University of Massachusetts Memorial Health, Worcester, MA01655
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Hoz SS, Sharma M, Palmisciano P, Johnson MD, Ismail M, Muthana A, Al-Ageely TA, Forbes JA, Prestigiacomo CJ, Zuccarello M, Andaluz N. Peritrigeminal Safe Entry Zone Access to Anterolateral Pons Using the Presigmoid Retrolabyrinthine Suprameatal Approach: A Cadaveric Morphometric Study. Oper Neurosurg (Hagerstown) 2023; 25:e303-e307. [PMID: 37578224 DOI: 10.1227/ons.0000000000000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/09/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Access to the anterolateral pontine lesions can be achieved through the peritrigeminal and supratrigeminal safe entry zones using Kawase, retrosigmoid, or translabyrinthine approaches. However, these approaches entail shallow extensive dissection, tangential access, and compromise vestibulocochlear function. We aimed to investigate infratentorial presigmoid retrolabyrinthine approach to access pontine lesions through the peritrigeminal zone. METHODS We performed 10 presigmoid retrolabyrinthine suprameatal approach dissections in 5 cadaveric heads. Anatomic-radiological characteristics and variations were evaluated. Six morphometric parameters were measured and analyzed to predict surgical accessibility. RESULTS The pontine infratrigeminal area was accessible in all patients. The mean exposed area of the anterolateral pontine surface was 98.95 cm 2 (±38.11 cm 2 ). The mean length of the exposed trigeminal nerve was 7.9 cm (±2.9 cm). Preoperative anatomic-radiological parameters may allow to select patients with favorable anatomy that offers appropriate surgical accessibility to the anterior pontine cavernoma through a presigmoid retrolabyrinthine corridor. CONCLUSION Anterolateral pontine lesions can be accessed through a minimally invasive infratentorial presigmoid retrolabyrinthine approach by targeting the infratrigeminal safe entry zone. Further clinical studies should be conducted to evaluate the viability of this technique for treating these complex pathologies in real clinical settings.
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Affiliation(s)
- Samer S Hoz
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Neurosurgery, Goodyear Microsurgery Lab, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Mayur Sharma
- Department of Neurosurgery, Goodyear Microsurgery Lab, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Paolo Palmisciano
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Neurosurgery, Goodyear Microsurgery Lab, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Mark D Johnson
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Neurosurgery, Goodyear Microsurgery Lab, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Mustafa Ismail
- Department of Neurosurgery, University of Baghdad College of Medicine, Baghdad, Iraq
| | - Ahmed Muthana
- Department of Neurosurgery, University of Baghdad College of Medicine, Baghdad, Iraq
| | - Teeba A Al-Ageely
- Department of Neurosurgery, University of Baghdad College of Medicine, Baghdad, Iraq
| | - Jonathan A Forbes
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Neurosurgery, Goodyear Microsurgery Lab, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Charles J Prestigiacomo
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Neurosurgery, Goodyear Microsurgery Lab, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Mario Zuccarello
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Neurosurgery, Goodyear Microsurgery Lab, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Norberto Andaluz
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Department of Neurosurgery, Goodyear Microsurgery Lab, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Johnson MD, Prestigiacomo CJ. Preincisional Localization: An Overlooked Contribution by Ralph Bingham Cloward. World Neurosurg 2023; 179:37-42. [PMID: 37557981 DOI: 10.1016/j.wneu.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
Preincisional localization has become ubiquitous within spinal neurosurgery and has served as the foundation for modern minimally invasive surgery techniques. Dr. Ralph Bingham Cloward, renowned for his contributions to the field of spinal fusion, was a strong advocate and early adopter of diskography. In fact, Cloward credited cervical diskography for inspiring his anterior approach to the cervical disk. In his landmark 1958 article on what is now known as anterior cervical diskectomy and fusion, Cloward commented on a case of wrong-level surgery that motivated him to implement a standardized technique for spinal level localization with the patient under anesthesia in the operating room before skin incision. We trace the origins of the use of preincisional radiographs to localize the pathologic level at the time of diskectomy and highlight this original contribution by Cloward.
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Affiliation(s)
- Mark D Johnson
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
| | - Charles J Prestigiacomo
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Hou CC, Li D, Berry BC, Zheng S, Carroll RS, Johnson MD, Yang HW. Heterozygous FOXJ1 Mutations Cause Incomplete Ependymal Cell Differentiation and Communicating Hydrocephalus. Cell Mol Neurobiol 2023; 43:4103-4116. [PMID: 37620636 PMCID: PMC10661798 DOI: 10.1007/s10571-023-01398-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023]
Abstract
Heterozygous mutations affecting FOXJ1, a transcription factor governing multiciliated cell development, have been associated with obstructive hydrocephalus in humans. However, factors that disrupt multiciliated ependymal cell function often cause communicating hydrocephalus, raising questions about whether FOXJ1 mutations cause hydrocephalus primarily by blocking cerebrospinal fluid (CSF) flow or by different mechanisms. Here, we show that heterozygous FOXJ1 mutations are also associated with communicating hydrocephalus in humans and cause communicating hydrocephalus in mice. Disruption of one Foxj1 allele in mice leads to incomplete ependymal cell differentiation and communicating hydrocephalus. Mature ependymal cell number and motile cilia number are decreased, and 12% of motile cilia display abnormal axonemes. We observed decreased microtubule attachment to basal bodies, random localization and orientation of basal body patches, loss of planar cell polarity, and a disruption of unidirectional CSF flow. Thus, heterozygous FOXJ1 mutations impair ventricular multiciliated cell differentiation, thereby causing communicating hydrocephalus. CSF flow obstruction may develop secondarily in some patients harboring FOXJ1 mutations. Heterozygous FOXJ1 mutations impair motile cilia structure and basal body alignment, thereby disrupting CSF flow dynamics and causing communicating hydrocephalus.
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Affiliation(s)
- Connie C Hou
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Danielle Li
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Bethany C Berry
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Shaokuan Zheng
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Rona S Carroll
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Mark D Johnson
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
- UMass Memorial Health, Worcester, MA, 01655, USA.
| | - Hong Wei Yang
- Department of Neurological Surgery, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
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Hoz SS, Palmisciano P, Albairmani SS, Kaye J, Muthana A, Johnson MD, Doyle EJ, Forbes JA, Prestigiacomo CJ, Samy R, Pensak ML, Zuccarello M, Andaluz N. A proposed classification system for presigmoid approaches: a scoping review. J Neurosurg 2023; 139:965-971. [PMID: 36905661 DOI: 10.3171/2023.2.jns222227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/06/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE The "presigmoid corridor" covers a spectrum of approaches using the petrous temporal bone either as a target in treating intracanalicular lesions or as a route to access the internal auditory canal (IAC), jugular foramen, or brainstem. Complex presigmoid approaches have been continuously developed and refined over the years, leading to great heterogeneity in their definitions and descriptions. Owing to the common use of the presigmoid corridor in lateral skull base surgery, a simple anatomy-based and self-explanatory classification is needed to delineate the operative perspective of the different variants of the presigmoid route. Herein, the authors conducted a scoping review of the literature with the aim of proposing a classification system for presigmoid approaches. METHODS The PubMed, EMBASE, Scopus, and Web of Science databases were searched from inception to December 9, 2022, following the PRISMA Extension for Scoping Reviews guidelines to include clinical studies reporting the use of "stand-alone" presigmoid approaches. Findings were summarized based on the anatomical corridor, trajectory, and target lesions to classify the different variants of the presigmoid approach. RESULTS Ninety-nine clinical studies were included for analysis, and the most common target lesions were vestibular schwannomas (60/99, 60.6%) and petroclival meningiomas (12/99, 12.1%). All approaches had a common entry pathway (i.e., mastoidectomy) but were differentiated into two main categories based on their relationship to the labyrinth: translabyrinthine or anterior corridor (80/99, 80.8%) and retrolabyrinthine or posterior corridor (20/99, 20.2%). The anterior corridor comprised 5 variations based on the extent of bone resection: 1) partial translabyrinthine (5/99, 5.1%), 2) transcrusal (2/99, 2.0%), 3) translabyrinthine proper (61/99, 61.6%), 4) transotic (5/99, 5.1%), and 5) transcochlear (17/99, 17.2%). The posterior corridor consisted of 4 variations based on the target area and trajectory in relation to the IAC: 6) retrolabyrinthine inframeatal (6/99, 6.1%), 7) retrolabyrinthine transmeatal (19/99, 19.2%), 8) retrolabyrinthine suprameatal (1/99, 1.0%), and 9) retrolabyrinthine trans-Trautman's triangle (2/99, 2.0%). CONCLUSIONS Presigmoid approaches are becoming increasingly complex with the expansion of minimally invasive techniques. Descriptions of these approaches using the existing nomenclature can be imprecise or confusing. Therefore, the authors propose a comprehensive classification based on the operative anatomy that unequivocally describes presigmoid approaches simply, precisely, and efficiently.
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Affiliation(s)
| | | | | | | | - Ahmed Muthana
- 2University of Baghdad College of Medicine, Baghdad, Iraq
| | | | - Edward J Doyle
- 3Otolaryngology-Head and Neck Surgery, University of Cincinnati, Ohio; and
| | | | | | - Ravi Samy
- 3Otolaryngology-Head and Neck Surgery, University of Cincinnati, Ohio; and
| | - Myles L Pensak
- 3Otolaryngology-Head and Neck Surgery, University of Cincinnati, Ohio; and
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Yamani AS, Johnson MD, Smith MS, Ngwenya LB, Prestigiacomo CJ. Post-traumatic Middle Meningeal Artery Pseudoaneurysm Treated With Endovascular Coil Embolization. Cureus 2023; 15:e45402. [PMID: 37854762 PMCID: PMC10581326 DOI: 10.7759/cureus.45402] [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] [Accepted: 09/17/2023] [Indexed: 10/20/2023] Open
Abstract
Pseudoaneurysms of the middle meningeal artery are rare events following head trauma. Given the potential for significant morbidity and mortality associated with pseudoaneurysm rupture, it is recommended that they be treated early. Endovascular embolization is a viable alternative to open surgical intervention. Here, we describe a case of an incidentally found middle meningeal artery pseudoaneurysm in a patient with a carotid-cavernous fistula after head injury. The pseudoaneurysm was treated with endovascular coil embolization.
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Affiliation(s)
- Ali S Yamani
- Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Mark D Johnson
- Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Matthew S Smith
- Neurology, University of Cincinnati College of Medicine, Cincinnati, USA
| | - Laura B Ngwenya
- Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, USA
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Wang RL, Gingrich KJ, Vance A, Johnson MD, Welch BG, McDonagh DL. The effects of aneurysmal subarachnoid hemorrhage on cerebral vessel diameter and flow velocity. J Stroke Cerebrovasc Dis 2023; 32:107056. [PMID: 36933521 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/05/2023] [Accepted: 02/07/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND Transcranial Doppler flow velocity is used to monitor for cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Generally, blood flow velocities appear inversely related to the square of vessel diameter representing local fluid dynamics. However, studies of flow velocity-diameter relationships are few, and may identify vessels for which diameter changes are better correlated with Doppler velocity. We therefore studied a large retrospective cohort with concurrent transcranial Doppler velocities and angiographic vessel diameters. METHODS This is a single-site, retrospective, cohort study of adult patients with aneurysmal subarachnoid hemorrhage, approved by the UT Southwestern Medical Center Institutional Review Board. Study inclusion required transcranial Doppler measurements within </= 24 hours of vessel imaging. Vessels assessed were: bilateral anterior, middle, posterior cerebral arteries; internal carotid siphons; vertebral arteries; and basilar artery. Flow velocity-diameter relationships were constructed and fitted with a simple inverse power function. A greater influence of local fluid dynamics is suggested as power factors approach two. RESULTS 98 patients were included. Velocity-diameter relationships are curvilinear, and well fit by a simple inverse power function. Middle cerebral arteries showed the highest power factors (>1.1, R2>0.9). Furthermore, velocity and diameter changed (P<0.033) consistent with the signature time course of cerebral vasospasm. CONCLUSIONS These results suggest that middle cerebral artery velocity-diameter relationships are most influenced by local fluid dynamics, which supports these vessels as preferred endpoints in Doppler detection of cerebral vasospasm. Other vessels showed less influence of local fluid dynamics, pointing to greater role of factors outside the local vessel segment in determining flow velocity.
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Affiliation(s)
- Richard L Wang
- Department of Anesthesiology and Pain Management; The University of Texas Southwestern, Dallas, Texas, USA; Department of Radiology, University of Miami Miller School of Medicine.
| | - Kevin J Gingrich
- Department of Anesthesiology and Pain Management; The University of Texas Southwestern, Dallas, Texas, USA; Department of Anesthesiology and Pain Management, Univ. of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390 USA.
| | - Awais Vance
- Department of Neurological Surgery; The University of Texas Southwestern, Dallas, Texas, USA; Departments of Radiology; The University of Texas Southwestern, Dallas, Texas, USA; Department of Neurosurgery, Baylor Scott & White Medical Center.
| | - Mark D Johnson
- Department of Neurology; The University of Texas Southwestern, Dallas, Texas, USA; Department of Neurology, Univ. of Texas Southwestern Medical Center.
| | - Babu G Welch
- Department of Neurological Surgery; The University of Texas Southwestern, Dallas, Texas, USA; Departments of Radiology; The University of Texas Southwestern, Dallas, Texas, USA; Departments of Neurological Surgery & Radiology, Univ. of Texas Southwestern Medical Center.
| | - David L McDonagh
- Department of Anesthesiology and Pain Management; The University of Texas Southwestern, Dallas, Texas, USA; Department of Neurological Surgery; The University of Texas Southwestern, Dallas, Texas, USA; Department of Neurology; The University of Texas Southwestern, Dallas, Texas, USA; Departments of Anesthesiology and Pain Management, Neurology, and Neurological Surgery; Univ. of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, Texas 75390 USA.
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Palmisciano P, Hoz SS, Johnson MD, Forbes JA, Prestigiacomo CJ, Zuccarello M, Andaluz N. External Validation of an Extreme Gradient Boosting Model for Prediction of Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage. World Neurosurg 2023:S1878-8750(23)00331-5. [PMID: 36914029 DOI: 10.1016/j.wneu.2023.03.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Delayed cerebral ischemia (DCI) may significantly worsen the functional status of patients with aneurysmal subarachnoid hemorrhage (aSAH). Several authors have designed predictive models for early identification of patients at risk of post-aSAH DCI. In this study, we externally validate an extreme gradient boosting (EGB) forecasting model for post-aSAH DCI prediction. METHODS A 9-year institutional retrospective review of patients with aSAH was performed. Patients were included if they underwent surgical or endovascular treatment and had available follow-up data. DCI was diagnosed as new onset neurological deficits at 4-12 days after aneurysm rupture, defined as worsening GCS for ≥2 points, and new ischemic infarcts at imaging. RESULTS 267 patients with aSAH were collected. At admission, median Hunt-Hess score was 2 (range, 1-5), median Fisher score 3 (range, 1-4), and median modified Fisher score 3 (range, 1-4). 145 patients underwent EVD placement for hydrocephalus (54.3%). The ruptured aneurysms were treated with clipping (64%), coiling (34.8%), and stent-assisted coiling (1.1%). 58 patients (21.7%) were diagnosed with clinical DCI and 82 (30.7%) with asymptomatic imaging vasospasm. The EGB classifier correctly predicted 19 cases of DCI (7.1%) and 154 cases of no-DCI (57.7%), achieving sensitivity of 32.76% and specificity of 73.68%. The calculated F1-score and accuracy were 0.288 and 64.8%, respectively. CONCLUSION We validated the EGB model has a potential assistant tool to predict post-aSAH DCI in clinical practice, finding moderate-high specificity but low sensitivity. Future research should investigate the underlying pathophysiology of DCI to allow the development of high-performing forecasting models.
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Affiliation(s)
- Paolo Palmisciano
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Samer S Hoz
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mark D Johnson
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan A Forbes
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Charles J Prestigiacomo
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mario Zuccarello
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Norberto Andaluz
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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11
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Johnson MD, Freeland JR, Parducci L, Evans DM, Meyer RS, Molano-Flores B, Davis MA. Environmental DNA as an emerging tool in botanical research. Am J Bot 2023; 110:e16120. [PMID: 36632660 DOI: 10.1002/ajb2.16120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
Over the past quarter century, environmental DNA (eDNA) has been ascendant as a tool to detect, measure, and monitor biodiversity (species and communities), as a means of elucidating biological interaction networks, and as a window into understanding past patterns of biodiversity. However, only recently has the potential of eDNA been realized in the botanical world. Here we synthesize the state of eDNA applications in botanical systems with emphases on aquatic, ancient, contemporary sediment, and airborne systems, and focusing on both single-species approaches and multispecies community metabarcoding. Further, we describe how abiotic and biotic factors, taxonomic resolution, primer choice, spatiotemporal scales, and relative abundance influence the utilization and interpretation of airborne eDNA results. Lastly, we explore several areas and opportunities for further development of eDNA tools for plants, advancing our knowledge and understanding of the efficacy, utility, and cost-effectiveness, and ultimately facilitating increased adoption of eDNA analyses in botanical systems.
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Affiliation(s)
- Mark D Johnson
- Engineering Research and Development Center, Construction Engineering Research Laboratory (CERL), Champaign, IL, USA
- Illinois Natural History Survey, Prairie Research Institute, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Joanna R Freeland
- Department of Biology, Trent University, 1600 West Bank Drive, Peterborough, ON, K9L 0G2, Canada
| | - Laura Parducci
- Department of Environmental Biology, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
- Department of Ecology and Genetics, Evolutionary Biology Centre, Uppsala University, Norbyvagen 18D, SE-75236, Uppsala, Sweden
| | - Darren M Evans
- School of Natural and Environmental Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Rachel S Meyer
- Department of Ecology and Evolutionary Biology, University of California Santa Cruz, Santa Cruz, CA, USA
| | - Brenda Molano-Flores
- Illinois Natural History Survey, Prairie Research Institute, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Mark A Davis
- Illinois Natural History Survey, Prairie Research Institute, University of Illinois Urbana-Champaign, Champaign, IL, USA
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12
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Alfawares Y, Folz C, Johnson MD, Prestigiacomo CJ, Ngwenya LB. The history of antibiotic irrigation and prophylaxis in operative neurotrauma: perpetuation of military care in civilian settings. Neurosurg Focus 2022; 53:E7. [DOI: 10.3171/2022.6.focus22253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/21/2022] [Indexed: 11/06/2022]
Abstract
The benefit of antibiotic irrigation for prophylaxis against wound infections, not only for traumatic cranial injuries but also in elective neurosurgical care, has recently been called into question. Several articles have cast doubt on the utility of topical antibiotics, and recently, bacitracin irrigation was made unavailable in some US markets. The pervasive nature of antibiotic irrigation, considering the lack of evidence supporting its use, led the authors to question when and how neurosurgeons started using antibiotic irrigation in cranial neurosurgery. Through a review of historical literature, they highlight the adoption of antibiotic irrigation as it began in battlefield surgical practice, gradually leading to the modern concept of antibiotic prophylaxis in civilian and military care.
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Affiliation(s)
| | | | - Mark D. Johnson
- College of Medicine, University of Cincinnati
- Department of Neurosurgery, University of Cincinnati; and
| | - Charles J. Prestigiacomo
- College of Medicine, University of Cincinnati
- Department of Neurosurgery, University of Cincinnati; and
| | - Laura B. Ngwenya
- College of Medicine, University of Cincinnati
- Department of Neurosurgery, University of Cincinnati; and
- Department of Neurology & Rehabilitation Medicine, University of Cincinnati, Ohio
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13
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Yang GL, Johnson MD, Solomon D, Ferguson AM, Johnson RA, Gerges C, Wright JM, Parr AM, Ngwenya LB. The Effects of the COVID-19 Pandemic on Penetrating Neurotrauma at a Level 1 Trauma Center. World Neurosurg 2022; 164:e530-e539. [PMID: 35552030 PMCID: PMC9085351 DOI: 10.1016/j.wneu.2022.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 05/03/2022] [Indexed: 11/19/2022]
Abstract
Background/Objective The COVID-19 pandemic has had a profound impact on the global delivery of health care. Recent data suggest a possible impact of the pandemic on patterns of neurotrauma. The aim was to assess the impact of the pandemic on the incidence of neurotrauma, with a focus on cranial gunshot wounds (cGSWs) at a large Midwestern level 1 trauma center. Methods We conducted a retrospective review of our trauma registry from March through September 2020 and compared it to the same months in 2019. Odds ratios were utilized to assess for differences in patient demographics, injury characteristics, rates of neurotrauma, and rates of cGSWs. Results A total of 1188 patients presented with neurotrauma, 558 in 2019 and 630 in 2020. The majority of patients were male (71.33% in 2019; 68.57% in 2020) and Caucasian (78.67% in 2019; 75.4% in 2020). Patients presented with cGSWs more frequently in 2020 (n = 49, 7.78%) than in 2019 (n = 25, 4.48%). The odds of suffering a cGSW in 2020 was 73.6% higher than those in 2019 (95% confidence interval = [1.0871, 2.7722]; P = 0.0209). The etiology of such injury was most commonly assault (n = 16, 21.62% in 2019; n = 34, 45.95% in 2020), followed by self-inflicted injury (n = 4, 5.41% in 2019; 12, 16.22% in 2020). Conclusions Despite the government-mandated shutdown, we observed an increase in the number of neurotrauma cases in 2020. There was a significant increase in the incidence cGSWs in 2020, with an increase in assaults and self-inflicted injuries. Further investigation into socioeconomic factors for the observed increase in cGSWs is warranted.
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Affiliation(s)
- George L Yang
- Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA; Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio, USA; University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
| | - Mark D Johnson
- Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA; Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio, USA; University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Daniel Solomon
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Andrew M Ferguson
- Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio, USA; University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Reid A Johnson
- University of Minnesota Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christina Gerges
- Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - James M Wright
- Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Ann M Parr
- Department of Neurosurgery, Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, USA
| | - Laura B Ngwenya
- Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio, USA; Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio, USA; Department of Neurology & Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio, USA; University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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14
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Johnson MD, Stolz U, Carroll CP, Yang GL, Andaluz N, Foreman B, Kreitzer N, Goodman MD, Ngwenya LB. An independent, external validation and component analysis of the Surviving Penetrating Injury to the Brain score for civilian cranial gunshot injuries. J Neurosurg 2022; 137:1839-1846. [PMID: 35426813 DOI: 10.3171/2022.2.jns212256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/23/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Surviving Penetrating Injury to the Brain (SPIN) score utilizes clinical variables to estimate in-hospital and 6-month mortality for patients with civilian cranial gunshot wounds (cGSWs) and demonstrated good discrimination (area under the receiver operating characteristic curve [AUC] 0.880) in an initial validation study. The goal of this study was to provide an external, independent validation of the SPIN score for in-hospital and 6-month mortality. METHODS To accomplish this, the authors retrospectively reviewed 6 years of data from their institutional trauma registry. Variables used to determine SPIN score were collected, including sex, transfer status, injury motive, pupillary reactivity, motor component of the Glasgow Coma Scale (mGCS), Injury Severity Score (ISS), and international normalized ratio (INR) at admission. Multivariable logistic regression analysis identified variables associated with mortality. The authors compared AUC between models by using a nonparametric test for equality. RESULTS Of the 108 patients who met the inclusion criteria, 101 had all SPIN score components available. The SPIN model had an AUC of 0.962. The AUC for continuous mGCS score alone (0.932) did not differ significantly from the AUC for the full SPIN model (p = 0.26). The AUC for continuous mGCS score (0.932) was significantly higher compared to categorical mGCS score (0.891, p = 0.005). Use of only mGCS score resulted in fewer exclusions due to missing data. No additional variable included in the predictive model alongside continuous mGCS score was a significant predictor of inpatient mortality, 6-month mortality, or increased model discrimination. CONCLUSIONS Given these findings, continuous 6-point mGCS score may be sufficient as a generalizable predictor of inpatient and 6-month mortality in patients with cGSW, demonstrating excellent discrimination and reduced bias due to missing data.
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Affiliation(s)
- Mark D Johnson
- 1Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio.,2Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio
| | - Uwe Stolz
- 2Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio.,3Department of Emergency Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Christopher P Carroll
- 4Department of Brain & Spine Surgery, Naval Medical Center Portsmouth, Portsmouth, Virginia.,5Division of Neurosurgery, Department of Surgery, Uniformed Services University, Bethesda, Maryland
| | - George L Yang
- 1Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio.,2Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio
| | - Norberto Andaluz
- 1Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio
| | - Brandon Foreman
- 1Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio.,2Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio.,6Department of Neurology & Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Natalie Kreitzer
- 2Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio.,3Department of Emergency Medicine, University of Cincinnati, Cincinnati, Ohio.,6Department of Neurology & Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio; and
| | - Michael D Goodman
- 7Division of Trauma, Critical Care, and Acute Care Surgery, Department of Surgery, University of Cincinnati, Cincinnati, Ohio
| | - Laura B Ngwenya
- 1Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio.,2Collaborative for Research on Acute Neurological Injury (CRANI), University of Cincinnati, Cincinnati, Ohio.,6Department of Neurology & Rehabilitation Medicine, University of Cincinnati, Cincinnati, Ohio; and
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15
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Yang GL, Johnson MD, Solomon D, Ferguson A, Wright JM, Johnson RA, Gerges C, Parr AM, Ngwenya LB. 320 The Effects of the COVID-19 Pandemic on Penetrating Neurotrauma at a Level 1 Trauma Center. Neurosurgery 2022. [DOI: 10.1227/neu.0000000000001880_320] [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: 11/19/2022] Open
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16
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Mathew EN, Berry BC, Yang HW, Carroll RS, Johnson MD. Delivering Therapeutics to Glioblastoma: Overcoming Biological Constraints. Int J Mol Sci 2022; 23:ijms23031711. [PMID: 35163633 PMCID: PMC8835860 DOI: 10.3390/ijms23031711] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 02/01/2023] Open
Abstract
Glioblastoma multiforme is the most lethal intrinsic brain tumor. Even with the existing treatment regimen of surgery, radiation, and chemotherapy, the median survival time is only 15–23 months. The invasive nature of this tumor makes its complete removal very difficult, leading to a high recurrence rate of over 90%. Drug delivery to glioblastoma is challenging because of the molecular and cellular heterogeneity of the tumor, its infiltrative nature, and the blood–brain barrier. Understanding the critical characteristics that restrict drug delivery to the tumor is necessary to develop platforms for the enhanced delivery of effective treatments. In this review, we address the impact of tumor invasion, the molecular and cellular heterogeneity of the tumor, and the blood–brain barrier on the delivery and distribution of drugs using potential therapeutic delivery options such as convection-enhanced delivery, controlled release systems, nanomaterial systems, peptide-based systems, and focused ultrasound.
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17
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Owusu‐Adjei B, Ogagan C, Smith J, Luiselli G, Johnson MD. Bacterial translocation as a cause of ventriculoperitoneal shunt infection: A case report. Clin Case Rep 2022; 10:e04921. [PMID: 35035957 PMCID: PMC8752371 DOI: 10.1002/ccr3.4921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/30/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022] Open
Abstract
Bacterial translocation as a mechanism of distal catheter infection may play a larger role in ventriculoperitoneal shunt infections than previously recognized.
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Affiliation(s)
- Brittany Owusu‐Adjei
- Department of Neurological SurgeryUniversity of Massachusetts Medical SchoolWorcesterMassachusettsUSA
- UMass Memorial HealthWorcesterMassachusettsUSA
| | - Charles Ogagan
- Department of Neurological SurgeryUniversity of Massachusetts Medical SchoolWorcesterMassachusettsUSA
| | - Jordan Smith
- Department of Neurological SurgeryUniversity of Massachusetts Medical SchoolWorcesterMassachusettsUSA
| | - Gabrielle Luiselli
- Department of Neurological SurgeryUniversity of Massachusetts Medical SchoolWorcesterMassachusettsUSA
| | - Mark D. Johnson
- Department of Neurological SurgeryUniversity of Massachusetts Medical SchoolWorcesterMassachusettsUSA
- UMass Memorial HealthWorcesterMassachusettsUSA
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18
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Johnson MD, Fokar M, Cox RD, Barnes MA. Airborne environmental DNA metabarcoding detects more diversity, with less sampling effort, than a traditional plant community survey. BMC Ecol Evol 2021; 21:218. [PMID: 34872490 PMCID: PMC8647488 DOI: 10.1186/s12862-021-01947-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/24/2021] [Indexed: 01/04/2023] Open
Abstract
Background Airborne environmental DNA (eDNA) research is an emerging field that focuses on the detection of species from their genetic remnants in the air. The majority of studies into airborne eDNA of plants has until now either focused on single species detection, specifically only pollen, or human health impacts, with no previous studies surveying an entire plant community through metabarcoding. We therefore conducted an airborne eDNA metabarcoding survey and compared the results to a traditional plant community survey. Results Over the course of a year, we conducted two traditional transect-based visual plant surveys alongside an airborne eDNA sampling campaign on a short-grass rangeland. We found that airborne eDNA detected more species than the traditional surveying method, although the types of species detected varied based on the method used. Airborne eDNA detected more grasses and forbs with less showy flowers, while the traditional method detected fewer grasses but also detected rarer forbs with large showy flowers. Additionally, we found the airborne eDNA metabarcoding survey required less sampling effort in terms of the time needed to conduct a survey and was able to detect more invasive species than the traditional method. Conclusions Overall, we have demonstrated that airborne eDNA can act as a sensitive and efficient plant community surveying method. Airborne eDNA surveillance has the potential to revolutionize the way plant communities are monitored in general, track changes in plant communities due to climate change and disturbances, and assist with the monitoring of invasive and endangered species. Supplementary Information The online version contains supplementary material available at 10.1186/s12862-021-01947-x.
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Affiliation(s)
- Mark D Johnson
- Department of Natural Resources Management, Texas Tech University, Lubbock, TX, 79409, USA.
| | - Mohamed Fokar
- Center for Biotechnology & Genomics, Texas Tech University, Lubbock, TX, 79409, USA
| | - Robert D Cox
- Department of Natural Resources Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Matthew A Barnes
- Department of Natural Resources Management, Texas Tech University, Lubbock, TX, 79409, USA
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19
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Matur AV, Body AM, Johnson MD, Smith MS, Bhabhra R, Lester EJ, Stahl TL, Grossman AW, Shirani P, Forbes JA, Prestigiacomo CJ. An algorithm to improve lateralization accuracy of inferior petrosal sinus sampling: procedural nuances for complex patterns of venous drainage. Patient series. Journal of Neurosurgery: Case Lessons 2021; 2:CASE21374. [PMID: 35854787 PMCID: PMC9265235 DOI: 10.3171/case21374] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/19/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND
Inferior petrosal sinus sampling (IPSS) is a useful technique in the diagnosis of Cushing’s disease (CD) when the imaging finding is negative or equivocal. Different authors have reported considerable variability in the ability to determine tumor laterality with IPSS. Here the authors present a retrospective case series of 7 patients who underwent IPSS using a systematic algorithm to improve lateralization accuracy by identifying optimal sampling sites on the basis of individual cavernous sinus drainage patterns in each patient.
OBSERVATIONS
Of the 7 patients identified, 6 were determined to have CD and subsequently underwent surgery. IPSS was accurate in all patients from whom laterality was predicted. Arterial and venous angiography were used to define cavernous sinus drainage patterns and determine optimal sampling sites. All patients who underwent surgery achieved hormonal cure.
LESSONS
All IPSS predictions of lateralization were correct when available, and all patients who underwent surgery achieved hormonal cure. Advances in angiographic techniques for identification of the site of primary drainage from the cavernous sinus and subsequent optimization of microcatheter placement may improve the ability to predict tumor laterality.
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Affiliation(s)
- Abhijith V. Matur
- Department of General Surgery, University of Kentucky College of Medicine, Lexington, Kentucky; and
| | | | | | | | | | - Emily J. Lester
- Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Trisha L. Stahl
- Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio
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20
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Johnson MD, Carroll CP, Cass D, Andaluz N, Foreman B, Goodman MD, Ngwenya LB. Single-Center Experience With Antibiotic Prophylaxis and Infectious Complications in Civilian Cranial Gunshot Wounds. Neurosurg open 2021. [DOI: 10.1093/neuopn/okaa013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Yang HW, Lee S, Yang D, Dai H, Zhang Y, Han L, Zhao S, Zhang S, Ma Y, Johnson MF, Rattray AK, Johnson TA, Wang G, Zheng S, Carroll RS, Park PJ, Johnson MD. Deletions in CWH43 cause idiopathic normal pressure hydrocephalus. EMBO Mol Med 2021; 13:e13249. [PMID: 33459505 PMCID: PMC7933959 DOI: 10.15252/emmm.202013249] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 11/12/2022] Open
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a neurological disorder that occurs in about 1% of individuals over age 60 and is characterized by enlarged cerebral ventricles, gait difficulty, incontinence, and cognitive decline. The cause and pathophysiology of iNPH are largely unknown. We performed whole exome sequencing of DNA obtained from 53 unrelated iNPH patients. Two recurrent heterozygous loss of function deletions in CWH43 were observed in 15% of iNPH patients and were significantly enriched 6.6‐fold and 2.7‐fold, respectively, when compared to the general population. Cwh43 modifies the lipid anchor of glycosylphosphatidylinositol‐anchored proteins. Mice heterozygous for CWH43 deletion appeared grossly normal but displayed hydrocephalus, gait and balance abnormalities, decreased numbers of ependymal cilia, and decreased localization of glycosylphosphatidylinositol‐anchored proteins to the apical surfaces of choroid plexus and ependymal cells. Our findings provide novel mechanistic insights into the origins of iNPH and demonstrate that it represents a distinct disease entity.
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Affiliation(s)
- Hong Wei Yang
- University of Massachusetts Medical School, Worcester, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Semin Lee
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Dejun Yang
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Huijun Dai
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Yan Zhang
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Lei Han
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Sijun Zhao
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Shuo Zhang
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Yan Ma
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Marciana F Johnson
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Anna K Rattray
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Tatyana A Johnson
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - George Wang
- University of Massachusetts Medical School, Worcester, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Shaokuan Zheng
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Rona S Carroll
- University of Massachusetts Medical School, Worcester, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Peter J Park
- Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Mark D Johnson
- University of Massachusetts Medical School, Worcester, MA, USA.,Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,UMass Memorial Health Care, Worcester, MA, USA
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22
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Lee C, Chiu L, Mathew P, Luiselli G, Ogagan C, Daci R, Owusu-Adjei B, Carroll RS, Johnson MD. Evidence for increased intraabdominal pressure as a cause of recurrent migration of the distal catheter of a ventriculoperitoneal shunt: illustrative case. Journal of Neurosurgery: Case Lessons 2021; 1:CASE2032. [PMID: 36034506 PMCID: PMC9394158 DOI: 10.3171/case2032] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 09/29/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Placement of a ventriculoperitoneal (VP) shunt is an effective treatment for several disorders of cerebrospinal fluid flow. A rare complication involves postoperative migration of the distal catheter out of the intraperitoneal compartment and into the subcutaneous space. Several theories attempt to explain this phenomenon, but the mechanism remains unclear. OBSERVATIONS The authors report the case of a 37-year-old nonobese woman who underwent placement of a VP shunt for idiopathic intracranial hypertension. Postoperatively, the distal catheter of the VP shunt migrated into the subcutaneous space on three occasions despite the use of multiple surgical techniques, including open and laparoscopic methods of abdominal catheter placement. Notably, the patient repeatedly displayed radiographic evidence of chronic bowel distention consistent with increased intraperitoneal pressure. LESSONS In this case, the mechanism of catheter migration into the subcutaneous space did not appear to be caused by pulling of the catheter from above but rather by expulsion of the catheter from the peritoneum. Space in the subcutaneous tissues caused by open surgical placement of the catheter was permissive for this process. Patients with chronic increased intraabdominal pressure, such as that caused by bowel distention, obesity, or Valsalva maneuvers, may be at increased risk for distal catheter migration.
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Affiliation(s)
- Christopher Lee
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | - Lucinda Chiu
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | - Pawan Mathew
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | - Gabrielle Luiselli
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | - Charles Ogagan
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | - Rrita Daci
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | - Brittany Owusu-Adjei
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | - Rona S. Carroll
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
| | - Mark D. Johnson
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts; and
- UMass Memorial Health Care, Worcester, Massachusetts
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23
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Abstract
BACKGROUND The influence of social media and Twitter in general surgery research, mentorship, networking, and education is growing. Limited data exist regarding individuals who control the dialogue. Our goal was to characterize influencers leading the discussion in general surgery. METHODS Right Relevance Insight API was searched for "general surgery," and individual influencers were ranked by a comprehensive assessment of connections (followers/following) and engagement (likes, retweets, and comments). Profession, specialty, gender, and location were collected utilizing Twitter, Doximity, LinkedIn, ResearchGate, and institutional websites. American Board of Surgery and Royal College of Physicians and Surgeons of Canada were queried for board certification and academic h-index scores were acquired from Scopus. RESULTS Eighty-eight individual influencers in general surgery were identified, with 73 holding positions in general surgery. Attending level general surgeons comprised 50%, of which 91% are board certified, and 94% completed a fellowship (surgical oncology, laparoscopic surgery, critical care/trauma, and colorectal surgery). Residents comprised 31%; 11% were nonsurgeons and 3% were not physicians. The majority of residents and fellow influencers were female (72%). Many general surgery influencers were international (51%), particularly Canadian (28% overall). The academic h-indices for these influencers (n = 73) ranged from 0 to 73 (mean 14.5 ± 8.2; median 9.5). DISCUSSION Our data describe the positions, backgrounds, and research contributions of the top Twitter influencers in general surgery. Those engaged in social media should consider the background, expertise, and motivation of these influencers as the utilization and impact of this platform grows.
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Affiliation(s)
- Nora C Elson
- 12303 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Diana T Le
- 12303 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mark D Johnson
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Chantal Reyna
- 12303 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Elizabeth A Shaughnessy
- 12303 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Michael D Goodman
- 12303 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jaime D Lewis
- 12303 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Daci R, Kennelly M, Ferris A, Azeem MU, Johnson MD, Hamzei-Sichani F, Jun-O'Connell AH, Natarajan SK. Bilateral Basal Ganglia Hemorrhage in a Patient with Confirmed COVID-19. AJNR Am J Neuroradiol 2020; 41:1797-1799. [PMID: 32819902 DOI: 10.3174/ajnr.a6712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/11/2020] [Indexed: 11/07/2022]
Abstract
Bilateral basal ganglia hemorrhage is exceedingly rare. To our knowledge, our patient is the first reported case of a confirmed coronavirus disease 2019 (COVID-19) patient who had bilateral basal ganglia hemorrhage. In the absence of other risk factors for bilateral deep cerebral involvement, we suspect that COVID-19 may be contributing to these rare pathologies. Most published data represent a correlation between COVID-19 and neurologic complications, and more research is still needed to prove causation.
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Affiliation(s)
- R Daci
- Department of Neurological Surgery (R.D., M.K., M.D.J., F.H.-S., S.K.N.), University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, Massachusetts
| | - M Kennelly
- Department of Neurological Surgery (R.D., M.K., M.D.J., F.H.-S., S.K.N.), University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, Massachusetts
| | - A Ferris
- Department of Neurology (A.F., M.U.A., A.H.J.), University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, Massachusetts
| | - M U Azeem
- Department of Neurology (A.F., M.U.A., A.H.J.), University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, Massachusetts
| | - M D Johnson
- Department of Neurological Surgery (R.D., M.K., M.D.J., F.H.-S., S.K.N.), University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, Massachusetts
| | - F Hamzei-Sichani
- Department of Neurological Surgery (R.D., M.K., M.D.J., F.H.-S., S.K.N.), University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, Massachusetts
| | - A H Jun-O'Connell
- Department of Neurology (A.F., M.U.A., A.H.J.), University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, Massachusetts
| | - S K Natarajan
- Department of Neurological Surgery (R.D., M.K., M.D.J., F.H.-S., S.K.N.), University of Massachusetts Medical School, UMass Memorial Health Care, 55 Lake Avenue North, Worcester, Massachusetts
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25
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Johnson MD, Prestigiacomo CJ, Ferioli S, Flaherty ML. Persistent Hypoglossal Artery and Concurrent Carotid Thrombus. Ann Neurol 2020; 88:233-234. [DOI: 10.1002/ana.25795] [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: 04/08/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Mark D. Johnson
- Department of Neurosurgery University of Cincinnati Cincinnati OH USA
| | | | - Simona Ferioli
- Department of Neurology University of Cincinnati Cincinnati OH USA
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Affiliation(s)
- Rrita Daci
- Department of Neurological Surgery University of Massachusetts Medical School UMass Memorial Health Care Worcester, Massachusetts
| | - Sabareesh K Natarajan
- Department of Neurological Surgery University of Massachusetts Medical School UMass Memorial Health Care Worcester, Massachusetts
| | - Mark D Johnson
- Department of Neurological Surgery University of Massachusetts Medical School UMass Memorial Health Care Worcester, Massachusetts
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Porter ZR, Johnson MD, Horn PS, Ngwenya LB. Traumatic spinal subdural hematoma: An illustrative case and series review. Interdisciplinary Neurosurgery 2020. [DOI: 10.1016/j.inat.2019.100570] [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: 10/26/2022] Open
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28
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Rispens JR, Jones SA, Clemmons NS, Ahmed S, Harduar-Morano L, Johnson MD, Edge C, Vyas A, Bourgikos E, Orr MF. Anhydrous Ammonia Chemical Release — Lake County, Illinois, April 2019. MMWR Morb Mortal Wkly Rep 2020; 69:109-113. [PMID: 31999683 PMCID: PMC7004403 DOI: 10.15585/mmwr.mm6904a4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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29
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Mathew P, Chiu L, Lee C, Carroll R, Johnson MD. Idiopathic Normal Pressure Hydrocephalus With Stuttering: Report of Two Cases and Review of the Literature. World Neurosurg 2019; 135:176-179. [PMID: 31805405 DOI: 10.1016/j.wneu.2019.11.152] [Citation(s) in RCA: 3] [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] [Received: 10/02/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Idiopathic normal pressure hydrocephalus (iNPH) is a disorder of aging that is characterized by enlarged cerebral ventricles, gait apraxia, dementia, and urinary incontinence. iNPH is frequently misdiagnosed, in part because the symptoms resemble other neurological disorders, and because other associated symptoms have not been fully characterized. Importantly, iNPH has not previously been associated with stuttering, and shunting has not been shown to alleviate the symptom of stuttering. CASE DESCRIPTIONS Here, we report 2 cases of patients with iNPH presenting with stuttering that resolved after ventriculoperitoneal (VP) shunt placement. Each patient presented with gait difficulty, incontinence, cognitive impairment, and stuttering. Lasting improvements of the symptoms (including stuttering) were seen in both patients after cerebrospinal fluid (CSF) drainage procedures that included lumbar puncture, extended lumbar CSF drainage, placement of a VP shunt, and VP shunt revision. CONCLUSIONS These findings suggest that iNPH can present with stuttering or dysarthria. The significant improvement in stuttering and dysarthria, along with the improvements in gait difficulty, incontinence, and cognitive impairment that occurred after CSF drainage, suggests that the motor apraxia observed in iNPH can affect speech production. Practitioners should be aware that iNPH can present with stuttering, and that CSF drainage can improve stuttering in select circumstances.
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Affiliation(s)
- Pawan Mathew
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Lucinda Chiu
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Christopher Lee
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Rona Carroll
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Mark D Johnson
- Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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Abstract
Genetic analysis of airborne plant material has historically focused (generally implicitly rather than as a stated goal) on pollen from anemophilous (wind-pollinated) species, such as in multiple studies examining the relationship of allergens to human health. Inspired by the recent influx of literature applying environmental DNA (eDNA) approaches to targeted-species and whole-ecosystem study, we conducted a proof-of-concept experiment to determine whether airborne samples reliably detect genetic material from non-anemophilous species that may not be releasing large plumes of pollen. We collected airborne eDNA using Big Spring Number Eight dust traps and quantified the amount of eDNA present for a flowering wind-pollinated genus (Bouteloua) and insect-pollinated honey mesquite (Prosopis glandulosa) that was not flowering at the time of the study. We were able to detect airborne eDNA from both species. Since honey mesquite is insect-pollinated and was not flowering during the time of this study, our results confirm that airborne eDNA consists of and can detect species through more than just pollen. Additionally, we were able to detect temporal patterns reflecting Bouteloua reproductive ecology and suggest that airborne honey mesquite eDNA responded to weather conditions during our study. These findings suggest a need for more study of the ecology of airborne eDNA to uncover its potential for single-species and whole-community research and management in terrestrial ecosystems.
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Affiliation(s)
- Mark D. Johnson
- Department of Natural Resources Management, Texas Tech University, Lubbock, TX, United States of America
- * E-mail:
| | - Robert D. Cox
- Department of Natural Resources Management, Texas Tech University, Lubbock, TX, United States of America
| | - Matthew A. Barnes
- Department of Natural Resources Management, Texas Tech University, Lubbock, TX, United States of America
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31
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Wood S, Telu K, Tribble D, Ganesan A, Kunz A, Fairchok M, Schnaubelt E, Johnson MD, Maves R, Fraser J, Mitra I, Lalani T, Yun HC, For The Infectious Disease Clinical Research Program TravMil Study Group. Influenza-Like Illness in Travelers to the Developing World. Am J Trop Med Hyg 2019; 99:1269-1274. [PMID: 30226131 DOI: 10.4269/ajtmh.17-0884] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Travelers to developing regions are at risk for development of influenza-like illness (ILI). Little is known of traveler and trip characteristics associated with the development of ILI. TravMil is a prospective observational study, enrolling subjects presenting to six military travel clinics or predeployment-screening sites. We analyzed pre- and post-travel surveys from travelers visiting regions outside of the continental United States, Western or Northern Europe, Canada, Australia, or New Zealand between January 2010 and March 2016. Influenza-like illness was defined as a self-reported fever associated with either sore throat or cough. Trip and traveler characteristics were analyzed to determine risk factors for the development of ILI. Two thousand nine hundred and thirty-two trips were recorded (55% male, median age 45 years, 69% white, 51% on vacation, median travel duration 17 days). The 2,337 trips included the number of self-reported influenza vaccinations in the preceding 5 years (median 5). Eleven percent of the trips were complicated by an ILI lasting a median of 5 days; 70% and 17% of these reported upper and lower respiratory tract infection, respectively, and 12% reported both. On multivariate analysis, increased risk of ILI was associated with female gender (odds ratio [OR]: 1.60 [confidence interval (CI): 1.25-2.05], P < 0.01), age (years) (OR: 1.01 [CI: 1.01-1.02], P < 0.01); and duration of travel (days) (OR: 1.01 [CI: 1.00-1.01], P < 0.01). Influenza-like illness is common in travelers, regardless of traveler characteristics, purpose of travel, destination, or season of year. Female gender, older age, and longer duration of travel were associated with an increased risk of ILI. Additional tools and strategies are needed to prevent ILI in international travelers.
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Affiliation(s)
- Stuart Wood
- San Antonio Military Medical Center, Joint Base San Antonio, Fort Sam Houston, Texas
| | - Kalyani Telu
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - David Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Anuradha Ganesan
- Walter Reed National Military Medical Center, Bethesda, Maryland.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Anjali Kunz
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington
| | - Mary Fairchok
- Madigan Army Medical Center, Joint Base Lewis-McChord, Washington.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Mark D Johnson
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, California.,Naval Medical Center, San Diego, California
| | - Ryan Maves
- Naval Medical Center, San Diego, California
| | - Jamie Fraser
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Indrani Mitra
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Tahaniyat Lalani
- Naval Medical Center, Portsmouth, Virginia.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Heather C Yun
- San Antonio Military Medical Center, Joint Base San Antonio, Fort Sam Houston, Texas.,Uniformed Services University of the Health Sciences, Department of Medicine, Bethesda, Maryland
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32
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Loeian MS, Mehdi Aghaei S, Farhadi F, Rai V, Yang HW, Johnson MD, Aqil F, Mandadi M, Rai SN, Panchapakesan B. Liquid biopsy using the nanotube-CTC-chip: capture of invasive CTCs with high purity using preferential adherence in breast cancer patients. Lab Chip 2019; 19:1899-1915. [PMID: 31049504 DOI: 10.1039/c9lc00274j] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this paper, we report the development of the nanotube-CTC-chip for isolation of tumor-derived epithelial cells (circulating tumor cells, CTCs) from peripheral blood, with high purity, by exploiting the physical mechanisms of preferential adherence of CTCs on a nanotube surface. The nanotube-CTC-chip is a new 76-element microarray technology that combines carbon nanotube surfaces with microarray batch manufacturing techniques for the capture and isolation of tumor-derived epithelial cells. Using a combination of red blood cell (RBC) lysis and preferential adherence, we demonstrate the capture and enrichment of CTCs with a 5-log reduction of contaminating WBCs. EpCAM negative MDA-MB-231/luciferase-2A-green fluorescent protein (GFP) cells were spiked in the blood of wild mice and enriched using an RBC lysis protocol. The enriched samples were then processed using the nanotube-CTC-chip for preferential CTC adherence on the nanosurface and counting the GFP cells yielded anywhere from 89% to 100% capture from the droplets. Electron microscopy (EM) studies showed focal adhesion with filaments from the cell body to the nanotube surface. We compared the nanotube preferential adherence to collagen adhesion matrix (CAM) scaffolding, reported as a viable strategy for CTC capture in patients. The CAM scaffolding on the device surface yielded 50% adherence with 100% tracking of cancer cells (adhered vs. non-adhered) versus carbon nanotubes with >90% adherence and 100% tracking for the same protocol. The nanotube-CTC-chip successfully captured CTCs in the peripheral blood of breast cancer patients (stage 1-4) with a range of 4-238 CTCs per 8.5 ml blood or 0.5-28 CTCs per ml. CTCs (based on CK8/18, Her2, EGFR) were successfully identified in 7/7 breast cancer patients, and no CTCs were captured in healthy controls (n = 2). CTC enumeration based on multiple markers using the nanotube-CTC-chip enables dynamic views of metastatic progression and could potentially have predictive capabilities for diagnosis and treatment response.
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Affiliation(s)
- Masoud S Loeian
- Small Systems Laboratory, Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA 01609, USA.
| | - Sadegh Mehdi Aghaei
- Small Systems Laboratory, Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA 01609, USA.
| | - Farzaneh Farhadi
- Small Systems Laboratory, Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA 01609, USA.
| | - Veeresh Rai
- Small Systems Laboratory, Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA 01609, USA.
| | - Hong Wei Yang
- Department of Neurological Surgery, UMass Memorial Healthcare, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Mark D Johnson
- Department of Neurological Surgery, UMass Memorial Healthcare, University of Massachusetts Medical School, Worcester, MA 01655, USA
| | - Farrukh Aqil
- James Graham Brown Cancer Center, University of Louisville School of Medicine, The University of Louisville, Louisville, KY 40292, USA
| | - Mounika Mandadi
- James Graham Brown Cancer Center, University of Louisville School of Medicine, The University of Louisville, Louisville, KY 40292, USA
| | - Shesh N Rai
- James Graham Brown Cancer Center, University of Louisville School of Medicine, The University of Louisville, Louisville, KY 40292, USA
| | - Balaji Panchapakesan
- Small Systems Laboratory, Department of Mechanical Engineering, Worcester Polytechnic Institute, Worcester, MA 01609, USA.
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Ashley DP, Fraser J, Yun H, Kunz A, Fairchok M, Tribble D, Mitra I, Johnson MD, Hickey PW, Ganesan A, Deiss RG, Lalani T, For The Idcrp TravMil Study Group. A Comparison of Pretravel Health Care, Travel-Related Exposures, and Illnesses among Pediatric and Adult U.S. Military Beneficiaries. Am J Trop Med Hyg 2019; 100:1285-1289. [PMID: 30915948 DOI: 10.4269/ajtmh.18-0353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We evaluated differences in pretravel care, exposures, and illnesses among pediatric and adult travelers, using a prospective, observational cohort. Eighty-one pediatric travelers were matched 1:1 with adult military dependents by travel region, destination's malaria risk, and travel duration. Pediatric travelers were more likely to have coverage for hepatitis A and B (90% versus 67% of adults; 85% versus 44%), visit friends and relatives (36% versus 16%), report mosquito bites (69% versus 44%), and have close contact with wild or domesticated animals (40% versus 20%) than adults (P < 0.05). Subjects < 10 years of age were less likely to be prescribed antibiotics (28% versus 95%; RR = 0.63; 95% CI: 0.46-0.85) and antidiarrheals (9% versus 100%; RR = 0.10; 95% CI: 0.03-0.29) for travelers' diarrhea (TD) self-treatment than adults. Travel medicine providers should emphasize strategies for vector avoidance, prevention of animal bites and scratches, and TD self-treatment in pediatric pretravel consultations.
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Affiliation(s)
- David P Ashley
- Naval Medical Center, San Diego, California.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Jamie Fraser
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Heather Yun
- San Antonio Military Medical Center, San Antonio, Texas
| | - Anjali Kunz
- Madigan Army Medical Center, Tacoma, Washington
| | - Mary Fairchok
- Madigan Army Medical Center, Tacoma, Washington.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - David Tribble
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Indrani Mitra
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Patrick W Hickey
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Anuradha Ganesan
- Walter Reed National Military Medical Center, Bethesda, Maryland.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Robert G Deiss
- Naval Medical Center, San Diego, California.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Tahaniyat Lalani
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Naval Medical Center, Portsmouth, Virginia.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
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Zhao Y, Huang W, Kim TM, Jung Y, Menon LG, Xing H, Li H, Carroll RS, Park PJ, Yang HW, Johnson MD. MicroRNA-29a activates a multi-component growth and invasion program in glioblastoma. J Exp Clin Cancer Res 2019; 38:36. [PMID: 30683134 PMCID: PMC6347789 DOI: 10.1186/s13046-019-1026-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 10/31/2018] [Accepted: 01/06/2019] [Indexed: 12/12/2022]
Abstract
Background Glioblastoma is a malignant brain tumor characterized by rapid growth, diffuse invasion and therapeutic resistance. We recently used microRNA expression profiles to subclassify glioblastoma into five genetically and clinically distinct subclasses, and showed that microRNAs both define and contribute to the phenotypes of these subclasses. Here we show that miR-29a activates a multi-faceted growth and invasion program that promotes glioblastoma aggressiveness. Methods microRNA expression profiles from 197 glioblastomas were analyzed to identify the candidate miRNAs that are correlated to glioblastoma aggressiveness. The candidate miRNA, miR-29a, was further studied in vitro and in vivo. Results Members of the miR-29 subfamily display increased expression in the two glioblastoma subclasses with the worst prognoses (astrocytic and neural). We observed that miR-29a is among the microRNAs that are most positively-correlated with PTEN copy number in glioblastoma, and that miR-29a promotes glioblastoma growth and invasion in part by targeting PTEN. In PTEN-deficient glioblastoma cells, however, miR-29a nevertheless activates AKT by downregulating the metastasis suppressor, EphB3. In addition, miR-29a robustly promotes invasion in PTEN-deficient glioblastoma cells by repressing translation of the Sox4 transcription factor, and this upregulates the invasion-promoting protein, HIC5. Indeed, we identified Sox4 as the most anti-correlated predicted target of miR-29a in glioblastoma. Importantly, inhibition of endogenous miR-29a decreases glioblastoma growth and invasion in vitro and in vivo, and increased miR-29a expression in glioblastoma specimens correlates with decreased patient survival. Conclusions Taken together, these data identify miR-29a as a master regulator of glioblastoma growth and invasion. Electronic supplementary material The online version of this article (10.1186/s13046-019-1026-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yun Zhao
- Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Chemotherapy, Tumor Hospital of Guangxi Medical University, No.2, Nanning, Guangxi, China
| | - Wei Huang
- Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Tae-Min Kim
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Yuchae Jung
- Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lata G Menon
- Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Hongyan Xing
- Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Hongwei Li
- Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Rona S Carroll
- Department of Neurological Surgery, University of Massachusetts Medical School, Albert Sherman Center AS6-1001, 368 Plantation Street, Worcester, MA, 01605, USA.,Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Peter J Park
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - Hong Wei Yang
- Department of Neurological Surgery, University of Massachusetts Medical School, Albert Sherman Center AS6-1001, 368 Plantation Street, Worcester, MA, 01605, USA. .,Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Mark D Johnson
- Department of Neurological Surgery, University of Massachusetts Medical School, Albert Sherman Center AS6-1001, 368 Plantation Street, Worcester, MA, 01605, USA. .,Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. .,Program in Neuro-Oncology, Dana Farber Cancer Institute, Boston, MA, USA. .,Department of Neurological Surgery, UMass Memorial Healthcare, University of Massachusetts Medical School, 55 Lake Avenue North, S2-855, Worcester, MA, 01655, USA.
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35
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Luo C, Yang Q, Liu Y, Zhou S, Jiang J, Reiter RJ, Bhattacharya P, Cui Y, Yang H, Ma H, Yao J, Lawler SE, Zhang X, Fu J, Rozental R, Aly H, Johnson MD, Chiocca EA, Wang X. The multiple protective roles and molecular mechanisms of melatonin and its precursor N-acetylserotonin in targeting brain injury and liver damage and in maintaining bone health. Free Radic Biol Med 2019; 130:215-233. [PMID: 30315933 DOI: 10.1016/j.freeradbiomed.2018.10.402] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/01/2018] [Accepted: 10/02/2018] [Indexed: 12/20/2022]
Abstract
Melatonin is a neurohormone associated with sleep and wakefulness and is mainly produced by the pineal gland. Numerous physiological functions of melatonin have been demonstrated including anti-inflammation, suppressing neoplastic growth, circadian and endocrine rhythm regulation, and its potent antioxidant activity as well as its role in regeneration of various tissues including the nervous system, liver, bone, kidney, bladder, skin, and muscle, among others. In this review, we summarize the recent advances related to the multiple protective roles of melatonin receptor agonists, melatonin and N-acetylserotonin (NAS), in brain injury, liver damage, and bone health. Brain injury, including traumatic brain injury, ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, and newborn perinatal hypoxia-ischemia encephalopathy, is a major cause of mortality and disability. Liver disease causes serious public health problems and various factors including alcohol, chemical pollutants, and drugs induce hepatic damage. Osteoporosis is the most common bone disease in humans. Due in part to an aging population, both the cost of care of fracture patients and the annual fracture rate have increased steadily. Despite the discrepancy in the pathophysiological processes of these disorders, time frames and severity, they may share several common molecular mechanisms. Oxidative stress is considered to be a critical factor in these pathogeneses. We update the current state of knowledge related to the molecular processes, mainly including anti-oxidative stress, anti-apoptosis, autophagy dysfunction, and anti-inflammation as well as other properties of melatonin and NAS. Particularly, the abilities of melatonin and NAS to directly scavenge oxygen-centered radicals and toxic reactive oxygen species, and indirectly act through antioxidant enzymes are disscussed. In this review, we summarize the similarities and differences in the protection provided by melatonin and/or NAS in brain, liver and bone damage. We analyze the involvement of melatonin receptor 1A (MT1), melatonin receptor 1B (MT2), and melatonin receptor 1C (MT3) in the protection of melatonin and/or NAS. Additionally, we evaluate their potential clinical applications. The multiple mechanisms of action and multiple organ-targeted properties of melatonin and NAS may contribute to development of promising therapies for clinical trials.
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Affiliation(s)
- Chengliang Luo
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Qiang Yang
- Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye, Hubei, China
| | - Yuancai Liu
- Hubei Provincial Key Lab for Quality and Safety of Traditional Chinese Medicine Health Food, Jing Brand Research Institute, Daye, Hubei, China
| | - Shuanhu Zhou
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jiying Jiang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Histology and Embryology, Weifang Medical University, Weifang, Shandong, China
| | - Russel J Reiter
- Department of Cellular and Structural Biology, University Texas Health Science Center, San Antonio, TX, USA
| | - Pallab Bhattacharya
- National Institute of Pharmaceutical Education and Research, Ahmedabad, India
| | - Yongchun Cui
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hongwei Yang
- Department of Neurosurgery, University of Massachusetts Medical School, Worcester, MA, USA
| | - He Ma
- Third Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiemin Yao
- Third Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China
| | - Sean E Lawler
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Xinmu Zhang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jianfang Fu
- Department of Endocrinology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Renato Rozental
- Lab Neuroproteção & Estratégias Regenerativas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Hany Aly
- Department of Neonatology, Cleveland Clinic Children's Hospital, Cleveland, OH, USA
| | - Mark D Johnson
- Department of Neurosurgery, University of Massachusetts Medical School, Worcester, MA, USA
| | - E Antonio Chiocca
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Xin Wang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Drummond CA, Pielemeier R, Sweet J, DeVries J, Gesaman J, LaBar M, Nugent G, Johnson MD. Abstract 225: Comparison of Myocardial Infarction and Congestive Heart Failure Induced Through Interventional Ischemia Reperfusion Injury in Yorkshire (Domestic), Yucatan, and Göttingen Swine. Circ Res 2018. [DOI: 10.1161/res.123.suppl_1.225] [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: 11/16/2022]
Abstract
Swine are important translational research models for developing and gaining regulatory approval for novel therapies for heart failure. Three swine species in particular are utilized in these studies, the Domestic Yorkshire (DY), Yucatan Minipigs (Yuc), and Göttingen minipigs (Gott). Selecting the right swine breed is important to the translational success of novel therapies and is the source of debate in the field. The current study compared interventionally induced Ischemia-reperfusion injury (IRI), a method that mimics clinical myocardial infarction and subsequent heart failure, in these breeds. Interventional IRI was induced by occluding the Left Anterior Descending Coronary Artery for 90 minutes using a PTCA balloon placed distal to the first diagonal branch. Yuc have the highest rate of survival of the three breeds following a 90 min occlusion (81%; 56 out of 69), Gott survival was 70% (28 out of 40), and DY survival was 57% (75 out of 131). Assessment of serum levels of Cardiac Troponin I (CTnI) revealed significant increases in this parameter that peak at 3 hrs following occlusion. Gott have the highest levels at 122ng/mL, followed by Yuc (99ng/mL), and DY (85ng/mL) at this time point. Functionally, all three breeds displayed an Ejection Fraction assessed by echocardiography of less than 40%, with Gott having the lowest mean, followed by Yuc, and DY. These levels remain low or decrease slightly over 1 to 4 months. Magnetic Resonance imaging demonstrates infarct sizes are approximately 25% of the left ventricle following 1 month and decreasing over time to 22% at 2 months post and 13% 4 months post. Additionally, all three species lose their hemodynamic responsiveness to dobutamine challenge following IRI. All three breeds respond similarly to IRI functionally and structurally, and they develop the clinical features of congestive heart failure, the main distinguishing factor in the current study was survival of the IRI procedure. Based on this data, factors such as rate of body weight gain in relation to the ability to obtain functional endpoints, availability, and other practical considerations should drive the selection of breed for translational studies.
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Graybill RM, Cardenosa-Rubio MC, Yang H, Johnson MD, Bailey RC. Multiplexed microRNA Expression Profiling by Combined Asymmetric PCR and Label-Free Detection using Silicon Photonic Sensor Arrays. Anal Methods 2018; 10:1618-1623. [PMID: 30275912 PMCID: PMC6162071 DOI: 10.1039/c8ay00190a] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Analysis methods based upon the quantitative, real-time polymerase chain reaction are extremely powerful; however, they face intrinsic limitations in terms of target multiplexing. In contrast, silicon photonic microring resonators represent a modularly multiplexable sensor array technology that is well-suited to the analysis of targeted biomarker panels. In this manuscript we employ an asymmetric polymerase chain reaction approach to selectively amplify copies of cDNAs generated from targeted miRNAs before multiplexed, label-free quantitation through hybridization to microring resonator arrays pre-functionalized with capture sequences. This method, which shows applicability to low input amounts and a large dynamic range, was demonstrated for the simultaneous detection of eight microRNA targets from twenty primary brain tumor samples with expression profiles in good agreement with literature precedent.
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Affiliation(s)
- Richard M. Graybill
- Department of Chemistry, University of Illinois at Urbana-Champaign, 600 S. Matthews Ave., Urbana, IL 61801, USA
| | - Maria C. Cardenosa-Rubio
- Department of Chemistry, University of Illinois at Urbana-Champaign, 600 S. Matthews Ave., Urbana, IL 61801, USA
- Department of Chemistry, University of Michigan, 930 N. University Ave. Ann Arbor, MI 48104, USA
| | - Hongwei Yang
- Department of Neurological Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA
- Department of Neurological Surgery, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Mark D. Johnson
- Department of Neurological Surgery, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA
- Department of Neurological Surgery, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Ryan C. Bailey
- Department of Chemistry, University of Illinois at Urbana-Champaign, 600 S. Matthews Ave., Urbana, IL 61801, USA
- Department of Chemistry, University of Michigan, 930 N. University Ave. Ann Arbor, MI 48104, USA
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Capper CP, Liu J, McIntosh LR, Larios JM, Johnson MD, Hollenberg PF, Osawa Y, Auchus RJ, Rae JM. Functional characterization of the G162R and D216H genetic variants of human CYP17A1. J Steroid Biochem Mol Biol 2018; 178:159-166. [PMID: 29229304 PMCID: PMC5835412 DOI: 10.1016/j.jsbmb.2017.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/30/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
Abstract
Cytochrome P450 17A1 (CYP17A1) is a dual-function enzyme catalyzing reactions necessary for cortisol and androgen biosynthesis. CYP17A1 is a validated drug target for prostate cancer as CYP17A1 inhibition significantly reduces circulating androgens and improves survival in castration-resistant prostate cancer. Germline CYP17A1 genetic variants with altered CYP17A1 activity manifesting as various endocrinopathies are extremely rare; however, characterizing these variants provides critical insights into CYP17A1 protein structure and function. By querying the dbSNP online database and publically available data from the 1000 genomes project (http://browser.1000genomes.org), we identified two CYP17A1 nonsynonymous genetic variants with unknown consequences for enzymatic activity and stability. We hypothesized that the resultant amino acid changes would alter CYP17A1 stability or activity. To test this hypothesis, we utilized a HEK-293T cell-based expression system to characterize the functional consequences of two CYP17A1 variants, D216H (rs200063521) and G162R (rs141821705). Cells transiently expressing the D216H variant demonstrate a selective impairment of 16α-hydroxyprogesterone synthesis by 2.1-fold compared to wild-type (WT) CYP17A1, while no effect on 17α-hydroxyprogesterone synthesis was observed. These data suggest that substrate orientations in the active site might be altered with this amino acid substitution. In contrast, the G162R substitution exhibits decreased CYP17A1 protein stability compared to WT with a near 70% reduction in protein levels as determined by immunoblot analysis. This variant is preferentially ubiquitinated and degraded prematurely, with an enzyme half-life calculated to be ∼2.5 h, and proteasome inhibitor treatment recovers G162R protein expression to WT levels. Together, these data provide new insights into CYP17A1 structure-function and stability mechanisms.
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Affiliation(s)
- C P Capper
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA; Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - J Liu
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - L R McIntosh
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA
| | - J M Larios
- Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - M D Johnson
- Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, D.C., USA
| | - P F Hollenberg
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA
| | - Y Osawa
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA
| | - R J Auchus
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA; Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - J M Rae
- Department of Pharmacology, University of Michigan, Ann Arbor, MI, USA; Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Kratz M, Thomas A, Hora R, Vera D, Lutz M, Johnson MD. Development and Implementation of the DHAPP Military eHealth Information Network System. Curr HIV Res 2018; 15:102-108. [PMID: 28521714 DOI: 10.2174/1570162x15666170517093714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 09/22/2016] [Accepted: 10/06/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND As the Joint United Nations Programme on HIV/AIDS, the Global Fund, and the US President's Emergency Plan for AIDS Relief focus on reaching 90-90-90 goals, military health systems are scaling up to meet the data demands of these ambitious objectives. METHODS Since 2008, the US Department of Defense HIV/AIDS Prevention Program (DHAPP) has been working with military partners in 14 countries on implementation and adoption of a Military eHealth Information Network (MeHIN). Each country implementation plan followed a structured process using international eHealth standards. DHAPP worked with the private sector to develop a commercial-off-the-shelf (COTS) electronic medical record (EMR) for the collection of data, including patient demographic information, clinical notes for general medical care, HIV encounters, voluntary medical male circumcision, and tuberculosis screening information. RESULTS The COTS software approach provided a zero-dollar software license and focused on sharing a single version of the EMR across countries, so that all countries could benefit from software enhancements and new features over time. DHAPP also worked with the public sector to modify open source disease surveillance tools and open access of HIV training materials. Important lessons highlight challenges to eHealth implementation, including a paucity of technology infrastructure, military leadership rotations, and the need for basic computer skills building. CONCLUSION While not simple, eHealth systems can be built and maintained with requisite security, flexibility, and reporting capabilities that provide critical information to improve the health of individuals and organizations.
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Affiliation(s)
- Mary Kratz
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106. United States
| | - Anne Thomas
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106. United States
| | - Ricardo Hora
- Biomedical Informatics Department, Naval Medical Research Unit No. 6, Lima, Peru
| | - Delphis Vera
- Biomedical Informatics Department, Naval Medical Research Unit No. 6, Lima, Peru
| | - Mickey Lutz
- Vista Life Sciences, Parker, CO. United States
| | - Mark D Johnson
- Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, CA. United States
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Leles SG, Mitra A, Flynn KJ, Stoecker DK, Hansen PJ, Calbet A, McManus GB, Sanders RW, Caron DA, Not F, Hallegraeff GM, Pitta P, Raven JA, Johnson MD, Glibert PM, Våge S. Oceanic protists with different forms of acquired phototrophy display contrasting biogeographies and abundance. Proc Biol Sci 2018; 284:rspb.2017.0664. [PMID: 28768886 DOI: 10.1098/rspb.2017.0664] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 06/28/2017] [Indexed: 11/12/2022] Open
Abstract
This first comprehensive analysis of the global biogeography of marine protistan plankton with acquired phototrophy shows these mixotrophic organisms to be ubiquitous and abundant; however, their biogeography differs markedly between different functional groups. These mixotrophs, lacking a constitutive capacity for photosynthesis (i.e. non-constitutive mixotrophs, NCMs), acquire their phototrophic potential through either integration of prey-plastids or through endosymbiotic associations with photosynthetic microbes. Analysis of field data reveals that 40-60% of plankton traditionally labelled as (non-phototrophic) microzooplankton are actually NCMs, employing acquired phototrophy in addition to phagotrophy. Specialist NCMs acquire chloroplasts or endosymbionts from specific prey, while generalist NCMs obtain chloroplasts from a variety of prey. These contrasting functional types of NCMs exhibit distinct seasonal and spatial global distribution patterns. Mixotrophs reliant on 'stolen' chloroplasts, controlled by prey diversity and abundance, dominate in high-biomass areas. Mixotrophs harbouring intact symbionts are present in all waters and dominate particularly in oligotrophic open ocean systems. The contrasting temporal and spatial patterns of distribution of different mixotroph functional types across the oceanic provinces, as revealed in this study, challenges traditional interpretations of marine food web structures. Mixotrophs with acquired phototrophy (NCMs) warrant greater recognition in marine research.
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Affiliation(s)
- S G Leles
- Biosciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - A Mitra
- Biosciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - K J Flynn
- Biosciences, Swansea University, Singleton Park, Swansea SA2 8PP, UK
| | - D K Stoecker
- Horn Point Laboratory, University of Maryland Center for Environmental Science, Cambridge, MD 21613, USA
| | - P J Hansen
- Marine Biological Section, University of Copenhagen, 3000 Helsingør, Denmark
| | - A Calbet
- Institut de Ciències del Mar, CSIC. Pg Marítim de la Barceloneta 37-49, 08003, Barcelona, Spain
| | - G B McManus
- Department of Marine Sciences, University of Connecticut, Groton CT, 06340, USA
| | - R W Sanders
- Department of Biology, Temple University, Philadelphia, PA 19122, USA
| | - D A Caron
- Department of Biological Sciences, University of Southern California, Los Angeles, CA 90089-0371, USA
| | - F Not
- UPMC Université Paris 06, CNRS, Laboratoire Adaptation et Diversité en Milieu Marin UMR7144, Sorbonne Universités, Station Biologique de Roscoff, 29688 Roscoff, France
| | - G M Hallegraeff
- Institute for Marine and Antarctic Studies, University of Tasmania, Private Bag 129, Hobart, Tasmania 7001, Australia
| | - P Pitta
- Hellenic Centre for Marine Research, Institute of Oceanography, 71003 Heraklion, Crete, Greece
| | - J A Raven
- Division of Plant Science, University of Dundee at the James Hutton Institute, Invergowrie, Dundee DD2 5DQ, UK.,Climate Change Cluster, University of Technology Sydney, Ultimo, New South Wales 2007, Australia
| | - M D Johnson
- Department of Biology, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
| | - P M Glibert
- Horn Point Laboratory, University of Maryland Center for Environmental Science, Cambridge, MD 21613, USA
| | - S Våge
- Department of Biology, University of Bergen, 5020 Bergen, Norway
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Arvold ND, Shi DD, Aizer AA, Norden AD, Reardon DA, Lee EQ, Nayak L, Dunn IF, Golby AJ, Johnson MD, Claus EB, Chiocca EA, Ligon KL, Wen PY, Alexander BM. Salvage re-irradiation for recurrent high-grade glioma and comparison to bevacizumab alone. J Neurooncol 2017; 135:581-591. [PMID: 28975467 DOI: 10.1007/s11060-017-2611-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 08/20/2017] [Indexed: 11/27/2022]
Abstract
While salvage re-irradiation is often used for recurrent high-grade glioma (HGG), there have been few comparisons between various re-radiation dose/fractionation schedules or with bevacizumab alone. We analyzed patients with recurrent HGG who received re-irradiation at Dana-Farber Cancer Institute and Brigham and Women's Hospital from 2010 to 2014 (n = 67), as well as those who received bevacizumab alone (n = 177). Cox proportional hazards modeling was used to examine factors associated with overall survival (OS). Propensity score modeling was used to compare survival after re-irradiation vs. bevacizumab alone. Median time from initial diagnosis to re-irradiation was 31.4 months. The most common re-irradiation dose/fractionations used were 6 Gy × 5 (36%), 3.5 Gy × 10 (21%), 2.67 Gy × 15 (15%), and 18-20 Gy × 1 (15%). No early or late toxicities >grade 2 were observed. Median PFS and OS after re-irradiation were 4.8 and 10.7 months, respectively. Number of progressions prior to re-irradiation (adjusted hazard ratio [AHR] 1.6; 95% CI, 1.1-2.3; p = .007), and recurrence in a new brain location (vs. local-only; AHR 7.4; 95% CI, 2.4-23.1; p < .001) were associated with OS; dose/fractionation was not. Compared with bevacizumab alone, re-irradiated patients had a non-significant increase in OS (HR 0.80; 95% CI, 0.53-1.23; P = .31). Among patients with a local-only recurrence, there was a trend towards longer median OS after re-irradiation compared to bevacizumab alone (12.4 vs. 8.0 months; p = .12). Survival after re-irradiation for recurrent HGG appears independent of dose/fractionation and compares favorably with bevacizumab alone.
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Affiliation(s)
- Nils D Arvold
- St. Luke's Radiation Oncology Associates, St. Luke's Cancer Center, and Whiteside Institute for Clinical Research, University of Minnesota Duluth, Duluth, MN, USA
| | | | - Ayal A Aizer
- Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, USA
| | - Andrew D Norden
- Harvard Medical School, Boston, MA, USA
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - David A Reardon
- Harvard Medical School, Boston, MA, USA
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Eudocia Q Lee
- Harvard Medical School, Boston, MA, USA
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lakshmi Nayak
- Harvard Medical School, Boston, MA, USA
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Ian F Dunn
- Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, MA, USA
| | - Alexandra J Golby
- Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, MA, USA
| | - Mark D Johnson
- Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, MA, USA
| | - Elizabeth B Claus
- Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, MA, USA
- School of Public Health, Yale University, New Haven, CT, USA
| | - E Antonio Chiocca
- Harvard Medical School, Boston, MA, USA
- Department of Neurosurgery, Brigham & Women's Hospital, Boston, MA, USA
| | - Keith L Ligon
- Harvard Medical School, Boston, MA, USA
- Department of Pathology, Dana-Farber Cancer Institute, Brigham & Women's Hospital, Boston, MA, USA
| | - Patrick Y Wen
- Harvard Medical School, Boston, MA, USA
- Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Brian M Alexander
- Harvard Medical School, Boston, MA, USA.
- Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA, USA.
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Johnson MD, Lewis DD, Winter MD. Intraoperative use of a transarticular circular fixator construct to facilitate reduction and stabilisation of a proximal tibial physeal fracture in a dog. Aust Vet J 2017; 95:161-166. [PMID: 28444758 DOI: 10.1111/avj.12581] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 07/01/2016] [Accepted: 08/07/2016] [Indexed: 11/29/2022]
Abstract
CASE REPORT A 4-month-old female intact American Pit Bull Terrier was presented for right pelvic limb lameness 1 day after the dog had been hit by an all-terrain vehicle. Orthogonal radiographs of the right stifle revealed a Salter-Harris type IV fracture through the proximal tibial physis extending caudodistally through the proximal tibial metaphysis. The distal tibia was markedly displaced cranially, laterally and proximally, resulting in complete overriding of the fracture segments. An open approach was made in order to facilitate direct reduction, but the fracture could not be sufficiently distracted and the epiphyseal segment remained fixed caudal to the remainder of the tibia. Concerns regarding possible iatrogenic trauma to the epiphysis prompted the use of a transarticular circular fixator construct to distract the fracture segments to facilitate reduction. Distraction that facilitated reduction was performed using three TrueLok Rapid Quick Adjust Struts that were positioned between the two ring components. The struts also allowed for multiplanar adjustment of alignment, which allowed the fracture to be maintained in anatomic reduction as divergent interfragmentary Kirschner wires were placed. Radiographic union was confirmed 19 days after surgery. CONCLUSION/CLINICAL SIGNIFICANCE Transient intraoperative application of a circular construct incorporating the TrueLok components facilitated accurate fracture reduction without inflicting further iatrogenic trauma to the epiphysis, after traditional direct reduction techniques proved ineffective, and afforded a successful clinical outcome in the dog reported here.
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Affiliation(s)
- M D Johnson
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida 32610-0126, USA
| | - D D Lewis
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida 32610-0126, USA
| | - M D Winter
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida 32610-0126, USA
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Lindholm DA, Myers T, Widjaja S, Grant EM, Telu K, Lalani T, Fraser J, Fairchok M, Ganesan A, Johnson MD, Kunz A, Tribble DR, Yun HC. Mosquito Exposure and Chikungunya and Dengue Infection Among Travelers During the Chikungunya Outbreak in the Americas. Am J Trop Med Hyg 2017; 96:903-912. [PMID: 28115671 DOI: 10.4269/ajtmh.16-0635] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractTravelers are at risk for arbovirus infection. We prospectively enrolled 267 Department of Defense beneficiaries traveling to chikungunya-outbreak regions in the Americas between December 2013 and May 2015 and assessed travel characteristics and serologic exposure to chikungunya virus (CHIKV) and dengue virus (DENV). Ten ill-returning travelers were also assessed retrospectively. Self-reported mosquito exposure was common (64% of 198 evaluable travelers saw mosquitoes; 53% of 201 reported ≥ 1 bite). Increased exposure was associated with active-duty travelers (odds ratio [OR] = 2.6 [1.3-5.4] for seeing mosquitoes) or travelers visiting friends and relatives (VFR) (OR = 3.5 [1.0-10.0] for high-intensity bite exposure). Arbovirus infection was defined as seroconversion on plaque reduction neutralization testing (PRNT) of pre- and posttravel sera. For ill subjects enrolled posttravel, infection was defined by a positive convalescent PRNT and/or a positive reverse transcription polymerase chain reaction for CHIKV or DENV. We identified seven cases of arbovirus infection: four with CHIKV, five with DENV, and two with both. The composite attack rate for CHIKV and DENV infection was 3.7% of 108 evaluable, immunologically naïve, prospectively assessed travelers; there was serologic and/or polymerase chain reaction evidence of arbovirus infection in three of four evaluable (three of 10 total) ill-returning travelers. We identified both symptomatic and asymptomatic cases. Military purpose of travel and VFR travel accounted for five of seven cases. Pretravel counseling is important and should target higher risk groups. Given a shared vector between CHIKV, DENV, and Zika virus (ZIKV), this study can also help guide counseling for travelers to ZIKV-outbreak regions.
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Affiliation(s)
| | - Todd Myers
- Naval Infectious Diseases Diagnostic Laboratory, Silver Spring, Maryland
| | - Susana Widjaja
- Naval Infectious Diseases Diagnostic Laboratory, Silver Spring, Maryland
| | - Edward M Grant
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Kalyani Telu
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Tahaniyat Lalani
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Naval Medical Center, Portsmouth, Virginia
| | - Jamie Fraser
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland
| | - Mary Fairchok
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Madigan Army Medical Center, Tacoma, Washington
| | - Anuradha Ganesan
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland.,Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Mark D Johnson
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Naval Health Research Center, San Diego, California
| | - Anjali Kunz
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland.,Madigan Army Medical Center, Tacoma, Washington
| | - David R Tribble
- Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Heather C Yun
- San Antonio Military Medical Center, San Antonio, Texas.,Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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Mamidi RNVS, Dallas S, Sensenhauser C, Lim HK, Scheers E, Verboven P, Cuyckens F, Leclercq L, Evans DC, Kelley MF, Johnson MD, Snoeys J. In vitro and physiologically-based pharmacokinetic based assessment of drug-drug interaction potential of canagliflozin. Br J Clin Pharmacol 2016; 83:1082-1096. [PMID: 27862160 DOI: 10.1111/bcp.13186] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 04/18/2016] [Revised: 10/19/2016] [Accepted: 11/06/2016] [Indexed: 12/16/2022] Open
Abstract
AIMS Canagliflozin is a recently approved drug for use in the treatment of type 2 diabetes. The potential for canagliflozin to cause clinical drug-drug interactions (DDIs) was assessed. METHODS DDI potential of canagliflozin was investigated using in vitro test systems containing drug metabolizing enzymes or transporters. Basic predictive approaches were applied to determine potential interactions in vivo. A physiologically-based pharmacokinetic (PBPK) model was developed and clinical DDI simulations were performed to determine the likelihood of cytochrome P450 (CYP) inhibition by canagliflozin. RESULTS Canagliflozin was primarily metabolized by uridine 5'-diphospho-glucuronosyltransferase 1A9 and 2B4 enzymes. Canagliflozin was a substrate of efflux transporters (P-glycoprotein, breast cancer resistance protein and multidrug resistance-associated protein-2) but was not a substrate of uptake transporters (organic anion transporter polypeptide isoforms OATP1B1, OATP1B3, organic anion transporters OAT1 and OAT3, and organic cationic transporters OCT1, and OCT2). In inhibition assays, canagliflozin was shown to be a weak in vitro inhibitor (IC50 ) of CYP3A4 (27 μmol l -1 , standard error [SE] 4.9), CYP2C9 (80 μmol l -1 , SE 8.1), CYP2B6 (16 μmol l-1 , SE 2.1), CYP2C8 (75 μmol l -1 , SE 6.4), P-glycoprotein (19.3 μmol l -1 , SE 7.2), and multidrug resistance-associated protein-2 (21.5 μmol l -1 , SE 3.1). Basic models recommended in DDI guidelines (US Food & Drug Administration and European Medicines Agency) predicted moderate to low likelihood of interaction for these CYPs and efflux transporters. PBPK DDI simulations of canagliflozin with CYP probe substrates (simvastatin, S-warfarin, bupropion, repaglinide) did not show relevant interaction in humans since mean areas under the concentration-time curve and maximum plasma concentration ratios for probe substrates with and without canagliflozin and its 95% CIs were within 0.80-1.25. CONCLUSIONS In vitro DDI followed by a predictive or PBPK approach was applied to determine DDI potential of canagliflozin. Overall, canagliflozin is neither a perpetrator nor a victim of clinically important interactions.
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Affiliation(s)
- Rao N V S Mamidi
- Preclinical Development & Safety, Janssen Research & Development, LLC, Raritan, New Jersey, USA
| | - Shannon Dallas
- Preclinical Development & Safety, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Carlo Sensenhauser
- Preclinical Development & Safety, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Heng Keang Lim
- Preclinical Development & Safety, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Ellen Scheers
- Preclinical Development & Safety, Janssen Research & Development, Beerse, Belgium
| | - Peter Verboven
- Preclinical Development & Safety, Janssen Research & Development, Beerse, Belgium
| | - Filip Cuyckens
- Preclinical Development & Safety, Janssen Research & Development, Beerse, Belgium
| | - Laurent Leclercq
- Preclinical Development & Safety, Janssen Research & Development, Beerse, Belgium
| | - David C Evans
- Preclinical Development & Safety, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Michael F Kelley
- Preclinical Development & Safety, Janssen Research & Development, LLC, Spring House, Pennsylvania, USA
| | - Mark D Johnson
- Preclinical Development & Safety, Janssen Research & Development, LLC, Raritan, New Jersey, USA
| | - Jan Snoeys
- Preclinical Development & Safety, Janssen Research & Development, Beerse, Belgium
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Hickman TT, Shuman ME, Johnson TA, Yang F, Rice RR, Rice IM, Chung EH, Wiemann R, Tinl M, Iracheta C, Chen G, Flynn P, Mondello MB, Thompson J, Meadows ME, Carroll RS, Yang HW, Xing H, Pilgrim D, Chiocca EA, Dunn IF, Golby AJ, Johnson MD. Association between shunt-responsive idiopathic normal pressure hydrocephalus and alcohol. J Neurosurg 2016; 127:240-248. [PMID: 27689463 DOI: 10.3171/2016.6.jns16496] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/06/2022]
Abstract
OBJECTIVE Idiopathic normal pressure hydrocephalus (iNPH) is characterized by ventriculomegaly, gait difficulty, incontinence, and dementia. The symptoms can be ameliorated by CSF drainage. The object of this study was to identify factors associated with shunt-responsive iNPH. METHODS The authors reviewed the medical records of 529 patients who underwent shunt placement for iNPH at their institution between July 2001 and March 2015. Variables associated with shunt-responsive iNPH were identified using bivariate and multivariate analyses. Detailed alcohol consumption information was obtained for 328 patients and was used to examine the relationship between alcohol and shunt-responsive iNPH. A computerized patient registry from 2 academic medical centers was queried to determine the prevalence of alcohol abuse among 1665 iNPH patients. RESULTS Bivariate analysis identified associations between shunt-responsive iNPH and gait difficulty (OR 4.59, 95% CI 2.32-9.09; p < 0.0001), dementia (OR 1.79, 95% CI 1.14-2.80; p = 0.01), incontinence (OR 1.77, 95% CI 1.13-2.76; p = 0.01), and alcohol use (OR 1.98, 95% CI 1.23-3.16; p = 0.03). Borderline significance was observed for hyperlipidemia (OR 1.56, 95% CI 0.99-2.45; p = 0.054), a family history of hyperlipidemia (OR 3.09, 95% CI 0.93-10.26, p = 0.054), and diabetes (OR 1.83, 95% CI 0.96-3.51; p = 0.064). Multivariate analysis identified associations with gait difficulty (OR 3.98, 95% CI 1.81-8.77; p = 0.0006) and alcohol (OR 1.94, 95% CI 1.10-3.39; p = 0.04). Increased alcohol intake correlated with greater improvement after CSF drainage. Alcohol abuse was 2.5 times more prevalent among iNPH patients than matched controls. CONCLUSIONS Alcohol consumption is associated with the development of shunt-responsive iNPH.
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Affiliation(s)
- Thu-Trang Hickman
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Matthew E Shuman
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Tatyana A Johnson
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Felix Yang
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Rebecca R Rice
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Isaac M Rice
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Esther H Chung
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Robert Wiemann
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Megan Tinl
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School.,Department of Rehabilitation Services, Brigham and Women's Hospital; and
| | - Christine Iracheta
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School.,Department of Rehabilitation Services, Brigham and Women's Hospital; and
| | - Grace Chen
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School.,Department of Rehabilitation Services, Brigham and Women's Hospital; and
| | - Patricia Flynn
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School.,Department of Rehabilitation Services, Brigham and Women's Hospital; and
| | - Mary Beth Mondello
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Jillian Thompson
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Mary-Ellen Meadows
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School.,Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Rona S Carroll
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Hong Wei Yang
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Hongyan Xing
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - David Pilgrim
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School.,Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - E Antonio Chiocca
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Ian F Dunn
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Alexandra J Golby
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
| | - Mark D Johnson
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School
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Johnson MD, Miller RK, Morrill JC, Anderson DP, Wickersham TA, Sawyer JE, Richardson JW, Palma MA. The influence of taste in willingness-to-pay valuations of sirloin steaks from postextraction algal residue-fed cattle. J Anim Sci 2016; 94:3072-83. [PMID: 27482694 DOI: 10.2527/jas.2016-0301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Consumer preferences and willingness-to-pay (WTP) for beef sirloin steaks with differing production, physical, and credence attributes related to the use of postextraction algal residue (PEAR), a novel feed ingredient, were estimated. Ninety-six consumers participated in a sensory tasting panel before completing a choice set survey; 127 consumers completed only the choice set survey without sampling products. Steaks from grain- and PEAR-fed steers had similar Warner-Bratzler shear force (WBSF) scores (1.89 kg and 2.01 kg, respectively; = 0.77) and had lower WBSF scores than steaks from grass-fed steers (3.37 kg; < 0.05). Eicosapentaenoic acid (20:5) was not different among steaks from grain- and PEAR-fed steers ( = 0.39) but was greater compared with steaks from grass-fed cattle ( ≤ 0.03). Panelists in the sensory portion of the study evaluated beef samples for like/dislike of overall sample, overall flavor, beefy flavor, and juiciness. Panelist rating of overall like, overall flavor like, and beefy flavor like were not different between the PEAR- and grain-fed treatments ( > 0.26). Panelists rated the juiciness like/dislike of steaks from PEAR-fed cattle the highest ( < 0.01) among the 3 samples. Sensory tasting of the products was observed to alter the preferences of consumers. Consumers who completed only the survey negatively perceived beef from PEAR-fed cattle compared with beef from grain-fed cattle, with a WTP discount of -US$1.17/kg. However, with sensory tasting, the WTP for beef from PEAR-fed cattle was not discounted relative to beef from grain-fed cattle ( = 0.21). The nontasting consumers had much higher stated WTP values for credence attributes. Factors that influence the eating experience (tenderness and quality grade) dominated as the most important attributes on WTP among the tasting group. The use of no hormones and no antibiotics in production had a premium of $2.34/kg among the nontasting group, but with tasting, the premium was $1.19/kg. If PEAR-fed beef came to market, there would be no need to differentiate it from grain-fed beef unless retailers wanted to market it as a differentiated product. If it were marketed as a differentiated product, retailers would need to hold promotional tastings to change consumer's preconceived notions about the product.
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Lalani T, Yun H, Tribble D, Ganesan A, Kunz A, Fairchok M, Schnaubelt E, Fraser J, Mitra I, Kronmann KC, Burgess T, Deiss RG, Riddle MS, Johnson MD. A comparison of compliance rates with anti-vectorial protective measures during travel to regions with dengue or chikungunya activity, and regions endemic for Plasmodium falciparum malaria. J Travel Med 2016; 23:taw043. [PMID: 27378367 PMCID: PMC4939934 DOI: 10.1093/jtm/taw043] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/24/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is limited information on compliance rates with anti-vectorial protective measures (AVPMs) during travel to countries with risk of dengue and chikungunya. We evaluated differences in mosquito exposures, and factors associated with AVPM compliance in travellers going to countries where the principal mosquito-borne infectious disease threat is falciparum malaria and those where risk of dengue or chikungunya predominates. METHODS Department of Defence beneficiaries with planned travel to regions where the predominant mosquito-borne infection is falciparum malaria, and those with predominantly dengue or chikungunya risk, were included. Regions were divided into three groups: 'high-risk falciparum malaria', 'low-risk falciparum malaria' and 'chikungunya/dengue risk'. Demographics, trip characteristics, arthropod exposure and AVPM compliance were captured using pre- and post-travel surveys. Skin repellent compliance was defined as self-reported use, categorized as 'often/every day'. A logistic regression model was used to estimate factors associated with AVPM compliance. RESULTS 183 (9%), 185 (9%) and 149 (7%) travelled to high and low falciparum malaria risk regions, and chikungunya/dengue risk regions, respectively. Overall, 53% (95% CI: 48-57%) and 16% (95% CI: 12-19%) were compliant with repellent use on skin and clothing, respectively. Daytime bites were reported more frequently in chikungunya/dengue risk regions than high malaria risk regions (37% vs. 10%), while night time bites were frequently in high malaria risk regions (53% vs 20%; P < 0.001). Compliance with skin repellents was associated with female gender [RR: 1.54 (95% CI: 1.05-2.28)], observing mosquitoes during travel [RR: 2.77 (95% CI: 1.76-4.36)] and travel during the rainy season [RR: 2.45 (95% CI: 1.66-3.71)]). CONCLUSIONS Poor AVPM compliance was observed in the overall cohort. Compliance with skin repellent use was associated with female gender, observing mosquitoes and travelling during the rainy season, and was not associated with the risk of malaria or chikungunya/dengue at the travel destination.
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Affiliation(s)
- Tahaniyat Lalani
- Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Division of Infectious Diseases, Naval Medical Center Portsmouth, Portsmouth, VA, USA.,Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Heather Yun
- San Antonio Uniformed Services Health Education, Fort Sam Houston, TX, USA
| | - David Tribble
- Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Anuradha Ganesan
- Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Anjali Kunz
- Madigan Army Medical Center, Tacoma, WA, USA
| | - Mary Fairchok
- Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,Madigan Army Medical Center, Tacoma, WA, USA
| | | | - Jamie Fraser
- Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Indrani Mitra
- Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA
| | - Karl C Kronmann
- Division of Infectious Diseases, Naval Medical Center Portsmouth, Portsmouth, VA, USA
| | - Timothy Burgess
- San Antonio Uniformed Services Health Education, Fort Sam Houston, TX, USA
| | - Robert G Deiss
- Department of Preventive Medicine and Biostatistics, Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.,Henry M Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD, USA.,Naval Medical Center of San Diego, San Diego, CA, USA
| | - Mark S Riddle
- Enteric Diseases Department, Naval Medical Research Center, Silver Spring, MD, USA
| | - Mark D Johnson
- Naval Medical Center of San Diego, San Diego, CA, USA.,DoD HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, CA, USA
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48
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Muralidharan A, Jensen AL, Connolly A, Hendrix CM, Johnson MD, Baker KB, Vitek JL. Physiological changes in the pallidum in a progressive model of Parkinson's disease: Are oscillations enough? Exp Neurol 2016; 279:187-196. [PMID: 26946223 DOI: 10.1016/j.expneurol.2016.03.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 11/05/2015] [Revised: 02/29/2016] [Accepted: 03/01/2016] [Indexed: 11/17/2022]
Abstract
Neurophysiological changes in the basal ganglia thalamo-cortical circuit associated with the development of parkinsonian motor signs remain poorly understood. Theoretical models have ranged from those emphasizing changes in mean discharge rate to increased oscillatory activity within the beta range. The present study characterized neuronal activity within and across the internal and external segments of the globus pallidus as a function of motor severity using a staged, progressively severe 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine model of Parkinsonism in three rhesus monkeys. An increase in coherence between neuronal pairs across the external and internal globus pallidus was present in multiple frequency bands in the parkinsonian state; both the peak frequency of oscillatory coherence and the variability were reduced in the parkinsonian state. The incidence of 8-20Hz oscillatory activity in the internal globus pallidus increased with the progression of the disease when pooling the data across the three animals; however it did not correlate with motor severity when assessed individually and increased progressively in only one of three animals. No systematic relationship between mean discharge rates or the incidence or structure of bursting activity and motor severity was observed. These data suggest that exaggerated coupling across pallidal segments contribute to the development of the parkinsonian state by inducing an exaggerated level of synchrony and loss of focusing within the basal ganglia. These data further point to the lack of a defined relationship between rate changes, the mere presence of oscillatory activity in the beta range and bursting activity in the basal ganglia to the motor signs of Parkinson's disease.
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Affiliation(s)
- A Muralidharan
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, United States
| | - A L Jensen
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, United States
| | - A Connolly
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, United States
| | - C M Hendrix
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, United States
| | - M D Johnson
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, United States
| | - K B Baker
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, United States
| | - J L Vitek
- Department of Neurology, University of Minnesota, Minneapolis, MN 55455, United States.
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49
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Yang F, Hickman TT, Tinl M, Iracheta C, Chen G, Flynn P, Shuman ME, Johnson TA, Rice RR, Rice IM, Wiemann R, Johnson MD. Quantitative evaluation of changes in gait after extended cerebrospinal fluid drainage for normal pressure hydrocephalus. J Clin Neurosci 2016; 28:31-7. [PMID: 26775149 DOI: 10.1016/j.jocn.2015.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/12/2015] [Accepted: 11/29/2015] [Indexed: 11/18/2022]
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is characterized by gait instability, urinary incontinence and cognitive dysfunction. These symptoms can be relieved by cerebrospinal fluid (CSF) drainage, but the time course and nature of the improvements are poorly characterized. Attempts to prospectively identify iNPH patients responsive to CSF drainage by evaluating presenting gait quality or via extended lumbar cerebrospinal fluid drainage (eLCD) trials are common, but the reliability of such approaches is unclear. Here we combine eLCD trials with computerized quantitative gait measurements to predict shunt responsiveness in patients undergoing evaluation for possible iNPH. In this prospective cohort study, 50 patients presenting with enlarged cerebral ventricles and gait, urinary, and/or cognitive difficulties were evaluated for iNPH using a computerized gait analysis system during a 3day trial of eLCD. Gait speed, stride length, cadence, and the Timed Up and Go test were quantified before and during eLCD. Qualitative assessments of incontinence and cognition were obtained throughout the eLCD trial. Patients who improved after eLCD underwent ventriculoperitoneal shunt placement, and symptoms were reassessed serially over the next 3 to 15months. There was no significant difference in presenting gait characteristics between patients who improved after drainage and those who did not. Gait improvement was not observed until 2 or more days of continuous drainage in most cases. Symptoms improved after eLCD in 60% of patients, and all patients who improved after eLCD also improved after shunt placement. The degree of improvement after eLCD correlated closely with that observed after shunt placement.
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Affiliation(s)
- Felix Yang
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Thu-Trang Hickman
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Megan Tinl
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; Department of Rehabilitation Services, Brigham and Women's Hospital, Boston, MA, USA
| | - Christine Iracheta
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; Department of Rehabilitation Services, Brigham and Women's Hospital, Boston, MA, USA
| | - Grace Chen
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; Department of Rehabilitation Services, Brigham and Women's Hospital, Boston, MA, USA
| | - Patricia Flynn
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA; Department of Rehabilitation Services, Brigham and Women's Hospital, Boston, MA, USA
| | - Matthew E Shuman
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Tatyana A Johnson
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Rebecca R Rice
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Isaac M Rice
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Robert Wiemann
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Mark D Johnson
- Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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50
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Wade J, Alsop AT, Vertin NR, Yang H, Johnson MD, Bailey RC. Rapid, Multiplexed Phosphoprotein Profiling Using Silicon Photonic Sensor Arrays. ACS Cent Sci 2015; 1:374-382. [PMID: 26539563 PMCID: PMC4626792 DOI: 10.1021/acscentsci.5b00250] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Indexed: 05/04/2023]
Abstract
Extracellular signaling is commonly mediated through post-translational protein modifications that propagate messages from membrane-bound receptors to ultimately regulate gene expression. Signaling cascades are ubiquitously intertwined, and a full understanding of function can only be gleaned by observing dynamics across multiple key signaling nodes. Importantly, targets within signaling cascades often represent opportunities for therapeutic development or can serve as diagnostic biomarkers. Protein phosphorylation is a particularly important post-translational modification that controls many essential cellular signaling pathways. Not surprisingly, aberrant phosphorylation is found in many human diseases, including cancer, and phosphoprotein-based biomarker signatures hold unrealized promise for disease monitoring. Moreover, phosphoprotein analysis has wide-ranging applications across fundamental chemical biology, as many drug discovery efforts seek to target nodes within kinase signaling pathways. For both fundamental and translational applications, the analysis of phosphoprotein biomarker targets is limited by a reliance on labor-intensive and/or technically challenging methods, particularly when considering the simultaneous monitoring of multiplexed panels of phosphoprotein biomarkers. We have developed a technology based upon arrays of silicon photonic microring resonator sensors that fills this void, facilitating the rapid and automated analysis of multiple phosphoprotein levels from both cell lines and primary human tumor samples requiring only minimal sample preparation.
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Affiliation(s)
- James
H. Wade
- Department
of Chemistry, University of Illinois at
Urbana−Champaign, 600 South Mathews Avenue, Urbana, Illinois 61801, United
States
| | - Aurora T. Alsop
- Department
of Chemistry, University of Illinois at
Urbana−Champaign, 600 South Mathews Avenue, Urbana, Illinois 61801, United
States
| | - Nicholas R. Vertin
- Department
of Chemistry, University of Illinois at
Urbana−Champaign, 600 South Mathews Avenue, Urbana, Illinois 61801, United
States
| | - Hongwei Yang
- Department
of Neurological Surgery, Brigham and Women’s
Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Mark D. Johnson
- Department
of Neurological Surgery, Brigham and Women’s
Hospital and Harvard Medical School, Boston, Massachusetts 02115, United States
| | - Ryan C. Bailey
- Department
of Chemistry, University of Illinois at
Urbana−Champaign, 600 South Mathews Avenue, Urbana, Illinois 61801, United
States
- E-mail:
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