1
|
Young S, Sanghvi T, Ragulojan R, Torkian P, Todatry S, D'Souza D, Flanagan S, Golzarian J. Local recurrence following a complete radiologic response in hepatocellular carcinoma patients: comparison of transarterial chemoembolisation and transarterial radioembolisation. Clin Radiol 2024; 79:371-377. [PMID: 38341344 DOI: 10.1016/j.crad.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/11/2023] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
AIM To evaluate and compare the rates of local recurrence in hepatocellular carcinoma (HCC) patients who undergo selective transarterial radioembolisation (TARE) or transarterial chemoembolisation (TACE) and achieve a complete response (CR) radiologically. MATERIALS AND METHODS All patients undergoing treatment with TARE or TACE at a single academic institution were reviewed retrospectively. Those who had been treated previously, presented with multifocal disease, had non-selective TARE or TACE, or did not achieve a complete response (CR) radiologically were excluded. RESULTS In total 110 patients were included (TACE n=60 [54.5%]; TARE n=50 [45.5%]). TARE patients were older (66.4 ± 9.4 versus 61.2 ± 5.6 years, p<0.001) and had larger tumours (4.4 ± 2.2 versus 3 ± 1.4 cm, p=0.002). TACE patients were significantly more likely to suffer a local recurrence (31/60, 51.7% versus 9/50, 18%, p<0.001) and had a significantly shorter time to recurrence (median 8.3 {interquartile range [IQR]}: 12 versus median 17.9 [IQR: 23.5] months, p=0.001). A local time to progression (TTP) Kaplan-Meier curve demonstrated TACE patients had a significantly shorter local TTP (hazard ratio [HR]: 7.2; 95% confidence interval [CI]: 3.64-14.24; p<0.001) and treatment modality (TACE or TARE; HR: 0.05; 95% CI: 0.005-0.5; p=0.01) was found to be associated with local recurrences on multivariate Cox proportional HR analysis. When overall TTP was evaluated, again TACE patients were found to have a significantly shorter TTP (HR: 2.13 [1.28-3.53], p=0.004). CONCLUSION In HCC patients undergoing selective treatment who achieve a CR radiologically, those treated with TARE may be less likely to suffer recurrence, either local or general, than those treated with TACE.
Collapse
Affiliation(s)
- S Young
- Department of Radiology, University of Arizona, Division of Interventional Radiology, 1501 N Campbell Ave, PO Box 245067, Tucson, AZ 85724, USA.
| | - T Sanghvi
- Minneapolis VA Hospital, 1 Veterans Dr, Minneapolis, MN 55417, USA
| | - R Ragulojan
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - P Torkian
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - S Todatry
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - D D'Souza
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - S Flanagan
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| | - J Golzarian
- Department of Radiology, University of Minnesota, Division of Interventional Radiology, 420 Delaware St SE, MMC 292, MN 55455, USA
| |
Collapse
|
2
|
Kwok BYC, Young AS, Kong JHK, Birman CS, Flanagan S, Greenberg SL, Gibson WP, Argaet EC, Fratturo L, Pogson JM, Taylor RL, Rosengren SM, Halmagyi GM, Welgampola MS. Post Cochlear Implantation Vertigo: Ictal Nystagmus and Audiovestibular Test Characteristics. Otol Neurotol 2024; 45:65-74. [PMID: 37853785 DOI: 10.1097/mao.0000000000004037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To investigate ictal nystagmus and audiovestibular characteristics in episodic spontaneous vertigo after cochlear implantation (CI). STUDY DESIGN Retrospective and prospective case series. PATIENTS Twenty-one CI patients with episodic spontaneous vertigo after implantation were recruited. INTERVENTIONS Patient-initiated home video-oculography recordings were performed during one or more attacks of vertigo, using miniature portable home video-glasses. To assess canal and otolith function, video head-impulse tests (vHITs) and vestibular-evoked myogenic potential tests were conducted. MAIN OUTCOME MEASURES Nystagmus slow-phase velocities (SPVs), the presence of horizontal direction-changing nystagmus, and post-CI audiovestibular tests. RESULTS Main final diagnoses were post-CI secondary endolymphatic hydrops (48%) and exacerbation of existing Ménière's disease (29%). Symptomatic patients demonstrated high-velocity horizontal ictal-nystagmus (SPV, 44.2°/s and 68.2°/s in post-CI secondary endolymphatic hydrop and Ménière's disease). Direction-changing nystagmus was observed in 80 and 75%. Two were diagnosed with presumed autoimmune inner ear disease (SPV, 6.6°/s and 172.9°/s). One patient was diagnosed with probable vestibular migraine (15.1°/s).VHIT gains were 0.80 ± 0.20 (lateral), 0.70 ± 0.17 (anterior), and 0.62 ± 0.27 (posterior) in the implanted ear, with abnormal values in 33, 35, and 35% of each canal. Bone-conducted cervical and ocular vestibular-evoked myogenic potentials were asymmetric in 52 and 29% of patients (all lateralized to the implanted ear) with mean asymmetry ratios of 51.2 and 35.7%. Reversible reduction in vHIT gain was recorded in three acutely symptomatic patients. CONCLUSION High-velocity, direction-changing nystagmus time-locked with vertigo attacks may be observed in post-CI implant vertigo and may indicate endolymphatic hydrops. Fluctuating vHIT gain may be an additional marker of a recurrent peripheral vestibulopathy.
Collapse
Affiliation(s)
| | | | | | | | - Sean Flanagan
- Department of Otolaryngology, Head and Neck, and Skull Base Surgery, St Vincent's Public Hospital, Sydney
| | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Argaet EC, Kwok BYC, Bradley J, Young AS, Nham B, Calic Z, Taylor RL, Pogson JM, Reid N, Kong JHK, Flanagan S, Halmagyi GM, Rosengren SM, Welgampola MS. Subjective visual horizontal correlates better with ocular than with cervical vestibular evoked myogenic potentials. Clin Neurophysiol 2023; 152:1-10. [PMID: 37257318 DOI: 10.1016/j.clinph.2023.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 04/03/2023] [Accepted: 04/24/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To examine the relationship between widely used otolith function tests: the Subjective Visual Horizontal (SVH) and Vestibular Evoked Myogenic Potentials (VEMP). METHODS A retrospective analysis was performed on 301 patients who underwent SVH, ocular and cervical VEMP (oVEMP and cVEMP) tests on the same day. Correlations between the mean SVH tilt and amplitude asymmetry ratios for bone-conducted (BC) oVEMP and air-conducted (AC) cVEMP were examined. Diagnoses included vestibular neuritis, stroke, vestibular migraine, Meniere's disease, sudden sensorineural hearing loss (SSNHL) and vestibular schwannoma. RESULTS SVH results were concordant with the oVEMP in 64% of cases and the cVEMP in 51%. Across all patients, SVH demonstrated a significant moderate correlation with BC oVEMP amplitude asymmetry ratios (r = 0.55, p < 0.001) and a weak correlation with AC cVEMP amplitude asymmetry ratios (r = 0.35, p < 0.001). A stronger correlation between SVH and oVEMPs was observed in patients with vestibular neuritis (r = 0.67, p < 0.001) and SSNHL (r = 0.76, p = 0.001). CONCLUSIONS SVH correlates better with oVEMP than cVEMP symmetry. SIGNIFICANCE This finding reinforces the hypothesis of a common utricular origin for both SVH and oVEMPs which is distinct from the saccular origin of cVEMPs.
Collapse
Affiliation(s)
- Emma C Argaet
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia
| | - Belinda Y C Kwok
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia
| | - Justine Bradley
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia
| | - Allison S Young
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia
| | - Benjamin Nham
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia
| | - Zeljka Calic
- Department of Neurophysiology, Liverpool Hospital, Sydney, Australia.
| | - Rachael L Taylor
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.
| | - Jacob M Pogson
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.
| | - Nicole Reid
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.
| | - Jonathan H K Kong
- Department of Otolaryngology, Royal Prince Alfred Hospital, Sydney, Australia; Discipline of Surgery, Sydney Medical School, University of Sydney, Sydney, Australia; Department of Otolaryngology, Head and Neck Surgery, Macquarie University Hospital, Sydney, Australia
| | - Sean Flanagan
- Department of Otolaryngology, St Vincent's Hospital, Sydney, Australia
| | - Gabor M Halmagyi
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.
| | - Sally M Rosengren
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.
| | - Miriam S Welgampola
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia.
| |
Collapse
|
4
|
Heredia JE, Sorenson C, Flanagan S, Nunez V, Jones C, Martzall A, Leong L, Martinez AP, Scherl A, Brightbill HD, Ghilardi N, Ding N. IL-23 signaling is not an important driver of liver inflammation and fibrosis in murine non-alcoholic steatohepatitis models. PLoS One 2022; 17:e0274582. [PMID: 36107926 PMCID: PMC9477333 DOI: 10.1371/journal.pone.0274582] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/30/2022] [Indexed: 11/18/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD), represents an unmet medical need that can progress to non-alcoholic steatohepatitis (NASH), which, without intervention, can result in the development of cirrhosis and hepatocellular carcinoma (HCC). Inflammation is a pathological hallmark of NASH, and targeting key inflammatory mediators of NASH may lead to potential therapeutics for the disease. Herein, we aimed to investigate the role of IL-23 signaling in NASH progression in murine models. We showed that recombinant IL-23 can promote IL-17 producing cell expansion in the liver and that these cells are predominately γδ T cells and Mucosal Associated Invariant T cells (MAITs). Reciprocally, we found that IL-23 signaling is necessary for the expansion of γδ T cells and MAIT cells in the western diet (WD) diet induced NASH model. However, we did not observe any significant differences in liver inflammation and fibrosis between wild type and Il23r-/- mice in the same NASH model. Furthermore, we found that Il23r deletion does not impact liver inflammation and fibrosis in the choline-deficient, L-amino acid-defined and high-fat diet (CDA-HFD) induced NASH model. Based on these findings, we therefore propose that IL-23 signaling is not necessary for NASH pathogenesis in preclinical models and targeting this pathway alone may not be an effective therapeutic approach to ameliorate the disease progression in NASH patients.
Collapse
Affiliation(s)
- Jose E. Heredia
- Department of Discovery Immunology, Genentech, South San Francisco, CA, United States of America
| | - Clara Sorenson
- Department of Pathology, Genentech, South San Francisco, CA, United States of America
| | - Sean Flanagan
- Department of Pathology, Genentech, South San Francisco, CA, United States of America
| | - Victor Nunez
- Department of Pathology, Genentech, South San Francisco, CA, United States of America
| | - Charles Jones
- Department of Pathology, Genentech, South San Francisco, CA, United States of America
| | - Angela Martzall
- Department of Pathology, Genentech, South San Francisco, CA, United States of America
| | - Laurie Leong
- Department of Pathology, Genentech, South San Francisco, CA, United States of America
| | - Andres Paler Martinez
- Department of Discovery Immunology, Genentech, South San Francisco, CA, United States of America
| | - Alexis Scherl
- Department of Pathology, Genentech, South San Francisco, CA, United States of America
| | - Hans D. Brightbill
- Department of Translational Immunology, Genentech, South San Francisco, CA, United States of America
| | - Nico Ghilardi
- Department of Discovery Immunology, Genentech, South San Francisco, CA, United States of America
| | - Ning Ding
- Department of Discovery Immunology, Genentech, South San Francisco, CA, United States of America
- * E-mail:
| |
Collapse
|
5
|
Flanagan S, Young S. Abstract No. 584 Recanalization of chronically occluded portal and mesenteric veins: a non-transplant pediatric cohort. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
6
|
Young S, Sanghvi T, Ragulojan R, Torkian P, Todarty S, D’Souza D, Flanagan S, Golzarian J. Abstract No. 30 Local recurrence following complete radiologic response: a comparison of transarterial radioembolization and transarterial chemoembolization. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.111] [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: 10/18/2022] Open
|
7
|
Young S, Ragulojan R, Torkian P, Todarty S, Sanghvi T, D’Souza D, Golzarian J, Flanagan S. Abstract No. 559 Planar vs 3D: comparison of two lung shunt fraction calculation methods utilized for radioembolization. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.541] [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: 10/18/2022] Open
|
8
|
Guidi R, Xu D, Choy DF, Ramalingam TR, Lee WP, Modrusan Z, Liang Y, Marsters S, Ashkenazi A, Huynh A, Mills J, Flanagan S, Hambro S, Nunez V, Leong L, Cook A, Tran TH, Austin CD, Cao Y, Clarke C, Panettieri RA, Koziol-White C, Jester WF, Wang F, Wilson MS. Steroid-induced fibroblast growth factors drive an epithelial-mesenchymal inflammatory axis in severe asthma. Sci Transl Med 2022; 14:eabl8146. [PMID: 35442706 DOI: 10.1126/scitranslmed.abl8146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Asthma and inflammatory airway diseases restrict airflow in the lung, compromising gas exchange and lung function. Inhaled corticosteroids (ICSs) can reduce inflammation, control symptoms, and improve lung function; however, a growing number of patients with severe asthma do not benefit from ICS. Using bronchial airway epithelial brushings from patients with severe asthma or primary human cells, we delineated a corticosteroid-driven fibroblast growth factor (FGF)-dependent inflammatory axis, with FGF-responsive fibroblasts promoting downstream granulocyte colony-stimulating factor (G-CSF) production, hyaluronan secretion, and neutrophilic inflammation. Allergen challenge studies in mice demonstrate that the ICS, fluticasone propionate, inhibited type 2-driven eosinophilia but induced a concomitant increase in FGFs, G-CSF, hyaluronan, and neutrophil infiltration. We developed a model of steroid-induced neutrophilic inflammation mediated, in part, by induction of an FGF-dependent epithelial-mesenchymal axis, which may explain why some individuals do not benefit from ICS. In further proof-of-concept experiments, we found that combination therapy with pan-FGF receptor inhibitors and corticosteroids prevented both eosinophilic and steroid-induced neutrophilic inflammation. Together, these results establish FGFs as therapeutic targets for severe asthma patients who do not benefit from ICS.
Collapse
Affiliation(s)
- Riccardo Guidi
- Immunology Discovery, Genentech, South San Francisco, CA 94080, USA
| | - Daqi Xu
- Immunology Discovery, Genentech, South San Francisco, CA 94080, USA
| | - David F Choy
- Biomarker Discovery OMNI, Genentech, South San Francisco, CA 94080, USA
| | | | - Wyne P Lee
- Translational Immunology, Genentech, South San Francisco, CA 94080, USA
| | - Zora Modrusan
- Next Generation Sequencing (NGS), Genentech, South San Francisco, CA 94080, USA
| | - Yuxin Liang
- Next Generation Sequencing (NGS), Genentech, South San Francisco, CA 94080, USA
| | - Scot Marsters
- Cancer Immunology, Genentech, South San Francisco, CA 94080, USA
| | - Avi Ashkenazi
- Cancer Immunology, Genentech, South San Francisco, CA 94080, USA
| | - Alison Huynh
- Necropsy, Genentech, South San Francisco, CA 94080, USA
| | - Jessica Mills
- Necropsy, Genentech, South San Francisco, CA 94080, USA
| | - Sean Flanagan
- Necropsy, Genentech, South San Francisco, CA 94080, USA
| | | | - Victor Nunez
- Necropsy, Genentech, South San Francisco, CA 94080, USA
| | - Laurie Leong
- Pathology, Genentech, South San Francisco, CA 94080, USA
| | - Ashley Cook
- Pathology, Genentech, South San Francisco, CA 94080, USA
| | | | - Cary D Austin
- Pathology, Genentech, South San Francisco, CA 94080, USA
| | - Yi Cao
- OMNI Bioinformatics, Genentech, South San Francisco, CA 94080, USA
| | - Christine Clarke
- OMNI Bioinformatics, Genentech, South San Francisco, CA 94080, USA
| | - Reynold A Panettieri
- Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Cynthia Koziol-White
- Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - William F Jester
- Institute for Translational Medicine and Science, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Fen Wang
- Center for Cancer Biology and Nutrition, Texas A&M University, Houston, TX 77030, USA
| | - Mark S Wilson
- Immunology Discovery, Genentech, South San Francisco, CA 94080, USA
| |
Collapse
|
9
|
Hannigan IP, Rosengren SM, Young AS, Bradshaw AP, Calic Z, Kwok B, Alraddy B, Gibson WPR, Kong J, Flanagan S, Halmagyi GM, Watson SRD, Welgampola MS. A Portrait of Menière's Disease Using Contemporary Hearing and Balance Tests. Otol Neurotol 2022; 43:e489-e496. [PMID: 35085109 DOI: 10.1097/mao.0000000000003479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Menière's disease (MD) is characterized by recurrent vertigo and fluctuating aural symptoms. Diagnosis is straightforward in typical presentations, but a proportion of patients present with atypical symptoms. Our aim is to profile the array of symptoms patients may initially present with and to analyze the vestibular and audiological test results of patients with a diagnosis of MD. DESIGN A retrospective study of patient files. SETTING A tertiary, neuro-otology clinic Royal Prince Alfred Hospital, Sydney, Australia. METHOD We identified 375 patients. Their history, examination, vestibular-evoked myogenic potentials (VEMP), video head-impulse test, canal-paresis on caloric testing, subjective visual horizontal (SVH), electrocochleography, ictal nystagmus, and audiometry were assessed. RESULTS Atypical presenting symptoms were disequilibrium (n = 49), imbalance (n = 13), drop-attacks (n = 12), rocking vertigo (n = 2), and unexplained vomiting (n = 3), nonspontaneous vestibular symptoms in 21.6%, fluctuation of aural symptoms only (46%), and headaches (31.2%). Low velocity, interictal spontaneous-nystagmus in 13.3% and persistent positional-nystagmus in 12.5%. Nystagmus recorded ictally in 90 patients was mostly horizontal (93%) and of high velocity (48 ± 34°/s). Testing yielded abnormal caloric responses in 69.6% and abnormal video head impulse test 12.7%. Air-conducted cervical VEMPs were abnormal in 32.2% (mean asymmetry ratio [AR] 30.2 ± 46.5%) and bone-conducted ocular VEMPs abnormal in 8.8% (AR 11.2 ± 26.8%). Abnormal interictal SVH was in 30.6%, (ipsiversive n = 46 and contraversive n = 19). Mean pure-tone averages 50 dB ± 23.5 and 20 dB ± 13 for affected and unaffected ears. CONCLUSION Menière's disease has a distinctive history, but atypical presentations with normal vestibular function and hearing are a diagnostic challenge delaying treatment initiation.
Collapse
Affiliation(s)
- Imelda P Hannigan
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Blacktown Neurology Clinic, Blacktown, NSW, Australia
| | - Sally M Rosengren
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Allison S Young
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Andrew P Bradshaw
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Zeljka Calic
- Department of Neurophysiology, Liverpool Hospital, Liverpool, NSW, Australia
| | - Belinda Kwok
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Bashayer Alraddy
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - William P R Gibson
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Jonathan Kong
- Department of Otorhinolaryngology, Royal North Shore Hospital, NSW, Australia
| | - Sean Flanagan
- ENT Department, Saint Vincent's Hospital, Sydney, Australia
| | - G Michael Halmagyi
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | | | - Miriam S Welgampola
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| |
Collapse
|
10
|
Headland SE, Dengler HS, Xu D, Teng G, Everett C, Ratsimandresy RA, Yan D, Kang J, Ganeshan K, Nazarova EV, Gierke S, Wedeles CJ, Guidi R, DePianto DJ, Morshead KB, Huynh A, Mills J, Flanagan S, Hambro S, Nunez V, Klementowicz JE, Shi Y, Wang J, Bevers J, Ramirez-Carrozzi V, Pappu R, Abbas A, Vander Heiden J, Choy DF, Yadav R, Modrusan Z, Panettieri RA, Koziol-White C, Jester WF, Jenkins BJ, Cao Y, Clarke C, Austin C, Lafkas D, Xu M, Wolters PJ, Arron JR, West NR, Wilson MS. Oncostatin M expression induced by bacterial triggers drives airway inflammatory and mucus secretion in severe asthma. Sci Transl Med 2022; 14:eabf8188. [PMID: 35020406 DOI: 10.1126/scitranslmed.abf8188] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Sarah E Headland
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | - Hart S Dengler
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | - Daqi Xu
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | - Grace Teng
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | - Christine Everett
- Biochemical and Cellular Pharmacology, Genentech Inc., South San Francisco, CA 94080, USA
| | | | - Donghong Yan
- Translational Immunology, Genentech Inc., South San Francisco, CA 94080, USA
| | - Jing Kang
- Translational Immunology, Genentech Inc., South San Francisco, CA 94080, USA
| | - Kirthana Ganeshan
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | | | - Sarah Gierke
- Center for Advanced Light Microscopy, Genentech Inc., South San Francisco, CA 94080, USA.,Pathology, Genentech Inc., South San Francisco, CA 94080, USA
| | | | - Riccardo Guidi
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | - Daryle J DePianto
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | | | - Alison Huynh
- Necropsy, Genentech Inc., South San Francisco, CA 94080, USA
| | - Jessica Mills
- Necropsy, Genentech Inc., South San Francisco, CA 94080, USA
| | - Sean Flanagan
- Necropsy, Genentech Inc., South San Francisco, CA 94080, USA
| | - Shannon Hambro
- Necropsy, Genentech Inc., South San Francisco, CA 94080, USA
| | - Victor Nunez
- Necropsy, Genentech Inc., South San Francisco, CA 94080, USA
| | | | - Yongchang Shi
- Biochemical and Cellular Pharmacology, Genentech Inc., South San Francisco, CA 94080, USA
| | - Jianyong Wang
- Biochemical and Cellular Pharmacology, Genentech Inc., South San Francisco, CA 94080, USA
| | - Jack Bevers
- Antibody Discovery, Genentech Inc., South San Francisco, CA 94080, USA
| | | | - Rajita Pappu
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | - Alex Abbas
- OMNI Bioinformatics, Genentech Inc., South San Francisco, CA 94080, USA
| | | | - David F Choy
- Biomarker Discovery OMNI, Genentech Inc., South San Francisco, CA 94080, USA
| | - Rajbharan Yadav
- Preclinical and Translational Pharmacokinetics and Pharmacodynamics, Genentech Inc., South San Francisco, CA 94080, USA
| | - Zora Modrusan
- Molecular Biology, Genentech Inc., South San Francisco, CA 94080, USA
| | - Reynold A Panettieri
- Rutgers Institute for Translational Medicine and Science, State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Cynthia Koziol-White
- Rutgers Institute for Translational Medicine and Science, State University of New Jersey, New Brunswick, NJ 08901, USA
| | - William F Jester
- Rutgers Institute for Translational Medicine and Science, State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Brendan J Jenkins
- Centre for Innate Immunity and Infectious Diseases, Hudson Institute of Medical Research, Clayton, Victoria, Australia.,Department of Molecular Translational Science, Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Victoria 3800, Australia
| | - Yi Cao
- OMNI Bioinformatics, Genentech Inc., South San Francisco, CA 94080, USA
| | - Christine Clarke
- OMNI Bioinformatics, Genentech Inc., South San Francisco, CA 94080, USA
| | - Cary Austin
- Pathology, Genentech Inc., South San Francisco, CA 94080, USA
| | - Daniel Lafkas
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | - Min Xu
- Translational Immunology, Genentech Inc., South San Francisco, CA 94080, USA
| | - Paul J Wolters
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94110, USA
| | - Joseph R Arron
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| | - Nathaniel R West
- Cancer Immunology Discovery, Genentech Inc., South San Francisco, CA 94080, USA
| | - Mark S Wilson
- Immunology Discovery,Genentech Inc., South San Francisco, CA 94080, USA
| |
Collapse
|
11
|
Nunez V, Cook A, Havnar C, Flanagan S, Ge N, Martzall A, Taylor RE, Lu M, Mayba O, Foreman O. Tissue cryopreservation using the 3M™ Novec™ 7000 freezing coolant offers a comparable and safe alternative to customary coolants. J Histotechnol 2021; 45:85-91. [PMID: 34787535 DOI: 10.1080/01478885.2021.1993528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cryopreserving tissues for histology requires the use of coolants to buffer the sample from liquid nitrogen (LN2) and to control the rate of temperature decline. Several coolants sharing similar physical characteristics are available on the market; however, commonly used coolants are variably flammable and/or toxic and pose risks to personnel and facilities. The purpose of this study was to compare the performance of three commercially available coolants: hexane, 2-methylbutane (2 M), and 1-methoxyheptafluoropropane (N7000). Fresh mouse tissues were frozen by each method, for their ability to preserve microscopic architecture and to protect RNA from degradation were evaluated and compared to tissue characteristics obtained by direct immersion in LN2. Our results show that for most tissues, the N7000 freezing coolant provides equal or improved preservation of microscopic architecture. While snap-freezing tissues in LN2 provides superior RNA protection, no significant differences in RNA quality were seen between tissues frozen in hexane, 2 M, and N7000.
Collapse
Affiliation(s)
- Victor Nunez
- Department of Research Pathology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Ashley Cook
- Department of Research Pathology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Charles Havnar
- Department of Research Pathology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Sean Flanagan
- Department of Research Pathology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Nianfeng Ge
- Department of Research Pathology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Angela Martzall
- Department of Research Pathology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Robin E Taylor
- Department of Research Pathology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Millicent Lu
- Department of gRED Animal Resources, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Oleg Mayba
- Department of Bioinformatics and Computational Biology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - Oded Foreman
- Department of Research Pathology, Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| |
Collapse
|
12
|
Moran P, Young S, Pontolillo J, Chen T, Sharma P, Owen J, Golzarian J, Flanagan S, D’Souza D, Sanghvi T. Abstract No. 153 Neutrophil-to-lymphocyte ratio may predict survival and radiologic response in those undergoing radioembolization for hepatocellular carcinoma. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.159] [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: 10/21/2022] Open
|
13
|
Pontolillo J, Young S, Sharma P, Chen T, Moran P, Owen J, Golzarian J, D’Souza D, Flanagan S, Sanghvi T. Abstract No. 168 Platelet-to-lymphocyte ratio: utility in metastatic colorectal patients undergoing radioembolization. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.174] [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: 11/17/2022] Open
|
14
|
Young S, Flanagan S, D’Souza D, Golzarian J, Pontolillo J, Chen T, Sharma P, Owen J, Moran P, Sanghvi T. Abstract No. 445 Dose distribution in radioembolization: a comparison between glass and resin microspheres. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.254] [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: 10/21/2022] Open
|
15
|
Sharma P, Young S, Chen T, Pontolillo J, Moran P, Owen J, Golzarian J, D’Souza D, Flanagan S, Sanghvi T. Abstract No. 38 Novel composite score of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and aspartate-aminotransferase-lymphocyte ratio predicts overall survival in metastatic colorectal patients undergoing radioembolization. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
16
|
Sharma P, Young S, Pontolillo J, Chen T, Moran P, Owen J, D’Souza D, Golzarian J, Flanagan S, Sanghvi T. Abstract No. 35 Platelet-to-lymphocyte ratio: evaluation of relevancy in hepatocellular carcinoma patients undergoing radioembolization. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.451] [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: 11/27/2022] Open
|
17
|
Spano A, Young S, Flanagan S. Abstract No. 523 Pre-operative Botox injection for ventral hernia repair: early experience at a single institution. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.332] [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: 10/21/2022] Open
|
18
|
Ulrich IP, Lugo B, Hughes P, Doucette L, Creith BB, Flanagan S, Gilmer B. Access to clinical pharmacy services in a pharmacist-physician covisit model. Res Social Adm Pharm 2020; 17:1321-1326. [PMID: 33153913 DOI: 10.1016/j.sapharm.2020.10.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND A pharmacist-physician covisit model in which patients see both a pharmacist and physician on the same day was established in a primary care practice. Previously, patients were seen in a referrals-based model in which providers referred patients for clinical pharmacy services on a different day. OBJECTIVE To assess access to clinical pharmacy services in a pharmacist-physician covisit model compared to a referrals-based model. METHODS A retrospective chart review was completed for patients who were seen by physicians on pre-specified half-days of clinic before and after implementation of the covisit model. Covisit model half-days between June 29, 2018 and September 30, 2018 and matched half-days from 2015 were included. Charts were reviewed to determine if patients scheduled to see the physician would benefit from clinical pharmacy services, including being seen for chronic disease management, eligible for a Medicare Annual Wellness Visit (AWV), prescribed medications that required counseling, had an adverse medication-related event, or had adherence concerns. Those eligible for clinical pharmacy services were further reviewed to determine if the patient interacted with a pharmacist within three months of their visit. RESULTS Prior to implementation of the covisit model, 123 patient visits were completed on the pre-specified half-days. Of these, 61 patients (49.6%) were deemed eligible for clinical pharmacy services. In the covisit model, 149 patients were seen by the physician, of which 69 patients (46%) were eligible for clinical pharmacy services. More patients in the covisit cohort went on to interact with a pharmacist (56 patients, 81% vs. 10 patients, 16%, adjusted OR = 32.98, 95% CI [8.89-122.39]). The most common reasons patients were identified for clinical pharmacy services were eligibility for AWV, hypertension, and diabetes. CONCLUSIONS A pharmacist-physician covisit model significantly increased accessibility to clinical pharmacy services compared to a referrals-based model.
Collapse
Affiliation(s)
- Irene Park Ulrich
- Mountain Area Health Education Center; UNC Eshelman School of Pharmacy; UNC School of Medicine; 123 Hendersonville Road, Asheville, NC, 28803, USA.
| | - Brunilda Lugo
- UNC Health Sciences at the Mountain Area Health Education Center, USA.
| | - Phillip Hughes
- UNC Health Sciences at the Mountain Area Health Education Center, USA.
| | - Lorna Doucette
- UNC Eshelman School of Pharmacy, UNC Gillings School of Global Public Health, USA.
| | | | | | - Benjamin Gilmer
- Family Medicine Faculty Physician, Mountain Area Health Education Center, UNC School of Medicine, USA.
| |
Collapse
|
19
|
Berman Z, Fischman A, Young L, Flanagan S, Katz M, Diiulio M, Kuban J, Golzarian J, Rose S. Abstract No. 390 Feasibility, safety, and efficacy of in-line balloon occlusion assisted delivery of ethylene-vinyl alcohol copolymer (Onyx) for peripheral arterial applications: a multicenter case series. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.451] [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: 11/16/2022] Open
|
20
|
Pogson JM, Taylor RL, McGarvie LA, Bradshaw AP, D’Souza M, Flanagan S, Kong J, Halmagyi GM, Welgampola MS. Head impulse compensatory saccades: Visual dependence is most evident in bilateral vestibular loss. PLoS One 2020; 15:e0227406. [PMID: 31940394 PMCID: PMC6961882 DOI: 10.1371/journal.pone.0227406] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 12/18/2019] [Indexed: 11/19/2022] Open
Abstract
The normal vestibulo-ocular reflex (VOR) generates almost perfectly compensatory smooth eye movements during a 'head-impulse' rotation. An imperfect VOR gain provokes additional compensatory saccades to re-acquire an earth-fixed target. In the present study, we investigated vestibular and visual contributions on saccade production. Eye position and velocity during horizontal and vertical canal-plane head-impulses were recorded in the light and dark from 16 controls, 22 subjects after complete surgical unilateral vestibular deafferentation (UVD), eight subjects with idiopathic bilateral vestibular loss (BVL), and one subject after complete bilateral vestibular deafferentation (BVD). When impulses were delivered in the horizontal-canal plane, in complete darkness compared with light, first saccade frequency mean(SEM) reduced from 96.6(1.3)-62.3(8.9) % in BVL but only 98.3(0.6)-92.0(2.3) % in UVD; saccade amplitudes reduced from 7.0(0.5)-3.6(0.4) ° in BVL but were unchanged 6.2(0.3)-5.5(0.6) ° in UVD. In the dark, saccade latencies were prolonged in lesioned ears, from 168(8.4)-240(24.5) ms in BVL and 177(5.2)-196(5.7) ms in UVD; saccades became less clustered. In BVD, saccades were not completely abolished in the dark, but their amplitudes decreased from 7.3-3.0 ° and latencies became more variable. For unlesioned ears (controls and unlesioned ears of UVD), saccade frequency also reduced in the dark, but their small amplitudes slightly increased, while latency and clustering remained unchanged. First and second saccade frequencies were 75.3(4.5) % and 20.3(4.1) %; without visual fixation they dropped to 32.2(5.0) % and 3.8(1.2) %. The VOR gain was affected by vision only in unlesioned ears of UVD; gains for the horizontal-plane rose slightly, and the vertical-planes reduced slightly. All head-impulse compensatory saccades have a visual contribution, the magnitude of which depends on the symmetry of vestibular-function and saccade latency: BVL is more profoundly affected by vision than UVD, and second saccades more than first saccades. Saccades after UVD are probably triggered by contralateral vestibular function.
Collapse
Affiliation(s)
- Jacob M. Pogson
- Royal Prince Alfred Hospital, Institute of Clinical Neuroscience, Camperdown, New South Wales, Australia
- Faculty of Health and Medicine, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Rachael L. Taylor
- Royal Prince Alfred Hospital, Institute of Clinical Neuroscience, Camperdown, New South Wales, Australia
- Faculty of Health and Medicine, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Leigh A. McGarvie
- Royal Prince Alfred Hospital, Institute of Clinical Neuroscience, Camperdown, New South Wales, Australia
- Department of Psychology, Faculty of Science, The University of Sydney, Camperdown, New South Wales, Australia
| | - Andrew P. Bradshaw
- Royal Prince Alfred Hospital, Institute of Clinical Neuroscience, Camperdown, New South Wales, Australia
| | - Mario D’Souza
- Department of Clinical Research, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Sean Flanagan
- Otolaryngology, Head and Neck and Skull Base Surgery, St Vincent’s Hospital, Darlinghurst, New South Wales, Australia
- Faculty of Medicine, University of NSW, Kensington, New South Wales, Australia
| | - Jonathan Kong
- Faculty of Health and Medicine, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
- Department of Neurosurgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Department of Otolaryngology, Head & Neck Surgery, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - G. Michael Halmagyi
- Royal Prince Alfred Hospital, Institute of Clinical Neuroscience, Camperdown, New South Wales, Australia
- Faculty of Health and Medicine, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| | - Miriam S. Welgampola
- Royal Prince Alfred Hospital, Institute of Clinical Neuroscience, Camperdown, New South Wales, Australia
- Faculty of Health and Medicine, Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
| |
Collapse
|
21
|
Young S, Taylor A, Golzarian J, Flanagan S, D'Souza D, Sanghvi T. Clinical utility of one month imaging following selective internal radiation therapy. Diagn Interv Imaging 2019; 100:39-46. [DOI: 10.1016/j.diii.2018.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/21/2018] [Accepted: 07/06/2018] [Indexed: 01/15/2023]
|
22
|
Grover H, Qian Y, Boada FE, Lakshmanan K, Flanagan S, Lui YW. MRI Evidence of Altered Callosal Sodium in Mild Traumatic Brain Injury. AJNR Am J Neuroradiol 2018; 39:2200-2204. [PMID: 30498019 DOI: 10.3174/ajnr.a5903] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 09/27/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND AND PURPOSE Mild traumatic brain injury is a leading cause of death and disability worldwide with 42 million cases reported annually, increasing the need to understand the underlying pathophysiology because this could help guide the development of targeted therapy. White matter, particularly the corpus callosum, is susceptible to injury. Animal models suggest stretch-induced mechanoporation of the axonal membrane resulting in ionic shifts and altered sodium ion distribution. The purpose of this study was to compare the distribution of total sodium concentration in the corpus callosum between patients with mild traumatic brain injury and controls using sodium (23Na) MR imaging. MATERIALS AND METHODS Eleven patients with a history of mild traumatic brain injury and 10 age- and sex-matched controls underwent sodium (23Na) MR imaging using a 3T scanner. Total sodium concentration was measured in the genu, body, and splenium of the corpus callosum with 5-mm ROIs; total sodium concentration of the genu-to-splenium ratio was calculated and compared between patients and controls. RESULTS Higher total sodium concentration in the genu (49.28 versus 43.29 mmol/L, P = .01) and lower total sodium concentration in the splenium (which was not statistically significant; 38.35 versus 44.06 mmol/L, P = .08) was seen in patients with mild traumatic brain injury compared with controls. The ratio of genu total sodium concentration to splenium total sodium concentration was also higher in patients with mild traumatic brain injury (1.3 versus 1.01, P = .001). CONCLUSIONS Complex differences are seen in callosal total sodium concentration in symptomatic patients with mild traumatic brain injury, supporting the notion of ionic dysfunction in the pathogenesis of mild traumatic brain injury. The total sodium concentration appears to be altered beyond the immediate postinjury phase, and further work is needed to understand the relationship to persistent symptoms and outcome.
Collapse
Affiliation(s)
- H Grover
- From the New York University Langone Medical Center, New York, New York
| | - Y Qian
- From the New York University Langone Medical Center, New York, New York
| | - F E Boada
- From the New York University Langone Medical Center, New York, New York
| | - K Lakshmanan
- From the New York University Langone Medical Center, New York, New York
| | - S Flanagan
- From the New York University Langone Medical Center, New York, New York
| | - Y W Lui
- From the New York University Langone Medical Center, New York, New York.
| |
Collapse
|
23
|
Flanagan S, Anthony J, Dyson L, Page N, Williams M, Brady P. VETERAN-CENTRIC VD-HCBS: HOW VETERANS USE FLEXIBLE SPENDING BUDGETS TO MEET INDEPENDENT LIVING GOALS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
24
|
Ohtsuki M, Flanagan S, Freedberg IM, Blumenberg M. A cluster of five nuclear proteins regulates keratin gene transcription. Gene Expr 2018; 3:201-13. [PMID: 7505672 PMCID: PMC6081630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A common feature of all epithelial cells is the presence of keratin proteins that assemble into an intermediate filament cytoskeletal network. Whereas other cell types often use a specific master transcription factor to coordinate cell type-specific transcription, analysis of transcriptional regulation of keratin genes suggests that specific groupings of widely expressed transcription factors, acting on clusters of recognition elements in the promoter regions, confer epithelia-specific transcription. We define such a cluster of three sites that binds five transcription factors in the human K5 keratin gene. Within this cluster, an unusual Sp1 site binds the Sp1 transcription factor and two additional proteins. Flanking the Sp1 site are an AP2 site and another sequence, Site A; each binds a transcription factor. Similar clusters of recognition sites for the same five transcription factors have been also identified in other keratin genes. Such clusters may play a role in epithelia-specific expression of keratins.
Collapse
Affiliation(s)
- M Ohtsuki
- Ronald O. Perelman Department of Dermatology, New York University Medical Center, NY 10016
| | | | | | | |
Collapse
|
25
|
Flanagan S, Feng A, Young S, Hunter D. 3:27 PM Abstract No. 364 Recanalization of chronic visceral venous occlusions. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
26
|
Chen MZ, Chang JC, Zavala-Solorio J, Kates L, Thai M, Ogasawara A, Bai X, Flanagan S, Nunez V, Phamluong K, Ziai J, Newman R, Warming S, Kolumam G, Sonoda J. FGF21 mimetic antibody stimulates UCP1-independent brown fat thermogenesis via FGFR1/βKlotho complex in non-adipocytes. Mol Metab 2017; 6:1454-1467. [PMID: 29107292 PMCID: PMC5681280 DOI: 10.1016/j.molmet.2017.09.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 09/08/2017] [Accepted: 09/12/2017] [Indexed: 02/06/2023] Open
Abstract
Objective Fibroblast Growth Factor 21 (FGF21) is a potent stimulator of brown fat thermogenesis that improves insulin sensitivity, ameliorates hepatosteatosis, and induces weight loss by engaging the receptor complex comprised of Fibroblast Growth Factor Receptor 1 (FGFR1) and the requisite coreceptor βKlotho. Previously, recombinant antibody proteins that activate the FGFR1/βKlotho complex were proposed to act as an FGF21-mimetic; however, in vivo action of these engineered proteins has not been well studied. Methods We investigated the mechanism by which anti-FGFR1/βKlotho bispecific antibody (bFKB1) stimulates thermogenesis in UCP1-expressing brown adipocytes using genetically engineered mice. Anti-FGFR1 agonist antibody was also used to achieve brown adipose tissue restricted activation in transgenic mice. Results Studies with global Ucp1-deficient mice and adipose-specific Fgfr1 deficient mice demonstrated that bFKB1 acts on targets distal to adipocytes and indirectly stimulates brown adipose thermogenesis in a UCP1-independent manner. Using a newly developed transgenic system, we also show that brown adipose tissue restricted activation of a transgenic FGFR1 expressed under the control of Ucp1 promoter does not stimulate energy expenditure. Finally, consistent with its action as a FGF21 mimetic, bFBK1 suppresses intake of saccharin-containing food and alcohol containing water in mice. Conclusions Collectively, we propose that FGFR1/βKlotho targeted therapy indeed mimics the action of FGF21 in vivo and stimulates UCP1-independent brown fat thermogenesis through receptors outside of adipocytes and likely in the nervous system. Anti-FGFR1/βKlotho bispecific antibody stimulates energy expenditure in Ucp1-deficient mice. Anti-FGFR1/βKlotho bispecific antibody stimulates energy expenditure in adipocyte-selective Fgfr1-deficient mice. Brown adipocyte restricted activation of transgenic FGFR1 does not stimulate energy expenditure. Anti-FGFR1/βKlotho bispecific antibody mimics FGF21, inducing sweet and alcohol aversion.
Collapse
Affiliation(s)
- Mark Z Chen
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA
| | - Joshua C Chang
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA
| | | | - Lance Kates
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA
| | - Minh Thai
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA
| | - Annie Ogasawara
- Biomedical Imaging, Genentech Inc., South San Francisco, CA, USA
| | - Xiaobo Bai
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA
| | - Sean Flanagan
- Pathology, Genentech Inc., South San Francisco, CA, USA
| | - Victor Nunez
- Pathology, Genentech Inc., South San Francisco, CA, USA
| | | | - James Ziai
- Pathology, Genentech Inc., South San Francisco, CA, USA
| | - Robert Newman
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA
| | - Søren Warming
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA
| | - Ganesh Kolumam
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA
| | - Junichiro Sonoda
- Molecular Biology, Genentech Inc., South San Francisco, CA, USA.
| |
Collapse
|
27
|
Young S, Golzarian J, Flanagan S, Sanghvi T. Is 1-month treatment imaging of benefit in yttrium-90 therapy. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1122] [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: 11/16/2022] Open
|
28
|
Abstract
While existing literature suggests that professional students (e.g., medical, dental, law, nursing, etc.) experience high levels of stress and depression, the experiences of veterinary medical students have been less well examined. The purpose of this study was to explore the levels of stress and depression among veterinary medical students and to examine the relationship between these variables. Study participants were 1,245 veterinary medical students from North America. The findings provide support for the assertion that veterinary medical students experience high levels of stress and depression. Results also indicated that there is a correlation between stress and depression for veterinary medical students and that female students experience higher levels of stress and depression than their male counterparts.
Collapse
|
29
|
Orkin C, Flanagan S, Wallis E, Ireland G, Dhairyawan R, Fox J, Nandwani R, O'Connell R, Lascar M, Bulman J, Reeves I, Palfreeman A, Foster GR, Ahmad K, Anderson J, Tong CYW, Lattimore S. Incorporating HIV/hepatitis B virus/hepatitis C virus combined testing into routine blood tests in nine UK Emergency Departments: the "Going Viral" campaign. HIV Med 2016; 17:222-30. [PMID: 26919291 DOI: 10.1111/hiv.12364] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Routine HIV screening is recommended in those UK hospitals and primary care settings where the HIV prevalence is > 0.2%. For hepatitis B virus (HBV) and hepatitis C virus (HCV), however, testing is targeted at at-risk groups. We investigated the prevalence of these blood-borne viruses (BBVs) during a routine testing pilot in UK Emergency Departments (EDs). METHODS During the "Going Viral" campaign (13-19 October 2014), nine UK EDs in areas of high HIV prevalence offered routine tests for HIV, HBV and HCV to adults having blood taken as part of routine care. Patients who tested positive were linked to care. RESULTS A total of 7807 patients had blood taken during their ED visit; of these, 2118 (27%) were tested for BBVs (range 9-65%). Seventy-one BBV tests were positive (3.4%) with 32 (45.1%) new diagnoses. There were 39 HCV infections (15 newly diagnosed), 17 HIV infections (six newly diagnosed), and 15 HBV infections (11 newly diagnosed). Those aged 25-54 years had the highest prevalence: 2.46% for HCV, 1.36% for HIV and 1.09% for HBV. Assuming the cost per diagnosis is £7, the cost per new case detected would be £988 for HCV, £1351 for HBV and £2478 for HIV. CONCLUSIONS In the first study in the UK to report prospectively on BBV prevalence in the ED, we identified a high number of new viral hepatitis diagnoses, especially hepatitis C, in addition to the HIV diagnoses. Testing for HIV alone would have missed 54 viral hepatitis diagnoses (26 new), supporting further evaluation of routine BBV testing in UK EDs.
Collapse
Affiliation(s)
- C Orkin
- Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - S Flanagan
- Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - E Wallis
- Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK
| | | | - R Dhairyawan
- Sexual Health Department, Barking, Havering and Redbridge NHS Trust, London, UK
| | - J Fox
- Sexual Health Department, Kings College Hospital, London, UK
| | - R Nandwani
- Sexual Health Department, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - R O'Connell
- Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - M Lascar
- Ambrose King Centre, Barts Health NHS Trust, Royal London Hospital, London, UK
| | - J Bulman
- Sexual Health Department, Leeds Teaching Hospital, Leeds, UK
| | - I Reeves
- Sexual Health Department, Homerton University Hospital, London, UK
| | - A Palfreeman
- Sexual Health Department, University Hospital of Leicester NHS Trust, Leicester, UK
| | - G R Foster
- Hepatology Department, Queen Mary University London, London, UK
| | - K Ahmad
- Emergency Department, Barts Health NHS Trust, Royal London Hospital, London, UK
| | | | - C Y W Tong
- Virology Department, Barts Health NHS Trust, Royal London Hospital, London, UK
| | | |
Collapse
|
30
|
Nurlaela E, Wang H, Shinagawa T, Flanagan S, Ould-Chikh S, Qureshi M, Mics Z, Sautet P, Le Bahers T, Cánovas E, Bonn M, Takanabe K. Enhanced Kinetics of Hole Transfer and Electrocatalysis during Photocatalytic Oxygen Evolution by Cocatalyst Tuning. ACS Catal 2016. [DOI: 10.1021/acscatal.6b00508] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Ela Nurlaela
- Division
of Physical Sciences and Engineering, KAUST Catalysis Center (KCC), King Abdullah University of Science and Technology (KAUST), 4700 KAUST, Thuwal 23955-6900, Saudi Arabia
| | - Hai Wang
- Department
of Molecular Spectroscopy, Max Planck Institute for Polymer Research, Ackermannweg 10, 55128 Mainz, Germany
- Graduate
School of Material Science in Mainz, University of Mainz, Staudingerweg
9, 55128 Mainz, Germany
| | - Tatsuya Shinagawa
- Division
of Physical Sciences and Engineering, KAUST Catalysis Center (KCC), King Abdullah University of Science and Technology (KAUST), 4700 KAUST, Thuwal 23955-6900, Saudi Arabia
| | - Sean Flanagan
- Division
of Physical Sciences and Engineering, KAUST Catalysis Center (KCC), King Abdullah University of Science and Technology (KAUST), 4700 KAUST, Thuwal 23955-6900, Saudi Arabia
| | - Samy Ould-Chikh
- Division
of Physical Sciences and Engineering, KAUST Catalysis Center (KCC), King Abdullah University of Science and Technology (KAUST), 4700 KAUST, Thuwal 23955-6900, Saudi Arabia
| | - Muhammad Qureshi
- Division
of Physical Sciences and Engineering, KAUST Catalysis Center (KCC), King Abdullah University of Science and Technology (KAUST), 4700 KAUST, Thuwal 23955-6900, Saudi Arabia
| | - Zoltán Mics
- Department
of Molecular Spectroscopy, Max Planck Institute for Polymer Research, Ackermannweg 10, 55128 Mainz, Germany
| | - Philippe Sautet
- Université de Lyon, Université Claude Bernard Lyon 1, ENS Lyon, Centre Nationale de Recherche Scientifique, 46 allée d’Italie, 69007 Lyon Cedex 07, France
| | - Tangui Le Bahers
- Université de Lyon, Université Claude Bernard Lyon 1, ENS Lyon, Centre Nationale de Recherche Scientifique, 46 allée d’Italie, 69007 Lyon Cedex 07, France
| | - Enrique Cánovas
- Department
of Molecular Spectroscopy, Max Planck Institute for Polymer Research, Ackermannweg 10, 55128 Mainz, Germany
| | - Mischa Bonn
- Department
of Molecular Spectroscopy, Max Planck Institute for Polymer Research, Ackermannweg 10, 55128 Mainz, Germany
| | - Kazuhiro Takanabe
- Division
of Physical Sciences and Engineering, KAUST Catalysis Center (KCC), King Abdullah University of Science and Technology (KAUST), 4700 KAUST, Thuwal 23955-6900, Saudi Arabia
| |
Collapse
|
31
|
Flanagan S, Hunter D, Alper S. Use of Onyx in the treatment of peripheral arteriovenous malformations (AVMs). J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.523] [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: 10/22/2022] Open
|
32
|
Perry MEO, Taylor GP, Sabin CA, Conway K, Flanagan S, Dwyer E, Stevenson J, Mulka L, McKendry A, Williams E, Barbour A, Dermont S, Roedling S, Shah R, Anderson J, Rodgers M, Wood C, Sarner L, Hay P, Hawkins D, deRuiter A. Lopinavir and atazanavir in pregnancy: comparable infant outcomes, virological efficacies and preterm delivery rates. HIV Med 2015. [PMID: 26200570 DOI: 10.1111/hiv.12277] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the study was to identify differences in infant outcomes, virological efficacy, and preterm delivery (PTD) outcome between women exposed to lopinavir/ritonavir (LPV/r) and those exposed to atazanavir/ritonavir (ATV/r). METHODS A retrospective case note review was carried out. The case notes of 493 women who conceived while on LPV/r or ATV/r or initiated LPV/r or ATV/r during pregnancy and who delivered between 1 September 2007 and 30 August 2012 were reviewed. Data collected included demographics, antiretroviral use, HIV markers, and pregnancy and infant outcomes. Infant outcomes, virological efficacies and PTD rates for LPV/r and ATV/r were compared. RESULTS A total of 306 women received LPV/r (82 conceiving while on the drug and 224 commencing it post-conception) and 187 received ATV/r (96 conceiving while on the drug and 91 commencing it post-conception). Comparing the two protease inhibitors (PIs), viral suppression rates were similar and, in women starting antiretroviral therapy (ART) post-conception, the median times to first undetectable HIV viral load were not significantly different (P = 0.64). PTD rates did not differ by therapy overall (ATV/r, 13%; LPV/r, 14%) or when considering the timing of first exposure (conceiving on ART, P = 0.81; commencing ART in pregnancy, P = 0.08). Poor fetal outcomes were very uncommon. There were two transmissions, giving a mother-to-child transmission (MTCT) rate of 0.4% (95% confidence interval 0.05-1.5%). CONCLUSIONS Both ART regimens were well tolerated and successful in preventing MTCT. No significant differences in tolerability or in pregnancy or infant outcomes were observed, which supports the provision of a choice of PI in pregnancy.
Collapse
Affiliation(s)
- M E O Perry
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - G P Taylor
- Imperial College Healthcare NHS Trust, London, UK
| | - C A Sabin
- Research Department of Infection and Population Health, University College London, London, UK
| | - K Conway
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Flanagan
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - E Dwyer
- Croydon University Hospital NHS Trust, London, UK
| | - J Stevenson
- Croydon University Hospital NHS Trust, London, UK
| | - L Mulka
- Imperial College Healthcare NHS Trust, London, UK
| | - A McKendry
- The North Middlesex University Hospital NHS Trust, London, UK
| | | | | | - S Dermont
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - S Roedling
- (Mortimer Market Centre) Central and North West London NHS Foundation Trust, London, UK
| | - R Shah
- Barnet and Chase Farm Hospital NHS Trust, London, UK
| | - J Anderson
- Homerton University Hospital NHS Foundation Trust, London, UK
| | - M Rodgers
- Croydon University Hospital NHS Trust, London, UK
| | - C Wood
- The North Middlesex University Hospital NHS Trust, London, UK
| | - L Sarner
- Barts Health NHS Trust, London, UK
| | - P Hay
- St George's NHS Trust, London, UK
| | - D Hawkins
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - A deRuiter
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
33
|
Taylor RL, Kong J, Flanagan S, Pogson J, Croxson G, Pohl D, Welgampola MS. Prevalence of vestibular dysfunction in patients with vestibular schwannoma using video head-impulses and vestibular-evoked potentials. J Neurol 2015; 262:1228-37. [PMID: 25794859 DOI: 10.1007/s00415-015-7697-4] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 02/27/2015] [Accepted: 03/01/2015] [Indexed: 11/30/2022]
Abstract
We sought to investigate the utility of new non-invasive tests of semicircular-canal and otolith function that are usable in the neuro-otology office practice in patients with vestibular schwannoma. Fifty patients with vestibular schwannoma were assessed using a 5-item battery consisting of air-conducted cervical- and bone conducted ocular-vestibular-evoked myogenic potentials (AC cVEMPs and BC oVEMPs) and video head impulse testing (vHIT) in all three canal planes. VEMP asymmetry ratios, latencies, and vHIT gains were used to determine the test sensitivity, relationship with tumour size and the pattern of vestibular nerve involvement. The percentage of abnormalities for each of the five tests for the entire sample ranged between 36.2-61.7%. In 58.3 % of patients, test abnormalities were referable to both superior and inferior vestibular nerve divisions. Selective inferior nerve dysfunction was identified in 10.4% and superior nerve dysfunction in 12.5%. The remaining 18.8% of patients demonstrated a normal test profile. The sensitivity of the 5-item battery increased with tumour size and all patients with medium to large (>14 mm) schwannoma had at least two abnormal vestibular test result. Our results indicate that dysfunction of the superior and inferior vestibular nerve evolves in parallel for most patients with schwannoma. Unexplained vHIT and VEMP asymmetry should alert otologists and neurologists to undertake imaging in patients presenting with non-specific disequilibrium or vertigo.
Collapse
Affiliation(s)
- Rachael L Taylor
- Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Sydney, Australia
| | | | | | | | | | | | | |
Collapse
|
34
|
Kyaw Tun J, Khwaja S, Flanagan S, Fotheringham T, Low D. Current practice of periprocedural haematological management for patients undergoing image-guided procedures. Br J Radiol 2015; 88:20140778. [PMID: 25587917 DOI: 10.1259/bjr.20140778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate current UK practice of periprocedural haematological management for image-guided procedures in relation to Cardiovascular and Interventional Radiological Society guidelines, which provide recommendations according to bleeding risk of procedures from Category 1 (lowest) to 3 (highest). METHODS Survey of practice in UK radiology departments conducted over a 1-year period RESULTS 48 radiology departments responded. The percentage of departments that stop antithrombotics pre-procedurally are as follows (for Category 1, 2 and 3, respectively): aspirin (31.3%, 43.8%, 54.2%); clopidogrel (54.2%, 68.8%, 72.9%); therapeutic low-molecular-weight heparin (56.3%, 77.1%, 75.0%). The percentage of departments that perform pre-procedural laboratory testing are as follows (for Category 1, 2 and 3, respectively): international normalized ratio (INR; 81.3%, 95.8%, 93.8%); activated partial thrombin time ratio (APTTR; 60.4%, 75.0%, 93.8%); platelet (77.1%, 91.7%, 95.7%); haemoglobin (70.8%, 85.4%, 87.5%). Mean threshold (standard deviation) of laboratory results for conducting procedures (Level 1, 2 and 3, respectively) are as follows: INR [1.53 (0.197), 1.47 (0.186), 1.47 (0.188)]; APTTR [1.50 (0.392), 1.50 (0.339), 1.48 (0.344)]; platelet count (x10(3) cells per microlitre) [74.4 (28.7), 79.9 (29.1), 80.5 (29.3)]; haemoglobin (grams per decilitre) [9.05 (1.40), 9.00 (1.33), 8.92 (1.21)]. No department practices conformed to current recommendations for (1) pre-procedural cessation of antithrombotics and (2) pre-procedural laboratory testing. Two (4.2%) department practices conformed to recommendations for thresholds of haematological parameters. CONCLUSION Current peri-procedural haematological management is variable and often does not conform to existing recommendations. Further research into the impact of this variation in practice on patient outcome is required. ADVANCES IN KNOWLEDGE This study demonstrates wide variation in practice in haematological management for image-guided procedures.
Collapse
Affiliation(s)
- J Kyaw Tun
- 1 Department of Diagnostic Imaging, Barts Health NHS Trust, London, UK
| | | | | | | | | |
Collapse
|
35
|
Kennedy G, Osborn J, Flanagan S, Alsayed N, Bertolami S. Stability of crushed tedizolid phosphate tablets for nasogastric tube administration. Crit Care 2015. [PMCID: PMC4472820 DOI: 10.1186/cc14194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
36
|
Flanagan S, Kennedy N, Kelly G. AB1187-HPR Rheumatologist and Rheumatology Health Care Professionals' Current Practice and Beliefs around Physical Activity Promotion in Rheumatoid Arthritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3296] [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: 11/04/2022]
|
37
|
Wright JC, Greenwald M, Stillerman J, Abla G, Chanthavong B, Flanagan S, Schissel D, Lee X, Romosan A, Shoshani A. The MPO API: A tool for recording scientific workflows. Fusion Engineering and Design 2014. [DOI: 10.1016/j.fusengdes.2014.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
38
|
Sanna M, Piazza P, Shin SH, Flanagan S, Mancini F. Microsurgery of Skull Base Paraganglioma. Ann R Coll Surg Engl 2014. [DOI: 10.1308/rcsann.2014.96.1.84a] [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: 11/22/2022] Open
|
39
|
Flanagan S. Atheism: The Infinite Absurdity. Chest 2014. [DOI: 10.5840/chesterton2014401/243] [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: 11/30/2022] Open
|
40
|
Yan Y, Kizilay E, Seeman D, Flanagan S, Dubin PL, Bovetto L, Donato L, Schmitt C. Heteroprotein complex coacervation: bovine β-lactoglobulin and lactoferrin. Langmuir 2013; 29:15614-15623. [PMID: 24164315 DOI: 10.1021/la4027464] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Lactoferrin (LF) and β-lactoglobulin (BLG), strongly basic and weakly acidic bovine milk proteins, form optically clear coacervates under highly limited conditions of pH, ionic strength I, total protein concentration C(P), and BLG:LF stoichiometry. At 1:1 weight ratio, the coacervate composition has the same stoichiometry as its supernatant, which along with DLS measurements is consistent with an average structure LF(BLG2)2. In contrast to coacervation involving polyelectrolytes here, coacervates only form at I < 20 mM. The range of pH at which coacervation occurs is similarly narrow, ca. 5.7-6.2. On the other hand, suppression of coacervation is observed at high C(P), similar to the behavior of some polyelectrolyte-colloid systems. It is proposed that the structural homogeneity of complexes versus coacervates with polyelectrolytes greatly reduces the entropy of coacervation (both chain configuration and counterion loss) so that a very precise balance of repulsive and attractive forces is required for phase separation of the coacervate equilibrium state. The liquid-liquid phase transition can however be obscured by the kinetics of BLG aggregation which can compete with coacervation by depletion of BLG.
Collapse
Affiliation(s)
- Yunfeng Yan
- Department of Chemistry, University of Massachusetts Amherst , Amherst, Massachusetts 01003, United States
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Hilz M, Koehn J, Ammon F, Marcus J, Flanagan S, De Fina P, Baltadzhieva R, Schwab S, Moeller S. Valsalva maneuver shows prolonged sympathetic outflow in patients with a history of mild traumatic brain injury. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
42
|
Flanagan S, Morris D, Boyea T, Dreskin H, Minassian SL, Alcorn H, Marbury T, Abdelhameed M, Fang E, Prokocimer P. A phase 1 study of intravenously administered TR-701 FA in subjects with advanced renal impairment. Crit Care 2013. [PMCID: PMC3891555 DOI: 10.1186/cc12641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
43
|
Lim SH, Hong JYH, Fuziah MZ, Flanagan S, Ellard S, Hussain K. Short term outcome of congenital hyperinsulinism: case series. Int J Pediatr Endocrinol 2013. [PMCID: PMC3850233 DOI: 10.1186/1687-9856-2013-s1-p176] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Song Hai Lim
- Endocrine Unit, Paediatric Department, Putrajaya Hospital, Malaysia
| | - Janet YH Hong
- Endocrine Unit, Paediatric Department, Putrajaya Hospital, Malaysia
| | - MZ Fuziah
- Endocrine Unit, Paediatric Department, Putrajaya Hospital, Malaysia
| | - S Flanagan
- Molecular Genetics Laboratory, Royal Devon and Exeter NHS Healthcare Trust, Exeter, UK
| | - S Ellard
- Molecular Genetics Laboratory, Royal Devon and Exeter NHS Healthcare Trust, Exeter, UK
| | - K Hussain
- Molecular Genetics Laboratory, Royal Devon and Exeter NHS Healthcare Trust, Exeter, UK
| |
Collapse
|
44
|
|
45
|
Hilz M, Moeller S, Ammon F, Markus J, Flanagan S, De Fina P, Schwab S, Koehn J. Valsalva Maneuver Identifies Subtle Sympathetic Cardiac Dysfunction in Patients with Mild Traumatic Brain Injury (P05.200). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.200] [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: 11/15/2022] Open
|
46
|
Abstract
There is now a growing body of evidence supporting the use of fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) in gynaecological malignancies. Although this molecular imaging technique is becoming increasingly available, PET/CT remains an expensive imaging tool. It is essential to be familiar with the circumstances in which FDG-PET/CT can add value and contribute to patient management and indeed to know when it is unlikely to be of benefit. It is also important to understand and recognize the potential pitfalls. FDG-PET/CT has been most widely adopted for staging patients with suspected advanced disease or in suspected recurrence, offering a whole-body imaging approach. However, there is great potential for this technique to act as a predictive biomarker of response to treatment, as well as a prognostic biomarker. In addition, FDG-PET images may now be incorporated into radiotherapy planning in order to refine the delineation of dose according to metabolically active sites of disease. This article reviews the literature that provides the evidence for the use of FDG-PET in gynaecological malignancies, identifies areas of real benefit and future potential, and highlights circumstances where there is limited value.
Collapse
Affiliation(s)
- Andrea G Rockall
- Department of Diagnostic Imaging, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
| | | | | | | | | |
Collapse
|
47
|
Gupta R, Flanagan S, Lee M, Stankovic R, Buckland M. IDH gene testing in gliomas: rare and novel mutations in an australian cohort. Pathology 2012. [DOI: 10.1016/s0031-3025(16)32816-1] [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: 11/15/2022]
|
48
|
Li C, Lee M, Flanagan S, Gupta R, Suter C, Buckland M. MGMT Hydroxymethylation in glioblastoma. Pathology 2012. [DOI: 10.1016/s0031-3025(16)32781-7] [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: 10/22/2022]
|
49
|
Piccirillo E, Guida M, Flanagan S, Lauda L, Fois P, Sanna M. CNAP To Predict Functional Cochlear Nerve Preservation in NF-2: Cochlear Implant or Auditory Brainstem Implant. Skull Base 2011; 18:281-7. [PMID: 19119343 DOI: 10.1055/s-2008-1043753] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The ideal management of bilateral vestibular schwannomas (VSs) involves complete tumor resection with preservation of hearing in at least one ear. While auditory brainstem implants (ABIs) have represented a significant advance in the management of neurofibromatosis type 2 (NF-2) patients, hearing rehabilitation is far from ideal. More recently, cochlear implantation has been used in selected cases of NF-2, following tumor removal, where the patient is left with bilateral profound hearing loss but with anatomical continuity of the cochlear nerve. In selected cases, cochlear implant (CI) has given superior results to ABI. The Gruppo Otologico experience in managing NF-2 patients consists of 29 patients treated between December 1996 and December 2007 out of a total of 1723 VSs. Thirty-nine tumors have been removed, with 10 patients having had bilateral tumor removed. Ten ABIs have been implanted and 5 CIs placed. We present a case that illustrates some of the difficulties encountered in the management of NF-2 VS and provides a basis for discussion of a technique to assist intraoperative decision-making to achieve optimal hearing rehabilitation. In the setting of a negative fast auditory brainstem response (ABR), but preserved cochlear nerve action potential (CNAP), the option of a CI can be considered. However, where the fast ABR and the morphology and amplitude of the CNAP are significantly degraded at the brainstem, the placement of an ABI should be strongly considered at the time of tumor removal. This technique must be further evaluated, but it represents an adjunct in this difficult area for the neurotologist. To this end we propose that a multicenter trial be undertaken to further elucidate the role of intraoperative monitoring to determine the functional preservation of the cochlear nerve.
Collapse
Affiliation(s)
- Enrico Piccirillo
- Gruppo Otologico, Otology and Skull Base Quaternary Referral Center, Piacenza-Rome, Italy
| | | | | | | | | | | |
Collapse
|
50
|
Gupta R, Webb-Myers R, Flanagan S, Buckland ME. Isocitrate dehydrogenase mutations in diffuse gliomas: clinical and aetiological implications. J Clin Pathol 2011; 64:835-44. [PMID: 21752797 DOI: 10.1136/jclinpath-2011-200227] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The discovery of isocitrate dehydrogenase (IDH) mutations in gliomas is one example of the large impact that next-generation sequencing is having on the understanding of tumour biology and human disease in general. IDH mutations are early and common events in the development of astrocytomas, oligodendrogliomas and oligoastrocytomas. IDH mutations are also found in some myeloid malignancies and soft tissue tumours, but are rare in other malignancies. IDH mutation detection can be incorporated into routine pathology practice via immunohistochemistry and/or standard sequencing techniques and has great diagnostic value. An emerging theme is that IDH mutation status in gliomas is of great prognostic relevance, and there are proposals to include IDH mutation status in the next iteration of the WHO classification of gliomas. The mechanisms of action(s) of mutant IDH are not fully understood, but the understanding is progressing rapidly, and may provide a mechanism to link diverse proneoplastic processes such as oxidative damage and epigenetic dysregulation. There are exciting prospects of novel therapies for glioma patients emerging from the elucidation of these mechanisms. Given the diagnostic and prognostic implications of IDH mutation, and the potential for new therapies, all gliomas should be assessed for IDH mutation status in the future.
Collapse
Affiliation(s)
- R Gupta
- Department of Neuropathology, Royal Prince Alfred Hospital, Sydney, Australia
| | | | | | | |
Collapse
|