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Vaughan T, Romero-Velez G, Barajas-Gamboa JS, Dang JT, Rodriguez J, Navarrete S, Strong AT, Rosenthal R, Corcelles R, Kroh M. Hiatal hernia repair after previous laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 2024; 20:432-437. [PMID: 38151414 DOI: 10.1016/j.soard.2023.11.012] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Symptomatic hiatal hernia (HH) with pouch migration after previous laparoscopic Roux-en-Y gastric bypass (RYGB) is an uncommon complication, with limited extant evidence for the utility of surgical repair. OBJECTIVE To evaluate the presentation and resolution of symptoms in patients with HH repair after previous RYGB. SETTING Multicenter University Hospital. METHODS A retrospective review was conducted from 2010 to 2022. Patients with prior RYGB who were undergoing subsequent isolated HH repair were included. Patients undergoing incidental HH repair during concomitant revisional bariatric surgery were excluded. Baseline characteristics and surgical outcomes were evaluated and presented as medians (25th-75th percentile). RESULTS Forty-four patients met the inclusion criteria. The time from RYGB to HH repair was 59 months (39-88). Body mass index at HH repair was 31 kg/m2 (27-39). The most common presenting symptoms of hernia were dysphagia (52%), gastric reflux (39%), and abdominal pain (36%). All HH repairs were completed with a minimally invasive approach (98% laparoscopic, 2% robotic). Nonabsorbable suture was used in 98% of patients, with bioabsorbable mesh in 30%. At a median 28-day (12-117) follow-up, 70% of patients reported full symptom resolution and 23% partial resolution. At follow-up, 2 patients had radiologic HH recurrence, with 1 requiring reoperation. CONCLUSIONS This is the largest series of isolated HH repair for symptomatic pouch migration after previous RYGB. Common presenting symptoms are dysphagia and reflux, and surgical repair yields a high rate of symptom resolution in the short term. Longer follow-up is needed to evaluate the durability of this intervention.
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Affiliation(s)
- Tiffany Vaughan
- Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio; Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Case Western Reserve University School of Medicine, Cleveland, Ohio
| | | | - Juan S Barajas-Gamboa
- Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Jerry T Dang
- Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - John Rodriguez
- Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Salvador Navarrete
- Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Andrew T Strong
- Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Raul Rosenthal
- Digestive Disease & Surgery Institute, Cleveland Clinic, Weston, Florida
| | - Ricard Corcelles
- Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio
| | - Matthew Kroh
- Digestive Disease & Surgery Institute, Cleveland Clinic, Cleveland, Ohio.
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Vaughan T, Hammoud MS, Pande A, Chu L, Cummins K, McCloskey O, Parfyonov M, Doh CY, Edwards A, Sharew B, Greason C, Abushanab E, Gupta A, Marino B, Najm HK, Karamlou T. Can Perioperative Electroencephalogram and Adverse Hemodynamic Events Predict Neurodevelopmental Outcomes in Infants with Congenital Heart Disease? J Thorac Cardiovasc Surg 2023:S0022-5223(23)01086-3. [PMID: 37951534 DOI: 10.1016/j.jtcvs.2023.10.063] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 09/26/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE To characterize pre- and postoperative continuous electroencephalogram (CEEG) metrics and hemodynamic adverse events (AE) as predictors of neurodevelopment in congenital heart disease (CHD) infants undergoing cardiac surgery. PATIENTS AND METHODS From 2010-2021, 320 infants underwent CHD surgery at our institution, of whom 217 had perioperative CEEG monitoring and were included in our study. Neurodevelopment was assessed in 76 patients by the Bayley Scales of Infant and Toddler Development®, 3rd edition (BSID-III), consisting of cognitive, communication, and motor scaled scores. Patient and procedural factors, including hemodynamic AE, were included by means of the likelihood of covariate selection in our predictive model. Median (25th, 75th percentile) follow-up was 1.03 (0.09, 3.44) years with 3 (1, 6) BSID-III evaluations per patient. RESULTS Median age at index surgery was 7 (4, 23) days, and 81 (37%) were female. Epileptiform discharges, encephalopathy, and abnormality (lethargy and coma) were more prevalent on postoperative CEEGs, compared to preoperative (P<0.005). In 76 patients with BSID-III evaluations, patients with diffuse abnormality (P=0.009), waveform discontinuity (P=0.007) and lack of continuity (P=0.037) on preoperative CEEG had lower cognitive scores. Patients with synchrony (P<0.005) on preoperative and waveform continuity (P=0.009) on postoperative CEEG had higher fine motor scores. Patients with postoperative AE had lower cognitive (P<0.005) and gross motor scores (P<0.005). CONCLUSIONS Phenotypic patterns of perioperative CEEG metrics are associated with late-term neurologic injury in CHD infants requiring surgery. CEEG metrics can be integrated with hemodynamic AE in a predictive algorithm for neurologic impairment.
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Affiliation(s)
- Tiffany Vaughan
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Miza Salim Hammoud
- Division of Pediatric and Congenital Cardiac Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, US
| | - Amol Pande
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland OH
| | - Lee Chu
- Division of Pediatric and Congenital Cardiac Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, US
| | - Kaleigh Cummins
- Division of Pediatric and Congenital Cardiac Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, US
| | - Olivia McCloskey
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Maksim Parfyonov
- Department of Pediatric Neurology, Cleveland Clinic Children's, Cleveland, OH, USA
| | - Chang Yoon Doh
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Alyssa Edwards
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Betemariam Sharew
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Christie Greason
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Elham Abushanab
- Department of Pediatric Neurology, Cleveland Clinic Children's, Cleveland, OH, USA
| | - Ajay Gupta
- Department of Pediatric Neurology, Cleveland Clinic Children's, Cleveland, OH, USA
| | - Bradley Marino
- Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, OH, USA
| | - Hani K Najm
- Division of Pediatric and Congenital Cardiac Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, US
| | - Tara Karamlou
- Division of Pediatric and Congenital Cardiac Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, US.
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NeMoyer R, Vaughan T, Witten J, Mahboubi R, Hammoud MS, Shah S, Ahmad M, Najm H, Stewart R, Karamlou T. Mind the gap: Open repair of iatrogenic cor triatriatum dexter after previous atrial septal defect repair. JTCVS Tech 2023; 21:181-183. [PMID: 37854821 PMCID: PMC10580161 DOI: 10.1016/j.xjtc.2023.08.006] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/28/2023] [Accepted: 08/04/2023] [Indexed: 10/20/2023] Open
Affiliation(s)
- Rachel NeMoyer
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Tiffany Vaughan
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - James Witten
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Rashed Mahboubi
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Miza Salim Hammoud
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Shawn Shah
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Munir Ahmad
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Hani Najm
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Robert Stewart
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Tara Karamlou
- Department of Thoracic & Cardiovascular Surgery, Heart Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
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Dang JT, Vaughan T, Mocanu V, Mubashir H, Barajas-Gamboa JS, Codina RC, Rodriguez J, Karmali S, Kroh M. Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass: Indications, Prevalence, and Safety. Obes Surg 2023; 33:1486-1493. [PMID: 36922465 PMCID: PMC10017068 DOI: 10.1007/s11695-023-06546-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 01/11/2023] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Sleeve gastrectomy (SG) frequently requires conversion to Roux-en-Y gastric bypass (RYGB) due to gastroesophageal reflux disease (GERD) or weight recurrence. Current evidence evaluating the safety of conversion from SG to RYGB and its indications is limited to single centers. METHODS The objective was to determine the rate of serious complications and mortality of conversion of SG to RYGB (SG-RYGB) compared to primary RYGB (P-RYGB). This was a retrospective analysis of the MBSAQIP database which includes 30-day outcomes. Individuals undergoing P-RYGB or SG-RYGB were included. Multivariable logistic regression was performed to determine if revisional surgery was an independent predictor of serious complications or mortality. RESULTS In 2020 and 2021, 84,543 (86.3%) patients underwent P-RYGB and 13,432 (13.7%) underwent SG-RYGB. SG-RYGB cohort had lower body mass index, lower rates of diabetes and hypertension, and higher rates of GERD. GERD was the most common indication for revision (55.3%) followed by weight regain (24.4%) and inadequate weight loss (12.7%). SG-RYGB had longer operative times (145 vs. 125 min, p < 0.001) and a higher rate of serious complications (7.2 vs. 5.0%, p < 0.001). This included higher rates of anastomotic leak (0.5 vs. 0.4%, p = 0.002), bleeding (2.0 vs. 1.6%, p < 0.001), and reoperation (3.0 vs. 1.9%, p < 0.001) but not death (0.1 vs. 0.1%, p = 0.385). On multivariable analysis, SG-RYGB was independently predictive of serious complications (OR 1.21, 95%CI 1.12 to 1.32, p < 0.001) but not mortality (p = 0.316). CONCLUSIONS While SG-RYGB is safe with a low complication rate, SG-RYGB was associated with a higher rate of serious complications compared to P-RYGB.
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Affiliation(s)
- Jerry T Dang
- Digestive Diseases & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Tiffany Vaughan
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Valentin Mocanu
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Hadika Mubashir
- Digestive Diseases & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Juan S Barajas-Gamboa
- Digestive Diseases Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | | | - John Rodriguez
- Digestive Diseases Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Shahzeer Karmali
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Matthew Kroh
- Digestive Diseases & Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
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Proulx CE, Higgins J, Vincent C, Vaughan T, Hewko M, Gagnon DH. User-centered development process of an operating interface to couple a robotic glove with a virtual environment to optimize hand rehabilitation following a stroke. J Rehabil Assist Technol Eng 2023; 10:20556683231166574. [PMID: 37077202 PMCID: PMC10107379 DOI: 10.1177/20556683231166574] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/14/2023] [Indexed: 04/21/2023] Open
Abstract
Introduction Task-specific neurorehabilitation is crucial to optimize hand recovery shortly after a stroke, but intensive neurorehabilitation remains limited in resource-constrained healthcare systems. This has led to a growing interest in the use of robotic gloves as an adjunct intervention to intensify hand-specific neurorehabilitation. This study aims to develop and assess the usability of an operating interface supporting such a technology coupled with a virtual environment through a user-centered design approach. Methods Fourteen participants with hand hemiparesis following a stroke were invited to don the robotic glove before browsing through the operating interface and its functionalities, and perform two mobility exercises in a virtual environment. Feedback was collected for improving technology usability. Participants completed the System Usability Scale and ABILHAND questionnaires and their recommendations were gathered and prioritized in a Pugh Matrix. Results The System Usability Scale (SUS) score for the operating interface was excellent (M = 87.0 SD = 11.6). A total of 74 recommendations to improve the user interface, calibration process, and exercise usability were identified. Conclusion The application of a full cycle of user-centred design approach confirms the high level of usability of the system which is perceived by end users as acceptable and useful for intensifying neurorehabilitation.
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Affiliation(s)
- CE Proulx
- School of Rehabilitation, Faculty
of Medicine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary
Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la
Réadaptation en Déficience Physique de Montréal, CIUSSS
Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - J Higgins
- School of Rehabilitation, Faculty
of Medicine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary
Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la
Réadaptation en Déficience Physique de Montréal, CIUSSS
Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
| | - C Vincent
- Department of Rehabilitation, Université Laval, Quebec, QC, Canada
- Center for Interdisciplinary
Research in Rehabilitation and Social Integration, Centre Intégré Universitaire de Santé
et de Services Sociaux de la Capitale-Nationale, Quebec, QC, Canada
| | - T Vaughan
- Simulation and Digital Health,
Medical Devices Research Centre, National Research Council
Canada, Boucherville, QC, Canada
| | - M Hewko
- Simulation and Digital Health,
Medical Devices Research Centre, National Research Council Canada,
Winnipeg, Winnipeg, MB, Canada
| | - DH Gagnon
- School of Rehabilitation, Faculty
of Medicine, Université de Montréal, Montreal, QC, Canada
- Center for Interdisciplinary
Research in Rehabilitation of Greater Montreal, Institut Universitaire sur la
Réadaptation en Déficience Physique de Montréal, CIUSSS
Centre-Sud-de-l’Île-de-Montréal, Montreal, QC, Canada
- DH Gagnon, School of Rehabilitation,
Université de Montréal-Pavillon Ave du Parc, C.P. 6128, succursale Centre-Ville,
Montreal, QC H3C 3J7, Canada.
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Brastianos H, Vaughan T, Lasso A, Westerland M, Gooding J, Ungi T, Fichtinger G, Falkson C. OC-0178: Demonstration of Catheter Insertion Using Electromagnetic Guidance in Breast Brachytherapy. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30621-7] [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: 10/19/2022]
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Popovic B, Breed J, Rees DG, Gardener MJ, Vinall LMK, Kemp B, Spooner J, Keen J, Minter R, Uddin F, Colice G, Wilkinson T, Vaughan T, May RD. Structural Characterisation Reveals Mechanism of IL-13-Neutralising Monoclonal Antibody Tralokinumab as Inhibition of Binding to IL-13Rα1 and IL-13Rα2. J Mol Biol 2016; 429:208-219. [PMID: 27956146 DOI: 10.1016/j.jmb.2016.12.005] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/02/2016] [Accepted: 12/05/2016] [Indexed: 12/12/2022]
Abstract
Interleukin (IL)-13 is a pleiotropic T helper type 2 cytokine frequently associated with asthma and atopic dermatitis. IL-13-mediated signalling is initiated by binding to IL-13Rα1, which then recruits IL-4Rα to form a heterodimeric receptor complex. IL-13 also binds to IL-13Rα2, considered as either a decoy or a key mediator of fibrosis. IL-13-neutralising antibodies act by preventing IL-13 binding to IL-13Rα1, IL-4Rα and/or IL-13Rα2. Tralokinumab (CAT-354) is an IL-13-neutralising human IgG4 monoclonal antibody that has shown clinical benefit in patients with asthma. To decipher how tralokinumab inhibits the effects of IL-13, we determined the structure of tralokinumab Fab in complex with human IL-13 to 2 Å resolution. The structure analysis reveals that tralokinumab prevents IL-13 from binding to both IL-13Rα1 and IL-13Rα2. This is supported by biochemical ligand-receptor interaction assay data. The tralokinumab epitope is mainly composed of residues in helices D and A of IL-13. It is mostly light chain complementarity-determining regions that are driving paratope interactions; the variable light complementarity-determining region 2 plays a key role by providing residue contacts for a network of hydrogen bonds and a salt bridge in the core of binding. The key residues within the paratope contributing to binding were identified as Asp50, Asp51, Ser30 and Lys31. This study demonstrates that tralokinumab prevents the IL-13 pharmacodynamic effect by binding to IL-13 helices A and D, thus preventing IL-13 from interacting with IL-13Rα1 and IL-13Rα2.
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Affiliation(s)
- B Popovic
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK.
| | - J Breed
- Discovery Sciences, Innovative Medicines and Early Development Biotech Unit, AstraZeneca, Cambridge Science Park, Milton Road, Cambridge CB4 0WG, UK
| | - D G Rees
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - M J Gardener
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - L M K Vinall
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - B Kemp
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - J Spooner
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - J Keen
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - R Minter
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - F Uddin
- Department of Biopharmaceutical Development, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - G Colice
- Inflammation, Neuroscience, Respiratory, Global Medicines Development, AstraZeneca, One MedImmune Way, Gaithersburg, MD 20878, USA
| | - T Wilkinson
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - T Vaughan
- Department of Antibody Discovery and Protein Engineering, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
| | - R D May
- Department of Respiratory, Inflammation and Autoimmunity, MedImmune Ltd., Granta Park, Cambridge CB21 6GH, UK
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Bove R, Healy BC, Secor E, Vaughan T, Katic B, Chitnis T, Wicks P, De Jager PL. Patients report worse MS symptoms after menopause: findings from an online cohort. Mult Scler Relat Disord 2014; 4:18-24. [PMID: 25787049 DOI: 10.1016/j.msard.2014.11.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [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: 08/06/2014] [Revised: 10/17/2014] [Accepted: 11/25/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Many women with multiple sclerosis (MS) are postmenopausal, yet the impact of menopause on MS symptoms is unknown. OBJECTIVE To investigate patient-reported impact of menopause in a large online research platform, PatientsLikeMe (PLM). METHODS A detailed reproductive history survey was deployed to PLM members, and responses were linked to PLM׳s prospectively collected patient-reported severity score (MS Rating Scale, MSRS). The MSRS has previously shown good correlation with physician-derived EDSS scores. RESULTS Of the 513 respondents, 55% were postmenopausal; 54% of these reported induced menopause. Median age at natural menopause was 51. Surgical menopause occurred at an earlier age (p<0.001) and was associated with more hormone replacement therapy use (p=0.02) than natural menopause. Postmenopausal status, surgical menopause, and earlier age at menopause were all associated with worse MSRS scores (p≤0.01) in regressions adjusting for age, disease type and duration. CONCLUSION Postmenopausal patients in this study reported worse MS disease severity. Further, this study highlights a utility for online research platforms, which allow for rapid generation of hypotheses that then require validation in clinical settings.
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Affiliation(s)
- R Bove
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA.
| | - B C Healy
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA; Massachusetts General Hospital Biostatistics Center, Boston, MA 02114, USA.
| | - E Secor
- Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA.
| | - T Vaughan
- PatientsLikeMe, Inc., Cambridge, MA, USA.
| | - B Katic
- PatientsLikeMe, Inc., Cambridge, MA, USA.
| | - T Chitnis
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA.
| | - P Wicks
- PatientsLikeMe, Inc., Cambridge, MA, USA.
| | - P L De Jager
- Partners Multiple Sclerosis Center, Department of Neurology, Brigham and Women׳s Hospital, Brookline, MA 02445, USA; Harvard Medical School, Boston, MA 02115, USA; Center for Neurologic Diseases, Harvard Medical School, 77 Avenue Louis Pasteur, NRB168, Boston, MA 02115, USA.
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Weaver E, Vaughan T. SUCCESSFUL INTERVENTION: RAISING AWARENESS OF ADVANCED CARE PLANNING (ACP) IN THE RURAL COMMUNITY SETTING:. BMJ Support Palliat Care 2013. [DOI: 10.1136/bmjspcare-2013-000491.23] [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: 11/03/2022]
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10
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Ellermann J, Goerke U, Morgan P, Ugurbil K, Tian J, Schmitter S, Vaughan T, Van De Moortele PF. Simultaneous bilateral hip joint imaging at 7 Tesla using fast transmit B₁ shimming methods and multichannel transmission - a feasibility study. NMR Biomed 2012; 25:1202-8. [PMID: 22311346 PMCID: PMC3419302 DOI: 10.1002/nbm.2779] [Citation(s) in RCA: 24] [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] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 12/13/2011] [Accepted: 12/16/2011] [Indexed: 05/04/2023]
Abstract
The objective of this study was to demonstrate the feasibility of simultaneous bilateral hip imaging at 7 Tesla. Hip joint MRI becomes clinically critical since recent advances have made hip arthroscopy an efficacious approach to treat a variety of early hip diseases. The success of these treatments requires a reliable and accurate diagnosis of intraarticular abnormalities at an early stage. Articular cartilage assessment is especially important to guide surgical decisions but is difficult to achieve with current MR methods. Because of gains in tissue contrast and spatial resolution reported at ultra high magnetic fields, there are strong expectations that imaging the hip joint at 7 Tesla will improve diagnostic accuracy. Furthermore, there is growing evidence that the majority of these hip abnormalities occur bilaterally, emphasizing the need for bilateral imaging. However, obtaining high quality images in the human torso, in particular of both hips simultaneously, must overcome a major challenge arising from the damped traveling wave behaviour of RF waves at 7 Tesla that leads to severe inhomogeneities in transmit B1 (B(1) (+) ) phase and magnitude, typically resulting in areas of low signal and contrast, and consequently impairing use for clinical applications. To overcome this problem, a 16-channel stripline transceiver RF coil was used, together with a B1 shimming algorithm aiming at maximizing B(1) (+) in six regions of interest over the hips that were identified on axial scout images. Our successful results demonstrate that this approach effectively reduces inhomogeneities observed before B1 shimming and provides high joint tissue contrast in both hips while reducing the required RF power. Critical to this success was a fast small flip angle B(1) (+) calibration scan that permitted the computation of subject-specific B1 shimming solutions, a necessary step to account for large spatial variations in B(1) (+) phase observed in different subjects.
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Affiliation(s)
- J Ellermann
- University of Minnesota Medical Center, Department of Radiology, Center for Magnetic Resonance Research, Minneapolis, MN, USA.
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Bove R, Secor E, Vaughan T, Wicks P, Glanz B, Weiner H, Chitnis T, De Jager P. Comparison of Demographic and Disease Characteristics in Patients with Multiple Sclerosis at an MS Clinic and on an Online Research Forum (P01.145). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p01.145] [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
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Racelis AE, Rubio A, Vaughan T, Goolsby JA. Passive Restoration Potential of Riparian Areas Invaded by Giant Reed (Arundo donax) in Texas. ECOL RESTOR 2012. [DOI: 10.3368/er.30.2.103] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Suttie JJ, Delabarre L, Pitcher A, van de Moortele PF, Dass S, Snyder CJ, Francis JM, Metzger GJ, Weale P, Ugurbil K, Neubauer S, Robson M, Vaughan T. 7 Tesla (T) human cardiovascular magnetic resonance imaging using FLASH and SSFP to assess cardiac function: validation against 1.5 T and 3 T. NMR Biomed 2012; 25:27-34. [PMID: 21774009 PMCID: PMC3440016 DOI: 10.1002/nbm.1708] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 12/02/2010] [Accepted: 02/15/2011] [Indexed: 05/04/2023]
Abstract
We report the first comparison of cardiovascular magnetic resonance imaging (CMR) at 1.5 T, 3 T and 7 T field strengths using steady state free precession (SSFP) and fast low angle shot (FLASH) cine sequences. Cardiac volumes and mass measurements were assessed for feasibility, reproducibility and validity at each given field strength using FLASH and SSFP sequences. Ten healthy volunteers underwent retrospectively electrocardiogram (ECG) gated CMR at 1.5 T, 3 T and 7 T using FLASH and SSFP sequences. B1 and B0 shimming and frequency scouts were used to optimise image quality. Cardiac volume and mass measurements were not significantly affected by field strength when using the same imaging sequence (P > 0.05 for all parameters at 1.5 T, 3 T and 7 T). SSFP imaging returned larger end diastolic and end systolic volumes and smaller left ventricular masses than FLASH imaging at 7 T, and at the lower field strengths (P < 0.05 for each parameter). However, univariate general linear model analysis with fixed effects for sequence and field strengths found an interaction between imaging sequence and field strength (P = 0.03), with a smaller difference in volumes and mass measurements between SSFP and FLASH imaging at 7 T than 1.5 T and 3 T. SSFP and FLASH cine imaging at 7 T is technically feasible and provides valid assessment of cardiac volumes and mass compared with CMR imaging at 1.5 T and 3 T field strengths.
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Affiliation(s)
- J J Suttie
- Department of Cardiovascular Medicine, University of Oxford, Centre for Clinical Magnetic Resonance Research, Oxford, UK.
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Theys J, Pennington O, Dubois L, Anlezark G, Vaughan T, Mengesha A, Landuyt W, Anné J, Burke PJ, Dûrre P, Wouters BG, Minton NP, Lambin P. Repeated cycles of Clostridium-directed enzyme prodrug therapy result in sustained antitumour effects in vivo. Br J Cancer 2006; 95:1212-9. [PMID: 17024128 PMCID: PMC2360559 DOI: 10.1038/sj.bjc.6603367] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [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] [Indexed: 11/09/2022] Open
Abstract
The unique properties of the tumour microenvironment can be exploited by using recombinant anaerobic clostridial spores as highly selective gene delivery vectors. Although several recombinant Clostridium species have been generated during the past decade, their efficacy has been limited. Our goal was to substantially improve the prospects of clostridia as a gene delivery vector. Therefore, we have assessed a series of nitroreductase (NTR) enzymes for their capacity to convert the innocuous CB1954 prodrug to its toxic derivative. Among the enzymes tested, one showed superior prodrug turnover characteristics. In addition, we established an efficient gene transfer procedure, based on conjugation, which allows for the first time genetic engineering of Clostridium strains with superior tumour colonisation properties with high success rates. This conjugation procedure was subsequently used to create a recombinant C. sporogenes overexpressing the isolated NTR enzyme. Finally, analogous to a clinical setting situation, we have tested the effect of multiple consecutive treatment cycles, with antibiotic bacterial clearance between cycles. Importantly, this regimen demonstrated that intravenously administered spores of NTR-recombinant C. sporogenes produced significant antitumour efficacy when combined with prodrug administration.
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Affiliation(s)
- J Theys
- Department of Radiation Oncology (Maastro Lab), GROW Research Institute, University of Maastricht, UNS 50/23, PO Box 616, Maastricht 6200 MD, The Netherlands
| | - O Pennington
- Institute of Infection, Immunity and Inflammation, Centre for Biomolecular Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - L Dubois
- Department of Radiation Oncology (Maastro Lab), GROW Research Institute, University of Maastricht, UNS 50/23, PO Box 616, Maastricht 6200 MD, The Netherlands
| | - G Anlezark
- Centre for Applied Microbiology and Research, Porton Down, Salisbury SP4 0JG, UK
| | - T Vaughan
- Centre for Applied Microbiology and Research, Porton Down, Salisbury SP4 0JG, UK
| | - A Mengesha
- Department of Radiation Oncology (Maastro Lab), GROW Research Institute, University of Maastricht, UNS 50/23, PO Box 616, Maastricht 6200 MD, The Netherlands
| | - W Landuyt
- Experimental Radiobiology/LEO, Gasthuisberg-CDG, Herestraat 49, Leuven 3000, Belgium
| | - J Anné
- Laboratory of Bacteriology, Rega Institute, KU Leuven, Minderbroedersstraat 10, Leuven 3000, Belgium
| | - P J Burke
- Enact Pharma, Porton Down Science Park, Salisbury SP4 0JG, UK
| | - P Dûrre
- Mikrobiologie und Biotechnologie, University Ulm, Ulm 89069, Germany
| | - B G Wouters
- Department of Radiation Oncology (Maastro Lab), GROW Research Institute, University of Maastricht, UNS 50/23, PO Box 616, Maastricht 6200 MD, The Netherlands
| | - N P Minton
- Institute of Infection, Immunity and Inflammation, Centre for Biomolecular Sciences, University of Nottingham, University Park, Nottingham NG7 2RD, UK
| | - P Lambin
- Department of Radiation Oncology (Maastro Lab), GROW Research Institute, University of Maastricht, UNS 50/23, PO Box 616, Maastricht 6200 MD, The Netherlands
- E-mail:
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Pukac L, Kanakaraj P, Humphreys R, Alderson R, Bloom M, Sung C, Riccobene T, Johnson R, Fiscella M, Mahoney A, Carrell J, Boyd E, Yao XT, Zhang L, Zhong L, von Kerczek A, Shepard L, Vaughan T, Edwards B, Dobson C, Salcedo T, Albert V. HGS-ETR1, a fully human TRAIL-receptor 1 monoclonal antibody, induces cell death in multiple tumour types in vitro and in vivo. Br J Cancer 2005; 92:1430-41. [PMID: 15846298 PMCID: PMC2361994 DOI: 10.1038/sj.bjc.6602487] [Citation(s) in RCA: 235] [Impact Index Per Article: 12.4] [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] [Indexed: 11/08/2022] Open
Abstract
Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) induces apoptosis in a variety of tumour cells through activation of TRAIL-R1 and TRAIL-R2 death signalling receptors. Here, we describe the characterisation and activity of HGS-ETR1, the first fully human, agonistic TRAIL-R1 mAb that is being developed as an antitumour therapeutic agent. HGS-ETR1 showed specific binding to TRAIL-R1 receptor. HGS-ETR1 reduced the viability of multiple types of tumour cells in vitro, and induced activation of caspase 8, Bid, caspase 9, caspase 3, and cleavage of PARP, indicating activation of TRAIL-R1 alone was sufficient to induce both extrinsic and intrinsic apoptotic pathways. Treatment of cell lines in vitro with HGS-ETR1 enhanced the cytotoxicity of chemotherapeutic agents (camptothecin, cisplatin, carboplatin, or 5-fluorouracil) even in tumour cell lines that were not sensitive to HGS-ETR1 alone. In vivo administration of HGS-ETR1 resulted in rapid tumour regression or repression of tumour growth in pre-established colon, non-small-cell lung, and renal tumours in xenograft models. Combination of HGS-ETR1 with chemotherapeutic agents (topotecan, 5-fluorouracil, and irinotecan) in three independent colon cancer xenograft models resulted in an enhanced antitumour efficacy compared to either agent alone. Pharmacokinetic studies in the mouse following intravenous injection showed that HGS-ETR1 serum concentrations were biphasic with a terminal half-life of 6.9–8.7 days and a steady-state volume of distribution of approximately 60 ml kg−1. Clearance was 3.6–5.7 ml−1 day−1 kg−1. These data suggest that HGS-ETR1 is a specific and potent antitumour agent with favourable pharmacokinetic characteristics and the potential to provide therapeutic benefit for a broad range of human malignancies.
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Affiliation(s)
- L Pukac
- Human Genome Sciences Inc., 9800 Medical Center Drive, Rockville, MD 20850, USA.
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Abstract
The objective of this study was to convert corncobs to metal ion adsorbents for wastewater treatment. Ground corncobs were modified with either 0.6 M citric acid (CA) or 1.0 M phosphoric acid (PA) to help improve their natural adsorption capacity. The effect of a combination of wash and modification treatment was tested for corncob adsorption efficiency with five different metal ions (cadmium, copper, lead, nickel, zinc) individually or in a mixed solution containing each metal at a 20 mM concentration. Results were compared to those of commercial resins Amberlite IRC-718, Amberlite 200, Duolite GT-73 and carboxymethylcellulose (CMC). Modified corncobs showed the same adsorption efficiency as Duolite GT-73 for cadmium, copper, nickel and zinc ions and had greater adsorption than CMC for nickel and zinc ions. For mixed metals, the modified corncobs exhibited the same adsorption efficiency as Duolite GT-73 for cadmium and copper ions and the same or higher adsorption than Amberlite IRC-718 for lead ions. Adsorption capacities of modified samples were compared to those of Amberlite IRC-718, Amberlite 200 and Duolite GT-73. Commercial resins generally had higher adsorption capacities than modified corncobs. However, the adsorption capacity of modified corncobs for copper and lead ions was equivalent to Duolite GT-73, but was lower than for Amberlite IRC-718 or Amberlite 200. Depending on the specific metal ion and the presence or absence of other metal ions, chemically modified corncobs were at least equivalent in adsorption properties to all of the commercial cation exchange resins examined in this study.
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Affiliation(s)
- T Vaughan
- Department of Human Environment and Family Sciences, North Carolina A&T State University, Greensboro 27411, USA
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Abstract
An extensive series reviewing the benefits and drawbacks of use of the gracilis muscle in lower-extremity trauma has not previously been collected. In this series of 50 patients, the use of microvascular free transfer of the gracilis muscle for lower-extremity salvage in acute traumatic wounds and posttraumatic chronic wounds is reviewed. In addition, the wound size, injury patterns, problems, and results unique to the use of the gracilis as a donor muscle for lower-extremity reconstruction are identified. In a 7-year period from 1991 to 1998, 50 patients underwent lower-extremity reconstruction using microvascular free gracilis transfer at the University of Maryland Shock Trauma Center, Johns Hopkins Hospital, and Johns Hopkins Bayview Medical Center. There were 22 patients who underwent reconstruction for coverage of acute lower-extremity traumatic soft-tissue defects associated with open fractures. The majority of patients were victims of high-energy injuries with 91 percent involving motor vehicle or motorcycle accidents, gunshot wounds, or pedestrians struck by vehicles. Ninety-one percent of the injuries were Gustilo type IIIb tibial fractures and 9 percent were Gustilo type IIIc. The mean soft-tissue defect size was 92.2 cm2. Successful limb salvage was achieved in 95 percent of patients. Twenty-eight patients with previous Gustilo type IIIb tibia-fibula fractures presented with posttraumatic chronic wounds characterized by osteomyelitis or deep soft-tissue infection. Successful free-tissue transfer was accomplished in 26 of 28 patients (93 percent). All but one of the patients in this group who underwent successful limb salvage (26 of 27, or 96 percent) are now free of infection. Use of the gracilis muscle as a free-tissue transfer has been shown to be a reliable and predictable tool in lower-extremity reconstruction, with a flap success and limb salvage rate comparable to those in other large studies.
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Affiliation(s)
- R J Redett
- Department of Surgery, the Johns Hopkins School of Medicine, Baltimore, MD, USA
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18
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Raskind WH, Niakan KK, Wolff J, Matsushita M, Vaughan T, Stamatoyannopoulos G, Watanabe C, Rios J, Ochs HD. Mapping of a syndrome of X-linked thrombocytopenia with Thalassemia to band Xp11-12: further evidence of genetic heterogeneity of X-linked thrombocytopenia. Blood 2000; 95:2262-8. [PMID: 10733494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
X-linked thrombocytopenia with thalassemia (XLTT; Online Mendelian Inheritance in Man [OMIM] accession number 314050) is a rare disorder characterized by thrombocytopenia, platelet dysfunction, splenomegaly, reticulocytosis, and unbalanced hemoglobin chain synthesis. In a 4-generation family, the gene responsible for XLTT was mapped to the X chromosome, short arm, bands 11-12 (band Xp11-12). The maximum lod score possible in this family, 2.39, was obtained for markers DXS8054 and DXS1003, at a recombination fraction of 0. Recombination events observed for XLTT and markers DXS8080 and DXS8023 or DXS991 define a critical region that is less than or equal to 7.65 KcM and contains the gene responsible for the Wiskott-Aldrich syndrome (WAS; OMIM accession number 301000) and its allelic variant X-linked thrombocytopenia (XLT; OMIM accession number 313900). Manifestations of WAS include thrombocytopenia, eczema, and immunodeficiency. In WAS/XLT the platelets are usually small, and bleeding is proportional to the degree of thrombocytopenia. In contrast, in XLTT the platelet morphology is normal, and the bleeding time is disproportionately prolonged. In this study no alteration in the WAS gene was detected by Northern blot or Western blot analysis, flow cytometry, or complimentary DNA dideoxynucleotide fingerprinting or sequencing. As has been reported for WAS and some cases of XLT, almost total inactivation of the XLTT gene-bearing X chromosome was observed in granulocytes and peripheral blood mononuclear cells from 1 asymptomatic obligate carrier. The XLTT carrier previously found to have an elevated alpha:beta hemoglobin chain ratio had a skewed, but not clonal, X-inactivation pattern favoring activity of the abnormal allele. Clinical differences and results of the mutation analyses make it very unlikely that XLTT is another allelic variant of WAS/XLT and strongly suggest that X-linked thrombocytopenia mapping to band Xp11-12 is a genetically heterogeneous disorder.
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Affiliation(s)
- W H Raskind
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
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19
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Abstract
Breast cancer is the leading cause of cancer death among Australian women and its incidence is annually increasing. Genetic factors are involved in the complex etiology of breast cancer. The seco-steroid hormone, 1.25 dihydroxy vitamin D3 can influence breast cancer cell growth in vitro. A number of studies have reported correlations between vitamin D receptor (VDR) gene polymorphisms and several diseases including prostate cancer and osteoporosis. In breast cancer, low vitamin D levels in serum are correlated with disease progression and bone metastases, a situation also noted in prostate cancer and suggesting the involvement of the VDR. In our study, 2 restriction fragment length polymorphisms (RFLP) in the 3' region (detected by Apa1 and Taq1) and an initiation codon variant in the 5' end of the VDR gene (detected by Fok1) were tested for association with breast cancer risk in 135 females with sporadic breast cancer and 110 cancer-free female controls. Allele frequencies of the 3' Apa1 polymorphism showed a significant association (p = 0.016; OR = 1.56, 95% CI = 1.09-2.24) while the Taq1 RFLP showed a similar trend (p = 0.053; OR = 1.45, 95% CI = 1.00-2.00). Allele frequencies of the Fok1 polymorphism were not significantly different (p = 0.97; OR = 0.99, 95% CI = 0.69-1.43) in the study population. Our results suggest that specific alleles of the VDR gene located near the 3' region may identify an increased risk for breast cancer and justify further investigation of the role of VDR in breast cancer.
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Affiliation(s)
- J E Curran
- Genomics Research Centre, Griffith University Gold Coast, Southport, Queensland, Australia
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20
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Lenaway D, Koepsell TD, Vaughan T, van Belle G, Shy K, Cruz-Uribe F. Evaluation of a public-private certified nurse-midwife maternity program for indigent women. Am J Public Health 1998; 88:675-9. [PMID: 9551018 PMCID: PMC1508421 DOI: 10.2105/ajph.88.4.675] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study assessed the impact of a public-private certified nurse-midwife program on prenatal and delivery outcomes among medically indigent women. METHODS A population-based quasi-experimental design was used to compare 1 intervention county with 2 nonintervention counties. RESULTS The program significantly reduced the number of women who received no prenatal care and the risk of acquiring less than adequate prenatal care. Reductions in the proportion of infants born premature or with low birth-weights were of borderline significance. The use of induction and/or stimulation of labor was statistically elevated. CONCLUSIONS These results suggest that the intervention program was instrumental in reducing some, but not all, negative prenatal and delivery outcomes.
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Affiliation(s)
- D Lenaway
- Boulder County Health Department, CO 80304, USA
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21
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Pütz JH, Vaughan T, Roake W, Nagel E, Meyer zu Vilsendorl A, Klos A, Bautsch W, Köhl J. Selection of single-chain Fv antibodies against rat C3a and guinea-pig C3a from a large non-immunized phage-library. Mol Immunol 1998. [DOI: 10.1016/s0161-5890(98)90671-x] [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]
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Abstract
A historical cohort study was conducted to evaluate cancer incidence among chemical workers with occupational and environmental exposure to alachlor, the active ingredient in a family of pre-emergent acetanilide herbicides. The study followed 943 workers with at least 1 year of cumulative employment at the Monsanto plant in Muscatine, Iowa, from startup of the alachlor manufacturing process in March 1968 through December 1990. Approximately 96% of all workers were successfully traced to determine their last known residence and cancer status. Eighteen workers were diagnosed with cancer during the follow-up period, based on pathology information from the statewide cancer registry maintained by the State Health Registry of Iowa. The standardized incidence ratio for all cancers was 1.5 (95% CI 0.9-2.4) for all workers exposed to alachlor, which was due primarily to elevated rates for colorectal cancer and chronic myeloid leukemia. Workers with 5 or more years in estimated high alachlor exposure jobs had elevated rates of colorectal cancer (3 cases, SIR = 5.2, 95% CI 1.1-15.1). Interpretation of the study results is limited by the small size of the study population, minimal length of follow-up, and current information concerning alachlor metabolism in primates and humans. Nonetheless, the findings suggest the need for continued evaluation of this and other alachlor-exposed cohorts.
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Affiliation(s)
- T Leet
- Department of Epidemiology, Seattle, University of Washington, USA
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23
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Hetherington H, Kuzniecky R, Pan J, Mason G, Morawetz R, Harris C, Faught E, Vaughan T, Pohost G. Proton nuclear magnetic resonance spectroscopic imaging of human temporal lobe epilepsy at 4.1 T. Ann Neurol 1995; 38:396-404. [PMID: 7668825 DOI: 10.1002/ana.410380309] [Citation(s) in RCA: 102] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We performed proton magnetic resonance spectroscopic imaging (MRSI) at high magnetic field (4.1 T) to study N-acetylaspartate, creatine, and choline levels in the brains of normal control subjects and patients with intractable temporal lobe epilepsy. We compared the results of MRSI to those of other presurgical techniques to determine the sensitivity of this method in the lateralization of the epileptic focus. The normal hippocampal creatine-N-acetylaspartate ratio was 0.71 +/- 0.14 with no differences between left and right. Using the mean control hippocampal creatine-N-acetylaspartate ratio plus 2 standard deviations to identify statistically significant changes, we found lateralizing metabolic abnormalities corresponding to the operated temporal lobe in all patients. Four patients (40%) had contralateral abnormalities, and 2 of them had bilateral independent seizure onset confirmed by intracranial electroencephalographic studies. Statistically significant increases in the choline-N-acetylaspartate ratio in comparison to healthy volunteers were observed in 8 of the 10 patients. With the creatine-N-acetylaspartate ratio, MRSI demonstrated a 100% sensitivity compared to magnetic resonance imaging, which identified pathology in 70% of the patients. These findings suggest that proton MRSI yields a distinctive metabolic profile in patients with temporal lobe epilepsy and is sensitive in detecting bilateral metabolic abnormalities in some patients. These preliminary findings suggest that MRSI is more sensitive than magnetic resonance imaging in the lateralization of epileptic foci in temporal lobe epilepsy.
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Affiliation(s)
- H Hetherington
- UAB Epilepsy Center, University of Alabama at Birmingham, USA
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24
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Nugent P, Branch D, Baron E, Fisher A, Vaughan T, Hauschildt PH. Low Hubble constant from the physics of type Ia supernovae. Phys Rev Lett 1995; 75:394-397. [PMID: 10060010 DOI: 10.1103/physrevlett.75.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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25
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Szmulowicz F, Manasreh MO, Stutz CE, Vaughan T. Temperature and many-body effects on the intersubband transition in a GaAs/Al0.3Ga0.7As multiple quantum well. Phys Rev B Condens Matter 1994; 50:11618-11623. [PMID: 9975294 DOI: 10.1103/physrevb.50.11618] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Abstract
Before 1955 blunt traumatic ruptures of the heart and pericardium were reported almost exclusively in autopsy reports. Since then, because of improved prehospital care and early triage, it has been demonstrated that injuries resulting in rupture of the heart and pericardium are no longer always fatal. We present a case of a patient who arrived at the hospital with increasing abdominal girth and a tender abdomen who on exploration was found to have a tear of the pericardium and atrial appendage compounded by a supradiaphragmatic tear of the inferior vena cava.
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Affiliation(s)
- T Siegel
- Department of Surgery, University of Rochester, School of Medicine and Dentistry, New York 14642
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27
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Goldoft M, Weiss N, Vaughan T, Lee J. Nasal melanoma. Br J Ind Med 1993; 50:767-768. [PMID: 8398868 PMCID: PMC1012187 DOI: 10.1136/oem.50.8.767-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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28
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Chandrakumar M, Joseph CA, Soltanpoor N, Sim F, Susman MD, O'Mahony M, Vaughan T, Parsons CM. Food poisoning at a religious event. Commun Dis Rep CDR Rev 1992; 2:R123-4. [PMID: 1284929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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29
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Lane BG, Bernier F, Dratewka-Kos E, Shafai R, Kennedy TD, Pyne C, Munro JR, Vaughan T, Walters D, Altomare F. Homologies between members of the germin gene family in hexaploid wheat and similarities between these wheat germins and certain Physarum spherulins. J Biol Chem 1991; 266:10461-9. [PMID: 2037593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
By screening approximately 10(6) plaques in a wheat DNA library with a "full-length" germin cDNA probe, two genomic clones were detected. When digested with EcoRI, one clone yielded a 2.8-kilobase pair fragment (gf-2.8) and the other yielded a 3.8-kilobase pair fragment (gf-3.8). By nucleotide sequencing, each of gf-2.8 and gf-3.8 was found to encode a complete sequence for germin and germin mRNA, and to contain appreciable amounts of 5'- and 3'-flanking sequences. The "cap" site in gf-2.8 was determined by primer extension and the corresponding site in gf-3.8 was deduced by analogy. The mRNA coding sequences in gf-2.8 and gf-3.8 are intronless and 87% homologous with one another. The 5'-flanking regions in gf-2.8 and gf-3.8 contain recognizable sites of what are probably cis-acting elements but there is otherwise little if any significant similarity between them. In addition to putative TATA and CAAT boxes in the 5'-flanking regions of gf-2.8 and gf-3.8, there are AT-rich inverted-repeats, GC boxes, long purine-rich sequences, two 19-base pair direct-repeat sequences in gf-2.8, and a remarkably long (200-base pair) inverted-repeat sequence (approximately 90% homology) in gf-3.8. An 8% difference between the mature-protein coding regions in gf-2.8 and gf-3.8 is reflected by a corresponding 7% difference between the corresponding 201-residue proteins. Most significantly, the same 8% difference between the mature-protein coding regions in gf-2.8 and gf-3.8 is allied with no change whatever in a central part (61-151) of the encoded polypeptide sequences. It seems likely that this central, strongly conserved core in the germins is of first importance in the biochemical involvements of the proteins. When an equivalence is assumed between like amino acids, the gf-2.8 and gf-3.8 germins show significant (approximately 44%) similarity to spherulins 1a and 1b of Physarum polycephalum, a similarity that increases to approximately 50% in the conserved core of germin. Near the middle (87-96) of the conserved core in the germins is a rare PH(I/T)HPRATEI decapeptide sequence which is shared by spherulins (1a and 1b) and germins (gf-2.8 and gf-3.8). These similarities are discussed in the context of evidence which can be interpreted to suggest that the biochemistry of germins and spherulins is involved with cellular, perhaps cell-wall responses to desiccation, hydration, and osmotic stress.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- B G Lane
- Biochemistry Department, University of Toronto, Ontario, Canada
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30
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Manasreh MO, Szmulowicz F, Vaughan T, Evans KR, Stutz CE, Fischer DW. Origin of the blueshift in the intersubband infrared absorption in GaAs/Al0.3Ga0.7As multiple quantum wells. Phys Rev B Condens Matter 1991; 43:9996-9999. [PMID: 9996714 DOI: 10.1103/physrevb.43.9996] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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31
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Inmon J, Vaughan T, Morris J. Design of a limited-access facility and safety program for a genetic toxicology laboratory. Am Ind Hyg Assoc J 1985; 46:303-7. [PMID: 4014005 DOI: 10.1080/15298668591394860] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A limited-access facility has been designed as a result of the need for laboratories for testing hazardous materials found in the environment. The facility design features include room air flow and filtration, hood types, sink design and placement, design of countertops, type of flooring and wall sealant, and traffic flow within the laboratories. These laboratories required the diversity to handle weighing of stock hazardous materials, preparation and handling of aliquots, maintenance of dosed animals as well as sterile conditions required for tissue culture and continuous cell culture methods. A safety and health program was also developed which included specific dress (e.g., scrub suit, TYVEK jumpsuit, gloves, safety glasses and safety shoes), safety advisory group, safety response group, medical monitoring program and training of current and new staff members. The design and use of the facility are continuously reevaluated and changes are made as necessitated by either research needs or improved safety methods.
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Carty SE, Johnson RG, Vaughan T, Pallant A, Scarpa A. Amine transport into chromaffin ghosts. Kinetic measurements of net uptake of biologically and pharmacologically relevant amines using an on-line amperometric technique. Eur J Biochem 1985; 147:447-52. [PMID: 3884332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The kinetic parameters for net transport of dopamine, epinephrine, norepinephrine, 5-hydroxytryptamine, S alpha-methyldopamine, R alpha-methyldopamine, and 1R,2S alpha-methylnorepinephrine into highly purified bovine chromaffin ghosts were determined using an on-line amperometric technique. Chromaffin ghosts devoid of endogenous amines were formed from lysis of chromaffin granules under hypotonic conditions, extensive washing of the scattered membranes, followed by resuspension in iso-osmotic media and overnight dialysis. When chromaffin ghosts formed so as to generate and maintain a large delta pH were suspended in 185 mM KCl, 10 mM Hepes at pH 7.0, 37 degrees C, the addition of MgATP resulted in rapid acidification of the intravesicular space, which was maintained at pH 6.0 (+/- 0.1) for over 30 min. Kinetic net amine transport was subsequently measured with a glassy carbon electrode. The initial rates of uptake were found to follow Michaelis-Menten kinetics. Computer based statistical analysis of the data using distribution-free procedures yielded Km (and V) values as follows: in microM (nmol X mg protein-1 X min-1) dopamine, 16.2 (14.0); R-norepinephrine, 32.5 (12.9); R-epinephrine, 35.1 (15.2); 5-hydroxytryptamine, 4.7 (5.1); S alpha-methyldopamine, 17.7 (11.2); R alpha-methyldopamine, 44.2 (9.9); 1R,2S alpha-methylnorepinephrine, 76.5 (12.5). The physiologic and pharmacologic implications of these kinetic parameters are discussed.
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Zigman S, Groff J, Yulo T, Vaughan T. The response of mouse ocular tissues to continuous near-UV light exposure. Invest Ophthalmol 1975; 14:710-3. [PMID: 1158638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Continuous exposure of mice to near-ultraviolet (UV) light (black light) over a period of 19 weeks induces adverse alterations in lens protein chemistry, in lens epithelial cell differentiation, and in retinal photoreceptor structure at more than a doubled rate as for 12 hours a day of intermittent exposure. No histologic changes were found in the cornea. The results may indicate the presence of repair mechanisms in these ocular tissues for damage induced by radiant energy.
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Kaplan J, Dawson S, Vaughan T, Green R, Wyatt RJ. Effect of prolonged chlorpromazine administration on the sleep of chronic schizophrenics. Arch Gen Psychiatry 1974; 31:62-6. [PMID: 4365280 DOI: 10.1001/archpsyc.1974.01760130044007] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Zigman S, Vaughan T. Near-ultraviolet light effects on the lenses and retinas of mice. Invest Ophthalmol 1974; 13:462-5. [PMID: 4831699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Abstract
Oral administration of the serotonin precursor L-5-hydroxytryptophan with a peripheral decarboxylase inhibitor produced Mild to moderate improvement in six of seven chronic undifferentiated schizophrenic patients who were resistant to phenothiazine treatment, as compared to an oral administration of a placebo. Two of four chronic paranoid schizophrenic patients who were resistant to phenothiazine treatment became worse with 5-hydroxytryptophan, one improved. It is presumed that these psychological changes were directly or indirectly produced from increases in brain serotonin. Indirect data from animals and humans indicate that there may be an abnormality in serotonin metabolism in some schizophrenics. While our data are consistent with this hypothesis, other explanations for our data must be entertained.
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