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Wang J, Xie X, Wu Y, Zhou Y, Li Q, Li Y, Xu X, Wang M, Murdiyarso L, Houck K, Hilton T, Chung D, Li M, Zhang JN, Dong J. Brain-Derived Extracellular Vesicles Induce Vasoconstriction and Reduce Cerebral Blood Flow in Mice. J Neurotrauma 2022; 39:879-890. [PMID: 35316073 DOI: 10.1089/neu.2021.0274] [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] [Indexed: 12/21/2022] Open
Abstract
Traumatic brain injury (TBI) impairs cerebrovascular autoregulation and reduces cerebral blood flow (CBF), leading to ischemic secondary injuries. We have shown that injured brains release brain-derived extracellular vesicles (BDEVs) into circulation, where they cause a systemic hypercoagulable state that rapidly turns into consumptive coagulopathy. BDEVs induce endothelial injury and permeability, leading to the hypothesis that they contribute to TBI-induced cerebrovascular dysregulation. In a study designed to test this hypothesis, we detected circulating BDEVs in C57BL/6J mice subjected to severe TBI, reaching peak levels of 3x104/µl at 3 hours post injury (71.2±21.5% of total annexin V-binding EVs). We further showed in an adaptive transfer model that 41.7±5.8% of non-injured mice died within 6 hours after being infused with 3x104/µl of BDEVs. BDEVs transmigrated through the vessel walls, induced rapid vasoconstriction by inducing calcium influx in vascular smooth muscle cells, and reduced CBF by 93.8±5.6% within 30 minutes after infusion. The CBF suppression was persistent in mice that eventually died but it recovered quickly in surviving mice. It was prevented by the calcium channel blocker nimodipine. When being separated, neither protein nor phospholipid components from the lethal number of BDEVs induced vasoconstriction, reduced CBF, and caused death. These results demonstrate a novel vasoconstrictive activity of BDEVs that depends on the structure of BDEVs and contributes to TBI-induced disseminated cerebral ischemia and sudden death.
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Affiliation(s)
- Jiwei Wang
- Tianjin Neurological Institute, 230967, Anshan road No.154, Tianjin, China, 300052;
| | - Xiaofeng Xie
- Lanzhou University, 12426, Lanzhou, Gansu, China;
| | - Yingang Wu
- University of Science and Technology of China, 12652, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine., Hefei, Anhui, China;
| | - Yuan Zhou
- Tianjin Neurological Institute, 230967, Tianjin Medical University General Hospital, Tianjin, Tianjin, China;
| | - Qifeng Li
- Tianjin Neurological Institute, 230967, Tianjin Medical University General Hospital, Tianjin, Tianjin, China;
| | - Ying Li
- Tianjin Neurological Institute, 230967, Tianjin, Tianjin, China;
| | - Xin Xu
- Tianjin Neurological Institute, 230967, Tianjin Medical University General Hospital, Tianjin, Tianjin, China;
| | - Min Wang
- Lanzhou University, 12426, Lanzhou, Gansu, China;
| | | | - Katie Houck
- Bloodworks Research institute, Seattle, United States;
| | | | - Dominic Chung
- Bloodworks Research institute, Seattle, United States;
| | - Min Li
- Lanzhou University, 12426, Lanzhou, Gansu, China;
| | - Jian-Ning Zhang
- Tianjin Neurological Institute, 230967, Tianjin Medical University General Hospital, Tianjin, Tianjin, China;
| | - Jingfei Dong
- Bloodworks Research Institute, Bloodworks Northwest, Seattle, Seattle, Washington, United States.,Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, United States;
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Mugla W, Bauer H, Vogel J, Hosking K, Campbell N, Hilton T. Modular prosthetic reconstruction for primary bone tumours of the distal tibia in ten patients. SA orthop j 2022. [DOI: 10.17159/2309-8309/2022/v21n2a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Below-knee amputation (BKA) is the safest treatment for benign aggressive and malignant bone tumours of the distal tibia, yielding good oncological and functional results. However, in selected patients where limb salvage is feasible and amputation unacceptable to the patient, limb salvage using a distal tibial replacement (DTR) can be considered. This study aims to present the oncological and functional results of the use of the latter treatment method in our unit. METHODS: A retrospective folder review was performed for all ten patients who received a modular DTR between 1 January 2005 and 31 January 2019 for a primary bone tumour, either benign aggressive or malignant. Six were female and the mean age was 31 (12-75) years. There were five patients with giant cell tumour of bone, four with osteosarcoma and one with a low-grade chondrosarcoma. The patients with osteosarcoma had neoadjuvant chemotherapy before surgery. Function was assessed by the Musculoskeletal Tumor Society (MSTS) score. RESULTS: Two patients had local recurrence treated with a BKA and one other patient died of metastases three years postoperatively. At a mean follow-up of three years, the remaining eight patients had a mean MSTS score of 83% (67-93%). There were no radiological signs of loosening, and no revision surgeries. CONCLUSION: Endoprosthetic replacement of the distal tibia for primary bone tumours can be a safe treatment option in very selected cases. Level of evidence: Level 4
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3
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Xu X, Wang C, Wu Y, Houck K, Hilton T, Zhou A, Wu X, Han C, Yang M, Yang W, Shi FD, Stolla M, Cruz MA, Li M, Zhang J, Dong JF. Conformation-dependent blockage of activated VWF improves outcomes of traumatic brain injury in mice. Blood 2021; 137:544-555. [PMID: 33507292 PMCID: PMC7845006 DOI: 10.1182/blood.2020007364] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/27/2020] [Indexed: 12/22/2022] Open
Abstract
Traumatic brain injury-induced coagulopathy (TBI-IC) causes life-threatening secondary intracranial bleeding. Its pathogenesis differs mechanistically from that of coagulopathy arising from extracranial injuries and hemorrhagic shock, but it remains poorly understood. We report results of a study designed to test the hypothesis that von Willebrand factor (VWF) released during acute TBI is intrinsically hyperadhesive because its platelet-binding A1-domain is exposed and contributes to TBI-induced vascular leakage and consumptive coagulopathy. This hyperadhesive VWF can be selectively blocked by a VWF A2-domain protein to prevent TBI-IC and to improve neurological function with a minimal risk of bleeding. We demonstrated that A2 given through intraperitoneal injection or IV infusion reduced TBI-induced death by >50% and significantly improved the neurological function of C57BL/6J male mice subjected to severe lateral fluid percussion injury. A2 protected the endothelium from extracellular vesicle-induced injury, reducing TBI-induced platelet activation and microvesiculation, and preventing a TBI-induced hypercoagulable state. A2 achieved this therapeutic efficacy by specifically blocking the A1 domain exposed on the hyperadhesive VWF released during acute TBI. These results suggest that VWF plays a causal role in the development of TBI-IC and is a therapeutic target for this life-threatening complication of TBI.
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Affiliation(s)
- Xin Xu
- Bloodworks Research Institute, Seattle, WA
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chenyu Wang
- Institute of Pathology, School of Medical Sciences, and the Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Yingang Wu
- Department of Neurosurgery, the First Affiliated Hospital, University of Science and Technology, Hefei, China
| | | | | | | | | | - Cha Han
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mengchen Yang
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Yang
- Bloodworks Research Institute, Seattle, WA
- NanoString Technologies, Seattle, WA
| | - Fu-Dong Shi
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | | | - Miguel A Cruz
- Cardiovascular Research Section, Department of Medicine, Baylor College of Medicine, Houston, TX
- Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey Veterans Affairs (VA) Medical Center, Houston, TX; and
| | - Min Li
- Institute of Pathology, School of Medical Sciences, and the Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Jianning Zhang
- Departments of Neurosurgery, Neurology, and Obstetrics & Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-Fei Dong
- Bloodworks Research Institute, Seattle, WA
- Division of Hematology, Department of Medicine, University of Washington, School of Medicine, Seattle, WA
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4
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Li A, Bhatraju PK, Chen J, Chung DW, Hilton T, Houck K, Pao E, Weiss NS, Lee SJ, Davis C, Schmidt MJ, Lopez JA, Liles WC, Dong JF, Hingorani SR. Prognostic Biomarkers for Thrombotic Microangiopathy after Acute Graft-versus-Host Disease: A Nested Case-Control Study. Transplant Cell Ther 2020; 27:308.e1-308.e8. [PMID: 33836868 PMCID: PMC10122917 DOI: 10.1016/j.jtct.2020.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 12/27/2022]
Abstract
Transplantation-associated thrombotic microangiopathy (TA-TMA) is a complication of allogeneic hematopoietic cell transplantation (HCT) that often occurs following the development of acute graft-versus-host disease (aGVHD). In this study, we aimed to identify early TMA biomarkers among patients with aGVHD. We performed a nested-case-control study from a prospective cohort of allogeneic HCT recipients, matching on the timing and severity of antecedent aGVHD. We identified 13 TMA cases and 25 non-TMA controls from 208 patients in the cohort. Using multivariable conditional logistic regression, the odds ratio for TMA compared with non-TMA was 2.65 (95% confidence interval [CI], 1.00 to 7.04) for every 100 ng/mL increase in terminal complement complex sC5b9 and 2.62 (95% CI, 1.56 to 4.38) for every 1000 pg/mL increase in angiopoietin-2 (ANG2) at the onset of aGVHD. ADAMTS13 and von Willebrand factor (VWF) antigens were not appreciably associated with TMA. Using a Cox regression model incorporating sC5b9 >300 ng/mL and ANG2 >3000 pg/mL at the onset of aGVHD, the adjusted hazard ratio for mortality was 5.33 (95% CI, 1.57 to 18.03) for the high-risk group (both elevated) and 4.40 (95% CI, 1.60 to 12.07) for the intermediate-risk group (one elevated) compared with the low-risk group (neither elevated). In conclusion, we found that elevated sC5b9 and ANG2 levels at the onset of aGVHD were associated with the development of TMA and possibly mortality after accounting for the timing and severity of aGVHD. The results suggest important roles of complement activation and endothelial dysfunction in the pathogenesis of TMA. Measurement of these biomarkers at the onset of aGVHD may inform prognostic enrichment for preventive trials and improve clinical care.
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Affiliation(s)
- Ang Li
- Section of Hematology-Oncology, Department of Medicine, Baylor College of Medicine, Houston, Texas; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
| | - Pavan K Bhatraju
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Junmei Chen
- Bloodworks NW Research Institute, Seattle, Washington
| | | | | | - Katie Houck
- Bloodworks NW Research Institute, Seattle, Washington
| | - Emily Pao
- Division of Nephrology, Seattle Children's Hospital, Seattle, Washington
| | - Noel S Weiss
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Stephanie J Lee
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Chris Davis
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | | | - Jose A Lopez
- Bloodworks NW Research Institute, Seattle, Washington; Divsion of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - W Conrad Liles
- Divsion of Allergy and Infectious Diseases, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Jing-Fei Dong
- Bloodworks NW Research Institute, Seattle, Washington; Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Sangeeta R Hingorani
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Division of Nephrology, Seattle Children's Hospital, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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5
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Han C, Wang C, Chen Y, Wang J, Xu X, Hilton T, Cai W, Zhao Z, Wu Y, Li K, Houck K, Liu L, Sood AK, Wu X, Xue F, Li M, Dong JF, Zhang J. Placenta-derived extracellular vesicles induce preeclampsia in mouse models. Haematologica 2019; 105:1686-1694. [PMID: 31439676 PMCID: PMC7271597 DOI: 10.3324/haematol.2019.226209] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [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: 05/06/2019] [Accepted: 08/22/2019] [Indexed: 01/23/2023] Open
Abstract
Preeclampsia is a pregnancy-induced condition that impairs the mother’s health and results in pregnancy termination or premature delivery. Elevated levels of placenta-derived extracellular vesicles (pcEV) in the circulation have been consistently associated with preeclampsia, but whether these vesicles induce preeclampsia or are the product of preeclampsia is not known. Guided by a small cohort study of preeclamptic patients, we examined the impact of pcEV on the pathogenesis of preeclampsia in mouse models. We detected pcEV in pregnant C56BL/6J mice with a peak level of 3.8±0.9×107/mL at 17-18 days post-coitum. However, these pregnant mice developed hypertension and proteinuria only after being infused with vesicles purified from injured placenta. These extracellular vesicles released from injured placenta disrupted endothelial integrity and induced vasoconstriction. Enhancing the clearance of extracellular vesicles prevented the development of the extracellular vesicle-induced preeclampsia in mice. Our results demonstrate a causal role of pcEV in preeclampsia and identify microvesicle clearance as a new therapeutic strategy for the treatment of this pregnancy-associated complication.
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Affiliation(s)
- Cha Han
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China.,Bloodworks Research Institute, Seattle, WA, USA
| | - Chenyu Wang
- Institute of Pathology, School of Medical Sciences and Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Yuanyuan Chen
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiwei Wang
- Department of Neurosurgery, Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin, China
| | - Xin Xu
- Bloodworks Research Institute, Seattle, WA, USA
| | | | - Wei Cai
- Institute of Pathology, School of Medical Sciences and Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Zilong Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
| | - Yingang Wu
- Department of Neurosurgery, the First Affiliated Hospital, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ke Li
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Katie Houck
- Bloodworks Research Institute, Seattle, WA, USA
| | - Li Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
| | - Anil K Sood
- Department of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Xiaoping Wu
- Bloodworks Research Institute, Seattle, WA, USA
| | - Fengxia Xue
- Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital, Tianjin, China
| | - Min Li
- Institute of Pathology, School of Medical Sciences and Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Jing-Fei Dong
- Bloodworks Research Institute, Seattle, WA, USA .,Division of Hematology, Department of Medicine, University of Washington, School of Medicine, Seattle, WA, USA
| | - Jianning Zhang
- Department of Neurosurgery, Tianjin Medical University General Hospital and Tianjin Neurological Institute, Tianjin, China
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6
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Jassim SS, Hilton T, Saifuddin A, Pollock R. The incidence and outcome of chondral tumours as incidental findings on investigation of shoulder pathology. Eur J Orthop Surg Traumatol 2019; 30:97-102. [DOI: 10.1007/s00590-019-02532-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/13/2019] [Indexed: 12/14/2022]
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7
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Zhao Z, Zhou Y, Hilton T, Li F, Han C, Liu L, Yuan H, Li Y, Xu X, Wu X, Zhang F, Thiagarajan P, Cap A, Shi FD, Zhang J, Dong JF. Extracellular mitochondria released from traumatized brains induced platelet procoagulant activity. Haematologica 2019; 105:209-217. [PMID: 30975909 PMCID: PMC6939511 DOI: 10.3324/haematol.2018.214932] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 12/18/2018] [Accepted: 04/09/2019] [Indexed: 01/10/2023] Open
Abstract
Coagulopathy often develops soon after acute traumatic brain injury and its cause remains poorly understood. We have shown that injured brains release cellular microvesicles that disrupt the endothelial barrier and induce consumptive coagulopathy. Morphologically intact extracellular mitochondria accounted for 55.2% of these microvesicles, leading to the hypothesis that these extracellular mitochondria are metabolically active and serve as a source of oxidative stress that activates platelets and renders them procoagulant. In testing this hypothesis experimentally, we found that the extracellular mitochondria purified from brain trauma mice and those released from brains subjected to freeze-thaw injury remained metabolically active and produced reactive oxygen species. These extracellular mitochondria bound platelets through the phospholipid-CD36 interaction and induced α-granule secretion, microvesiculation, and procoagulant activity in an oxidant-dependent manner, but failed to induce aggregation. These results define an extracellular mitochondria-induced and redox-dependent intermediate phenotype of platelets that contribute to the pathogenesis of traumatic brain injury-induced coagulopathy and inflammation.
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Affiliation(s)
- Zilong Zhao
- BloodWorks Research Institute, Seattle, WA, USA.,Tianjin Institute of Neurology, Departments of Neurosurgery and Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuan Zhou
- BloodWorks Research Institute, Seattle, WA, USA.,Tianjin Institute of Neurology, Departments of Neurosurgery and Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | | | - Fanjian Li
- Tianjin Institute of Neurology, Departments of Neurosurgery and Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Cha Han
- BloodWorks Research Institute, Seattle, WA, USA
| | - Li Liu
- Tianjin Institute of Neurology, Departments of Neurosurgery and Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Hengjie Yuan
- Tianjin Institute of Neurology, Departments of Neurosurgery and Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Li
- Tianjin Institute of Neurology, Departments of Neurosurgery and Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Xu
- BloodWorks Research Institute, Seattle, WA, USA
| | - Xiaoping Wu
- BloodWorks Research Institute, Seattle, WA, USA
| | - Fangyi Zhang
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Perumal Thiagarajan
- Departments of Medicine and Pathology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA
| | - Andrew Cap
- US Army Institute of Surgical Research, San Antonio, TX, USA
| | - Fu-Dong Shi
- Tianjin Institute of Neurology, Departments of Neurosurgery and Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Jianning Zhang
- Tianjin Institute of Neurology, Departments of Neurosurgery and Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-Fei Dong
- BloodWorks Research Institute, Seattle, WA, USA .,Division of Hematology, Department of Medicine, University of Washington, School of Medicine, Seattle, WA, USA
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8
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Wu Y, Liu W, Zhou Y, Hilton T, Zhao Z, Liu W, Wang M, Yeon J, Houck K, Thiagarajan P, Zhang F, Shi FD, Wu X, Li M, Dong JF, Zhang J. von Willebrand factor enhances microvesicle-induced vascular leakage and coagulopathy in mice with traumatic brain injury. Blood 2018; 132:1075-1084. [PMID: 29941674 PMCID: PMC6128082 DOI: 10.1182/blood-2018-03-841932] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/14/2018] [Indexed: 11/20/2022] Open
Abstract
von Willebrand factor (VWF) is an adhesive ligand, and its activity is proteolytically regulated by the metalloprotease ADAMTS-13 (a disintegrin and metalloprotease with thrombospondin type 1 repeat 13). An elevated level of plasma VWF has been widely considered a marker for endothelial cell activation in trauma and inflammation, but its causal role in these pathological conditions remains poorly defined. Using a fluid percussion injury mouse model, we demonstrated that VWF released during acute traumatic brain injury (TBI) was activated and became microvesicle-bound. The VWF-bound microvesicles promoted vascular leakage and systemic coagulation. Recombinant ADAMTS-13 given either before or after TBI reduced the VWF reactivity with minimal influence on VWF secretion. rADAMTS-13 protected the integrity of endothelial cell barriers and prevented TBI-induced coagulopathy by enhancing VWF cleavage without impairing basal hemostasis. Promoting microvesicle clearance by lactadherin had efficacy similar to that of rADAMTS-13. This study uncovers a novel synergistic action between VWF and cellular microvesicles in TBI-induced vascular leakage and coagulopathy and demonstrates protective effects of rADAMTS-13.
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Affiliation(s)
- Yingang Wu
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin, China
- Tianjin Medical University General Hospital, Tianjin, China
- Bloodworks Research Institute, Seattle, WA
| | - Wei Liu
- Institute of Pathology, School of Medical Sciences, and
- Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Yuan Zhou
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin, China
- Tianjin Medical University General Hospital, Tianjin, China
| | | | - Zilong Zhao
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin, China
- Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Liu
- Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurology, Tianjin Institute of Neurology, Tianjin, China
| | - Min Wang
- Institute of Pathology, School of Medical Sciences, and
- Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
| | - Jason Yeon
- Bloodworks Research Institute, Seattle, WA
| | | | - Perumal Thiagarajan
- Department of Medicine and
- Department of Pathology, Baylor College of Medicine, Houston, TX
- Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center, Houston, TX
| | - Fangyi Zhang
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, WA
| | - Fu-Dong Shi
- Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital, Phoenix, AZ; and
- Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Xiaoping Wu
- Institute of Pathology, School of Medical Sciences, and
| | - Min Li
- Gansu Provincial Key Laboratory of Preclinical Study for New Drug Development, Lanzhou University, Lanzhou, China
- Department of Neurology, Tianjin Institute of Neurology, Tianjin, China
| | - Jing-Fei Dong
- Institute of Pathology, School of Medical Sciences, and
- Division of Hematology, Department of Medicine, University of Washington School of Medicine, Seattle, WA
| | - Jianning Zhang
- Department of Neurosurgery, Tianjin Institute of Neurology, Tianjin, China
- Tianjin Medical University General Hospital, Tianjin, China
- Bloodworks Research Institute, Seattle, WA
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9
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Zhou Y, Cai W, Zhao Z, Hilton T, Wang M, Yeon J, Liu W, Zhang F, Shi FD, Wu X, Thiagarajan P, Li M, Zhang J, Dong JF. Lactadherin promotes microvesicle clearance to prevent coagulopathy and improves survival of severe TBI mice. Blood 2018; 131:563-572. [PMID: 29162596 PMCID: PMC5794502 DOI: 10.1182/blood-2017-08-801738] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 11/05/2017] [Indexed: 11/20/2022] Open
Abstract
Coagulopathy is common in patients with traumatic brain injury (TBI) and predicts poor clinical outcomes. We have shown that brain-derived extracellular microvesicles, including extracellular mitochondria, play a key role in the development of TBI-induced coagulopathy. Here, we further show in mouse models that the apoptotic cell-scavenging factor lactadherin, given at a single dose of 400 μg/kg 30 minutes before (preconditioning) or 30 minutes after cerebral fluid percussion injury, prevented coagulopathy as defined by clotting time, fibrinolysis, intravascular fibrin deposition, and microvascular bleeding of the lungs. Lactadherin also reduced cerebral edema, improved neurological function, and increased survival. It achieved these protective effects by enhancing the clearance of circulating microvesicles through phosphatidylserine-mediated phagocytosis. Together, these results identify the scavenging system for apoptotic cells as a potential therapeutic target to prevent TBI-induced coagulopathy and improve the outcome of TBI.
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Affiliation(s)
- Yuan Zhou
- Tianjin Institute of Neurology, Tianjin, China
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Bloodworks Research Institute, Seattle, WA
| | - Wei Cai
- Institute of Pathology, Lanzhou University School of Basic Medical Sciences, Lanzhou, China
| | - Zilong Zhao
- Tianjin Institute of Neurology, Tianjin, China
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | | | - Min Wang
- Institute of Pathology, Lanzhou University School of Basic Medical Sciences, Lanzhou, China
| | - Jason Yeon
- Bloodworks Research Institute, Seattle, WA
| | - Wei Liu
- Tianjin Institute of Neurology, Tianjin, China
- Bloodworks Research Institute, Seattle, WA
| | - Fangyi Zhang
- Department of Neurosurgery, University of Washington School of Medicine, Seattle, WA
| | - Fu-Dong Shi
- Tianjin Institute of Neurology, Tianjin, China
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ
| | | | - Perumal Thiagarajan
- Departments of Pathology and Medicine, Baylor College of Medicine and Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center, Houston, TX; and
| | - Min Li
- Institute of Pathology, Lanzhou University School of Basic Medical Sciences, Lanzhou, China
| | - Jianning Zhang
- Tianjin Institute of Neurology, Tianjin, China
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing-Fei Dong
- Bloodworks Research Institute, Seattle, WA
- Division of Hematology, Department of Medicine, University of Washington, School of Medicine, Seattle, WA
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Ho TH, Serie DJ, Parasramka M, Cheville JC, Bot BM, Tan W, Wang L, Joseph RW, Hilton T, Leibovich BC, Parker AS, Eckel-Passow JE. Differential gene expression profiling of matched primary renal cell carcinoma and metastases reveals upregulation of extracellular matrix genes. Ann Oncol 2017; 28:604-610. [PMID: 27993815 DOI: 10.1093/annonc/mdw652] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background The majority of renal cell carcinoma (RCC) studies analyze primary tumors, and the corresponding results are extrapolated to metastatic RCC tumors. However, it is unknown if gene expression profiles from primary RCC tumors differs from patient-matched metastatic tumors. Thus, we sought to identify differentially expressed genes between patient-matched primary and metastatic RCC tumors in order to understand the molecular mechanisms underlying the development of RCC metastases. Patients and methods We compared gene expression profiles between patient-matched primary and metastatic RCC tumors using a two-stage design. First, we used Affymetrix microarrays on 15 pairs of primary RCC [14 clear cell RCC (ccRCC), 1 papillary] tumors and patient-matched pulmonary metastases. Second, we used a custom NanoString panel to validate seven candidate genes in an independent cohort of 114 ccRCC patients. Differential gene expression was evaluated using a mixed effect linear model; a random effect denoting patient was included to account for the paired data. Third, The Cancer Genome Atlas (TCGA) data were used to evaluate associations with metastasis-free and overall survival in primary ccRCC tumors. Results We identified and validated up regulation of seven genes functionally involved in the formation of the extracellular matrix (ECM): DCN, SLIT2, LUM, LAMA2, ADAMTS12, CEACAM6 and LMO3. In primary ccRCC, CEACAM6 and LUM were significantly associated with metastasis-free and overall survival (P < 0.01). Conclusions We evaluated gene expression profiles using the largest set to date, to our knowledge, of patient-matched primary and metastatic ccRCC tumors and identified up regulation of ECM genes in metastases. Our study implicates up regulation of ECM genes as a critical molecular event leading to visceral, bone and soft tissue metastases in ccRCC.
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Affiliation(s)
- T H Ho
- Division of Hematology and Medical Oncology, Mayo Clinic, Scottsdale, USA
| | - D J Serie
- Departments of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | | | - J C Cheville
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, NY, USA
| | - B M Bot
- Computational Oncology, Sage Bionetworks, Seattle, USA
| | - W Tan
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - L Wang
- Department of Pathology, Medical College of Hebei University of Engineering, Handan, Hebei Province, China
| | - R W Joseph
- Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - T Hilton
- Departments of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | | | - A S Parker
- Departments of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | - J E Eckel-Passow
- Department of Pathology, Medical College of Hebei University of Engineering, Handan, Hebei Province, China
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Abstract
SUMMARY
This article gives an overview of the state of the art of different restorative treatment procedures and techniques needed for placing extended posterior resin composite restorations. Clinical aspects related to the procedure are discussed and reviewed based on the current literature, such as the use of proper adhesive restorative materials, use of liners and bases, moisture control, reconstruction of proximal contacts, extended resin composite restorations, and techniques to address restoring teeth with deep subgingival margins.
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Affiliation(s)
- B Loomans
- Bas Loomans, DDS, PhD, Radboud Institute for Molecular Life Sciences, Department of Dentistry, Radboud university medical center, Nijmegen, PO Box 9101, Nijmegen 6500 HB, The Netherlands
| | - T Hilton
- Thomas Hilton, DMD, MS, Department of Restorative Dentistry, Oregon Health and Science University, 2730 S.W. Moody Ave. Portland, OR 97201-0007, USA
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Bell R, Feng Z, Moudgil T, Cheng A, Paustian C, Dubay C, Hu H, Bui T, Hulett T, Leidner R, Hilton T, Bifulco C, Fox B. “Immunoscore” as a biomarker for oral, head and neck squamous cell carcinoma. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.004] [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: 10/24/2022]
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Neuberger M, Paustian C, Hilton T, Engel N, Reu S, Linder A, Huber R, Hatz R, Winter H. P11. Developing an immunotherapy strategy for the effective treatment of patients with Non Small Cell Lung Cancer (NSCLC): strategies to evaluate immunity in patients on clinical trials. J Immunother Cancer 2014. [PMCID: PMC4072310 DOI: 10.1186/2051-1426-2-s2-p2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Armamento-Villareal R, Aguirre L, Napoli N, Shah K, Hilton T, Sinacore DR, Qualls C, Villareal DT. Changes in thigh muscle volume predict bone mineral density response to lifestyle therapy in frail, obese older adults. Osteoporos Int 2014; 25:551-8. [PMID: 23892583 PMCID: PMC3903658 DOI: 10.1007/s00198-013-2450-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 06/14/2013] [Indexed: 12/14/2022]
Abstract
UNLABELLED We studied the relationships among strength, muscle mass, and bone mineral density (BMD) with lifestyle change. Lifestyle therapy consisted of exercise, diet, and diet plus exercise. Diet was by caloric restriction to induce and maintain a weight loss of 10 % from baseline body weight. Exercise attenuated weight loss-induced muscle and bone losses. Exercise improved strength despite muscle loss in patients on diet and exercise. Changes in strength did not correlate with changes in BMD. However, changes in thigh muscle volume correlated with, and predicted changes in hip BMD. INTRODUCTION Losses of hip BMD and lean body mass are major complications of lifestyle therapy in frail, obese older adults; however, the contribution of mechanical strain loss from muscle loss is poorly defined. We determined the effect of changes in thigh muscle volume and muscle strength on BMD in frail, obese older adults undergoing lifestyle therapy aimed at intentional weight loss with or without exercise. METHODS One hundred seven obese older adults were randomized to control, diet, exercise, and diet-exercise groups for 1 year. Thigh muscle volume was measured by magnetic resonance imaging, BMD by DXA, knee strength by dynamometry, total strength by one-repetition maximum (1-RM), and bone markers by immunoassay. RESULTS Thigh muscle volume decreased in the diet group (-6.2 ± 4.8 %) and increased in the exercise group (2.7 ± 3.1 %), while it was not significantly different from the control in the diet-exercise group. Changes in hip BMD followed similar pattern as those in thigh muscle volume. Knee extension and flexion increased in the exercise group (23 ± 20 %; 25 ± 19 %) and diet-exercise group (20 ± 19 %; 20.6 ± 27 %) but were unchanged in the control and diet groups. Changes in thigh muscle volume correlated with changes in hip BMD (r = 0.55, P = <0.001) and were an independent predictor of changes in hip BMD (β = 0.12, P = 0.03) in the multiple regression analyses after accounting for demographic factors and changes in weight and physical activity. There were no correlations between BMD changes and knee strength, 1-RM, and sclerostin changes. CONCLUSIONS Changes in thigh muscle volume predict hip BMD changes in obese older patients undergoing lifestyle therapy. The effect of exercise in attenuating thigh muscle loss when added to diet may in part account for the reduction in weight loss-induced bone loss in the diet-exercise group.
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Affiliation(s)
- R. Armamento-Villareal
- New Mexico VA Health Care System, Albuquerque, NM, USA
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - L. Aguirre
- New Mexico VA Health Care System, Albuquerque, NM, USA
| | - N. Napoli
- Campus Biomedico, Rome, Italy
- Washington University School of Medicine, St. Louis, MO, USA
| | - K. Shah
- University of Rochester School of Medicine, Rochester, NY, USA
| | | | - D. R. Sinacore
- Washington University School of Medicine, St. Louis, MO, USA
| | - C. Qualls
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - D. T. Villareal
- New Mexico VA Health Care System, Albuquerque, NM, USA,
- University of New Mexico School of Medicine, Albuquerque, NM, USA
- Washington University School of Medicine, St. Louis, MO, USA
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da Costa JB, McPharlin R, Hilton T, Ferracane JL, Wang M. Comparison of Two At-home Whitening Products of Similar Peroxide Concentration and Different Delivery Methods. Oper Dent 2012; 37:333-9. [DOI: 10.2341/11-053-c] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Purpose
This study compared the whitening efficacy, side effects, and patients' preferences/perceptions of two whitening systems of similar peroxide concentration but different formulation and delivery methods.
Methods
The tooth color change of 24 participants was measured using a shade guide (BSG) and a spectrophotometer (ES). Color difference was calculated: ΔE* = [(ΔL*)2 + (Δa*)2 + (Δb*)2]1/2. One whitening treatment was randomly applied to the right or left maxillary anterior teeth and the other was applied to the contralateral teeth, at-home with 35% carbamide peroxide in a tray (TW) or with 14% hydrogen peroxide in strips (WS). The tooth color was evaluated at baseline, 15 and 30 days (15 days postwhitening). Participants rated their tooth and soft tissue sensitivity (1–10 scale) and completed a questionnaire on their preferences. Results were analyzed by repeated measurement regression analysis/Tukey and Mann-Whitney (p<0.05).
Results
At 15 days, the teeth treated with TW and WS presented ΔE* = 7 and 6, respectively (ΔBSG=3 for both), and at 30 days, they presented ΔE* = 7.5 and 6.5, respectively (ΔBSG=3 for both). There was no significant difference in tooth and soft tissue sensitivity between treatments. No participant reported tooth and gingival sensitivity at the postwhitening appointment. Of the participants, 83% preferred the TW over WS.
Conclusion
Both ΔE* and ΔBSG showed no significant difference in tooth color change between TW and SW at either time point. By the end of the study no participants reported tooth and gingival sensitivity. Participants preferred TW over SW.
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Ferracane J, Hilton T, Korpak A, Gillette J, McIntyre PS, Berg J. Use of caries prevention services in the Northwest PRECEDENT dental network. Community Dent Oral Epidemiol 2010; 39:69-78. [PMID: 21114514 DOI: 10.1111/j.1600-0528.2010.00570.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This cross-sectional study assessed the use of caries preventive services by Northwest PRECEDENT dental network practitioners and compared the caries experience of patients who received such services in the past 12 months with those who had not. METHODS An oral health survey was conducted on approximately 20 patients seen by each of 97 private practice dental practitioners in the network. Eligible patients (total of 1877 aged 3-92) were randomly assessed for the occurrence of one or more new caries lesions as well as having received the following preventive services within the past 12 months: fluoride varnish or gel, sealant in molar or premolar, and prophylaxis. Patients were stratified by gender and age (1-17 years old, 18-64 years old, and 65+ years old). Logistic regression was used to investigate the association between the practitioner characteristics and the use of preventive services, as well as the preventive services and the presence of a new caries lesion in the past 12 months. RESULTS The percent of patients in age category 1-17 years old/18-64 years old/65+ years old receiving each preventive treatment varied as follows: 95%/85%/81% for prophylaxis, 87%/24%/22% for fluoride, and 27%/2%/0% for sealant. There was a very limited association between the use of a specific preventive service and practitioner gender, and no significant association between use of services and practice location (rural, urban or suburban). There was a significant association between greater use of sealants for dentists with 0-15 years of practice experience as compared with those having more than 25 years of experience. For the 1-17-year-old age group, boys had about 1.7 times the odds of having a new lesion than girls in the past 12 months, and patients receiving a sealant had 1.9 times the odds of having a new caries lesion. In the 18-64-year-old group, receiving a prophylaxis in the past 12 months was significantly associated with lower odds for having a new lesion (odds ratio = 0.57). CONCLUSIONS This study reports that aside from prophylaxis, which more than 85% of the patients had received, about one-third of the patients overall received preventive services consisting of either sealants or some type of fluoride treatment in private dental practices in the Northwest PRECEDENT network.
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Affiliation(s)
- J Ferracane
- Department of Restorative Dentistry, Oregon Health & Science University School of Dentistry, Portland, OR 97239, USA.
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Abstract
OBJECTIVE We suggest that the identification of depression in the medically ill (DMI) might be improved by focussing on cognitive features. METHOD We recruited 302 patients to complete our provisional cognitive-based measure. Subsets also completed one of two comparator screening measures, either the Hospital and Anxiety Depression Scale (HADS) or the Beck Depression Inventory for Primary Care (BDI-PC). One hundred and sixty patients were then assessed by a psychiatrist who estimated whether they were 'clinically depressed' and who also administered a standardized interview for depression (the CIDI). RESULTS Analyses identified items discriminating clinically depressed and non-depressed individuals, allowing development of brief (10-item) and extended (18-item) measures. The two new measures were compared with the HADS and the BDI-PC in discriminating depressed and non-depressed medically ill patients. CONCLUSION A cognitive construct-based approach to assessing depression in the medically ill appears strongly supported. We provide brief (DMI-10) and extended (DMI-18) measures that appear to have utility as screening instruments. Consideration of the discriminating items may also assist clinical decision making.
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Affiliation(s)
- G Parker
- School of Psychiatry, University of New South Wales, and Mood Disorders Unit, Prince of Wales Hospital, Sydney, Australia
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Abstract
OBJECTIVE There is a need for a valid measure of depression in the medically ill, and one that is independent of medical illness characteristics. As yet, there is no such widely accepted measure. We thus report on the early development of such a measure using cognitive constructs that define depressive mood state nuances. METHOD We studied 67 patients with a significant medical illness, verbally administering a set of 81 provisional items. Sample members also alternatively completed one of two comparison measures: the Hospital Anxiety and Depression Scale (HADS) or the Beck Depression Inventory for Primary Care (BDI-PC). A psychiatrist interviewed a subset to determine severity of any depression and whether subjects met formalized caseness criteria for depression. The Composite International Diagnostic Interview (CIDI) was also administered during interviews to assess agreement with psychiatrist judgements about caseness. RESULTS A 16-item measure with high internal consistency was derived, with validation analyses suggesting it was distinctly superior to the HADS and somewhat superior to the BDI-PC measure. CONCLUSIONS A cognitive-based approach (as used by both our measure and the BDI-PC) to screen for depression in medically ill groups appears to have distinct utility in identifying depressed patients, and in avoiding confounding influences of physical symptoms.
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Affiliation(s)
- G Parker
- School of Psychiatry, University of New South Wales, Prince of Wales Hospital, Randwick, Australia.
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Abstract
The modus operandi of female serial killers was examined from a chronology of 58 cases in America and 47 cases in 17 other countries, compiled over 25-year intervals. Female serial killers in other countries accounted for a disproportionately greater number of victims, but those in America managed a longer killing career when associated with a low profile modus operandi.
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Affiliation(s)
- W Wilson
- Department of Psychology, Stephen F. Austin State University, Nacogdoches, TX 75962, USA
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Abstract
A spontaneous bone tumour in the foreleg of a Syrian hamster was shown to be a chondroma; this is only the second report of such a tumour and the first described in detail.
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Affiliation(s)
- P Brown
- University of Bristol Veterinary School, Langford
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Abstract
End of life care for patients with Duchenne muscular dystrophy (DMD) has become increasingly complex because of new technologies, changes in medical personnel over periods of time, emergence of home health care systems, and increasing patient and family autonomy in decision-making. In this review, we discuss the medical problems, particularly respiratory and cardiac failure, faced by DMD patients. Current concepts concerning the evaluation and options for treatment of these problems are presented as well as the ethical issues involved in the care of the DMD patient. These issues include the medical indications for treatment, patient preferences, quality-of-life issues, and contextual features related to legal, institutional, religious, geographic, cultural, social, and financial factors. We also present our experience at Loma Linda University Medical Center over the past 10 years in the development of a home mechanical ventilation program for DMD patients and an algorithm for the evaluation of these patients. Many patients with DMD do well on long-term ventilation, but some find that their quality of life is less than desirable and choose to discontinue this method of life-prolongation. Many of these new options are very expensive, making the decision to use them a difficult one. Ultimately, these are societal issues that require clear reflection on matters of resource allocation that should be performed by health care professionals, citizens, and health planners.
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Affiliation(s)
- T Hilton
- Department of Nursing, Loma Linda University School of Medicine, California 92350
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Davis R, Schwartz R, Hilton T. Marginal adaptation of castings made with dual-arch and custom trays. Am J Dent 1992; 5:253-4. [PMID: 1299250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This study compared the marginal fit of castings made with custom acrylic trays and metal or plastic dualarch impression trays. Standard clinical and laboratory procedures were used to make 36 gold castings for a metal tipodont die. Mean marginal openings were between 25 and 28 microns in all test groups.
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Affiliation(s)
- R Davis
- Department of General Practice, University of Texas Health Science Center, San Antonio 78284
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Abstract
To determine the predictive value of adenosine thallium-201 myocardial imaging for perioperative cardiac events, 60 consecutive patients referred for preoperative cardiac evaluation were studied before vascular (n = 25), orthopedic (n = 14), or general (n = 21) surgery. Tomographic (n = 52) and planar (n = 8) thallium-201 imaging was performed after adenosine infusion at a rate of 140 micrograms/kg/min for 6 minutes. Two blinded expert observers graded results of adenosine thallium-201 studies as normal (33%), fixed defect only (2%), reversible defect only (48%), and combined (fixed and reversible) defects (17%). After 6 +/- 3 months of follow-up, 81% proceeded to surgery and 43% underwent preoperative coronary angiography. Clinical variables that correlated with perioperative cardiac events were a history of diabetes mellitus (p = 0.05), left bundle branch block (p = 0.02), and left ventricular hypertrophy (p = 0.06) on the resting ECG. This clinically "high-risk" group had an event rate of 22% as compared with no cardiac events in patients in the "low-risk" group without these clinical characteristics (p = 0.005). Stepwise logistic regression analysis revealed that the presence of a combined (fixed and reversible) adenosine thallium-201 defect (p = 0.0007), three-vessel coronary artery disease (p = 0.001), and left bundle branch block (p = 0.02) was predictive of subsequent cardiac events with relative risk ratios of 4.9, 2.9, and 2.2, respectively. Therefore the presence of an adenosine thallium-201 perfusion defect is correlated with and predictive of an increased risk of perioperative cardiac events in patients referred for preoperative risk evaluation.
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Affiliation(s)
- L Shaw
- Department of Internal Medicine, St. Louis University School of Medicine, MO
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Affiliation(s)
- T Hilton
- Division of Cardiology, University Hospital, St. Louis University Medical Center, MO 63110-0250
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Affiliation(s)
- T Hilton
- Department of Internal Medicine, St. Louis University Hospital, St. Louis University School of Medicine, MO 63110-0250
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Hilton T, Pearson AC, Deligonul U, Barner H, Kern MJ. Acute mitral regurgitation with cardiogenic shock in a patient with hypertrophic cardiomyopathy: a critical management dilemma. Am Heart J 1990; 119:1205-7. [PMID: 2330880 DOI: 10.1016/s0002-8703(05)80257-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- T Hilton
- Department of Cardiothoracic Surgery, St. Louis University Hospital, MO 63110
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Abstract
Contractions of the transmurally stimulated guinea-pig ileum were not affected by 10 microM bicuculline, a competitive GABAA receptor antagonist. The GABAA potentiator alphaxalone depressed the responses to 2 and 20 Hz stimulation by 20% and 40%, respectively, but had no effect on 0.2 Hz responses. The depressions were prevented by 10 microM bicuculline. This suggests that endogenous activation of GABAA receptors during transmural stimulation was normally subthreshold but, when pharmacologically potentiated, inhibitory effects were seen.
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Affiliation(s)
- C Healing
- Department of Pharmacology, School of Pharmacy, University of London, UK
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Michalek SM, Gregory RL, Harmon CC, Katz J, Richardson GJ, Hilton T, Filler SJ, McGhee JR. Protection of gnotobiotic rats against dental caries by passive immunization with bovine milk antibodies to Streptococcus mutans. Infect Immun 1987; 55:2341-7. [PMID: 3498689 PMCID: PMC260710 DOI: 10.1128/iai.55.10.2341-2347.1987] [Citation(s) in RCA: 61] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A multivalent vaccine consisting of whole cell antigens of seven strains, representing four serotypes (b, c, d and g), of mutans streptococci was used to hyperimmunize a group of cows. Serum samples from these animals contained immunoglobulin G1 (IgG1) antibody activity to seven serotypes (a to g) of mutans streptococci. Whey obtained from the animal with the highest serum antibody activity, which also contained high levels of IgG1 antibody, was used in passive caries immunity studies. Gnotobiotic rats monoinfected with Streptococcus mutans MT8148 serotype c or Streptococcus sobrinus OMZ176 (d) or 6715 (g) and provided a caries-promoting diet containing immune whey had lower plaque scores, numbers of streptococci in plaque, and degree of caries activity than similarly infected animals given a diet containing control whey obtained from nonimmunized cows. To establish the nature of the protective component(s) present in the immune whey, an ultrafiltrate fraction of the whey was prepared. This preparation contained higher levels of IgG1 anti-S. mutans antibody activity than the immune whey. Rats monoinfected with S. mutans MT8148 and provided with a diet supplemented with 0.1% of this fraction exhibited a degree of caries protection similar to that seen in animals provided a diet containing 100% immune whey. In fact, a diet containing as little as 0.01% of the ultrafiltrate fraction gave some degree of protection against oral S. mutans infection. The active component in the immune whey was the IgG1 anti-S. mutans antibody, since rats monoinfected with S. mutans MT8148 and provided a diet supplemented with purified immune whey IgG1 had significantly reduced plaque scores, numbers of S. mutans in plaque, and caries activity compared with control animals. Prior adsorption of the IgG fraction with killed S. mutans MT8148 whole cells removed antibody activity and abrogated caries protection.
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Affiliation(s)
- S M Michalek
- Department of Microbiology, University of Alabama at Birmingham 35294
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Sikes A, Hilton T. Sensitivity of Foodborne Bacteria (Spoilage and Pathogenic) to a Methanol-Acetone Extract of Milk Fermented by Streptococcus thermophilus. J Food Prot 1987; 50:812-814. [PMID: 30978784 DOI: 10.4315/0362-028x-50.10.812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Effects of an inhibitory methanol-acetone (MA) extract of Streptococcus thermophilus -fermented milk was tested on growth of Salmonella enteritidis , two strains of Staphylococcus aureus (types A and E), two strains of Clostridium perfringens (types A and C) and Pseudomonas fluorescens . Each organism was tested at three levels of the extract, e.g., 250, 500 and 1000 ppm. Results indicated that the degree of sensitivity among the test organisms varied. C. perfringens (C) was the most sensitive, with a mean % inhibition (average % inhibition over the three MA extract concentrations) of 73.3, while S. enteritidis was the least sensitive (mean % inhibition = 51.8) to the extract. The differences between the mean % inhibition of P. fluorescens (65.4), S. aureus (A) (64.8), and C. perfringens (A) (62.2) were not significant (P>0.05); however, the sensitivity of these three organisms to the extract was significantly less (P<0.05) than C. perfringens (C) but significantly greater (P<0.05) than S. aureus (E) and S. enteritidis .
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Affiliation(s)
- A Sikes
- Department of Food Science and Animal Industries, Alabama A&M University, P.O. Box 264, Normal, Alabama 35762
| | - T Hilton
- Department of Food Science and Animal Industries, Alabama A&M University, P.O. Box 264, Normal, Alabama 35762
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Gregory RL, Michalek SM, Richardson G, Harmon C, Hilton T, McGhee JR. Characterization of immune response to oral administration of Streptococcus sobrinus ribosomal preparations in liposomes. Infect Immun 1986; 54:780-6. [PMID: 3781625 PMCID: PMC260237 DOI: 10.1128/iai.54.3.780-786.1986] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Gnotobiotic rats gastrically intubated with a total of 12.5 micrograms of Streptococcus sobrinus ribosomal protein incorporated into cholesterol-based liposomes had significantly (P less than or equal to 0.01) fewer carious lesions on their molar surfaces than did nonimmunized infected controls after challenge with a virulent organism. The immunized animals had significantly (P less than or equal to 0.01) lower numbers of molar-adherent S. sobrinus cells and higher levels of salivary immunoglobulin A antibodies to S. sobrinus whole cells and ribosomes than did the control group. Dose-response studies indicated that 12.5 micrograms of S. sobrinus ribosomal protein in liposomes induced slightly higher immune responses than did 62.5, 125.0, and 250.0 micrograms of ribosomal protein incorporated into liposomes. Intubation of rats with up to 250.0 micrograms of S. sobrinus ribosomal protein alone was no more effective in reducing the numbers of molar-adherent S. sobrinus cells than were nonimmunized infected controls, establishing that insertion of ribosomes into liposomes was required for inducing an effective immune response. These results indicate that oral administration of as little as 12.5 micrograms of S. sobrinus ribosomal protein incorporated into liposomes can protect rats from caries formation after challenge with the virulent organism by inducing specific salivary immunoglobulin A antibodies which can inhibit colonization by the challenged S. sobrinus.
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Ahern E, Ahern V, Hilton T, Serjeant GR, Serjeant BE, Seakins M, Lang A, Middleton A, Lehmann H. Haemoglobin caribbean beta91 (F7) Leu replaced by Arg: a mildly haemoglobin with a low oxygen affinity. FEBS Lett 1976; 69:99-102. [PMID: 992050 DOI: 10.1016/0014-5793(76)80662-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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