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Find video protocols related to scientific articles indexed in Pubmed.
Transient SNAIL1 Expression Is Necessary for Metastatic Competence in Breast Cancer.
Cancer Res.
PUBLISHED: 08-27-2014
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SNAIL1 has been suggested to regulate breast cancer metastasis based on analyses of human breast tumor transcriptomes and experiments using cancer cell lines and xenografts. However, in vivo genetic experimental support for a role for SNAIL1 in breast cancer metastasis that develops in an immunocompetent tumor microenvironment has not been determined. To address this question, we created a genetic SNAIL1 model by coupling an endogenous SNAIL1 reporter with an inducible SNAIL1 transgene. Using multiple genetic models of breast cancer, we demonstrated that endogenous SNAIL1 expression was restricted to primary tumors that ultimately disseminate. SNAIL1 gene deletion either during the premalignant phase or after primary tumors have reached a palpable size blunted metastasis, indicating that late metastasis was the main driver of metastasis and that this was dependent on SNAIL1. Importantly, SNAIL1 expression during breast cancer metastasis was transient and forced transient, but not continuous. SNAIL1 expression in breast tumors was sufficient to increase metastasis. Cancer Res; 74(21); 6330-40. ©2014 AACR.
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CALORIC EXPENDITURE OF AEROBIC, RESISTANCE OR COMBINED HIGH-INTENSITY INTERVAL TRAINING USING A HYDRAULIC RESISTANCE SYSTEM IN HEALTHY MEN.
J Strength Cond Res
PUBLISHED: 08-26-2014
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Though exercise regimens vary in content and duration, few studies have compared the caloric expenditure of multiple exercise modalities with the same duration. The purpose of the present study was to compare the energy expenditure of single sessions of resistance, aerobic, and combined exercise with the same duration. Nine recreationally active men (25 ± 7 years; 181.6 ± 7.6 cm; 86.6 ± 7.5 kg) performed the following four exercises for 30 minutes: a resistance training session using 75% of their 1 repetition maximum (1RM), an endurance cycling session at 70% maximum heart rate (maxHR), an endurance treadmill session at 70% maxHR, and a high-intensity interval training (HIIT) session on a hydraulic resistance system (HRS) that included repeating intervals of 20 seconds at maximum effort followed by 40 seconds of rest. Total caloric expenditure, substrate utilization, heart rate, and rating of perceived exertion (RPE) were recorded. Caloric expenditure was significantly (p < 0.05) greater when exercising with the HRS (12.62 kcal/min ± 2.36), compared to weights (8.83 kcal/min ± 1.55), treadmill (9.48 kcal/min ± 1.30) and cycling (9.23 kcal/min ± 1.25). Average heart rate was significantly (p < 0.05) greater with the HRS (156 beats/min ± 9), compared to weights (138 beats/min ± 16), treadmill (137 beats/min ± 5) and cycling (138 beats/min ± 6). Similarly, average RPE was significantly (p < 0.05) higher with the HRS (16 ± 2), compared to weights (13 ± 2), treadmill (10 ± 2) and cycle (11 ± 1). These data suggest that individuals can burn more calories performing a HIIT session with a HRS than spending the same amount of time performing a steady-state exercise session. This form of exercise intervention may be beneficial to individuals who want to gain the benefits of both resistance and cardiovascular training but have limited time to dedicate to exercise.
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The Canary in the Coal Mine: The Growth of Patient-Derived Tumorgrafts in Mice Predicts Clinical Recurrence after Surgical Resection of Pancreatic Ductal Adenocarcinoma.
Ann. Surg. Oncol.
PUBLISHED: 08-19-2014
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Recurrence after resection of pancreatic ductal adenocarcinoma (PDAC) is common, thus postoperative surveillance is critical for detection and treatment of recurrent disease. The development of biologically based techniques for early recurrence detection may enable more timely and effective treatment of such recurrences.
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Kcnn4 is a regulator of macrophage multinucleation in bone homeostasis and inflammatory disease.
Cell Rep
PUBLISHED: 08-14-2014
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Macrophages can fuse to form osteoclasts in bone or multinucleate giant cells (MGCs) as part of the immune response. We use a systems genetics approach in rat macrophages to unravel their genetic determinants of multinucleation and investigate their role in both bone homeostasis and inflammatory disease. We identify a trans-regulated gene network associated with macrophage multinucleation and Kcnn4 as being the most significantly trans-regulated gene in the network and induced at the onset of fusion. Kcnn4 is required for osteoclast and MGC formation in rodents and humans. Genetic deletion of Kcnn4 reduces macrophage multinucleation through modulation of Ca(2+) signaling, increases bone mass, and improves clinical outcome in arthritis. Pharmacological blockade of Kcnn4 reduces experimental glomerulonephritis. Our data implicate Kcnn4 in macrophage multinucleation, identifying it as a potential therapeutic target for inhibition of bone resorption and chronic inflammation.
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Statistical modeling of the drug load distribution on trastuzumab emtansine (Kadcyla), a lysine-linked antibody drug conjugate.
Bioconjug. Chem.
PUBLISHED: 06-24-2014
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Trastuzumab emtansine (Kadcyla) is a recently approved antibody-drug conjugate produced by attachment of the anti-tubulin drug, DM1, to lysine amines via the SMCC linker. The resulting product exhibits a drug load distribution from 0 to 8 drugs per antibody that can be quantified using mass spectrometry. Different statistical models were tested against the experimental data derived from samples produced during process characterization studies to determine best fit. The Poisson distribution gives the best correlation for samples manufactured using the target process conditions (yielding the target average drug to antibody ratio (DAR) of 3.5) as well as those produced under conditions that exceed the allowed manufacturing ranges and yield products with average DAR values that are significantly different from the target (i.e., ?3.0 or ?4.0). The Poisson distribution establishes a link between average DAR values and drug load distributions, implying that measurement and control of the former (i.e., via a simple UV spectrophotometric method) could be used to indirectly control the latter in trastuzumab emtansine.
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Novel use of an apical-femoral wire rail to assist with transfemoral transcatheter aortic valve replacement.
J Invasive Cardiol
PUBLISHED: 06-08-2014
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The inability to reposition or retrieve balloon-expandable transcatheter aortic valves once they have been deployed requires implantation of the valve in the descending aorta or open surgical procedures to extract the valve. We describe the challenging transfemoral delivery of an Edwards Lifesciences Sapien valve wherein we had difficulty crossing the aortic valve and the guidewire position was compromised. We performed a transapical puncture to snare the guidewire and create a left ventricular to femoral wire rail, allowing us to deliver the transfemoral transcatheter valve, salvaging a situation where we would have been required to implant the valve in the descending aorta. We believe this is the first time this technique has been reported and represents an important method to facilitate delivery of transcatheter valves where guidewire support is insufficient or lost.
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Health care burden of dyspepsia among nonvalvular atrial fibrillation patients.
J Manag Care Pharm
PUBLISHED: 04-02-2014
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Although dyspepsia is common among nonvalvular atrial fibrillation (NVAF) patients, its impact on patient health and cost has not been adequately studied.
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Elevation of soluble form of receptor for advanced glycation end products (sRAGE) in recurrent pregnancy losses (RPL): possible participation of RAGE in RPL.
Fertil. Steril.
PUBLISHED: 03-30-2014
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To determine whether the soluble receptor for advanced glycation end products (sRAGE) and immune inflammatory markers are associated with recurrent pregnancy losses (RPL).
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An amino acid-electrolyte beverage may increase cellular rehydration relative to carbohydrate-electrolyte and flavored water beverages.
Nutr J
PUBLISHED: 03-27-2014
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In cases of dehydration exceeding a 2% loss of body weight, athletic performance can be significantly compromised. Carbohydrate and/or electrolyte containing beverages have been effective for rehydration and recovery of performance, yet amino acid containing beverages remain unexamined. Therefore, the purpose of this study is to compare the rehydration capabilities of an electrolyte-carbohydrate (EC), electrolyte-branched chain amino acid (EA), and flavored water (FW) beverages.
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Peripheral blood monocyte-derived chemokine blockade prevents murine transfusion-related acute lung injury (TRALI).
Blood
PUBLISHED: 03-17-2014
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Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related mortality and can occur with any type of transfusion. TRALI is thought to be primarily mediated by donor antibodies activating recipient neutrophils resulting in pulmonary endothelial damage. Nonetheless, details regarding the interactions between donor antibodies and recipient factors are unknown. A murine antibody-mediated TRALI model was used to elucidate the roles of the F(ab')2 and Fc regions of a TRALI-inducing immunoglobulin G anti-major histocompatibility complex (MHC) class I antibody (34.1.2s). Compared with intact antibody, F(ab')2 fragments significantly increased serum levels of the neutrophil chemoattractant macrophage inflammatory protein 2 (MIP-2); however, pulmonary neutrophil levels were only moderately increased, and no pulmonary edema or mortality occurred. Fc fragments did not modulate any of these parameters. TRALI induction by intact antibody was completely abrogated by in vivo peripheral blood monocyte depletion by gadolinium chloride (GdCl3) or chemokine blockade with a MIP-2 receptor antagonist but was restored upon repletion with purified monocytes. The results suggest a two-step process for antibody-mediated TRALI induction: the first step involves antibody binding its cognate antigen on blood monocytes, which generates MIP-2 chemokine production that is correlated with pulmonary neutrophil recruitment; the second step occurs when antibody-coated monocytes increase Fc-dependent lung damage.
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Outcomes of patients undergoing elective percutaneous coronary interventions in the ambulatory versus in-hospital setting.
J Invasive Cardiol
PUBLISHED: 03-11-2014
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To compare outcomes of elective percutaneous coronary interventions (PCI) in same-day discharge and overnight hospital stays.
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Non-operative management of a rare diagnosis of splenic torsion in a child with a history of giant omphalocele: a case report and literature review.
Patient Saf Surg
PUBLISHED: 02-25-2014
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Splenic torsion is rare and as a result the appropriate management is unclear. While there has been a shift towards splenectomy and laparoscopic splenopexy, we present a successful case of non-operative management of splenic torsion in a patient with a history of a giant omphalocele.
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Ingesting a preworkout supplement containing caffeine, creatine, ?-alanine, amino acids, and B vitamins for 28 days is both safe and efficacious in recreationally active men.
Nutr Res
PUBLISHED: 02-21-2014
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The purpose of this study was to determine the safety and efficacy of consuming a preworkout supplement (SUP) containing caffeine, creatine, ?-alanine, amino acids, and B vitamins for 28 days. We hypothesized that little to no changes in kidney and liver clinical blood markers or resting heart rate and blood pressure (BP) would be observed. In addition, we hypothesized that body composition and performance would improve in recreationally active males after 28 days of supplementation. In a double-blind, placebo-controlled study, participants were randomly assigned to ingest one scoop of either the SUP or placebo every day for 28 days, either 20 minutes before exercise or ad libitum on nonexercise days. Resting heart rate and BP, body composition, and fasting blood samples were collected before and after supplementation. Aerobic capacity as well as muscular strength and endurance were also measured. Significant (P < .05) main effects for time were observed for resting heart rate (presupplementation, 67.59 ± 7.90 beats per minute; postsupplementation, 66.18 ± 7.63 beats per minute), systolic BP (presupplementation, 122.41 ± 11.25 mm Hg; postsupplementation, 118.35 ± 11.58 mm Hg), blood urea nitrogen (presupplementation, 13.12 ± 2.55 mg/dL; postsupplementation, 15.24 ± 4.47 mg/dL), aspartate aminotransferase (presupplementation, 34.29 ± 16.48 IU/L; postsupplementation, 24.76 ± 4.71 IU/L), and alanine aminotransferase (presupplementation, 32.76 ± 19.72 IU/L; postsupplementation, 24.88 ± 9.68 IU/L). Significant main effects for time were observed for body fat percentage (presupplementation, 15.55% ± 5.79%; postsupplementation, 14.21% ± 5.38%; P = .004) and fat-free mass (presupplementation, 70.80 ± 9.21 kg; postsupplementation, 71.98 ± 9.27 kg; P = .006). A significant decrease in maximal oxygen consumption (presupplementation, 47.28 ± 2.69 mL/kg per minute; postsupplementation, 45.60 ± 2.81 mL/kg per minute) and a significant increase in percentage of oxygen consumption per unit time at which ventilatory threshold occurred (presupplementation, 64.38% ± 6.63%; postsupplementation, 70.63% ± 6.39%) and leg press one-repetition maximum (presupplementation, 218.75 ± 38.43 kg; postsupplementation, 228.75 ± 44.79 kg) were observed in the SUP only. No adverse effects were noted for renal and hepatic clinical blood markers, resting heart rate, or BP. Supplements containing similar ingredients and doses should be safe for ingestion periods lasting up to 28 days in healthy, recreationally trained, college-aged men.
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Impact of dronedarone treatment on healthcare resource utilization in patients with atrial fibrillation/flutter.
Adv Ther
PUBLISHED: 01-16-2014
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The ATHENA (A Placebo-Controlled, Double-Blind, Parallel Arm Trial to Assess the Efficacy of Dronedarone 400 mg bid for the Prevention of Cardiovascular Hospitalization or Death from Any Cause in Patients with Atrial Fibrillation/Atrial Flutter) trial demonstrated a significant reduction (26%) in the rate of first cardiovascular (CV) hospitalization in dronedarone-treated patients with paroxysmal or persistent atrial fibrillation/flutter (AF/AFL). ATHENA was the first trial to demonstrate a CV outcomes benefit, specifically reduced CV hospitalizations, with an antiarrhythmic drug. The objective of this study was to assess the impact of dronedarone treatment on healthcare resource utilization among real-world patients with AF/AFL in United States clinical practice.
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Fetal MRI lung volumes are predictive of perinatal outcomes in fetuses with congenital lung masses.
J. Pediatr. Surg.
PUBLISHED: 01-10-2014
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The purpose of this study was to evaluate fetal magnetic resonance imaging (MRI) as a modality for predicting perinatal outcomes and lung-related morbidity in fetuses with congenital lung masses (CLM).
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Overuse of fluoroscopic gastrostomy studies in a children's hospital.
J. Surg. Res.
PUBLISHED: 01-05-2014
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Gastrostomy tubes are often dislodged or exchanged in children. Indications for fluoroscopic examination of gastrostomy location include concern for malposition, dislodgement, leak, or gastric outlet obstruction. We hypothesized that most of the studies obtained at our institution were not ordered for one of the aforementioned indications and do not ultimately affect patient management.
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Identifying and reducing early complications of surgical central lines in infants and toddlers.
J. Surg. Res.
PUBLISHED: 01-04-2014
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Hospitalized infants>1 y old often require central venous catheters (CVC) for prolonged therapy. There are limited data describing the complication profile for this young population. The purpose of this study was to review outcomes associated with CVC insertion in this high-risk group and compare them to those in older children to develop directed quality improvement projects.
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Molecular Recognition of Aliphatic Diamines by 3,3-Di(trifluoroacetyl)-1,1-bi-2-naphthol.
J. Org. Chem.
PUBLISHED: 12-06-2013
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The fluorescent responses of 3,3-di(trifluoroacetyl)-1,1-bi-2-naphthol toward a variety of amines have been studied. It was found that the aliphatic primary 1,2- and 1,5-diamines can greatly enhance the fluorescence of this compound, but under the same conditions, primary, secondary, and tertiary monoamines cannot turn on the fluorescence of this compound. In addition, this compound was shown to be an enantioselective and diastereoselective fluorescent sensor for chiral diamines. UV absorption and NMR spectroscopic methods have been used to study the interaction of the sensor with amines. These studies have demonstrated that the intramolecular OH···O?C hydrogen bonding of the sensor is important for both the reactivity of its trifluoroacetyl group with the amines and its fluorescent responses. The interaction of both of the two amine groups of a diamine molecule with the sensor is essential for the observed fluorescent sensitivity and selectivity.
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Allogeneic platelet transfusions prevent murine T cell-mediated immune thrombocytopenia (ITP).
Blood
PUBLISHED: 11-20-2013
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Platelet transfusions are life saving treatments for many patients with thrombocytopenia, however, their use is generally discouraged in the autoimmune disorder immune thrombocytopenia (ITP). We examined whether allogeneic platelet major histocompatibility complex (MHC) class I transfusions affected anti-platelet CD61-induced ITP. BALB/c CD61 knockout (KO) mice (CD61-/H-2(d)) were immunized against platelets from either wildtype syngeneic BALB/c (CD61+/ H-2(d)) or allogeneic C57BL/6 (CD61+/ H-2(b)) or C57BL/6 CD61 KO (CD61-/ H-2(b)) mice and their splenocytes were transferred into severe combined immunodeficient (SCID) mice to induce ITP. When non-depleted splenocytes were transferred to induce antibody-mediated ITP, both CD61+ platelet immunizations generated immunity that caused thrombocytopenia independently of allo-MHC molecules. In contrast, when B cell-depleted splenocytes were transferred to induce T cell-mediated ITP, transfer of allogeneic MHC-immunized splenocytes completely prevented CD61-induced ITP development. In addition, allogeneic platelet transfusions into SCID mice with established CD61-induced ITP rescued the thrombocytopenia. Compared with thrombocytopenic mice, bone marrow histology in the rescued mice showed normalized megakaryocyte morphology and in vitro CD61-specific T cell cytotoxicity was significantly suppressed. These results indicate that antibody-mediated ITP is resistant to allogeneic platelet transfusions whereas the T cell-mediated form of the disease is susceptible suggesting that transfusion therapy may be beneficial in antibody-negative ITP.
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Understanding facial nerve paralysis.
JAAPA
PUBLISHED: 10-25-2013
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Facial nerve paralysis has many causes and can be acute or chronic. Understanding the signs and symptoms, performing a careful patient evaluation, and obtaining appropriate diagnostic testing can help guide clinicians and improve outcomes.
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Part-based motor neuron recognition in the Drosophila ventral nerve cord.
Neuroimage
PUBLISHED: 08-21-2013
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We exploit the morphological stereotypy and relative simplicity of the Drosophila nervous system to model the diverse neuronal morphologies of individual motor neurons and understand underlying principles of synaptic connectivity in a motor circuit. In our analysis, we use images depicting single neurons labeled with green fluorescent protein (GFP) and serially imaged with laser scanning confocal microscopy. We model morphology with a novel formulation of Conditional Random Fields, a hierarchical latent-state CRF, to capture the highly varying compartment-based structure of the neurons (soma-axon-dendrites). In the training phase, we follow two approaches: (i) hierarchical learning, where compartment labels are given, and (ii) latent-state learning, where compartment labels are not given in the samples. We demonstrate the accuracy of our approach using wild-type motor neurons in the larval ventral nerve cord. However, our method can also be used for the identification of motor neuron mutations, as well as the automated annotation of the motor circuitry in wild type and mutant animals. Our method is directly applicable to the recognition of compartment-defined structures.
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Patent foramen ovale.
Cardiol Clin
PUBLISHED: 08-13-2013
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Patent foramen ovale (PFO) is a common developmental anomaly that allows for the passage of blood and other substances from the venous to the arterial circulation. The study of PFO closure has been challenging due to widely available off-label closures performed outside the clinical trial setting. To date, no study has demonstrated benefit of closure using intention-to-treat analyses. Secondary and subpopulation analyses suggest that there is benefit to closure in patients with atrial septal aneurysms and/or substantial degrees of right-to-left shunting. This article reviews the history, associated technologies, and current data regarding PFO closure.
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Removal of Impella® 2.5 while maintaining vascular access: A solution to a vascular quandary.
Catheter Cardiovasc Interv
PUBLISHED: 07-22-2013
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Cardiogenic shock (CS) in the setting of acute myocardial infarction is associated with high in-hospital mortality rates. Society guidelines provide a Class Ib recommendation for the use of hemodynamic support devices in patients with CS following ST-elevation myocardial infarction. Exchanging of hemodynamic support devices is often complicated by inability to maintain percutaneous vascular access upon device removal in the setting of anticoagulation. This report highlights one potential solution to the dilemma of maintaining vascular access following removal of an Impella® 2.5 mechanical support device to allow safe transition to a TandemHeart system in a patient with refractory CS. © 2013 Wiley Periodicals, Inc.
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Updates in forehead flap reconstruction of facial defects.
Curr Opin Otolaryngol Head Neck Surg
PUBLISHED: 06-08-2013
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The versatile and reliable paramedian forehead flap is the workhorse interpolated flap for nasal reconstruction and its use has been expanded to reconstruct other areas of the face. The goal of this article is to review the recent research describing the modern concepts and techniques in forehead flap reconstruction of facial defects.
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The relationship between defibrillation threshold and total mortality.
J Interv Card Electrophysiol
PUBLISHED: 05-31-2013
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The relationship between the defibrillation threshold (DFT) and total mortality is unclear.
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Prospective evaluation of cinefluoroscopy and chest radiography for Riata lead defects: implications for future lead screening.
J Interv Card Electrophysiol
PUBLISHED: 05-19-2013
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Lead insulation defects with externalization of the conductors exist in Riata defibrillator leads. Cinefluoroscopy is currently the gold standard to detect such defects. Prospective evaluation of alternative screening options such as chest radiography (CXR), which has been recommended by the FDA, is not well described.
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Foot and ankle injuries in sport: imaging correlation with arthroscopic and surgical findings.
Clin Sports Med
PUBLISHED: 05-16-2013
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Foot and ankle injuries are common in sport. Although many available imaging techniques can be useful in identifying and classifying injuries, magnetic resonance imaging (MRI) provides high levels of sensitivity and specificity for articular and soft-tissue injuries. Arthroscopic and minimally invasive treatment techniques for foot and ankle injuries are rapidly evolving, minimizing morbidity and improving postoperative rehabilitation and return to play. Correlation between MRI and surgical findings can aid in both accessing and treating pathologic processes and structures.
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Prediction of postdischarge venous thromboembolism using a risk assessment model.
J. Vasc. Surg.
PUBLISHED: 05-14-2013
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The risk of postdischarge venous thromboembolism (VTE) (either deep vein or pulmonary embolism) is increasingly recognized yet the prescription of postdischarge thromboprophylaxis is inconsistent. There is a paucity of information to aid clinicians in identifying surgical patients who are at increased risk for postdischarge VTE. This study aimed to determine the incidence and risk factors associated with symptomatic postdischarge VTE and develop a risk score to identify patients who may benefit from extended duration thromboprophylaxis.
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Localised normocalcaemic tetany secondary to dehydration in an individual with Gitelman syndrome.
BMJ Case Rep
PUBLISHED: 05-02-2013
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Dehydration is a common presentation to any emergency department with symptoms ranging from lethargy, confusion, oliguria as well as those specific to the underlying cause. In this case we describe a young patient who following a short history of vomiting and abdominal pain developed carpopedal spasm and distal parasthesia on a background of Gitelman syndrome. Biochemical blood analysis showed a marked hypokalaemia, hypomagnesaemia and mild metabolic alkalosis in addition to a prolonged QTc interval of 592 ms seen on ECG. Following fluid replacement and electrolyte correction his clinical symptoms resolved along with QTc normalisation. This case demonstrates a patient with a rare and interesting renal disorder who presented with typical biochemical and ECG abnormalities in addition to tetany in the presence of normal plasma calcium.
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Recurrent hemangioendothelioma in a pediatric patient: report and review of the literature.
J. Pediatr. Surg.
PUBLISHED: 03-25-2013
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The most common adrenal tumor in the pediatric population is a benign hemangioma. Adrenal hemangioendotheliomas are extremely rare variants of the hemangioma which are characterized by the presence of multiple anastomosing vascular spaces lined by endothelial cells, and have indeterminant biologic behavior. We report a unique case in a pediatric patient with Beckwith-Wiedemann syndrome which was complicated by a recurrence of the lesion.
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Effectiveness of VF induction with DC fibber versus conventional induction methods in patients on chronic amiodarone therapy.
J Interv Card Electrophysiol
PUBLISHED: 03-20-2013
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Amiodarone therapy, especially chronic, can result in difficult ventricular fibrillation (VF) inductions during implantable cardioverter defibrillator (ICD) testing. The efficacy of various VF induction methods on patients treated with amiodarone has not been well described. This prospective analysis evaluated the impact of direct current (DC) fibber, burst fibber, and synchronized T-wave shock VF induction methods.
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Live imaging of multicolor-labeled cells in Drosophila.
Development
PUBLISHED: 03-14-2013
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We describe LOLLIbow, a Brainbow-based live imaging system with applications in developmental biology and neurobiology. The development of an animal, including the environmentally sensitive adaptation of its brain, is thought to proceed through continual orchestration among diverse cell types as they divide, migrate, transform and interact with one another within the body. To facilitate direct visualization of such dynamic morphogenesis by individual cells in vivo, we have modified the original Brainbow for Drosophila in which live imaging is practical during much of its development. Our system offers permanent fluorescent labels that reveal fine morphological details of individual cells without requiring dissection or fixation of the samples. It also features a non-invasive means to control the timing of stochastic tricolor cell labeling with a light pulse. We demonstrate applicability of the new system in a variety of settings that could benefit from direct imaging of the developing multicellular organism with single-cell resolution.
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Assessing patient-reported outcomes and preferences for same-day discharge after percutaneous coronary intervention: results from a pilot randomized, controlled trial.
Circ Cardiovasc Qual Outcomes
PUBLISHED: 03-12-2013
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Same-day discharge after percutaneous coronary intervention (PCI) may be safe for some patients. Few data are available on patient-reported outcomes and preferences for same-day discharge after PCI.
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Implementation of real-time three-dimensional transesophageal echocardiography for mitral balloon valvuloplasty.
Catheter Cardiovasc Interv
PUBLISHED: 03-01-2013
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Transthoracic (TTE) and intracardiac echocardiography (ICE) have both been established as modalities for imaging guidance in mitral balloon valvuloplasty (MBV). Real-time three-dimensional transesophageal echocardiography (RT3D-TEE) improves depth resolution, characterization of pathology and visualization of interventional catheters and devices. Three-dimensional imaging should enhance catheter navigation but improvements in procedural outcomes are not easily quantified. Using time from transseptal puncture to balloon inflation, procedure time and radiation exposure as surrogates for improvements linked to image guidance, we describe our early experience in implementing RT3D-TEE during MBV, a prototypical left-sided structural intervention.
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Complications in periorbital surgery.
Facial Plast Surg
PUBLISHED: 02-20-2013
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Comprehensive rejuvenation of the periorbital region commonly involves management of the brow, as well as the upper and lower eyelids. Browlifting, upper and lower blepharoplasty, fat transfer, and neuromodulators are frequently utilized with excellent results. However, surgery in this region can be fraught with potential complications ranging from a poor cosmetic outcome to orbital hematoma and vision loss. Although avoidance of complications is preferred, it is incumbent on the surgeon to have a detailed understanding of the pathophysiology, prevention, and management of these complications. The authors examine the more common complications of periorbital surgery.
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Management of cardiovascular disease in patients with kidney disease.
Nat Rev Cardiol
PUBLISHED: 02-19-2013
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The burden of cardiovascular disease is high in patients with chronic kidney disease or end-stage renal disease. The presence of kidney dysfunction affects the cardiovascular system in multiple ways, including accelerated progression of atherosclerosis and valvular disease, the exacerbation of congestive heart failure, and the development of pericardial disease. This comorbidity results not only from the concordance of shared risk factors, but also from other issues specific to this population, such as systemic inflammation and vascular calcification. Furthermore, both the sensitivity and specificity of noninvasive testing modalities, and the efficacy of several pharmacotherapeutic strategies, are diminished in this population. The exclusion of patients with severe kidney disease from many clinical trials of cardiac interventions raises various therapeutic uncertainties, and kidney disease itself is likely to alter the underlying cardiovascular physiology. In this Review, we discuss aspects of the epidemiology, pathophysiology, and diagnosis of cardiovascular disease in patients with kidney disease, and propose specific, evidence-based recommendations for pharmacological and surgical treatment.
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Duodenum inversum: a report and review of the literature.
J. Pediatr. Surg.
PUBLISHED: 01-22-2013
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Duodenum inversum is a rare congenital malformation defined by a duodenum which travels superiorly and then posteriorly prior to crossing the midline above the pancreas. It is often confused with other, more common, anomalies of intestinal rotation. We present a case of duodenum inversum diagnosed incidentally in a one-month old infant with Trisomy 21 during evaluation for reflux disease. Due to an inability to definitively rule out malrotation, the diagnosis was confirmed with a diagnostic laparoscopy. We discuss available literature concerning this rare anatomic anomaly as well as provide recommendations for diagnosis and treatment.
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The potential of antimicrobials to induce thrombocytopenia in critically ill patients: data from a randomized controlled trial.
PLoS ONE
PUBLISHED: 01-01-2013
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Antimicrobial-induced thrombocytopenia is frequently described in the literature among critically ill patients. Several antimicrobials have been implicated, although experimental evidence to demonstrate causality is limited. We report, using a randomized trial, the potential of antimicrobials to induce thrombocytopenia.
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Three-dimensional motor neuron morphology estimation in the Drosophila ventral nerve cord.
IEEE Trans Biomed Eng
PUBLISHED: 12-22-2011
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Type-specific dendritic arborization patterns dictate synaptic connectivity and are fundamental determinants of neuronal function. We exploit the morphological stereotypy and relative simplicity of the Drosophila nervous system to model the diverse neuronal morphologies of individual motor neurons (MNs) and understand underlying principles of synaptic connectivity in a motor circuit. Our computational approach aims at the reconstruction of the neuron morphology, namely the robust segmentation of the neuron volumes from their surroundings with the simultaneous partitioning into their compartments, namely the soma, axon, and dendrites. We use the idea of cosegmentation, where every image along the z -axis (depth) is segmented using information from "neighboring" depths. We use 3-D Haar-like features to model appearance. Because soma and axon are determined by their distinctive shapes, we define an implicit shape representation of the 2-D segmentation sets to drive cosegmentation and achieve the desired partitioning. We validate our method using image stacks depicting single neurons labeled with green fluorescent protein (GFP) and serially imaged with laser scanning confocal microscopy.
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Very late stent thrombosis approximately 7 years after deployment and one-week cessation of dual antiplatelet therapy.
J Invasive Cardiol
PUBLISHED: 12-08-2011
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This work describes the longest reported interval between drug-eluting stent (DES) placement and very late stent thrombosis (VLST). A 69-year-old male presented with substernal chest pain associated with ST-segment myocardial infarction (STEMI) after having a DES deployed 6.9 years (2506 days) prior. The patients medical history revealed several risk factors for VLST. The patient suspended clopidogrel therapy in preparation for elective cystoscopy approximately 10 days before presenting.
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One-year treatment persistence and potential adverse events among patients with atrial fibrillation treated with amiodarone or sotalol: a retrospective claims database analysis.
Clin Ther
PUBLISHED: 10-12-2011
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The risk-benefit profile of antiarrhythmic drugs (AADs) affects the choice of pharmacotherapy for maintenance of sinus rhythm. Adverse events (AEs) associated with AADs may influence patient compliance and compromise the management of atrial fibrillation (AF). There are limited data on the incidence of AEs or persistence with AADs outside the clinical trial environment.
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Motor neuron morphology estimation for its classification in the Drosophila brain.
Conf Proc IEEE Eng Med Biol Soc
PUBLISHED: 08-29-2011
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Type-specific dendritic arborization patterns dictate synaptic connectivity and are fundamental determinants of neuronal function. We exploit the morphological stereotypy and relative simplicity of the Drosophila nervous system to model the diverse dendritic morphologies of individual motor neurons (MNs) to understand underlying principles of synaptic connectivity in a motor circuit. The genetic tractability of Drosophila allows us to label single MNs with green fluorescent protein (GFP) and serially reconstruct identifiable MNs in 3D with confocal microscopy. Our computational approach aims at the robust segmentation of the MN volumes and the simultaneous partitioning into their compartments, namely the soma, axon and dendrites. We use the idea of co-segmentation, where every image along the z-axis (depth) is clustered using information from neighboring depths. As appearance we use a 3D extension of Haar features and for the shape we define an implicit representation of the segmentation domain.
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The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study: a single-center experience.
Proc (Bayl Univ Med Cent)
PUBLISHED: 07-09-2011
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The AmBulatory Closure Device Percutaneous Intervention (ABCD-PCI) study is a multicenter randomized prospective controlled trial evaluating the safety of and patient satisfaction with same-day discharge following ambulatory percutaneous intervention with a closure device. This article reviews the findings from a single center, Baylor Jack and Jane Hamilton Heart and Vascular Hospital, from October 2008 through April 2010, with 23 patients in the same-day discharge group and 21 patients in the next-day discharge group. There were no differences between the groups in demographic or procedure characteristics. Outcomes were measured by a questionnaire and 7-day and 30-day follow-up phone calls. Results showed that same-day discharge after percutaneous intervention with a closure device is as safe as next-day discharge. However, there was a trend for a higher comfort level among patients in the next-day discharge group.
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Detection of promoter hypermethylation in salivary rinses as a biomarker for head and neck squamous cell carcinoma surveillance.
Clin. Cancer Res.
PUBLISHED: 05-31-2011
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Hypermethylation of tumor suppressor gene promoters has been found in head and neck squamous carcinoma (HNSCC) and other solid tumors. We evaluated these alterations in pretreatment salivary rinses from HNSCC patients by using real-time quantitative methylation-specific PCR (Q-MSP).
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ALDH activity selectively defines an enhanced tumor-initiating cell population relative to CD133 expression in human pancreatic adenocarcinoma.
PLoS ONE
PUBLISHED: 05-06-2011
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Multiple studies in recent years have identified highly tumorigenic populations of cells that drive tumor formation. These cancer stem cells (CSCs), or tumor-initiating cells (TICs), exhibit properties of normal stem cells and are associated with resistance to current therapies. As pancreatic adenocarcinoma is among the most resistant human cancers to chemo-radiation therapy, we sought to evaluate the presence of cell populations with tumor-initiating capacities in human pancreatic tumors. Understanding which pancreatic cancer cell populations possess tumor-initiating capabilities is critical to characterizing and understanding the biology of pancreatic CSCs towards therapeutic ends.
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Estimation of total incremental health care costs in patients with atrial fibrillation in the United States.
Circ Cardiovasc Qual Outcomes
PUBLISHED: 05-03-2011
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Detailed information on the cost burden of atrial fibrillation (AF) is limited. To provide an up-to-date estimate of the national cost of AF, we conducted a retrospective, observational cohort study using administrative claims from the MarketScan Commercial and Medicare Supplemental research data bases, 2004 to 2006.
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Impact of the everolimus-eluting stent on stent thrombosis: a meta-analysis of 13 randomized trials.
J. Am. Coll. Cardiol.
PUBLISHED: 04-29-2011
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We evaluated the impact of the everolimus-eluting stent (EES) on the frequency of stent thrombosis (ST), target vessel revascularization (TVR), myocardial infarction (MI), and cardiac death in randomized controlled trials comparing the EES to non-everolimus-eluting drug-eluting stents (EE-DES).
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Female gender and mortality after percutaneous coronary intervention: results from a large registry.
Catheter Cardiovasc Interv
PUBLISHED: 03-22-2011
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To investigate if previously reported gender-based outcome disparities following percutaneous coronary intervention (PCI) are applicable in a large and racially-diverse cohort in the drug eluting stent (DES) era.
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Safety and efficacy of dual-axis rotational coronary angiography vs. standard coronary angiography.
Catheter Cardiovasc Interv
PUBLISHED: 03-11-2011
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To determine the safety and efficacy of dual-axis rotational coronary angiography (DARCA) by directly comparing it to standard coronary angiography (SA).
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Predictors of low clopidogrel adherence following percutaneous coronary intervention.
Am. J. Cardiol.
PUBLISHED: 03-02-2011
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Few data are available on factors associated with low adherence or early clopidogrel discontinuation after percutaneous coronary intervention (PCI). Patients (n = 284) were evaluated before hospital discharge after PCI to identify factors associated with low adherence to clopidogrel 30 days later. Adherence to daily medications before PCI was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (score <6), medium (score 6 to <8), or high (score 8). Low adherence to clopidogrel was defined as MMAS-8 score <6 (n = 21) or having discontinued clopidogrel (n = 11), which was ascertained during a 30-day interview after PCI. At 30 days after PCI, 11% of patients had low adherence to clopidogrel. Odds ratios (95% confidence intervals [CIs]) for low adherence to clopidogrel were 3.78 (1.09 to 13.1), 3.06 (1.36 to 6.87), 2.46 (0.97 to 6.27), and 3.36 (0.99 to 11.4) for patients who before PCI reported taking smaller doses of medication because of cost, had difficulty filling prescriptions, had difficulty reaching their primary physician, and were not comfortable asking their doctor for instructions, respectively. Odds ratios (95% CIs) for low clopidogrel adherence after PCI in patients with medium and low versus high adherence to daily medications before PCI were 6.13 (1.34 to 28.2) and 10.9 (2.46 to 48.7), respectively. The c-statistic associated with MMAS-8 scores before PCI for discriminating low clopidogrel adherence at 30 days after PCI was 0.733 (95% CI 0.650 to 0.852). In conclusion, adherence to daily medications before PCI may be a useful indicator for identifying patients who will have low clopidogrel adherence after PCI.
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Molecular profiling of direct xenograft tumors established from human pancreatic adenocarcinoma after neoadjuvant therapy.
Ann. Surg. Oncol.
PUBLISHED: 02-11-2011
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Pancreatic adenocarcinoma is among the most resistant of human cancers, yet specific mechanisms of treatment resistance remain poorly understood. Models to study pancreatic cancer resistance remain limited and should reflect in vivo changes that occur within patient tumors. We sought to identify consistent, differentially expressed genes between treatment of naive pancreatic tumors and those exposed to neoadjuvant therapy using a strict, in vivo direct xenograft model system.
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Laparoscopic appendectomy is safe and efficacious for the elderly: an analysis using the National Surgical Quality Improvement Project database.
Surg Endosc
PUBLISHED: 02-07-2011
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Despite increasing use of laparoscopic appendectomy, data demonstrating outcomes of this technique exclusively among the elderly population are scarce. This study aimed to compare 30-day postoperative morbidity and length of hospital stay among elderly patients after appendectomy.
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Nmnat exerts neuroprotective effects in dendrites and axons.
Mol. Cell. Neurosci.
PUBLISHED: 01-17-2011
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Dendrites can be maintained for extended periods of time after they initially establish coverage of their receptive field. The long-term maintenance of dendrites underlies synaptic connectivity, but how neurons establish and then maintain their dendritic arborization patterns throughout development is not well understood. Here, we show that the NAD synthase Nicotinamide mononucleotide adenylyltransferase (Nmnat) is cell-autonomously required for maintaining type-specific dendritic coverage of Drosophila dendritic arborization (da) sensory neurons. In nmnat heterozygous mutants, dendritic arborization patterns of class IV da neurons are properly established before increased retraction and decreased growth of terminal branches lead to progressive defects in dendritic coverage during later stages of development. Although sensory axons are largely intact in nmnat heterozygotes, complete loss of nmnat function causes severe axonal degeneration, demonstrating differential requirements for nmnat dosage in the maintenance of dendritic arborization patterns and axonal integrity. Overexpression of Nmnat suppresses dendrite maintenance defects associated with loss of the tumor suppressor kinase Warts (Wts), providing evidence that Nmnat, in addition to its neuroprotective role in axons, can function as a protective factor against progressive dendritic loss. Moreover, motor neurons deficient for nmnat show progressive defects in both dendrites and axons. Our studies reveal an essential role for endogenous Nmnat function in the maintenance of both axonal and dendritic integrity and present evidence of a broad neuroprotective role for Nmnat in the central nervous system.
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A laparoscopic approach does reduce short-term complications in patients undergoing ileal pouch-anal anastomosis.
Dis. Colon Rectum
PUBLISHED: 01-14-2011
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Studies to date examining the impact of laparoscopy in the IPAA have failed to demonstrate a significant, consistent benefit in terms of a reduction in short-term morbidity or length of stay.
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Clustering of metabolic abnormalities among obese patients and mortality after percutaneous coronary intervention.
Am. J. Cardiol.
PUBLISHED: 01-06-2011
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Although current literature demonstrates metabolic abnormalities are associated with mortality, obese patients who tend to have more metabolic abnormalities paradoxically have lower overall mortality rates compared to their normal-weight counterparts. In this study, we examined the prevalence of metabolic abnormality clustering and its relation to mortality in obese and normal-weight patients after percutaneous coronary intervention (PCI). Patients (n = 9,673) undergoing elective PCI from October 2003 through December 2006 at a single urban hospital were categorized by body mass index (BMI) levels of 18.5 to 24.9, 25.0 to 29.9, 30.0 to 34.9, and ?35 kg/m(2) and by number of metabolic abnormalities possessed (hypertension, impaired fasting glucose/diabetes, triglycerides ?150 mg/dl, high-density lipoprotein cholesterol < 40 mg/dl, and C-reactive protein ?2.0 mg/L). All-cause mortality was assessed through June 30, 2007. Mean age of patients was 65.9 years and 66% were men. Prevalences of 4 or 5 metabolic abnormalities were 12%, 18%, 24%, and 31% in patients with BMI levels of 18.5 to 24.9, 25.0 to 29.9, 30 to 34.9, and ?35 kg/m(2), respectively. In patients with BMI of 30.0 to 34.9 kg/m(2), hazard ratios (95% confidence intervals) for mortality associated with 2, 3, and 4 to 5 metabolic abnormalities versus 0 to 1 metabolic abnormality were 1.31 (0.79 to 2.17), 1.42 (0.83 to 2.43), and 2.39 (1.24 to 4.59), respectively. Analogous hazard ratios for patients with BMI ?35 kg/m(2) were 1.94 (0.90 to 4.20), 1.44 (0.63 to 3.28), and 2.17 (0.91 to 5.18). All-cause mortality rates per 1,000 person-years were 55.5, 33.7, 28.3, and 33.8 in patients with BMI levels of 18.5 to 24.9, 25 to 29.9, 30 to 34.9, and ?35 kg/m(2), respectively. In conclusion, BMI levels of 25.0 to 29.9 and 30 to 34.9 kg/m(2) were associated with lower all-cause mortality after PCI. However, an increased number of metabolic abnormalities translated into increased all-cause mortality.
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Balancing the risk of postoperative surgical infections: a multivariate analysis of factors associated with laparoscopic appendectomy from the NSQIP database.
Ann. Surg.
PUBLISHED: 11-26-2010
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To establish the relationship between operative approach (laparoscopic or open) and subsequent surgical infection (both incisional and organ space infection) postappendectomy, independent of potential confounding factors.
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Renal ultrasonography in the evaluation of acute kidney injury: developing a risk stratification framework.
Arch. Intern. Med.
PUBLISHED: 11-25-2010
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In adult inpatients with acute kidney injury (AKI), clinicians routinely order a renal ultrasonography (RUS) study. It is unclear how often this test provides clinically useful information.
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A prospective, randomized comparison of the acute hemodynamic effects of biventricular and left ventricular pacing with cardiac resynchronization therapy.
Heart Rhythm
PUBLISHED: 10-15-2010
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Cardiac resynchronization therapy (CRT) is most commonly performed with biventricular (BiV) pacing. Left ventricular (LV) only pacing is an alternative pacing configuration for CRT, but comparative studies with BiV pacing have shown inconsistent results. This may be due to differences in LV activation pattern, which could be differentially affected by atriventricular (AV) programming or atrial pacing (AP).
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How much do we need to worry about venous thromboembolism after hospital discharge? A study of colorectal surgery patients using the National Surgical Quality Improvement Program database.
Dis. Colon Rectum
PUBLISHED: 09-18-2010
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It is well recognized that the increased risk of a postoperative venous thrombotic event extends beyond the inpatient treatment period. The purpose of this study was to determine the 30-day incidence and risk factors associated with the occurrence of early postdischarge symptomatic venous thromboembolic events in patients who have undergone major colorectal surgery.
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The future of innovation and training in surgical oncology.
Surg Oncol
PUBLISHED: 09-09-2010
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This article addresses the current paradigms of surgical oncology training and the directions in which the training process may evolve over the course of the next decade. In doing so, the potential influences upon this evolution are discussed along with potential barriers associated with each of these factors. In particular, the topics include issues of specialty training with regard to new technologies and procedures, involvement of the surgeon as part of the multi-disciplinary team of oncologists, and the very real issue of burnout and career satisfaction associated with the profession of surgical oncology. Changes to the training of tomorrows cancer surgeons will need to involve each one of these factors in a comprehensive and efficient manner, in order to ensure the continued strength and growth of the field.
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Physicochemical stability of the antibody-drug conjugate Trastuzumab-DM1: changes due to modification and conjugation processes.
Bioconjug. Chem.
PUBLISHED: 08-12-2010
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In the manufacture of the antibody-drug conjugate Trastuzumab-DM1 (T-DM1), the lysine residues on the antibody trastuzumab (Tmab) are modified to form the intermediate Tmab-MCC (T-MCC) and then conjugated with the drug DM1. Our goal is to understand the effects of modification and conjugation steps on the physicochemical stability of the antibody. The structural stability of Tmab relative to its modified and conjugated forms was assessed, employing thermally induced stress conditions to formulations containing Tmab, T-MCC, and T-DM1. DSC, SEC, CE-SDS, and LC-MS were used to study the stability of Tmab, T-MCC, and T-DM1 to thermal stress. The DSC thermograms show a decrease in melting temperature for the CH2 transition, in the order Tmab > T-MCC > T-DM1. As per SEC analysis, a significant increase in level of aggregation was detected in T-MCC (?32%) and T-DM1 (?5%) after 14 days at 40 °C. Tmab did not show significant aggregate formation. CE-SDS and LC-MS data demonstrate that the aggregation in the case of T-MCC is largely covalent and involves mechanisms other than formation of intermolecular disulfide cross-links. The aggregation observed for T-MCC was significantly inhibited upon addition of amino acids with nucleophilic side chains containing thiol (Cys) and hydroxyl moieties (Ser, Tyr). The covalent aggregation observed for T-MCC and the ability of nucleophilic amino acids, particularly Cys, to inhibit it indicate that the maleimide moiety in the MCC linker may react to form intermolecular covalent cross-links between T-MCC molecules, possibly through a Michael addition mechanism. In addition, DSC results demonstrate that the conjugation of the drug moiety DM1 to Tmab results in destabilization of the CH2 domain of the antibody.
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Recipient T lymphocytes modulate the severity of antibody-mediated transfusion-related acute lung injury.
Blood
PUBLISHED: 07-08-2010
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Transfusion-related acute lung injury (TRALI) is a serious complication of transfusion and has been ranked as one of the leading causes of transfusion-related fatalities. Nonetheless, many details of the immunopathogenesis of TRALI, particularly with respect to recipient factors are unknown. We used a murine model of antibody-mediated TRALI in an attempt to understand the role that recipient lymphocytes might play in TRALI reactions. Intravenous injection of an IgG2a antimurine major histocompatibility complex class I antibody (34-1-2s) into BALB/c mice induced moderate hypothermia and pulmonary granulocyte accumulation but no pulmonary edema nor mortality. In contrast, 34-1-2s injections into mice with severe combined immunodeficiency caused severe hypothermia, severe pulmonary edema, and approximately 40% mortality indicating a critical role for T and B lymphocytes in suppressing TRALI reactions. Adoptive transfer of purified CD8(+) T lymphocytes or CD4(+) T cells but not CD19(+) B cells into the severe combined immunodeficiency mice alleviated the antibody-induced hypothermia, lung damage, and mortality, suggesting that T lymphocytes were responsible for the protective effect. Taken together, these results suggest that recipient T lymphocytes play a significant role in suppressing antibody-mediated TRALI reactions. They identify a potentially new recipient mechanism that controls the severity of TRALI reactions.
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Adolescent women can perform a point-of-care test for trichomoniasis as accurately as clinicians.
Sex Transm Infect
PUBLISHED: 06-30-2010
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To compare the accuracy (ie, correlation, sensitivity, specificity) of self-performed point-of-care (POC) tests with clinician-performed tests for trichomoniasis in adolescent women.
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Total costs and atrial fibrillation ablation success or failure in Medicare-aged patients in the United States.
Adv Ther
PUBLISHED: 06-17-2010
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This retrospective cohort study compared the direct medical costs of successful versus unsuccessful catheter ablation in Medicare-aged patients with atrial fibrillation (AF), using medical claims data.
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Spontaneous left main coronary artery dissection and the role of intravascular ultrasonography.
J Ultrasound Med
PUBLISHED: 05-26-2010
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Spontaneous left main coronary artery (LMCA) dissection is a rare event with an unknown incidence and high risk of sudden cardiac death. The diagnosis of LMCA dissection is often challenging given the limitations of 2-dimensional angiography. The 3-dimensional perspective of intravascular ultrasonography (IVUS) is often indispensable in confirming or excluding the diagnosis of spontaneous LMCA dissection. We report 2 cases of spontaneous LMCA dissection with unique angiographic presentations wherein IVUS was essential in defining the extent of LMCA involvement and facilitated the subsequent referral for emergent coronary artery bypass grafting.
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Association of prior coronary artery bypass graft surgery with quality of care of patients with non-ST-segment elevation myocardial infarction: a report from the National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Netw
Am. Heart J.
PUBLISHED: 04-15-2010
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The American College of Cardiology/American Health Association guidelines recommend both an early invasive strategy and administration of antiplatelet/anticoagulant therapy for high-risk patients in the absence of contraindications. Little is known about adherence to guideline recommendations in patients with prior coronary artery bypass graft (CABG) surgery presenting with non-ST-segment elevation myocardial infarction (NSTEMI).
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In-stent restenosis.
Cardiovasc Ther
PUBLISHED: 04-09-2010
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The introduction of coronary stents marked a major turning point in the practice of interventional cardiology. Whereas the efficacy of balloon angioplasty was challenged both by immediate mechanical complications and by a high incidence of restenosis, coronary stents offered cardiologists a means by which to not only augment immediate procedural success, but also to reduce the incidence of restenosis following coronary intervention. However, despite technological advances and an improved understanding of the restenotic process, the overall rate of in-stent restenosis following bare metal stent implantation remains high. Although the introduction of drug-eluting stents has further reduced the incidence of restenosis, the "real-world" application of drug-eluting stents in increasingly complex lesion and patient subsets has given way to the even greater clinical challenge of managing drug-eluting stent restenosis. Although the standard treatment of bare metal stent restenosis typically involves placement of a drug-eluting stent, the optimal therapeutic approach to drug-eluting stent restenosis remains less defined. The issue of in-stent restenosis (especially following implantation of a drug-eluting stent) remains a clinical challenge, and investigation into therapeutic options remains ongoing. As technology evolves, such investigation will likely incorporate novel approaches including drug-coated balloons novel stent designs.
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Outcomes of patients discharged the same day following percutaneous coronary intervention.
JACC Cardiovasc Interv
PUBLISHED: 03-24-2010
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This study evaluated the outcomes of patients discharged the day of percutaneous coronary intervention (PCI) by analyzing the data from a single-center, large, multioperator registry of interventions.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.