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Yi T, Sui Y, Zheng D, Ren X, Lin X, Wu Y, Lin D, Pan Z, Zheng X, Hong G, Wu M, Zeng L, Chen W. Diagnostic Performance of Carotid Ring Sign on CT-Angiography in Internal Carotid True Occlusion. Stroke 2024; 55:1025-1031. [PMID: 38527154 DOI: 10.1161/strokeaha.123.045156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/24/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND To differentiate between pseudo occlusion (PO) and true occlusion (TO) of internal carotid artery (ICA) is important in thrombectomy treatment planning for patients with acute ischemic stroke. Although delayed contrast filling has been differentiated carotid PO from TO, its application has been limited by the implementations of multiphasic computed tomography angiography. In this study, we hypothesized that carotid ring sign, which is readily acquired from single-phasic CTA, can sufficiently differentiate carotid TO from PO. METHODS One thousand four hundred and twenty patients with anterior circulation stroke receiving endovascular therapy were consecutively recruited through a hospital- and web-based registry. Two hundred patients with nonvisualization of the proximal ICA were included in the analysis after a retrospective screening. Diagnosis of PO or TO of the cervical segment of ICA was made based on digital subtraction angiography. Diagnostic performances of carotid ring sign on arterial-phasic CTA and delayed contrast filling on multiphasic computed tomography angiography were evaluated and compared. RESULTS One-hundred twelve patients had ICA PO and 88 had TO. Carotid ring sign was more common in patients with TO (70.5% versus 6.3%; P<0.001), whereas delayed contrast filling was more common in PO (94.9% versus 7.7%; P<0.001). The sensitivity and specificity of carotid ring sign in diagnosing carotid TO were 0.70 and 0.94, respectively, whereas sensitivity and specificity of delayed contrast filling was 0.95 and 0.92 in judging carotid PO. CONCLUSIONS Carotid ring sign is a potent imaging marker in diagnosing ICA TO. Carotid ring sign could be complementary to delayed contrast filling sign in differentiating TO from PO, in particular in centers with only single-phasic CTA.
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Affiliation(s)
- Tingyu Yi
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
- Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China (T.Y.)
| | - Yi Sui
- Department of Neurology, Shenyang First People's Hospital, Shenyang Medical College, China (Y.S.)
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China (Y.S.)
| | - Dinghuan Zheng
- Department of Neurology, Huian County Hospital, Quanzhou, Fujian, China (D.Z.)
| | - Xinwen Ren
- George Institute for Global Health China (X.R.)
| | - Xiaohui Lin
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
| | - Yanmin Wu
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
| | - Dinglai Lin
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
| | - Zhinan Pan
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
| | - Xiufen Zheng
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
| | - Ganji Hong
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
| | - Meihua Wu
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
| | - Lisan Zeng
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
| | - Wenhuo Chen
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, China (T.Y., X.L., Y.W., D.L., Z.P., X.Z., G.H., M.W., L.Z., W.C.)
- Department of Neurology, Fujian Medical University Union Hospital, China (W.C.)
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Lee L, Yi T, Fice M, Achar RK, Jones C, Klein E, Buac N, Lopez-Hisijos N, Colman MW, Gitelis S, Blank AT. Development and external validation of a machine learning model for prediction of survival in undifferentiated pleomorphic sarcoma. Musculoskelet Surg 2024; 108:77-86. [PMID: 37658174 DOI: 10.1007/s12306-023-00795-w] [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: 07/01/2022] [Accepted: 08/20/2023] [Indexed: 09/03/2023]
Abstract
PURPOSE Machine learning (ML) algorithms to predict cancer survival have recently been reported for a number of sarcoma subtypes, but none have investigated undifferentiated pleomorphic sarcoma (UPS). ML is a powerful tool that has the potential to better prognosticate UPS. METHODS The Surveillance, Epidemiology, and End Results (SEER) database was queried for cases of histologically confirmed undifferentiated pleomorphic sarcoma (UPS) (n = 665). Patient, tumor, and treatment characteristics were recorded, and ML models were developed to predict 1-, 3-, and 5-year survival. The best performing ML model was externally validated using an institutional cohort of UPS patients (n = 151). RESULTS All ML models performed best at the 1-year time point and worst at the 5-year time point. On internal validation within the SEER cohort, the best models had c-statistics of 0.67-0.69 at the 5-year time point. The Multi-Layer Perceptron Neural Network (MLP) model was the best performing model and used for external validation. Similarly, the MLP model performed best at 1-year and worst at 5-year on external validation with c-statistics of 0.85 and 0.81, respectively. The MLP model was well calibrated on external validation. The MLP model has been made publicly available at https://rachar.shinyapps.io/ups_app/ . CONCLUSION Machine learning models perform well for survival prediction in UPS, though this sarcoma subtype may be more difficult to prognosticate than other subtypes. Future studies are needed to further validate the machine learning approach for UPS prognostication.
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Affiliation(s)
- L Lee
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA.
| | - T Yi
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - M Fice
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - R K Achar
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - C Jones
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - E Klein
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - N Buac
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - N Lopez-Hisijos
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - M W Colman
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - S Gitelis
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
| | - A T Blank
- Department of Orthopedic Surgery, Section of Orthopedic Oncology, Rush University Medical Center, 1611 W. Harrison St., Suite 300, Chicago, IL, USA
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Yi T, Li K, Lin XH, Lin DL, Wu YM, Pan ZN, Zheng XF, Chen RC, Zeng G, Chen WH. Predictors of futile recanalization in basilar artery occlusion patients undergoing endovascular treatment: a post hoc analysis of the ATTENTION trial. Front Neurol 2023; 14:1308036. [PMID: 38178887 PMCID: PMC10765589 DOI: 10.3389/fneur.2023.1308036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
Background Few studies have focused on factors associated with futile recanalization in patients with an acute basilar artery occlusion (BAO) that was treated with modern endovascular therapy (EVT). The aim of this study was to explore the factors associated with futile recanalization in patients with an acute BAO presented within 12 h. Methods This is a post-hoc analysis of the ATTENTION trial (The Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion, ClinicalTrials.gov, number NCT04751708). Demographics, clinical characteristics, acute stroke workflow interval times, and imaging characteristics were compared between the futile recanalization and favorable recanalization groups. The favorable outcome was defined as a modified Rankin scale (mRS) score of 0-3 at 90 days, successful reperfusion was defined as thrombolysis in cerebral infarction (TICI) 2b and 3 on the final angiogram, and futile recanalization was defined as failure to achieve a favorable outcome despite successful reperfusion. A multivariate analysis was performed to identify the predictors of futile recanalization. Results In total, 185 patients were included in the final analysis: 89 (48.1%) patients had futile recanalization and 96 (51.9%) patients had favorable recanalization. In the multivariable logistic regression analysis, older age (OR 1.04, 95% CI 1.01 to 1.08, p = 0.01) and diabetes mellitus (OR 3.35, 95% CI 1.40 to 8.01, p = 0.007) were independent predictors of futile recanalization. Conclusion Futile recanalization occurred in nearly half of patients with acute BAO following endovascular treatment. Old age and diabetes mellitus were identified as independent predictors of futile recanalization after endovascular therapy for acute BAO.
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Affiliation(s)
- Tingyu Yi
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Kai Li
- Department of Neurology, Heze Municipal Hospital, Heze, China
| | - Xiao-hui Lin
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Ding-lai Lin
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Yan-Min Wu
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Zhi-nan Pan
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Xiu-fen Zheng
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Rong-cheng Chen
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Guoyong Zeng
- Department of Neurology, Ganzhou People’s Hospital, Ganzhou, China
| | - Wen-huo Chen
- Department of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
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Wu K, Yuan Z, Chen W, Yi T, Chen X, Ma M, Guo J, Zhou M, Chen N, He L. A nomogram predicts early neurological deterioration after mechanical thrombectomy in patients with ischemic stroke. Front Neurol 2023; 14:1255476. [PMID: 37799278 PMCID: PMC10548384 DOI: 10.3389/fneur.2023.1255476] [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: 07/08/2023] [Accepted: 08/21/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction Early neurological deterioration (END) is common in acute ischemic stroke and is directly associated with poor outcome after stroke. Our aim is to develop and validate a nomogram to predict the risk of END after mechanical thrombectomy (MT) in acute ischemic stroke patients with anterior circulation large-vessel occlusion. Methods We conducted a real-world, multi-center study in patients with stroke treated with mechanical thrombectomy. END was defined as a worsening by 2 or more NIHSS points within 72-hour after stroke onset compared to admission. Multivariable logistic regression was used to determine the independent predictors of END, and the discrimination of the scale was assessed using the C-index. Calibration curves were constructed to evaluate the calibration of the nomogram, and decision curves were used to describe the benefits of using the nomogram. Results A total of 1007 patients were included in our study. Multivariate logistic regression analysis found age, admission systolic blood pressure, initial NIHSS scores, history of hyperlipemia, and location of occlusion were independent predictors of END. We developed a nomogram that included these 6 factors, and it revealed a prognostic accuracy with a C-index of 0.678 in the derivation group and 0.650 in the validation group. The calibration curves showed that the nomogram provided a good fit to the data, and the decision curves demonstrated a large net benefit. Discussion Our study established and validated a nomogram to stratify the risk of END before mechanical embolectomy and identify high-risk patients, who should be more cautious when making clinical decisions.
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Affiliation(s)
- Kongyuan Wu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhengzhou Yuan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Wenhuo Chen
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Tingyu Yi
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Xiwen Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Mengmeng Ma
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Guo
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Muke Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Ning Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Li He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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Tao C, Yuan G, Xu P, Wang H, Zhou P, Yi T, Li K, Cui T, Gao J, Li R, Sun J, Zhang C, Wang L, Liu T, Song J, Yin Y, Nguyen TN, Li Q, Hu W. Anesthetic Management and Outcomes of Endovascular Treatment of Basilar Artery Occlusion: Results From the ATTENTION Registry. J Stroke 2023; 25:399-408. [PMID: 37607695 PMCID: PMC10574300 DOI: 10.5853/jos.2023.00318] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/11/2023] [Accepted: 06/07/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND AND PURPOSE To examine the clinical and safety outcomes after endovascular treatment (EVT) for acute basilar artery occlusion (BAO) with different anesthetic modalities. METHODS This was a retrospective analysis using data from the Endovascular Treatment for Acute Basilar Artery Occlusion (ATTENTION) registry. Patients were divided into two groups defined by anesthetic modality performed during EVT: general anesthesia (GA) or non-general anesthesia (non-GA). The association between anesthetic management and clinical outcomes was evaluated in a propensity score matched (PSM) cohort and an inverse probability of treatment weighting (IPTW) cohort to adjust for imbalances between the two groups. RESULTS Our analytic sample included 1,672 patients from 48 centers. The anesthetic modality was GA in 769 (46.0%) and non-GA in 903 (54.0%) patients. In our primary analysis with the PSM-based cohort, non-GA was comparable to GA concerning the primary outcome (adjusted common odds ratio [acOR], 1.01; 95% confidence interval [CI], 0.82 to 1.25; P=0.91). Mortality at 90 days was 38.4% in the GA group and 35.8% in the non-GA group (adjusted risk ratio, 0.95; 95% CI, 0.83 to 1.08; P=0.44). In our secondary analysis with the IPTW-based cohort, the anesthetic modality was significantly associated with the distribution of modified Rankin Scale at 90 days (acOR: 1.45 [95% CI: 1.20 to 1.75]). CONCLUSION In this nationally-representative observational study, acute ischemic stroke patients due to BAO undergoing EVT without GA had similar clinical and safety outcomes compared with patients treated with GA. These findings provide the basis for large-scale randomized controlled trials to test whether anesthetic management provides meaningful clinical effects for patients undergoing EVT.
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Affiliation(s)
- Chunrong Tao
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Guangxiong Yuan
- Department of Emergency, Xiangtan Central Hospital, Xiangtan, China
| | - Pengfei Xu
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Hao Wang
- Department of Neurology, Linyi People’s Hospital, Linyi, China
| | - Peiyang Zhou
- Department of Neurology, Xiangyang No.1 People’s Hospital, Hubei University of Medicine, Xiangyang, China
| | - Tingyu Yi
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Kai Li
- Department of Neurology, Heze Municipal Hospital, Heze, Shandong, China
| | - Tao Cui
- Department of Neurology, Taihe County People’s Hospital, Fuyang, China
| | - Jun Gao
- Department of Neurology, Nanyang Central Hospital, Nanyang, China
| | - Rui Li
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jun Sun
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Chao Zhang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Li Wang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Tianlong Liu
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Jianlong Song
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Yamei Yin
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Thanh N. Nguyen
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Qing Li
- Department of Laboratory Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Core Facility Center, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wei Hu
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Huo X, Sun D, Chen W, Han H, Abdalkader M, Puetz V, Yi T, Wang H, Liu R, Tong X, Jia B, Ma N, Gao F, Mo D, Yan B, Mitchell PJ, Leung TW, Yavagal DR, Albers GW, Costalat V, Fiehler J, Zaidat OO, Jovin TG, Liebeskind DS, Nguyen TN, Miao Z. Endovascular Treatment for Acute Large Vessel Occlusion Due to Underlying Intracranial Atherosclerotic Disease. Semin Neurol 2023; 43:337-344. [PMID: 37549690 DOI: 10.1055/s-0043-1771207] [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: 08/09/2023]
Abstract
Intracranial atherosclerotic disease (ICAD) is one of the most common causes of acute ischemic stroke worldwide. Patients with acute large vessel occlusion due to underlying ICAD (ICAD-LVO) often do not achieve successful recanalization when undergoing mechanical thrombectomy (MT) alone, requiring rescue treatment, including intra-arterial thrombolysis, balloon angioplasty, and stenting. Therefore, early detection of ICAD-LVO before the procedure is important to enable physicians to select the optimal treatment strategy for ICAD-LVO to improve clinical outcomes. Early diagnosis of ICAD-LVO is challenging in the absence of consensus diagnostic criteria on noninvasive imaging and early digital subtraction angiography. In this review, we summarize the clinical and diagnostic criteria, prediction of ICAD-LVO prior to the procedure, and EVT strategy of ICAD-LVO and provide recommendations according to the current literature.
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Affiliation(s)
- Xiaochuan Huo
- Cerebrovascular Disease Department, Neurological Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Dapeng Sun
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenhuo Chen
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Hongxing Han
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China
| | | | - Volker Puetz
- Department of Neurology, University Clinics Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - Tingyu Yi
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Hao Wang
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China
| | - Raynald Liu
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xu Tong
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baixue Jia
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ning Ma
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Feng Gao
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dapeng Mo
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bernard Yan
- Department of Medicine and Neurology, Melbourne Brain Centre, Melbourne, Australia
| | - Peter J Mitchell
- Department of Radiology, Melbourne Brain Centre, Melbourne, Australia
| | - Thomas W Leung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - Dileep R Yavagal
- Departments of Neurology and Neurosurgery, Jackson Memorial Hospital, University of Miami Miller School of Medicine, Miami, Florida
| | - Gregory W Albers
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, California
| | - Vincent Costalat
- Department of Neuroradiology, Hôpital Güi-de-Chauliac, CHU de Montpellier, Montpellier, France
| | - Jens Fiehler
- Department of Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Osama O Zaidat
- Department of Neuroscience, Mercy Saint Vincent Medical Center, Toledo, Ohio
| | - Tudor G Jovin
- Department of Neurology, Cooper University Hospital, Camden, New Jersey
| | - David S Liebeskind
- Department of Neurology, University of California, Los Angeles, Los Angeles, California
| | - Thanh N Nguyen
- Department of Radiology, Boston Medical Center, Boston, Massachusetts
| | - Zhongrong Miao
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Yi T, Zhang Y, Chen WH, Wu YM, Lin DL, Lin XH, Zhang L, Xing PF, Li T, Zhang Y, Wang S, Yang P, Cai MZ, Liu J. Impact of leukoaraiosis in patients with acute ischemic stroke treated with thrombectomy: a post hoc analysis of the DIRECT-MT trial. J Neurointerv Surg 2023; 15:139-145. [PMID: 35101958 DOI: 10.1136/neurintsurg-2021-018293] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 10/05/2021] [Accepted: 01/09/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND The influence of leukoaraiosis in patients with acute ischemic stroke (AIS) given intra-arterial treatment (IAT) with or without preceding intravenous thrombolysis (IVT) remains unknown. OBJECTIVE To assess the clinical and radiological outcomes of IAT in patients with or without leukoaraiosis. METHODS Patients of the direct mechanical thrombectomy trial (DIRECT-MT) whose leukoaraiosis grade could be assessed were included. DIRECT-MT was a randomized clinical trial performed in China to assess the effect of direct IAT compared with intravenous thrombolysis plus IAT. We employed the Age-Related White Matter Changes Scale for grading leukoaraiosis (ARWMC, 0 indicates no leukoaraiosis, 1-2 indicates mild-to-moderate leukoaraiosis, and 3 indicates severe leukoaraiosis) based on brain CT. The primary outcome was the score on the modified Rankin Scale (mRS) assessed at 90 days. RESULTS There were 656 patients in the trial, 649 patients who were included, with 432 patients without leukoaraiosis, and 217 (33.4%) patients with leukoaraiosis divided into mild-to-moderate (n=139) and severe groups (n=78). Leukoaraiosis was a predictor of a worse mRS score (adjusted OR (aOR)=0.7 (95% CI 0.5 to 0.8)) and higher mortality (aOR=1.4 (1.1 to 1.9)), but it was not associated with symptomatic intracranial hemorrhage (sICH) (aOR=0.9 (0.5 to 1.5)). IVT preceding IAT did not increase sICH risk for patients with no (aOR=1.4 (0.6 to 3.4)), mild-to-moderate (aOR=1.5 (0.3 to 7.8)), or severe (aOR=1.5 (0.1 to 21.3)) leukoaraiosis. CONCLUSION Patients with leukoaraiosis with AIS due to large vessel occlusion are at increased risk of a poor functional outcome after IAT but demonstrate similar sICH rates, and IVT preceding IAT does not increase the risk of sICH in Chinese patients with leukoaraiosis.
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Affiliation(s)
- Tingyu Yi
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Yongxin Zhang
- Department of Cerebralvascular Disease Center, Changhai Hospital, Shanghai, China
| | - Wen-Huo Chen
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Yan-Min Wu
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Ding-Lai Lin
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Xiao-Hui Lin
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Lei Zhang
- Department of Cerebralvascular Disease Center, Changhai Hospital, Shanghai, China
| | - Peng-Fei Xing
- Department of Cerebralvascular Disease Center, Changhai Hospital, Shanghai, China
| | - Tianxiao Li
- Department of Cerebralvascular Disease Center, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Yongwei Zhang
- Department of Cerebralvascular Disease Center, Changhai Hospital, Shanghai, China
| | - Shouchun Wang
- Department of Neurology and Neuroscience Center, Jilin University First Hospital, Changchun, Jilin, China
| | - Pengfei Yang
- Department of Cerebralvascular Disease Center, Changhai Hospital, Shanghai, China
| | - Ming-Zhi Cai
- Department of Vascular Surgery, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China
| | - Jianmin Liu
- Department of Cerebralvascular Disease Center, Changhai Hospital, Shanghai, China
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Zhao H, Bai X, Li W, Tian Q, Wang W, Guo X, Feng Y, Duan L, Dmytriw AA, Patel AB, Yi T, Cao W, Min X, Chen W, Jiao L. Influence of pre-stroke dependency on safety and efficacy of endovascular therapy: A systematic review and meta-analysis. Front Neurol 2022; 13:956958. [PMID: 36212663 PMCID: PMC9532553 DOI: 10.3389/fneur.2022.956958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022] Open
Abstract
Background and purpose In the landmark trials studying endovascular thrombectomy (EVT), pre-stroke dependent (PSD) patients were generally excluded. This systematic review and meta-analysis aimed to compare the safety and efficacy of EVT between PSD and pre-stroke independent (PSI) patients. Methods We searched CENTRAL, Embase, and Ovid MEDLINE up to 11 November 2021 for studies assessing PSD and PSI patients, which were separately defined as pre-stroke mRS score >2 or >1, and ≤2 or ≤1 accordingly. Two authors extracted data and assessed the risk of bias. A meta-analysis was carried out using the random-effects model. Adjusted OR and 95% CI were used to estimate adjusted pool effects. The main outcomes included favorable outcomes, successful recanalization, symptomatic intracranial hemorrhage, and 90-day mortality. Results A total of 8,004 records met the initial search strategy, and ten studies were included in the final decision. Compared with PSImRS≤2, PSDmRS>2 had a lower favorable outcome (OR 0.51; 95% CI, 0.33-0.79) and higher 90-day mortality (OR 3.32; 95% CI, 2.77-3.98). No significant difference was found in successful recanalization and sICH. After adjustment, only 90-day mortality (aOR 1.99; 95% CI, 1.58-2.49) remained significantly higher in PSDmRS>2. Compared with PSImRS≤1, PSDmRS>1 had lower 90-day mortality (OR, 3.10; 95% CI, 1.84-5.24). No significant difference was found regarding the favorable outcome, successful recanalization, and sICH. After adjustment, no significant difference was found in a favorable outcome, but a higher rate of 90-day mortality (aOR, 2.13; 95% CI, 1.66-2.72) remained in PSDmRS>1. Conclusions PSD does not innately influence the EVT outcomes regarding sICH and favorable outcomes but may increase the risk of 90-day mortality. Until further evidence is available, it is reasonable to suggest EVT for patients with PSD.
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Affiliation(s)
- Hengxiao Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Xuesong Bai
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Wei Li
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Liaocheng Brain Hospital, Liaocheng, China
| | - Qiuyue Tian
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wenjiao Wang
- Department of Library, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaofan Guo
- Department of Neurology, Loma Linda University Health, Loma Linda, CA, United States
| | - Yao Feng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Linyan Duan
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China
| | - Adam A. Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Aman B. Patel
- Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Tingyu Yi
- Department of Neurology, Zhangzhou Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Wenbo Cao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
| | - Xiaoli Min
- Department of Cerebrovascular Diseases, The Second Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Wenhuo Chen
- Department of Neurology, Zhangzhou Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China International Neuroscience Institute (China-INI), Beijing, China
- Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
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9
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Lu S, Zhang Y, Zhang G, Zhou J, Cang S, Cheng Y, Wu G, Cao P, Lv D, Jian H, Chen C, Jin X, Tian P, Wang K, Jiang G, Chen G, Chen Q, Zhao H, Ding C, Guo R, Sun G, Wang B, Jiang L, Liu Z, Fang J, Yang J, Zhuang W, Liu Y, Zhang J, Pan Y, Chen J, Yu Q, Zhao M, Cui J, Li D, Yi T, Yu Z, Yang Y, Zhang Y, Zhi X, Huang Y, Wu R, Chen L, Zang A, Cao L, Li Q, Li X, Song Y, Wang D, Zhang S. EP08.02-139 A Phase 2 Study of Befotertinib in Patients with EGFR T790M Mutated NSCLC after Prior EGFR TKIs. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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10
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Zhou Q, Li J, Wang J, Yang L, Fang J, Dong X, Yi T, Min X, Xu F, Chen J, Zhong D, Bai J, Liu L, Zeng A, Tang J, Wu H, Luo X, Yu J, Su W, Wu YL. EP08.02-063 SANOVO: A Phase 3 Study of Savolitinib or Placebo in Combination with Osimertinib in Patients with EGFR-mutant and MET Overexpressed NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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11
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Yi T, Zhan A, Wu Y, Li Y, Zheng X, Lin D, Lin X, Pan Z, Chen R, Parsons M, Chen W, Lin L. Endovascular Treatment of ICAS Patients: Targeting Reperfusion Rather than Residual Stenosis. Brain Sci 2022; 12:brainsci12080966. [PMID: 35892407 PMCID: PMC9332149 DOI: 10.3390/brainsci12080966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/14/2022] [Accepted: 07/16/2022] [Indexed: 02/05/2023] Open
Abstract
Background and Purpose: Previous studies showed that acute reocclusion after endovascular therapy is related to residual stenosis. However, we observed that reperfusion status but not residual stenosis severity is related to acute reocclusion. This study aimed to assess which factor mention above is more likely to be associated with artery reocclusion after endovascular treatment. Methods: This study included 86 acute ischemic stroke patients who had middle cerebral artery (MCA) atherosclerotic occlusions and received endovascular treatment within 24 h of a stroke. The primary outcomes included intraprocedural reocclusion assessed during endovascular treatment and delayed reocclusion assessed through follow-up angiography. Results: Of the 86 patients, the intraprocedural reocclusion rate was 7.0% (6/86) and the delayed reocclusion rate was 2.3% (2/86). Regarding intraprocedural occlusion, for patients with severe residual stenosis, patients with successful thrombectomy reperfusion showed a significantly lower rate than unsuccessful thrombectomy reperfusion (0/30 vs. 6/31, p = 0.003); on the other hand, for patients with successful thrombectomy reperfusion, patients with severe residual stenosis showed no difference from those with mild to moderate residual stenosis in terms of intraprocedural occlusion (0/30 vs. 0/25, p = 1.00). In addition, after endovascular treatment, all patients achieved successful reperfusion. There was no significant difference in the delayed reocclusion rate between patients with severe residual stenosis and those with mild to moderate residual stenosis (2/25 vs. 0/61, p = 0.085). Conclusion: Reperfusion status rather than residual stenosis severity is associated with artery reocclusion after endovascular treatment. Once successful reperfusion was achieved, the reocclusion occurrence was fairly low in MCA atherosclerosis stroke patients, even with severe residual stenosis.
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Affiliation(s)
- Tingyu Yi
- Cerebrovascular and Neuro-Intervention Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (T.Y.); (Y.W.); (X.Z.); (D.L.); (X.L.); (Z.P.); (R.C.)
| | - Alai Zhan
- Radiology Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (A.Z.); (Y.L.)
| | - Yanmin Wu
- Cerebrovascular and Neuro-Intervention Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (T.Y.); (Y.W.); (X.Z.); (D.L.); (X.L.); (Z.P.); (R.C.)
| | - Yimin Li
- Radiology Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (A.Z.); (Y.L.)
| | - Xiufen Zheng
- Cerebrovascular and Neuro-Intervention Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (T.Y.); (Y.W.); (X.Z.); (D.L.); (X.L.); (Z.P.); (R.C.)
| | - Dinglai Lin
- Cerebrovascular and Neuro-Intervention Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (T.Y.); (Y.W.); (X.Z.); (D.L.); (X.L.); (Z.P.); (R.C.)
| | - Xiaohui Lin
- Cerebrovascular and Neuro-Intervention Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (T.Y.); (Y.W.); (X.Z.); (D.L.); (X.L.); (Z.P.); (R.C.)
| | - Zhinan Pan
- Cerebrovascular and Neuro-Intervention Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (T.Y.); (Y.W.); (X.Z.); (D.L.); (X.L.); (Z.P.); (R.C.)
| | - Rongcheng Chen
- Cerebrovascular and Neuro-Intervention Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (T.Y.); (Y.W.); (X.Z.); (D.L.); (X.L.); (Z.P.); (R.C.)
| | - Mark Parsons
- Department of Neurology and Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC 3050, Australia;
| | - Wenhuo Chen
- Cerebrovascular and Neuro-Intervention Department, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, China; (T.Y.); (Y.W.); (X.Z.); (D.L.); (X.L.); (Z.P.); (R.C.)
- Correspondence: (W.C.); (L.L.); Tel.: +86-13806906089 (W.C.); +86-13777446074 (L.L.)
| | - Longting Lin
- Department of Neurology and Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC 3050, Australia;
- Correspondence: (W.C.); (L.L.); Tel.: +86-13806906089 (W.C.); +86-13777446074 (L.L.)
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12
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Yang H, Lin D, Lin X, Wu Y, Yi T, Chen W. Outcomes and CT Perfusion Thresholds of Mechanical Thrombectomy for Patients With Large Ischemic Core Lesions. Front Neurol 2022; 13:856403. [PMID: 35720105 DOI: 10.3389/fneur.2022.856403] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To explore the clinical prognosis and factors after mechanical thrombectomy (MT) in patients with large cerebral infarction assessed by computed tomographic perfusion (CTP)and the optimal threshold of cerebral blood flow (CBF) for estimating ischemic core. Methods We analyzed data from the anterior circulation database of our hospital (August 2018-June 2021). Multivariate logistic regression analyses identified the predictors of clinical outcomes for patients with large baseline infarcts (>50 ml) assessed by the MIStar software. The receiver operating characteristic (ROC) analysis was used to explore the cutoff value of factors. Results The present study included one hundred thirty-seven patients with large baseline infarcts. Moreover, 23 (16.8%) patients achieved functionally independent outcomes, and 50 (36.5%) patients died at 90 days. A total of 20 (14.7%) patients had symptomatic intracranial hemorrhage (sICH). The multivariable analysis showed that higher age and larger core volume were independent of poor outcomes. The cutoff value of core volume was 90 ml, and the age was 76 years. Hypertension and rt-PA treatment were independent factors of sICH. Higher age and larger ischemic volume were independent risk factors of mortality. Conclusions Mechanical thrombectomy can be applied in patients with large ischemic core volumes. Patients older than 76 years with large cores (>90 ml) are unlikely to benefit from MT. These findings may be helpful in selecting patients with large baseline infarcts to be treated by MT. The threshold of CBF < 30% is the independent factor, and this is worth evaluating in future studies to find the optimal threshold of CBF.
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Affiliation(s)
- Hongchao Yang
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Dinglai Lin
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Xiaohui Lin
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Yanmin Wu
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Tingyu Yi
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Wenhuo Chen
- Department of Neurology, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China
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13
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Yi T, Chen W, Wu Y, Pan Z, Lin X, Lin D, Chen R, Zheng X. Intra-Arterial Injection of Thrombin as Rescue Therapy of Vessel Perforation during Mechanical Thrombectomy for Acute Ischemic Stroke. Brain Sci 2022; 12:brainsci12060760. [PMID: 35741645 PMCID: PMC9221224 DOI: 10.3390/brainsci12060760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/25/2022] [Accepted: 06/08/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Vessel perforation during stent mechanical thrombectomy (MT) is a rare and disastrous complication. A routine rescue strategy includes balloon occlusion for tamponade, procedure suspension, and lowering or normalizing blood pressure. However, this complication is still associated with poor outcome and high mortality. Objective: We present our experience with intra-arterial injection of thrombin in the treatment of vessel perforation secondary to microcatheter/microwire perforation, which prevents further deterioration in clinical outcomes. Methods: Cases with intraprocedural vessel perforation during mechanical thrombectomy were included in the final analysis. Clinical data, procedural details, and radiographic and clinical outcomes were collected. Results: Four patients with intraprocedural vessel perforation were included. Intraprocedural perforations occurred at the distal middle cerebral artery in two cases: the A2 segment in one case and the internal carotid artery terminus in one case. The etiology of four cases was intracranial atherosclerotic stenosis (ICAS). The ruptured vessels were effectively occluded in all cases. Endovascular therapy was continued in three cases, and mTICI ≥ 2b recanalization was achieved in all cases. The culprit artery was kept patent on CTA for 72 h post-operation. No active bleeding was detected on follow-up CT post-operation. During the 90-day follow-up period, one patient died, modified Rankle Scare (mRS) 3 was observed in two patients, and mRS 4 was observed in one patient. Conclusions: The key benefit of this method is occluding the ruptured vessel without affecting the following MT. We propose that intra-arterial injection of prothrombin may be simple yet effective in managing vessel perforation complications during MT.
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Hsieh B, Rex N, Yi T, Collins S, Kimia B, Bai H, Jiao Z. Abstract No. 128 Machine learning to assess treatment outcomes of microwave ablation for lung tumors based on pre-ablation radiomic features. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.209] [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
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15
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Tran L, Meng S, Wang P, Pan I, Yi T, Wang R, Jiao Z, Bai H. Abstract No. 240 Automated outcome prediction in mechanical thrombectomy for acute large vessel ischemic stroke using 3D convolutional neural networks applied to CT angiography. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.321] [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
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Min X, Du J, Bai X, Wei T, Dmytriw AA, Patel AB, Zhang X, Xu X, Feng Y, Wang T, Wang X, Yang K, Hu W, Yi T, Chen W, Jiao L. Antegrade or Retrograde Approach for the Management of Tandem Occlusions in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Front Neurol 2022; 12:757665. [PMID: 35095720 PMCID: PMC8790816 DOI: 10.3389/fneur.2021.757665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Acute ischemic stroke (AIS) caused by tandem intracranial and extracranial occlusions is not rare. However, optimal strategy between antegrade (extracranial first) or retrograde (intracranial first) approaches still remains elusive. This systematic review and meta-analysis aim to compare the two approaches to provide updated clinical evidence of strategy selection. Methods: PubMed, Ovid, Web of Science, and the Cochrane Library were searched for literature comparing antegrade and retrograde approaches for patients with AIS with concomitant tandem occlusions. Outcomes including successful reperfusion [Throbolysis in Cerebral Infarction (TICI) 2b-3] and 90-day favorable outcome [modified Rankin Scale (mRS) 0-2], any intracerebral hemorrhage, symptomatic intracerebral hemorrhage, procedural complications, and mortality were evaluated. The risk of bias was assessed using the Newcastle-Ottawa Scale and illustrated in the Funnel plot. Heterogeneity was assessed by I 2 statistic. Subgroup and sensitivity analyses were also performed. Results: A total of 11 studies accounting 1,517 patients were included. 831 (55%) patients were treated with an antegrade approach and 686 (45%) patients were treated with the retrograde approach. A higher successful reperfusion rate was achieved in retrograde group than that of antegrade group [83.8 vs. 78.0%; odds ratio (OR): 0.63, 95% CI: 0.40-0.99, p = 0.04]. 90-day favorable outcome (mRS 0-2 at 90 days) also showed significantly higher in retrograde group compared with antegrade group (47.3 vs. 40.2%; OR: 0.72, 95% CI: 0.58-0.89, p = 0.002). The incidence of any intracranial hemorrhage (ICH), symptomatic intracranial hemorrhage, 90-day mortality, and other complications did not differ between two groups. Conclusion: In AIS with tandem occlusions, the retrograde approach might achieve a higher successful reperfusion rate and better functional outcome with a comparable safety profile when compared with an antegrade approach. Further prospective controlled studies with more meticulous design and a higher level of evidence are needed to confirm these results. Systematic Review Registration: "PROSPERO" database (CRD 42020199093), https://www.crd.york.ac.uk/PROSPERO/.
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Affiliation(s)
- Xiaoli Min
- Department of Cerebrovascular Diseases, The Second Affiliated Hospital, Kunming Medical University, Kunming, China.,Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jianhua Du
- Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xuesong Bai
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,China International Neuroscience Institute (China-INI), Beijing, China
| | - Tao Wei
- Library, Kunming Medical University, Kunming, China
| | - Adam A Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Aman B Patel
- Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Xiao Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,China International Neuroscience Institute (China-INI), Beijing, China
| | - Xin Xu
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,China International Neuroscience Institute (China-INI), Beijing, China
| | - Yao Feng
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,China International Neuroscience Institute (China-INI), Beijing, China
| | - Tao Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,China International Neuroscience Institute (China-INI), Beijing, China
| | - Xue Wang
- Medical Library, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kun Yang
- Department of Evidence-Based Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Weiwu Hu
- Department of Neurology, The First Traditional Chinese Medicine Hospital of Chengde, Chengde, China
| | - Tingyu Yi
- Department of Neurology, Zhangzhou Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Wenhuo Chen
- Department of Neurology, Zhangzhou Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Liqun Jiao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.,China International Neuroscience Institute (China-INI), Beijing, China.,Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Wang J, Yi T, Dong Y, Ran R, Cao F, Li Y, Luo Z, Xu Y, Fu Y, Kuang L, Chen G, Qu G, Yin Y, Li J, Xu X, Chen Y, Song Q, Chu Q. P40.06 A Real-World Study: Efficacy and Safety of Anlotinib for Advanced Non-Small Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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18
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Zhou T, Yi T, Li T, Zhu L, Li Y, Li Z, Wang M, Li Q, He Y, Yang P, Zhang Y, Li Z, Zhang Y, Ye X, Chen W, Wang S, Liu J. Predictors of futile recanalization in patients undergoing endovascular treatment in the DIRECT-MT trial. J Neurointerv Surg 2021; 14:752-755. [PMID: 34475255 DOI: 10.1136/neurintsurg-2021-017765] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/23/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Futile recanalization-when patients have a successful recanalization but fail to achieve a satisfactory functional outcome- is a common phenomenon of endovascular treatment of acute ischemic stroke (AIS). The present study aimed to identify the predictors of futile recanalization in AIS patients who received endovascular treatment. METHODS This is a post-hoc analysis of the DIRECT-MT trial. Demographics, clinical characteristics, acute stroke workflow interval times, biochemical parameters, and imaging characteristics were compared between futile and meaningful recanalization groups. Multivariate analysis was performed to identify the predictors of futile recanalization. RESULTS Futile recanalization was observed in 277 patients. In multivariable logistic regression analysis, older age (p<0.001), higher baseline systolic blood pressure (SBP) (p=0.032), incomplete reperfusion defined by extended Thrombolysis In Cerebral Infarction (eTICI) grades (p=0.020), and larger final infarct volume (FIV) (p<0.001) were independent predictors of futile recanalization. CONCLUSIONS Old age, high baseline SBP, incomplete reperfusion defined by eTICI, and large FIV were independent predictors of futile recanalization after endovascular therapy for AIS.
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Affiliation(s)
- Tengfei Zhou
- Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China.,Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Tingyu Yi
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Tianxiao Li
- Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China .,Department of Cerebrovascular Disease, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Liangfu Zhu
- Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Yucheng Li
- Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Zhaoshuo Li
- Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Meiyun Wang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Qiang Li
- Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Yingkun He
- Department of Cerebrovascular Disease, Henan Provincial People's Hospital, Zhengzhou, Henan, China
| | - Pengfei Yang
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
| | - Yongwei Zhang
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
| | - Zifu Li
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
| | - Yongxin Zhang
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
| | - Xiaofei Ye
- Department of Statistics, Naval Medical University, Shanghai, China
| | - Wenhuo Chen
- Department of Neurology, Zhangzhou Municipal Hospital of Fujian Province and Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China
| | - Shouchun Wang
- Department of Neurology, The First Affiliated Hospital of Jilin University, Changchun, China
| | - Jianmin Liu
- Department of Neurosurgery, Naval Medical University Changhai Hospital, Shanghai, China
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Montardy Q, Wei M, Liu X, Yi T, Zhou Z, Lai J, Zhao B, Besnard S, Tighilet B, Chabbert C, Wang L. Selective optogenetic stimulation of glutamatergic, but not GABAergic, vestibular nuclei neurons induces immediate and reversible postural imbalance in mice. Prog Neurobiol 2021; 204:102085. [PMID: 34171443 DOI: 10.1016/j.pneurobio.2021.102085] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/21/2021] [Accepted: 05/25/2021] [Indexed: 11/24/2022]
Abstract
Glutamatergic and GABAergic neurons represent the neural components of the medial vestibular nuclei. We assessed the functional role of glutamatergic and GABAergic neuronal pathways arising from the vestibular nuclei (VN) in the maintenance of gait and balance by optogenetically stimulating the VN in VGluT2-cre and GAD2-cre mice. We demonstrate that glutamatergic, but not GABAergic VN neuronal subpopulation is responsible for immediate and strong posturo-locomotor deficits, comparable to unilateral vestibular deafferentation models. During optogenetic stimulation, the support surface dramatically increased in VNVGluT2+ mice, and rapidly fell back to baseline after stimulation, whilst it remained unchanged during similar stimulation of VNGAD2+ mice. This effect persisted when vestibular tactilo kinesthesic plantar inputs were removed. Posturo-locomotor alterations evoked in VNVGluT2+ animals were still present immediately after stimulation, while they disappeared 1 h later. Overall, these results indicate a fundamental role for VNVGluT2+ neurons in balance and posturo-locomotor functions, but not for VNGAD2+ neurons, in this specific context. This new optogenetic approach will be useful to characterize the role of the different VN neuronal populations involved in vestibular physiology and pathophysiology.
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Affiliation(s)
- Q Montardy
- Shenzhen Key Lab of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China; GDR Physiopathologie Vestibulaire - unité GDR2074 CNRS, France
| | - M Wei
- Shenzhen Key Lab of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - X Liu
- Shenzhen Key Lab of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - T Yi
- Shenzhen Key Lab of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - Z Zhou
- Shenzhen Key Lab of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China; McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - J Lai
- Shenzhen Key Lab of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - B Zhao
- Shenzhen Key Lab of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - S Besnard
- Aix Marseille University-CNRS, Laboratory of Sensory and Cognitive Neurosciences, UMR 7260, Team Pathophysiology and Therapy of Vestibular Disorders, Marseille, France; Université de Caen Normandie, CHU de Caen, Caen, France; GDR Physiopathologie Vestibulaire - unité GDR2074 CNRS, France
| | - B Tighilet
- Aix Marseille University-CNRS, Laboratory of Sensory and Cognitive Neurosciences, UMR 7260, Team Pathophysiology and Therapy of Vestibular Disorders, Marseille, France; GDR Physiopathologie Vestibulaire - unité GDR2074 CNRS, France.
| | - C Chabbert
- Aix Marseille University-CNRS, Laboratory of Sensory and Cognitive Neurosciences, UMR 7260, Team Pathophysiology and Therapy of Vestibular Disorders, Marseille, France; GDR Physiopathologie Vestibulaire - unité GDR2074 CNRS, France.
| | - L Wang
- Shenzhen Key Lab of Neuropsychiatric Modulation and Collaborative Innovation Center for Brain Science, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Center for Excellence in Brain Science and Intelligence Technology, The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.
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Zhou C, Jiang L, Dong X, Gu K, Pan Y, Shi Q, Zhang G, Wang H, Zhang X, Yang N, Li Y, Xiong J, Yi T, Peng M, Song Y, Fan Y, Cui J, Chen G, Tan W, Zang A, Guo Q, Zhao G, Wang Z, He J, Yao W, Wu X, Chen K, Hu X, Hu C, Yue L, Jiang D, Wang G, Liu J, Yu G. MA01.04 A Randomized Study Comparing Cisplatin/Paclitaxel Liposome vs Cisplatin/Gemcitabine in Chemonaive, Advanced Squamous NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.200] [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: 10/21/2022]
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21
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Shen R, Yin XL, Li JP, Peng JJ, Yi T, Jia HK, Xu HX, Zeng HQ, Zhou Y. [Myeloid sarcoma of the small intestine with CBFβ-MYH11 as the primary manifestation of acute myeloid leukemia with inv(16)and+22: a case report]. Zhonghua Xue Ye Xue Za Zhi 2021; 41:873. [PMID: 33190452 PMCID: PMC7656070 DOI: 10.3760/cma.j.issn.0253-2727.2020.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- R Shen
- Department of Hematology, Changsha Central Hospital, Nanhua University, Changsha 410004, China
| | - X L Yin
- Department of hematology, 923 hospital of the PLA joint logistic support force, Nanning 530021, China
| | - J P Li
- Department of Hematology, Changsha Central Hospital, Nanhua University, Changsha 410004, China
| | - J J Peng
- Department of Hematology, Changsha Central Hospital, Nanhua University, Changsha 410004, China
| | - T Yi
- Department of Hematology, Changsha Central Hospital, Nanhua University, Changsha 410004, China
| | - H K Jia
- Department of Hematology, Changsha Central Hospital, Nanhua University, Changsha 410004, China
| | - H X Xu
- Department of Hematology, Changsha Central Hospital, Nanhua University, Changsha 410004, China
| | - H Q Zeng
- Department of Hematology, Changsha Central Hospital, Nanhua University, Changsha 410004, China
| | - Y Zhou
- Department of Hematology, Changsha Central Hospital, Nanhua University, Changsha 410004, China
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Peng LY, Yi T, Song XP, Liu H, Yang HJ, Huang JG. Mobilization of recalcitrant phosphorous and enhancement of pepper P uptake and yield by a new biocontrol and bioremediation bacterium Burkholderia cepacia CQ18. J Appl Microbiol 2020; 130:1935-1948. [PMID: 32902082 DOI: 10.1111/jam.14844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 11/29/2022]
Abstract
AIMS Phosphorus (P) is a finite resource and inoculation of phosphorus-mobilizing bacteria (PMB) is a promising approach for the enhancement of soil P availability and plant P uptake. This drives scientists to search for the microbes effective in mobilizing legacy P in soils. METHODS AND RESULTS The current incubation and greenhouse pot experiments were conducted to investigate P mobilization and pepper P uptake as affected by a new biocontrol and bioremediation bacterium Burkholderia cepacia CQ18. This bacterium converted Ca3 (PO4 )2 , FePO4 , AlPO4 , and lecithin into soluble inorganic P in the culture solutions and increased available P (including water-soluble P and Olsen P) in the soil. There were positive correlations between the soluble inorganic phosphorus and the exudates (protons, organic acids (oxalate and gluconate), siderophores and phosphatases) in culture solutions. Pepper plant biomass, fruit yield and P uptake changed in the sequence: chemical fertilizers plus bacterial inoculant >only chemical fertilizers >only bacterial inoculant >blank control. CONCLUSIONS Taking into account the wide spectrums of P mobilization and simultaneous production of acid, neutral and alkaline phosphatases at a given pH, B.cepacia CQ18 may be a potential PMB used in soils with wide pH ranges. The mechanisms employed by this bacterium in the solubilization of recalcitrant inorganic P could be the efflux of protons, organic acids (oxalate and gluconate) and siderophores. Phosphatases could be of utmost importance in the mineralization of the organic P. The production of siderophores and phosphatases by of B.cepacia CQ18 could thus be crucial for not only the antagonism against plant pathogens but also the mobilization of soil sparingly available P. SIGNIFICANCE AND IMPACT OF THE STUDY Burkholderia cepacia CQ18 could be potentially developed into a biofertilizer.
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Affiliation(s)
- L Y Peng
- College of Resources and Environment, Southwest University, Chongqing, China
| | - T Yi
- College of Resources and Environment, Southwest University, Chongqing, China
| | - X P Song
- College of Resources and Environment, Southwest University, Chongqing, China
| | - H Liu
- College of Resources and Environment, Southwest University, Chongqing, China
| | - H J Yang
- College of Resources and Environment, Southwest University, Chongqing, China
| | - J G Huang
- College of Resources and Environment, Southwest University, Chongqing, China
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Sun H, Yi T, Hao X, Yan H, Wang J, Li Q, Gu X, Zhou X, Wang S, Wang X, Wan P, Han L, Chen J, Zhu H, Zhang H, He Y. Contribution of single-gene defects to congenital cardiac left-sided lesions in the prenatal setting. Ultrasound Obstet Gynecol 2020; 56:225-232. [PMID: 31633846 DOI: 10.1002/uog.21883] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/08/2019] [Accepted: 09/20/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To explore the contribution of single-gene defects to the genetic cause of cardiac left-sided lesions (LSLs), and to evaluate the incremental diagnostic yield of whole-exome sequencing (WES) for single-gene defects in fetuses with LSLs without aneuploidy or a pathogenic copy-number variant (pCNV). METHODS Between 10 April 2015 and 30 October 2018, we recruited 80 pregnant women diagnosed with a LSL who had termination of pregnancy and genetic testing. Eligible LSLs were aortic valve atresia or stenosis, coarctation of the aorta, mitral atresia or stenosis and hypoplastic left heart syndrome (HLHS). CNV sequencing (CNV-seq) and WES were performed sequentially on specimens from these fetuses and their parents. CNV-seq was used to identify aneuploidies and pCNVs, while WES was used to identify diagnostic genetic variants in cases without aneuploidy or pCNV. RESULTS Of 80 pregnancies included in the study, 27 (33.8%) had a genetic diagnosis. CNV-seq analysis identified six (7.5%) fetuses with aneuploidy and eight (10.0%) with pCNVs. WES analysis of the remaining 66 cases revealed diagnostic genetic variants in 13 (19.7%) cases, indicating that the diagnostic yield of WES for the entire cohort was 16.3% (13/80). KMT2D was the most frequently mutated gene (7/66 (10.6%)) in fetuses with LSL without aneuploidy or pCNVs, followed by NOTCH1 (4/66 (6.1%)). HLHS was the most prevalent cardiac phenotype (4/7) in cases with a KMT2D mutation in this cohort. An additional six (9.1%) cases were found to have potentially deleterious variants in candidate genes. CONCLUSIONS Single-gene defects contribute substantially to the genetic etiology of fetal LSLs. KMT2D mutations accounted for approximately 10% of LSLs in our fetal cohort. WES has the potential to provide genetic diagnoses in fetuses with LSLs without aneuploidy or pCNVs. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- H Sun
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing, China
- Beijing Advanced Innovation Center for Biomedical Engineering, Beihang University, Beijing, China
| | - T Yi
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing, China
| | - X Hao
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing, China
| | - H Yan
- Baijia kangran biotechnology LLC, Beijing, China
| | - J Wang
- College of Life Science, Tsinghua University, Beijing, China
| | - Q Li
- Baijia kangran biotechnology LLC, Beijing, China
| | - X Gu
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing, China
| | - X Zhou
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - S Wang
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - X Wang
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - P Wan
- Berry Genomics Corporation, Beijing, China
| | - L Han
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Laboratory for Cardiovascular Precision Medicine, Beijing, China
| | - J Chen
- Department of Ultrasound, Shenzhen Second People's Hospital, Shenzhen, China
| | - H Zhu
- State Key Laboratory of Software Development Environment, Beihang University, Beijing, China
| | - H Zhang
- Beijing Laboratory for Cardiovascular Precision Medicine, Beijing, China
- Department of Cardiac Surgery, Beijing ChaoYang Hospital, Capital Medical University, Beijing, China
| | - Y He
- Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Maternal-Fetal Medicine in Fetal Heart Disease, Beijing, China
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24
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Chen JW, Chang WJ, Zhang ZY, He GD, Feng QY, Zhu DX, Yi T, Lin Q, Wei Y, Xu JM. [Risk factors of anastomotic leakage after robotic surgery for low and mid rectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:364-369. [PMID: 32306604 DOI: 10.3760/cma.j.cn.441530-20200212-00052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the risk factors associated with anastomotic leakage after robotic surgery in mid-low rectal cancer. Methods: A retrospective case-control study method was conducted. Inclusion criteria: (1) 18 to 80 years old; (2) pathologically confirmed rectal cancer; (3) distance <10 cm from tumor to anal margin; (4) robotic anterior rectal resection. Patients with previous history of colorectal cancer surgery, distant metastases or other malignant tumors, undergoing emergency surgery, with severe abdominal adhesions or those receiving combined organ resection were excluded. Based on the above criteria, 636 patients undergoing robotic radical sphincter-preserving surgery for mid-low rectal cancer in Zhongshan Hospital from January 2015 to December 2018 were included in this study, including 398 males (62.6%) and 238 females (37.4%) with a mean age of (61.9±11.3) years. Sixty-eight cases (10.7%) received neoadjuvant chemoradiotherapy. Amony the 636 included patients, 123(19.3%) underwent natural orifice specimen extraction surgery (NOSES) and 15 (2.3%) underwent preventive stoma. According to the cirteria developed by the International Rectal Cancer Research Group in 2010, the anastomotic leakage was classified as grade A (no requirement of intervention), B (requirement of intervention), and C (requirement of operation). Logistic regression was used to analyze the relationship between anastomotic leakage and clinicopathological factors. Factors in univariate analysis with P<0.05 were included in the multivariate analysis. Results: Anastomotic leakage occurred in 38 cases (6.0%). The grading of anastomotic leakage was grade A in 13 cases (2.0%), grade B in 19 cases (3.0%), and grade C in 6 cases (0.9%). The 3-year disease-free survival rate of patients with anastomotic leakage and without anastomotic leakage was 83.5% and 83.6% respectively (P=0.862); the 3-year overall survival rate of the two group was 85.1% and 87.5% respectively (P=0.296). The results of univariate logistic regression analysis showed that male (P=0.011), longer operation time (P=0.042), distance ≤5 cm from tumor to anal margin (P=0.012), more intraoperative blood loss (P=0.048) were associated with anastomotic leakage (all P<0.05). NOSES was not associated with anastomotic leakage (P=0.704). Multivariate analysis confirmed that male (OR=3.03, 95%CI: 1.37 to 7.14, P=0.010), operation time ≥180 minutes (OR=2.04, 95%CI: 1.03 to 3.99, P=0.040), distance ≤5 cm from tumor to anal margin (OR=2.56, 95%CI:1.28 to 5.26, P=0.008) were independent risk factors for anastomotic leakage. Conclusion: Male, short distance from tumor to anal margin, and long operation time are independent risk factors for anastomotic leakage in patients undergoing robotic mid-low rectal cancer radical surgeries. These patients need to be cautiously treated during surgery.
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Affiliation(s)
- J W Chen
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - W J Chang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Z Y Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - G D He
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Q Y Feng
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - D X Zhu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - T Yi
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Q Lin
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Y Wei
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - J M Xu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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Jo SJ, Jeong SY, Kwon H, Lee SH, Oh HS, Yi T, Park PK, Lee CH, Kim TG. Effects of quorum quenching on temporal succession of activated sludge microbial community in a membrane bioreactor. J Appl Microbiol 2019; 128:907-918. [PMID: 31710752 DOI: 10.1111/jam.14514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 12/01/2022]
Abstract
AIMS Quorum quenching (QQ) is an attractive strategy for mitigating biofouling in membrane bioreactors (MBRs). However, the effects of QQ on the activated sludge (AS) process have not been adequately evaluated. This study investigated the long-term effects of QQ on a laboratory-scale anoxic-oxic MBR, focusing on AS performance and microbial community. METHODS AND RESULTS Anoxic-oxic MBRs with and without QQ were operated for 91 days. QQ did not affect COD and TN removal efficiencies over the experimental period, during which its activity remained >90%. QQ reduced floc size by approximately 8% but had no effect on biomass concentration. AS microbial communities were regularly analysed using massively parallel sequencing. AS bacterial communities were temporally dynamic irrespective of QQ presence, for example, a temporal increase in bacterial diversity and a temporal decay of community similarity. QQ counteracted the temporal change in diversity and the temporal distance-community decay. Community comparison revealed that QQ changed the successional trajectory of the AS community at a late period, because it decelerated temporal changes of specific members, such as Thiothrix and Sphingomonadaceae*. Correlation networks revealed that QQ increased network clustering, complexity and density. The combined results suggest that the tighter microbial association by QQ increased the community resistance. CONCLUSIONS QQ can enhance the diversity and stability of the AS community in MBR by counteracting the innate temporal change in community structure. SIGNIFICANCE AND IMPACT OF THE STUDY Our findings are useful for the further advancement of QQ-based strategies in engineered microbial environments.
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Affiliation(s)
- S J Jo
- School of Chemical and Biological Engineering, Seoul National University, Seoul, Republic of Korea
| | - S-Y Jeong
- Department of Microbiology, Pusan National University, Pusan, Republic of Korea
| | - H Kwon
- School of Chemical and Biological Engineering, Seoul National University, Seoul, Republic of Korea
| | - S H Lee
- Department of Earth Sciences, University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | - H-S Oh
- Department of Environmental Engineering, Seoul National University of Science and Technology, Seoul, Republic of Korea
| | - T Yi
- National Institute of Ecology, Seocheon, Republic of Korea
| | - P-K Park
- Department of Environmental Engineering, Yonsei University, Wonju, Republic of Korea
| | - C-H Lee
- School of Chemical and Biological Engineering, Seoul National University, Seoul, Republic of Korea
| | - T G Kim
- Department of Microbiology, Pusan National University, Pusan, Republic of Korea
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Yi T, Sun H, Fu Y, Wang J, He Y. P4649Whole exome sequencing and whole genome sequencing improves genetic diagnosis of fetals with heterotaxy syndrome revealed by prenatal ultrasound. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heterotaxy (Htx) syndrome is an congenital disorders resulting from incorrectly establishment of left-right patterning during embryogenesis. Over 96% of patients with Htx exhibit some form of congenital heart disease (CHD),and has relatively poor survival. Multiple lines of evidence support genetic contributions to the etiology of Htx. As a specific genetic etiology is currently identifiable in only a minority of patients, there remains enormous potential for novel gene and pathway discovery.
Purpose
The aim of this study was to investigate the diagnostic yield of whole-exome sequencing (WES) and whole-genome sequencing (WGS) in fetuses with the pathogenesis of Htx, to explore candidate genes for Htx and to expand the clinical phenotype of known genetic conditions.
Method
WES and WGS were performed on specimens from 46 fetuses diagnosed with Htx and their parents. The single-nucleotide variants (SNVs) and copy-number variants (CNVs) were filtered and annotated by standard analysis process. All reported variants were classified according to he American College of Medical Genetics and Genomics guidelines.
Results
In the 46 fetuses, the detection rates of pathogenic and likely pathogenic variations were21.7% (10/46) and 10.9% (5/46) respectively. Ten pathogenic variations were identified on genes of CCDC114, DNAH11, ARMC4, STRA6, PQBP1 (hemizygote), HYDIN, RAI1 (Alagille Syndrome), ZFMP2 and Del(22q11.2) Syndrome. Five likely pathogenic variation were on DNAAF1 (Holshner syndrome), NF1, NEXN, NOTCH3 and FOXC1. Of 30 fetuses with prenatally diagnosed right atrial isomerism (RAI), the main intracardiac anomalies were atrioventricular canal (AV canal), isomerism of right atrial appendages, pulmonary stenosis or atresia (PS & PA) and right aortic arch. In 16 fetuses diagnosed left atrial isomerism (LAI) the main intracardiac anomalies were isomerism of left atrial appendages, interrupted IVC and azygos vein continuation. Of the 10 positive cases, 8 fetus were diagnosed of RAI and 2 were diagnosed of LAI by prenatal ultrasonic examination or fetal autopsy. The detection rate was 8/30 (26.7%) for RAI and 2/16 (12.5%) for LAI.
Conclusion
This study outlines the way for a substantial improvement in the diagnostic yield of prenatal genetic disorders in Htx through WES and WGS. Our experience also expanded the knowledge of the clinical phenotype of known genetic conditions. Our results indicate that the proportion of SNV in Htx of prenatal cases was significantly higher than that in patients with other congenital heart abnormalities, and the recessive inheritance occurred in a higher proportion in Htx. Our results have important implications for clinical management and genetic counseling of Htx.
Acknowledgement/Funding
Ministry of Science and Technology of the People's Republic of China
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Affiliation(s)
- T Yi
- Beijing Anzhen Hospital, Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing, China
| | - H Sun
- Beijing Anzhen Hospital, Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing, China
| | - Y Fu
- Peking University international hospital, Beijing, China
| | - J Wang
- Tsinghua University, Beijing, China
| | - Y He
- Beijing Anzhen Hospital, Beijing Key Laboratory of Maternal-Fetal Medicine and Fetal Heart Disease, Beijing, China
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Sun HR, Hao XY, Yi T, Gu XY, He YH. P4647Next generation sequencing in 83 fetal left-sided CHDs reveals the entire genetic architecture of left-sided CHDs in fetal population. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
No data is available for the contribution of single gene disorders (SGDs) to left-sided congenital heart defects (LSCHDs) in the fetal population.
Purpose
The aim of this study was to explore the entire genetic architecture of LSCHDs, especially the contribution of SGDs in a cohort of fetal LSCHDs.
Methods
Low-pass whole genome sequencing (WGS) and whole exome sequencing (WES) were performed on specimens from 83 deceased fetuses with lSCHDs, including 48 HLHS, 22 CoA, 5 AS, 3 AAH, 2 AS+CoA and 1 case of AA, AS+MS, MA. Sequencing was predominantly performed in fetus-parent trios (n=63, 75.9%), or in fetus only (n=20, 24.1%).
Results
34.9% (n=29) of the 83 fetal left-sided CHDs were identified with related genetic abnormalities. WGS analysis identified 14 (16.9%) with chromosomal abnormalities, including 6 (7.2%) aneuploidies and 8 (9.6%) pathogenic copy number variants (CNVs). WES analysis of the remaining 69 cases without chromosomal abnormalities identified 15 (15/69, 21.7%) with pathogenic/likely pathogenic variants. Of these 15 cases, KMT2D was the most frequently mutated gene (7/69, 10.1%), followed by NOTCH1 (4/69, 2.5%). Compound heterozygosity was identified in 3 genes (DNAH11, POFUT1, CRB2) that are not yet well established as CHD genes. Finally, we also observed a LOF variant in NONO (X-linked) that was maternally transmitted to an affected male case.
The genetic results of this cohort Aneuploidies Trisomy 18 4 Turner syndrome 2 CNVs 11q terminal deletion 3 1p36 deletion 1 15q terminal deletion 1 7q11.23 deletion 1 4p terminal deletion 1 12q complex internal duplication 1 SGDs AD (KMT2D = 7; NOTCH1 = 4) 11 AR (DNAH11, POFUT1, CRB2) 3 X-recessive (NONO) 1 AD: autosomal dominant; AR: autosomal recessive.
Conclusions
Our experience supports that SGDs contribute a significant part to the pathogenesis of fetal CHDs, WES has the potential to provide molecular diagnoses in fetal left-sided CHDs without chromosomal abnormalities. KMT2D mutations accounted for a large fraction of left-sided CHDs in fetal population. If the KMT2D mutation is detected, further diagnosis of Kabuki syndrome should be considered.
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Affiliation(s)
- H R Sun
- Beijing Anzhen Hospital, Department of echocardiography, Beijing, China
| | - X Y Hao
- Beijing Anzhen Hospital, Department of echocardiography, Beijing, China
| | - T Yi
- Beijing Anzhen Hospital, Department of echocardiography, Beijing, China
| | - X Y Gu
- Beijing Anzhen Hospital, Department of echocardiography, Beijing, China
| | - Y H He
- Beijing Anzhen Hospital, Department of echocardiography, Beijing, China
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Abstract
Intraoperative cone-beam CT (CBCT) is increasingly used for surgical navigation and validation of device placement. In spinal deformity correction, CBCT provides visualization of pedicle screws and fixation rods in relation to adjacent anatomy. This work reports and evaluates a method that uses prior information regarding such surgical instrumentation for improved metal artifact reduction (MAR). The known-component MAR (KC-MAR) approach achieves precise localization of instrumentation in projection images using rigid or deformable 3D-2D registration of component models, thereby overcoming residual errors associated with segmentation-based methods. Projection data containing metal components are processed via 2D inpainting of the detector signal, followed by 3D filtered back-projection (FBP). Phantom studies were performed to identify nominal algorithm parameters and quantitatively investigate performance over a range of component material composition and size. A cadaver study emulating screw and rod placement in spinal deformity correction was conducted to evaluate performance under realistic clinical imaging conditions. KC-MAR demonstrated reduction in artifacts (standard deviation in voxel values) across a range of component types and dose levels, reducing the artifact to 5-10 HU. Accurate component delineation was demonstrated for rigid (screw) and deformable (rod) models with sub-mm registration errors, and a single-pixel dilation of the projected components was found to compensate for partial-volume effects. Artifacts associated with spine screws and rods were reduced by 40%-80% in cadaver studies, and the resulting images demonstrated markedly improved visualization of instrumentation (e.g. screw threads) within cortical margins. The KC-MAR algorithm combines knowledge of surgical instrumentation with 3D image reconstruction in a manner that overcomes potential pitfalls of segmentation. The approach is compatible with FBP-thereby maintaining simplicity in a manner that is consistent with surgical workflow-or more sophisticated model-based reconstruction methods that could further improve image quality and/or help reduce radiation dose.
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Affiliation(s)
- A Uneri
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, United States of America
| | - X Zhang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, United States of America
| | - T Yi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, United States of America
| | - J W Stayman
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, United States of America
| | - P A Helm
- Medtronic, Littleton, MA 01460, United States of America
| | - G M Osgood
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD 21287, United States of America
| | - N Theodore
- Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, MD 21287, United States of America
| | - J H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21205, United States of America
- Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, MD 21287, United States of America
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Tan L, Wei Q, Yi T, Gaiqin P. SUN-206 The Clinical Signicance of C1q deposition in the Progression of IgA Nephropathy. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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30
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Hu Z, Hong S, Zhang Y, Dai H, Lin S, Yi T, Zhuang H. Down-regulated WDR35 contributes to fetal anomaly via regulation of osteogenic differentiation. Gene 2019; 697:48-56. [PMID: 30790652 DOI: 10.1016/j.gene.2019.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/03/2019] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Autosomal recessive disorder is closely correlated with congenital fetal malformation. The mutation of WDR35 may lead to short rib-polydactyly syndrome (SRP), asphyxiating thoracic dystrophy (ATD, Jeune syndrome) and Ellis van Creveld syndrome. The purpose of this study is to investigate the role of WDR35 in fetal anomaly. RESULTS The fetuses presented malformation with abnormal head shape, cardiac dilatation, pericardial effusion, and non-displayed left pulmonary artery and left lung. After the detection of genomic DNA (gDNA) in amniotic fluid cells (AFC), chromosomal rearrangement was found in arr[hg19] 2p25.3p23.3. It was revealed through multiple PCR-DHPLC that MYCN, WDR35, LPIN1, ODC1, KLF11 and NBAS contained duplicated copy numbers in 2p25.3p23.3. AF-MSCs were mostly positive for CD44, CD105, negative for CD34 and CD14. Western Blot test showed that WDR35-encoded protein was decreased in the patients' AFC compared to that in normal pregnant women. In the patients' amniotic fluid-derived mesenchymal stem cells (AF-MSCs), WDR35 overexpression could repair cilia formation, and the overexpression of WDR35 or Gli2 could significantly enhance ALP activity and expressions of osteogenic differentiation marker genes, including RUNXE2, OCN, BSP and ALP. However, WDR35 silencing in C3H10T1/2 cells could remarkably inhibit cilia formation and osteogenic differentiation. This inhibitory effect could be attenuated by Gli2 overexpression. CONCLUSIONS The results demonstrated that copy number variation (CNV) of WDR35 may lead to skeletal dysplasia and fetal anomaly, and that down-regulated WDR35 may damage the cilia formation and sequentially indirectly regulate Gli signal, which would eventually result in negative regulation of osteogenic differentiation.
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Affiliation(s)
- Zhongren Hu
- Department of Obstetrics, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China
| | - Shurong Hong
- Department of Obstetrics, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China
| | - Yu Zhang
- Department of Obstetrics, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China
| | - Huijing Dai
- Department of Obstetrics, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China
| | - Shuzhen Lin
- Department of Obstetrics, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China
| | - Tingyu Yi
- Department of Obstetrics, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China
| | - Hongmei Zhuang
- Department of Obstetrics, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian Province, China.
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Uneri A, Zhang X, Yi T, Stayman JW, Helm PA, Theodore N, Siewerdsen JH. Image quality and dose characteristics for an O-arm intraoperative imaging system with model-based image reconstruction. Med Phys 2018; 45:4857-4868. [PMID: 30180274 DOI: 10.1002/mp.13167] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/13/2018] [Accepted: 08/16/2018] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To assess the imaging performance and radiation dose characteristics of the O-arm CBCT imaging system (Medtronic Inc., Littleton MA) and demonstrate the potential for improved image quality and reduced dose via model-based image reconstruction (MBIR). METHODS Two main studies were performed to investigate previously unreported characteristics of the O-arm system. First is an investigation of dose and 3D image quality achieved with filtered back-projection (FBP) - including enhancements in geometric calibration, handling of lateral truncation and detector saturation, and incorporation of an isotropic apodization filter. Second is implementation of an MBIR algorithm based on Huber-penalized likelihood estimation (PLH) and investigation of image quality improvement at reduced dose. Each study involved measurements in quantitative phantoms as a basis for analysis of contrast-to-noise ratio and spatial resolution as well as imaging of a human cadaver to test the findings under realistic imaging conditions. RESULTS View-dependent calibration of system geometry improved the accuracy of reconstruction as quantified by the full-width at half maximum of the point-spread function - from 0.80 to 0.65 mm - and yielded subtle but perceptible improvement in high-contrast detail of bone (e.g., temporal bone). Standard technique protocols for the head and body imparted absorbed dose of 16 and 18 mGy, respectively. For low-to-medium contrast (<100 HU) imaging at fixed spatial resolution (1.3 mm edge-spread function) and fixed dose (6.7 mGy), PLH improved CNR over FBP by +48% in the head and +35% in the body. Evaluation at different dose levels demonstrated 30% increase in CNR at 62% of the dose in the head and 90% increase in CNR at 50% dose in the body. CONCLUSIONS A variety of improvements in FBP implementation (geometric calibration, truncation and saturation effects, and isotropic apodization) offer the potential for improved image quality and reduced radiation dose on the O-arm system. Further gains are possible with MBIR, including improved soft-tissue visualization, low-dose imaging protocols, and extension to methods that naturally incorporate prior information of patient anatomy and/or surgical instrumentation.
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Affiliation(s)
- A Uneri
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - X Zhang
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - T Yi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - J W Stayman
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - P A Helm
- Medtronic Inc., Littleton, MA, 01460, USA
| | - N Theodore
- Department of Neurosurgery, Johns Hopkins Medical Institute, Baltimore, MD, 21287, USA
| | - J H Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, 21205, USA.,Department of Neurosurgery, Johns Hopkins Medical Institute, Baltimore, MD, 21287, USA
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Camidge R, Heist R, Goldman J, Angevin E, Strickler J, Morgensztern D, Barve M, Bauer T, Vokes E, Yi T, Motwani M, Parikh A, Wu J, Kelly K. An open-label, multicenter, phase I study of ABBV-399 (telisotuzumab vedotin, teliso-V) as monotherapy (T) and in combination with erlotinib (T+E) in non-small cell lung cancer (NSCLC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Lear J, Migden M, Lewis K, Chang A, Guminski A, Gutzmer R, Dirix L, Combemale P, Stratigos A, Plummer R, Castro H, Yi T, Mone M, Zhou J, Trefzer U, Kaatz M, Loquai C, Kudchadkar R, Sellami D, Dummer R. Long-term efficacy and safety of sonidegib in patients with locally advanced and metastatic basal cell carcinoma: 30-month analysis of the randomized phase 2 BOLT study. J Eur Acad Dermatol Venereol 2018; 32:372-381. [PMID: 28846163 PMCID: PMC5873455 DOI: 10.1111/jdv.14542] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [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: 03/14/2017] [Accepted: 08/07/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Patients with locally advanced basal cell carcinoma (laBCC) or metastatic BCC (mBCC), two difficult-to-treat populations, have had limited treatment options. Sonidegib, a hedgehog pathway inhibitor (HPI), was approved in laBCC based on results from the BOLT trial. OBJECTIVE To evaluate long-term efficacy and safety of sonidegib in laBCC and mBCC in the BOLT 18- and 30-month analyses. METHODS BOLT (NCT01327053, ClinicalTrials.gov), a double-blind phase 2 study, enrolled patients from July 2011 until January 2013. Eligible HPI-treatment-naïve patients with laBCC not amenable to curative surgery/radiotherapy or mBCC were randomized 1 : 2 to sonidegib 200 mg (laBCC, n = 66; mBCC, n = 13) or 800 mg (laBCC, n = 128; mBCC, n = 23). Tumour response was assessed per central and investigator review. RESULTS With 30 months of follow-up, among patients treated with sonidegib 200 mg (approved dose), objective response rates were 56.1% (central) and 71.2% (investigator) in laBCC and 7.7% (central) and 23.1% (investigator) in mBCC. Tumour responses were durable as follows: median duration of response was 26.1 months (central) and 15.7 months (investigator) in laBCC and 24.0 months (central) and 18.1 months (investigator) in mBCC. Five patients with laBCC and three with mBCC in the 200-mg arm died. Median overall survival was not reached in either population; 2-year overall survival rates were 93.2% (laBCC) and 69.3% (mBCC). In laBCC, efficacy was similar regardless of aggressive or non-aggressive histology. Sonidegib 200 mg continued to have a better safety profile than 800 mg, with lower rates of grade 3/4 adverse events (43.0% vs. 64.0%) and adverse events leading to discontinuation (30.4% vs. 40.0%). CONCLUSION Sonidegib continued to demonstrate long-term efficacy and safety in these populations. These data support the use of sonidegib 200 mg per local treatment guidelines.
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Affiliation(s)
- J.T. Lear
- Manchester Academic Health Science CentreUniversity of ManchesterManchesterUK
| | - M.R. Migden
- Departments of Dermatology and Head and Neck SurgeryThe University of Texas MD Anderson Cancer CenterHoustonTXUSA
| | - K.D. Lewis
- Division of Medical OncologyUniversity of Colorado School of MedicineAuroraCOUSA
| | - A.L.S. Chang
- Stanford University School of MedicineRedwood CityCAUSA
| | - A. Guminski
- Royal North Shore HospitalSt LeonardsNSWAustralia
| | - R. Gutzmer
- Medizinische Hochschule HannoverHannoverGermany
| | - L. Dirix
- Sint‐Augustinus ZiekenhuisAntwerpBelgium
| | | | - A. Stratigos
- Andreas Syggros HospitalUniversity of AthensAthensGreece
| | - R. Plummer
- Northern Centre for Cancer CareFreeman HospitalNewcastle upon TyneUK
| | | | - T. Yi
- Novartis Pharmaceuticals CorporationEast HanoverNJUSA
| | - M. Mone
- Novartis Pharmaceuticals CorporationEast HanoverNJUSA
| | - J. Zhou
- Novartis Pharmaceuticals CorporationEast HanoverNJUSA
| | | | - M. Kaatz
- University Hospital JenaJenaGermany
| | - C. Loquai
- University Medical Center MainzMainzGermany
| | - R. Kudchadkar
- Winship Cancer Institute of Emory UniversityAtlantaGAUSA
| | - D. Sellami
- Novartis Pharmaceuticals CorporationEast HanoverNJUSA
| | - R. Dummer
- UniversitätsSpital Zürich‐Skin Cancer CenterUniversity HospitalZürichSwitzerland
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Yi T, Ramchandran V, Siewerdsen JH, Uneri A. Technical Note: Known-Component Registration for Robotic Drill Guide Positioning. Proc SPIE Int Soc Opt Eng 2018; 10576:105760L. [PMID: 36092693 PMCID: PMC9461572 DOI: 10.1117/12.2322408] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A method for x-ray-guided robotic positioning of surgical instruments is reported and evaluated in preclinical studies of spine pedicle screw placement with the aim of improving delivery of transpedicle drills and screws. The known-component registration (KC-Reg) algorithm was used to register the 3D patient CT and the surface model of a drill guide to intraoperatively acquired 2D radiographs. Resulting transformations, combined with offline hand-eye calibration, drive a robotically-held drill guide to target trajectories established in the preoperative patient CT. The proposed method was assessed against more conventional surgical tracker guidance, and robustness to clinically realistic errors was tested in phantom and cadaver studies. Target registration error (TRE) was computed as drill guide deviation from the planned trajectory. The KC-Reg approach resulted in 1.51 ± 0.51 mm error at tooltip and 1.01 ± 0.92° in approach angle, showing comparable performance to the tracker-guided approach. In cadaver studies with anatomical deformation, TRE of 2.31 ± 1.05 mm and 0.66 ± 0.62° were observed, with statistically improved performance over a surgical tracker through registration of locally rigid bony anatomy. X-ray guidance offers an accurate means of driving robotic systems that is compatible with conventional fluoroscopic workflow. Specifically, such procedures involve multi-planar fluoroscopic views that are qualitatively interpreted by the surgeon; the KC-Reg approach accomplishes this using the same multi-planar views to provide greater quantitative accuracy and valuable guidance and QA. The method was robust against anatomical deformation due to the radiographic scene's local nature used in registration, presenting a potentially major surgical benefit.
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Affiliation(s)
- T. Yi
- Department of Biomedical Engineering, Johns Hopkins Univ., Baltimore, MD
| | - V. Ramchandran
- Department of Biomedical Engineering, Johns Hopkins Univ., Baltimore, MD
| | - J. H. Siewerdsen
- Department of Biomedical Engineering, Johns Hopkins Univ., Baltimore, MD
| | - A. Uneri
- Department of Biomedical Engineering, Johns Hopkins Univ., Baltimore, MD
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Xu J, Wei Y, Ren L, Feng Q, Chen J, Zhu D, Chang W, Yi T, Yang L, Qin X. Robot-assisted vs laparoscopic vs open abdominoperineal resections for low rectal cancer: Short-term outcomes of a single-center prospective randomized controlled trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yang JW, Li TS, Yi T, Wang CK, Yang M, Yang WM, Liu SY, Jiang SE, Ding YK. Measurement and Analysis of Electromagnetic Pulse from Laser-Target Interaction at ShenGuang II Laser Facility. Fusion Science and Technology 2017. [DOI: 10.1080/15361055.2016.1273690] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J. W. Yang
- Chinese Academy of Engineering Physics, Laser Fusion Research Center, Mianyang 621900, China
- University of Electronic Science and Technology of China, School of Energy Science and Engineering, Xiyuan Road 2006, Chengdu 611731, China
| | - T. S. Li
- University of Electronic Science and Technology of China, School of Energy Science and Engineering, Xiyuan Road 2006, Chengdu 611731, China
| | - T. Yi
- Chinese Academy of Engineering Physics, Laser Fusion Research Center, Mianyang 621900, China
| | - C. K. Wang
- Chinese Academy of Engineering Physics, Laser Fusion Research Center, Mianyang 621900, China
| | - M. Yang
- University of Electronic Science and Technology of China, School of Energy Science and Engineering, Xiyuan Road 2006, Chengdu 611731, China
| | - W. M. Yang
- Chinese Academy of Engineering Physics, Laser Fusion Research Center, Mianyang 621900, China
| | - S. Y. Liu
- Chinese Academy of Engineering Physics, Laser Fusion Research Center, Mianyang 621900, China
| | - S. E. Jiang
- Chinese Academy of Engineering Physics, Laser Fusion Research Center, Mianyang 621900, China
| | - Y. K. Ding
- Chinese Academy of Engineering Physics, Laser Fusion Research Center, Mianyang 621900, China
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Lei Q, Chen C, Wu XL, Chen WJ, Yi T, Ma MD, He Y, Shui XR, Huang SA, Chen C, Lei W. [Dynamic detection of surface blood flow in rat heart and its application in real time identification of myocardial infarction model]. Zhonghua Yi Xue Za Zhi 2017; 97:1019-1023. [PMID: 28395422 DOI: 10.3760/cma.j.issn.0376-2491.2017.13.012] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To establish a method for monitoring the surface blood flow in the heart of rats, and to clarify the relationship between the degree of myocardial infarction and the blood perfusion on the surface of the heart, so as to provide a new indicator for the identification of rat myocardial infarction model. Methods: The rats were divided into control group (n=23) and model group (n=107), the rat hearts were scanned by the laser doppler perfusion imager before and after operation respectively, and the data was analyzed to acquire the rate of surface blood flow change of the heart. Myocardial infarction size of model group was detected by NBT. Model group were divided into three subgroups of mild myocardial infarction, moderate myocardial infarction and severe myocardial infarction according to the myocardial infarction size, and an analysis was made on the correlativity between rate of surface blood flow change of the heart and myocardial infarction size. Results: Myocardial infarction size was highly correlated to the rate of surface blood flow change of the heart in model group (r=0.849 6, P<0.000 1). There was no significant correlation between infarction size and heart blood flow in the mild myocardial infarction subgroup (r=-0.133 6, P>0.05), while the correlation in moderate myocardial infarction was significant (r=0.721 7, P<0.000 1), and the highest correlation was shown in severe myocardial infarction subgroup (r=0.910 2, P<0.000 1). Conclusion: The heart surface blood flow has a close relationship with the myocardial infarction size in rat, so the change of heart blood perfusion can beused as an effective reference to establish and identify rat myocardial infarction model.
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Affiliation(s)
- Q Lei
- Cardiovascular Medicine Center, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, China
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Zhao L, Ji G, Le X, Luo Z, Wang C, Feng M, Xu L, Zhang Y, Lau WB, Lau B, Yang Y, Lei L, Yang H, Xuan Y, Chen Y, Deng X, Yi T, Yao S, Zhao X, Wei Y, Zhou S. An integrated analysis identifies STAT4 as a key regulator of ovarian cancer metastasis. Oncogene 2017; 36:3384-3396. [PMID: 28114283 DOI: 10.1038/onc.2016.487] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/26/2016] [Accepted: 11/21/2016] [Indexed: 02/05/2023]
Abstract
Epithelial ovarian cancer (EOC) is one of the most common gynecological cancers, with diagnosis often at a late stage. Metastasis is a major cause of death in patients with EOC, but the underlying molecular mechanisms remain obscure. Here, we utilized an integrated approach to find potential key transcription factors involved in ovarian cancer metastasis and identified STAT4 as a critical player in ovarian cancer metastasis. We found that activated STAT4 was overexpressed in epithelial cells of ovarian cancer and STAT4 overexpression was associated with poor outcome of ovarian cancer patients, which promoted metastasis of ovarian cancer in both in vivo and in vitro. Although STAT4 mediated EOC metastasis via inducing epithelial-to-mesenchymal transition (EMT) of ovarian cancer cells in vivo, STAT4 failed to induce EMT directly in vitro, suggesting that STAT4 might mediate EMT process via cancer-stroma interactions. Further functional analysis revealed that STAT4 overexpression induced normal omental fibroblasts and adipose- and bone marrow-derived mesenchymal stem cells to obtain cancer-associated fibroblasts (CAF)-like features via induction of tumor-derived Wnt7a. Reciprocally, increased production of CAF-induced CXCL12, IL6 and VEGFA within tumor microenvironment could enable peritoneal metastasis of ovarian cancer via induction of EMT program. In summary, our study established a model that STAT4 promotes ovarian cancer metastasis via tumor-derived Wnt7a-induced activation of CAFs.
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Affiliation(s)
- L Zhao
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - G Ji
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - X Le
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Z Luo
- College of Biological Sciences, Sichuan University, Chengdu, China
| | - C Wang
- College of Biological Sciences, Sichuan University, Chengdu, China
| | - M Feng
- Department of Pathology, West China Second Hospital, Sichuan University, Chengdu, China
| | - L Xu
- Department of Pathology, West China Second Hospital, Sichuan University, Chengdu, China
| | - Y Zhang
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - W B Lau
- Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - B Lau
- Department of Surgery, Emergency Medicine, Kaiser Santa Clara Medical Center, Affiliate of Stanford University, Santa Clara, CA, USA
| | - Y Yang
- West China School of Medicine, Sichuan University, Chengdu, China
| | - L Lei
- West China School of Medicine, Sichuan University, Chengdu, China
| | - H Yang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China
| | - Y Xuan
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Y Chen
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - X Deng
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - T Yi
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - S Yao
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - X Zhao
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Y Wei
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
| | - S Zhou
- Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second Hospital and State Key Laboratory of Biotherapy/Collaborative Innovation Center, West China Hospital, Sichuan University, Chengdu, China
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Waniska R, Yi T, Lu J, Xue-Ping L, Xu W, Lin H. Effects of preheating temperature, moisture, and sodium metabisulfite content on quality of noodles prepared from maize flour or meal / Efecto de la temperatura de precalentamiento, humedad y contenido de metabisulfito de sodio en la calidad de fideos de harina o de sémola de maíz. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201329900500406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Preheating temperature, maize flour particle size, and levels of water and sulfite were tested during preparation of maize noodles. Heating a mixture of maize flour and water (43-45 % moisture) at 90-95 °C was required to extrude maize noodles using a pasta maker. Maize flour with smaller par ticle size yielded better noodles than did maize meal. Addition of sulfite enabled production of noodles at lower processing temperatures, however, cooking losses increased. Addition of more water yielded noodles that required longer cooking time, but decreased cooking losses. Functionalities of starch and protein in raw ingredients and in products were determined. Starch gelatinized and retrograded during processing of maize extrudates, as indicated by changes in pasting viscosity curves. Above 40 °C, maize proteins increased mixing viscosity of dough. Increased integrity of cooked maize noodles, however, corresponded to increased amounts of gelatinized and retrograded starch.
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Affiliation(s)
- R.D. Waniska
- Cereal Quality Laboratory, Department of Soil and Crop Sciences, Texas A&M University, College Station, Texas, 77843-2474, USA
| | - T. Yi
- Ji Lin Light Industry Design and Research Institute, Gong Nong Road 12, Chang Chun City Ji Lin Province, PRC China 130021
| | - J. Lu
- Ji Lin Light Industry Design and Research Institute, Gong Nong Road 12, Chang Chun City Ji Lin Province, PRC China 130021
| | - L. Xue-Ping
- Ji Lin Light Industry Design and Research Institute, Gong Nong Road 12, Chang Chun City Ji Lin Province, PRC China 130021
| | - W. Xu
- Ji Lin Light Industry Design and Research Institute, Gong Nong Road 12, Chang Chun City Ji Lin Province, PRC China 130021
| | - H. Lin
- Ji Lin Light Industry Design and Research Institute, Gong Nong Road 12, Chang Chun City Ji Lin Province, PRC China 130021
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40
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Melchiorri AJ, Hibino N, Best CA, Yi T, Lee YU, Kraynak CA, Kimerer LK, Krieger A, Kim P, Breuer CK, Fisher JP. 3D-Printed Biodegradable Polymeric Vascular Grafts. Adv Healthc Mater 2016; 5:319-325. [PMID: 26627057 PMCID: PMC4749136 DOI: 10.1002/adhm.201500725] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 09/29/2015] [Indexed: 01/24/2023]
Abstract
Congenital heart defect interventions may benefit from the fabrication of patient-specific vascular grafts because of the wide array of anatomies present in children with cardiovascular defects. 3D printing is used to establish a platform for the production of custom vascular grafts, which are biodegradable, mechanically compatible with vascular tissues, and support neotissue formation and growth.
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Affiliation(s)
- A J Melchiorri
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742
| | - N Hibino
- Tissue Engineering Program and Surgical Research, Nationwide Children's Hospital, Columbus, OH 43205
- Department of Cardiothoracic Surgery, Nationwide Children's Hospital, Columbus, OH 43205
| | - C A Best
- Tissue Engineering Program and Surgical Research, Nationwide Children's Hospital, Columbus, OH 43205
| | - T Yi
- Tissue Engineering Program and Surgical Research, Nationwide Children's Hospital, Columbus, OH 43205
| | - Y U Lee
- Tissue Engineering Program and Surgical Research, Nationwide Children's Hospital, Columbus, OH 43205
| | - C A Kraynak
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742
| | - L K Kimerer
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742
| | - A Krieger
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, DC 200010
| | - P Kim
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742
| | - C K Breuer
- Department of Cardiothoracic Surgery, Nationwide Children's Hospital, Columbus, OH 43205
| | - J P Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, MD 20742
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41
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Ryu JK, Kim DH, Song KM, Ryu DS, Kim SN, Shin DH, Yi T, Suh JK, Song SU. Intracavernous delivery of clonal mesenchymal stem cells rescues erectile function in the streptozotocin-induced diabetic mouse. Andrology 2015; 4:172-84. [PMID: 26711324 DOI: 10.1111/andr.12138] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 09/02/2015] [Accepted: 10/26/2015] [Indexed: 12/24/2022]
Abstract
The major hurdle for the clinical application of stem cell therapy is the heterogeneous nature of the isolated cells, which may cause different treatment outcomes. The aim of this study was to examine the effectiveness of mouse clonal bone marrow-derived stem cells (BMSCs) obtained from a single colony by using subfractionation culturing method for erectile function in diabetic animals. Twelve-week-old C57BL/6J mice were divided into four groups: controls, diabetic mice, and diabetic mice treated with a single intracavernous injection of PBS (20 μL) or clonal BMSCs (3 × 10(5) cells/20 μL). Clonal BMSCs were isolated from 5-week-old C3H mice. Two weeks after treatment, erectile function was measured by electrical stimulation of the cavernous nerve. The penis was stained with antibodies to PECAM-1, smooth muscle α-actin, neuronal nitric oxide synthase (nNOS), neurofilament, and phosphorylated endothelial NOS (phospho-eNOS). We also performed Western blot for phospho-eNOS, and eNOS in the corpus cavernosum tissue. Local delivery of clonal BMSCs significantly restored cavernous endothelial and smooth muscle cell contents, and penile nNOS and neurofilament contents, and induced eNOS phosphorylation (Ser1177) in diabetic mice. Intracavernous injection of clonal BMSCs induced significant recovery of erectile function, which reached 80-90% of the control values. Clonal BMSCs successfully restored erectile function through dual angiogenic and neurotrophic effects in diabetic mice. The homogenous nature of clonal mesenchymal stem cells may allow their clinical applications and open a new avenue through which to treat diabetic erectile dysfunction.
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Affiliation(s)
- J-K Ryu
- National Research Center for Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea.,Inha Research Institute for Medical Sciences, Inha University School of Medicine, Incheon, Korea
| | - D-H Kim
- Translational Research Center, Inha University School of Medicine, Incheon, Korea
| | - K-M Song
- National Research Center for Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - D-S Ryu
- Department of Urology, Sungkyunkwan University School of Medicine, Samsung Changwon Hospital, Changwon, Korea
| | - S-N Kim
- Drug Development Program, Department of Medicine, Inha University School of Medicine, Incheon, Korea
| | - D-H Shin
- SCM Lifescience Co., Ltd., Incheon, Korea
| | - T Yi
- Translational Research Center, Inha University School of Medicine, Incheon, Korea
| | - J-K Suh
- National Research Center for Sexual Medicine and Department of Urology, Inha University School of Medicine, Incheon, Korea
| | - S U Song
- Translational Research Center, Inha University School of Medicine, Incheon, Korea
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42
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Chen W, Yi T, Chen Y, Zhang M, Wu Z, Wu Y, Chen B, Guo T, Wu C, Yang M, Chen X, Shi Y. Assessment of bilateral cerebral peduncular infarction: Magnetic resonance imaging, clinical features, and prognosis. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.07.016] [Citation(s) in RCA: 11] [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] [Indexed: 11/26/2022]
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43
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Dummer R, Sondak V, Grichnik J, Schwartz L, Guminski A, Gutzmer R, Yi T, Trylesinski A, Sellami D, Migden M. 3347 BOLT 18-month analysis: efficacy and safety of sonidegib in patients with locally advanced basal cell carcinoma (laBCC) and evaluation of tumor response using 2 sets of composite assessment criteria. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31865-2] [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]
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44
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Kaba M, Amm N, F D, Ao B, M T, I C, Ms B, A T, Ml K, D S, Yi T. Prévalence de l’insuffisance rénale chronique terminale traitée à Conakry. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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45
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Tan K, Cho SG, Luo W, Yi T, Wu X, Siwko S, Liu M, Yuan W. KiSS1-induced GPR54 signaling inhibits breast cancer cell migration and epithelial-mesenchymal transition via protein kinase D1. Curr Mol Med 2015; 14:652-62. [PMID: 24894166 DOI: 10.2174/1566524014666140603115314] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 05/08/2014] [Accepted: 05/12/2014] [Indexed: 11/22/2022]
Abstract
The metastasis suppressor protein Kisspeptin regulates cancer cell proliferation and motility through its receptor, GRP54. However, the critical downstream effectors remain unclear. In this study, we investigated GPR54 signaling in breast cancer cells. Kisspeptin stimulation caused a decrease in migration of multiple breast cancer cell lines. Also, Kisspeptin inhibited MDA-MB-231 cell colony formation in 3D matrigel culture and in soft agar. Kisspeptin treatment elevated phosphorylated PKD1 in a PKC-dependent manner. However, knockdown of either GPR54 or PKD1 increased breast cancer cell migration and invasion. Furthermore, GPR54 knockdown blocked Kisspeptin-induced phosphorylation of PKD1. Finally, Kisspeptin stimulation induced a PKD1 phosphorylation-dependent decrease in expression of Slug, a transcription factor that drives epithelial-mesenchymal transition (EMT), and a concomitant increase in E-cadherin expression. Therefore, KiSS1/GPR54 signaling through PKD1 acts to maintain the epithelial state and to inhibit breast cancer cell invasiveness, and exerts functions associated with its role as a metastasis suppressor.
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Affiliation(s)
| | | | | | | | | | | | | | - W Yuan
- College of Life Sciences, Hunan Normal University, Changsha, Hunan 410081, P.R. China.
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46
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Melchiorri AJ, Hibino N, Yi T, Lee YU, Sugiura T, Tara S, Shinoka T, Breuer C, Fisher JP. Contrasting biofunctionalization strategies for the enhanced endothelialization of biodegradable vascular grafts. Biomacromolecules 2015; 16:437-46. [PMID: 25545620 PMCID: PMC4325601 DOI: 10.1021/bm501853s] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [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: 06/02/2014] [Indexed: 01/26/2023]
Abstract
Surface modification of biodegradable vascular grafts is an important strategy to improve the in situ endothelialization of tissue engineered vascular grafts (TEVGs) and prevent major complications associated with current synthetic grafts. Important strategies for improving endothelialization include increasing endothelial cell mobilization and increased endothelial cell capture through biofunctionalization of TEVGs. The objective of this study was to assess two biofunctionalization strategies for improving endothelialization of biodegradable polyester vascular grafts. These techniques consisted of cross-linking heparin to graft surfaces to immobilize vascular endothelial growth factor (VEGF) or antibodies against CD34 (anti-CD34Ab). To this end, heparin, VEGF, and anti-CD34Ab attachment and quantification assays confirmed the efficacy of the modification strategy. Cell attachment and proliferation on these groups were compared to unmodified grafts in vitro and in vivo. To assess in vivo graft functionality, the grafts were implanted as inferior vena cava interpositional conduits in mice. Modified vascular grafts displayed increased endothelial cell attachment and activity in vivo, according to microscopy techniques, histological results, and eNOS expression. Inner lumen diameter of the modified grafts was also better maintained than controls. Overall, while both functionalized grafts outperformed the unmodified control, grafts modified with anti-CD34Ab appeared to yield the most improved results compared to VEGF-loaded grafts.
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Affiliation(s)
- A. J. Melchiorri
- Fischell
Department of Bioengineering, University
of Maryland, College Park, Maryland 20742, United States
| | - N. Hibino
- Tissue Engineering Program
and Surgical Research and Department of Cardiothoracic Surgery, Nationwide Children’s Hospital, Columbus, Ohio 43205, United States
| | - T. Yi
- Tissue Engineering Program
and Surgical Research and Department of Cardiothoracic Surgery, Nationwide Children’s Hospital, Columbus, Ohio 43205, United States
| | - Y. U. Lee
- Tissue Engineering Program
and Surgical Research and Department of Cardiothoracic Surgery, Nationwide Children’s Hospital, Columbus, Ohio 43205, United States
| | - T. Sugiura
- Tissue Engineering Program
and Surgical Research and Department of Cardiothoracic Surgery, Nationwide Children’s Hospital, Columbus, Ohio 43205, United States
| | - S. Tara
- Tissue Engineering Program
and Surgical Research and Department of Cardiothoracic Surgery, Nationwide Children’s Hospital, Columbus, Ohio 43205, United States
| | - T. Shinoka
- Tissue Engineering Program
and Surgical Research and Department of Cardiothoracic Surgery, Nationwide Children’s Hospital, Columbus, Ohio 43205, United States
| | - C. Breuer
- Tissue Engineering Program
and Surgical Research and Department of Cardiothoracic Surgery, Nationwide Children’s Hospital, Columbus, Ohio 43205, United States
| | - J. P. Fisher
- Fischell
Department of Bioengineering, University
of Maryland, College Park, Maryland 20742, United States
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47
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Dummer R, Guminski A, Gutzmer R, Dirix L, Lewis K, Combemale P, Herd R, Kaatz M, Loquai C, Stratigos A, Schulze H, Plummer R, Yi T, Chang A, Cornélis F, Kudchadkar R, Trefzer U, Lear J, Sellami D, Migden M. Randomized, Double-Blind Study of Sonidegib (Lde225) in Patients (Pts) with Advanced Basal Cell Carcinoma (Bcc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.41] [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: 11/14/2022] Open
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48
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Dummer R, Gutzmer R, Migden M, Dirix L, Lewis K, Combemale P, Higuchi K, Gogov S, Yi T, Herd R, Kudchadkar R, Trefzer U, Lear J, Sellami D, Guminski A. Patient-Reported Quality of Life (Qol) with Sonidegib (Lde225) in Advanced Basal Cell Carcinoma (Bcc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu344.41] [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: 11/13/2022] Open
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49
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Zou L, Yi T, Song X, Li S, Wei Y, Zhao X. Efficient inhibition of intraperitoneal human ovarian cancer growth by short hairpin RNA targeting CD44. Neoplasma 2014; 61:274-82. [PMID: 24824928 DOI: 10.4149/neo_2014_035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
CD44 is one member of a big glycoprotein family involved in adhesion of cells or cells and extracellular matrix (ECM). The heavily glycosylated CD44 has been proved to be a major receptor of hyaluronan and a marker of stem cells in ovarian cancer. Here, using short hairpin (shRNA) against CD44, we demonstrate that knockdown CD44 could inhibit cancer growth efficiently compared with controls. Plasmid targeting CD44 gene (pshCD44) or non-relative control sequences (pshHK) was constructed and delivered to ovarian cancer by biodegradable poly D, L-Lactide-co-glycolide acid nanoparticles (PLGANPs). Nude mice were utilized in an intraperitoneal model of ovarian carcinomatosis to assess antitumor efficacy in vivo. Antitumor efficacy was estimated by changes in tumor weights, proliferation (Ki-67), apoptosis (TUNEL) and angiogenesis (CD31 staining and alginate-encapsulated tumor beads assay) in tumor cells. As results, pshCD44 or pshHK could be effectively transfected into SKOV-3 cells by PLGANPs. Tumor weight in pshCD44/PLGANPs group was suppressed by 45% and 50% compared with those in pshHK/PLGANPs and untreated group, respectively (Ps < 0.001). Inhibition of cell proliferation, induction of apoptosis and reduction of angiogenesis in tumor cells of pshCD44/PLGANPs group also show significant difference compared with those in control groups (Ps < 0.05), respectively. These results indicate that pshCD44 delivered by PLGANPs might be a potential approach in ovarian cancer therapy, and point towards a mechanism involving the inhibition of angiogenesis, cellular proliferation and the induction of apoptosis.
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50
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Zou L, Song X, Yi T, Li S, Deng H, Chen X, Li Z, Bai Y, Zhong Q, Wei Y, Zhao X. Administration of PLGA nanoparticles carrying shRNA against focal adhesion kinase and CD44 results in enhanced antitumor effects against ovarian cancer. Cancer Gene Ther 2013; 20:242-50. [PMID: 23492823 DOI: 10.1038/cgt.2013.12] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The two membrane-bound proteins, focal adhesion kinase (FAK) and CD44, are involved in processes critical to cancer progression. FAK has an active role in angiogenesis, cell proliferation and cell apoptosis, whereas the heavily glycosylated CD44 has been implicated in cancer metastasis. Here, using short hairpin RNA (shRNA) against FAK and CD44, we demonstrate that simultaneous knockdown of both these genes inhibits cancer growth more efficiently than knockdown of either gene individually. Plasmids targeting these genes or non-relative control sequences were constructed and delivered to ovarian cancer targets by biodegradable poly D,L-lactide-co-glycolide acid nanoparticles (PLGANPs). Nude mice were utilized in an intraperitoneal model of ovarian carcinomatosis to assess antitumor efficacy in vivo. Single gene knockdown resulted in significantly smaller tumors than those observed in the empty-vector control (P's<0.001). More importantly, knockdown of both genes resulted in tumors smaller than both the empty-vector group (P<0.0001) and the single gene knockdown groups (P's<0.001). Knockdown of both FAK and CD44 resulted in tumors with inhibited angiogenesis, reduced proliferation and increased apoptosis as compared with controls (P's<0.001) and single knockdown groups (P's<0.05). These results indicate that dual knockdown of FAK and CD44 in the tumors of patients with ovarian cancer may have an enhanced therapeutic effect, and point toward a mechanism involving the inhibition of angiogenesis, cellular proliferation and the induction of apoptosis.
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Affiliation(s)
- L Zou
- Department of Gynecology and Obstetrics, Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, People's Republic of China
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