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A Comparison of Breast Surgeon and Nomogram-Generated Risk Predictions of Sentinel and Non-Sentinel Node Metastases

j.urnal of Cancer Therapy 2013年第7期4卷 1-6页

作者： Luisa Sugaya Paulo R. de Alcantara Filho Bruna Salani Mota Suj.ta Patil kimberly j. van zee j.sé Luiz B. Bevilacqua Breast Service Department of Surgery Memorial Sloan-Kettering Cancer Center New York USA Department of Epidemiology and Biostatistics Memorial Sloan-KetteringCancer Center New York USA Hospital Sirio-Libanes Sao Paulo Brazil

Memorial Sloan-Kettering Cancer Center (MSKCC) has developed 2 nomograms: the Sentinel Lymph Node Nomogram (SLNN), which is used to predict the likelihood of sentinel lymph node (SLN) metastases in patients with invasive breast cancer, and the Non-Sentinel Lymph Node Nomogram (NSLNN), which is used to predict the likelihood of residual axillary disease after a positive SLN biopsy. Our purpose was to compare the accuracy of MSKCC nomogram predictions with those made by breast surgeons. Two questionnaires were built with characteristics of two sets of 33 randomly selected patients from the MSKCC Sentinel Node Database. The first included only patients with invasive breast cancer, and the second included only patients with invasive breast cancer and positive SLN biopsy. 26 randomly selected Brazilian breast surgeons were asked about the probability of each patient in the first set having SLN metastases and each patient in the second set having additional non-SLN metastases. The predictions of the nomograms and breast surgeons were compared. There was no correlation between nomogram risk predictions and breast surgeon risk prediction estimates for either the SLNN or the NSLNN. The area under the receiver operating characteristics curves (AUCs) were 0.871 and 0.657 for SLNN and breast surgeons, respectively (p 0.0001), and 0.889 and 0.575 for the NSLNN and breast surgeons, respectively (p 0.0001). The nomograms were significantly more accurate as prediction tools than the risk predictions of breast surgeons in Brazil. This study demonstrates the potential utility of both nomograms in the decision-making process for patients with invasive breast cancer.

关键词： Sentinel Lymph Node Biopsy Nomogram Predictions Breast Cancer Completion Axillary Lymph Node Dissection

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Dynamics and mechanisms of permethrin resistance in a field population of the horn fly, Haematobia irritans irritans

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Insect Science 2009年第2期16卷 175-184页

作者： Andrew Y. Li kimberly H. Lohmeyer j. Allen Miller USDA ARS Knipling-Bushland US Livestock Insects Research Laboratory 2700 Fredericksburg Road Kerrville TX 78028 USA

A study was conducted at the Pressler ranch, near Kerrville, Texas, USA between 2002 and 2006 to determine the dynamics and mechanisms of resistance to permethrin in a field population of the horn fly, Haematobia irritans irritans （L.）. Changes of resistance to pyrethroid insecticide associated with use of a pour-on formulation of cyfluthrin in 2002 and use of diazinon ear tags in subsequent years were studied using a filter paper bioassay technique and a polymerase chain reaction assay that detects two sodium channel mutations, kdr and super-kdr resistance alleles. A maximum of 294-fold resistance to permethrin was observed in the summer of 2002. A significant decrease in the resistance level was observed in spring 2003, and resistance continued to decline after animals were treated with diazinon ear tags. In response to pyrethroid treatments, the allelic kdr and super-kdr frequency increased from 56.3% to 93.8% and from 7.5% to 43.8%, respectively in 2002, and decreased significantly in 2003 when the pyrethroid insecticide was no longer used to treat animals. Females were found to have a higher allelic super-kdr frequency than males in 2002, while no difference was detected between males and females in the allelic kdr frequency. There was a significant positive correlation between frequencies of the sodium channel mutations and levels ofpermethrin resistance, suggesting that the sodium channel mutations, kdr and super-kdr, are the maj.r mechanisms of resistance to pyrethroids in this horn fly population. Results of synergist bioassays also indicated possible contributions of two metabolic detoxification mechanisms, the mixed function oxidases （MFO） and glutathione S-trans- ferases （GST）. Compared to a horn fly infestation of an untreated herd, treatments with the pyrethroid pour-on formulation failed to control horn flies at the Pressler ranch in 2002. Sustained control of horn flies was achieved with the use of diazinon ear tags in 2003 and subsequent years.

关键词： efficacy horn fly insecticide resistance PCR permethrin pyrethroids

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Emerging pollutants in the environment:A challenge for water resource management

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International Soil and Water Conservation Research 2015年第1期3卷 57-65页

作者： Violette Geissen Hans Mol Erwin Klumpp Günter Umlauf Marti Nadal Martine van der Ploeg Sj.erd E.A.T.M.van de zee Coen j.Ritsema Soil Physics and Land Management Group Wageningen University6708PB WageningenThe Netherlands Rikilt WageningenThe Netherlands Agrosphere Forschungszentrum JülichJülichGermany j.int Research Center IspraItaly Laboratory of Toxicology and Environmental Health IISPVUniversitat Rovira i VirgiliReusSpain

A significant number of emerging pollutants(EPs)resulting from point and diffuse pollution is present in the aquatic *** are chemicals that are not commonly monitored but have the potential to enter the environment and cause adverse ecological and human health *** to the NORMAN network,at least 700 substances categorized into 20 classes,have been identified in the European aquatic *** light of their potential impact action is urgently *** this study,we present a concept that shows the current state of art and challenges for monitoring programs,fate and risk assessment tools and requirements for policies with respect to emerging pollutants as a base for sustainable water resource ***,methods for sampling and analysis are not harmonized,being typically focused on certain EP *** a number of known highly hazardous EPs detection limits are too high to allow proper risk *** other EPs such as microplastics method development is in its *** ultra-sensitive instrumental techniques should be used for quantitative determination of prioritized EPs in water,suspended matter,soil and *** on EPs'and their metabolites'properties that determine their fate in the environment are often not *** surveys on water quality often use different parameters for water quality assessment and often do not include EPs.A harmonized monitoring of surface and groundwater is not yet achieved and urgently *** component integrated into models assessing the fate of EPs in a multi compartment environmental approach are missing and must be *** main goal of risk assessment is the overall protection of ecological communities in the aquatic environment and human *** methods for assessing the cumulative risks from combined exposures to several stressors,including mixtures of EPs in a multi-scale approach are required.A combination of regulations and management meas

关键词： Emerging pollutants Water resource management Monitoring Risk assessment Water policies

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Clinical-based phenotypes in children with pediatric post-COVID-19 condition

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World j.urnal of Pediatrics 2024年第7期20卷 682-691页

作者： Lieke C.E.Noij.j.lle M.Blankestij. Coen R.Lap Marlies A.van Houten Giske Biesbroek Anke-Hilse Maitland-van der zee Mahmoud I.Abdel-Aziz j.hannes B.van Goudoever Mattij. W.Alsem Caroline L.H.Brackel Kim j.Oostrom Simone Hashimoto Suzanne W.j.Terheggen-Lagro Department of Pediatric Pulmonology and Allergy Amsterdam UMCLocation AMCEmma Children’s HospitalAmsterdam University Medical CenterRoom G2-222Meibergdreef 91105AZAmsterdamThe Netherlands Department of Pulmonary Medicine Amsterdam UMCAmsterdamThe Netherlands Department of Pediatrics Spaarne GasthuisHoofddorpThe Netherlands Department of Pediatrics Emma Children’s HospitalAmsterdam University Medical CenterAmsterdamThe Netherlands Department of Rehabilitation Medicine Amsterdam Movement SciencesMeibergdreef 9AmsterdamThe Netherlands Department of Paediatric Pulmonology Department of PaediatricsTergooi MCHilversumThe Netherlands Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam UMCAmsterdam Reproduction and DevelopmentAmsterdamThe Netherlands

Background Pediatric post coronavirus disease 2019(COVID-19)condition(PPCC)is a heterogeneous syndrome,which can significantly affect the daily lives of *** study aimed to identify clinically meaningful phenotypes in children with PPCC,to better characterize and treat this *** Participants were children with physician-diagnosed PPCC,referred to the academic hospital Amsterdam UMC in the Netherlands between November 2021 and March *** factors and information on post-COVID symptoms,comorbidities,and impact on daily life were *** clusters were identified using an unsupervised and unbiased approach for mixed data *** Analysis of 111 patients(aged 3–18 years)revealed three distinct clusters within *** 1(n=62,median age=15 years)predominantly consisted of girls(74.2%).These patients suffered relatively more from exercise intolerance,dyspnea,and smell *** 2(n=33,median age=13 years)contained patients with an even gender distribution(51.5%girls).They suffered from relatively more sleep problems,memory loss,gastrointestinal symptoms,and *** 3(n=16,median age=11 years)had a higher proportion of boys(75.0%),suffered relatively more from fever,had significantly fewer symptoms(median of 5 symptoms compared to 8 and 10 for clusters 1 and 2 respectively),and experienced a lower impact on daily *** This study identified three distinct clinical PPCC phenotypes,with variations in sex,age,symptom patterns,and impact on daily *** findings highlight the need for further research to understand the potentially diverse underlying mechanisms contributing to post-COVID symptoms in children.

关键词： Adolescents Clusters Long COVID Pediatric Phenotypes Post-COVID syndrome

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Perforated duodenal ulcer:An unusual manifestation of allergic eosinophilic gastroenteritis

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World j.urnal of Gastroenterology 2015年第44期21卷 12709-12712页

作者： Kevin M Riggle Ghassan Wahbeh Elizabeth M Williams kimberly j.Riehle Department of General Surgery University of Washington Seattle Division of Gastroenterology Seattle Children’s Hospital Seattle Division of Pathology Seattle Children’s Hospital Seattle Division of Pediatric General and Thoracic Surgery Seattle Children’s Hospital

Spontaneous perforation of a duodenal ulcer secondary to allergic eosinophilic gastroenteritis(EGE) has not been previously reported. We present such a case in a teenager who presented with peritonitis. After exploration and operative repair of his ulcer, he continued to experience intermittent abdominal pain, and further evaluation revealed eosinophilic gastroenteritis in the setting of multiple food allergies. His EGE resolved after adhering to a restrictive diet. Both duodenal ulcers and EGE are very rarely seen in pediatric patients. EGE has a variable presentation depending on the layer(s) of bowel wall affected and the segment of the gastrointestinal tract that is involved. Once diagnosed, it may respond to dietary changes in patients with recognized food allergies, or to steroids in patients in whom an underlying cause is not identified. Our case highlights the need to keep EGE in the differential diagnosis when treating pediatric patients with duodenal ulcers. The epidemiology, pathophysiology, and treatment of EGE are also discussed, along with a review of the current literature.

关键词： Pediatric Duodenal ulcer Eosinophilic Gastroenteri

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Treatment of distal femur fractures in a regional Australian hospital

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World j.urnal of Orthopedics 2014年第3期5卷 379-385页

作者： Ewan Batchelor Clare Heal j.kimberly Haladyn Herwig Drobetz Department of General Practice and Rural Medicine James Cook University School of Medicine and DentistryLevel 1Building KMackay Base HospitalMackay QLD 4740Australia Department of Orthopaedic Surgery Mackay Base HospitalMackay QLD 4740Australia

AIM:To review our outcomes and compare the results of the Less Invasive Stabilization System(LISS)to other implants for distal femur fracture management at a regional Australian ***:The LISS is a novel implant for the management of distal femur *** is,however,technically demanding and treatment results have not yet been assessed outside tertiary ***-seven patients with 28 distal femur fractures who had been managed surgically at the Mackay Base Hospital from j.nuary 2004 to December 2010 were retrospectively enrolled and assessed clinically and *** were union,pain,Lysholm score,knee range of motion,and complication ***:Twenty fractures were managed with the LISS and eight fractures were managed with alternative *** of the surgical techniques re-vealed that 11 fractures managed with the LISS were performed according to the recommended principles(LISS-R)and 9 were not(LISS-N).Union occurred in67.9%of fractures overall:9/11(82%)in the LISS-R group vs 5/9(56%)in the LISS-N group and 5/8(62.5%)in the alternative implant *** was no statistically significant difference between pain,Lysholm score,and complication rates between the ***,there was a trend towards the LISS-R group having superior outcomes which were clinically *** was a statistically significant greater range of median knee flexion in the LISS-R group with compared to the LISS-N group(P=0.0143)and compared with the alternative implant group(P=0.0454).CONCLUSION:The trends towards the benefits of the LISS procedure when correctly applied would suggest that not only should the LISS procedure be performed for distal femur fractures,but the correct principle of insertion is important in improving the patient’s outcome.

关键词： Distal femur fracture Less Invasive Stabilization System Locking plates Retrospective Operative technique

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Methods for engineering therapeutic peptides

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Chinese Chemical Letters 2018年第7期29卷 1074-1078页

作者： Yaohao Li kimberly A.Clark Zhongping Tan Department of Chemistry and Biochemistry and BioFrontiers Institute University of Colorado

Peptides are a class of drugs that have become increasingly important and influential for the treatment of many human diseases. Compared to traditional small molecule drugs, peptides have the potential for higher target specificity and potency, along with better safety profiles. On the other hand, the complex and fragile nature of peptides poses significant challenges for their administration. Of particular concern is that they are often unstable and can be rapidly degraded by various proteases after dosing. To address these inherent problems of peptides, many different methods have been attempted. Here, we briefly review these methods, with an emphasis on the effect of each method.

关键词： Therapeutic peptides Engineering Half-life Stability Solubility Aggregation Permeability

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Correlation and prognostic significance of beta-galactoside alpha-2,6-sialyltransferase and serum monosialylated alpha-fetoprotein in hepatocellular carcinoma

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World j.urnal of Gastroenterology 2005年第42期11卷 6701-6706页

作者： Terence CW Poon Clarissa HS Chiu Paul BS Lai Tony SK Mok Benny zee Anthony TC Chan j.seph j. Sung Philip j.j.hnson Department of Medicine and Therapeutics Sir YK Pao Cancer Centre the Chinese University of Hong Kong Prince of Wales Hospital NT Hong Kong China Department of Clinical Oncology Sir YK Pao Cancer Centre the Chinese University of Hong Kong Prince of Wales Hospital NT Hong Kong China Department of Surgery Sir YK Pao Cancer Centre the Chinese University of Hong Kong Prince of Wales Hospital NT Hong Kong China Cancer Research UK Institute for Cancer Studies University of Birmingham Vincent Drive Edgbaston Birmingham B15 2TT United Kingdom

AIM： To investigate the correlation between tissue ST6Gal I and serum msAFP in HCC patients, and to investigate their prognostic significance. METHODS： Preoperative sera, paired tumorous and non-tumorous tissues were collected from 19 consecutive patients who had undergone surgical resection of HCC. ST6Gal I activities in the tissues were measured by an in vitro microsomal enzyme activity assay. The percentages of tumor-specific msAFP in the sera were also estimated by an isoelectric focusing-immunoblotting assay. RESULTS： The tumor ST6Gal I activity was negatively correlated with serum msAFP percentage （r = -0.53, P = 0.019）. Both decreased tumor ST6Gal I activity and increased serum msAFP percentage were associated with poor tumor cell differentiation. Univariate analyses showed that both decreased tumor ST6Gal I activity （P = 0.028）, increased serum msAFP percentage （P = 0.034） and poor tumor cell differentiation （P = 0.031）were associated with shorter overall survival. Multivariate analysis using the Cox regression model showed that the preoperative serum msAFP percentage （P = 0.022） and tumor cell differentiation status （P = 0.048） were independent prognostic indicators for patient overall survival. CONCLUSION： Our results indicate that the presence of msAFP in blood circulation is associated with a decreased activity of ST6Gal I activity in HCC. Both tissue ST6Gal I and serum msAFP are potential prognostic markers for patients with operable HCC.

关键词： Alpha-fetoprotein Beta-galactoside alpha-2,6-sialyltransferase Hepatocellular carcinoma Patientsurvival Cell differentiation

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Another look at silent circulation of poliovirus in small populations

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Infectious Disease Modelling 2018年第1期3卷 107-117页

作者： Dominika A.Kalkowska Radboud j.Duintj.r Tebbens kimberly M.Thompson Kid Risk Inc.605 N.High St.#253ColumbusOH 43215USA

Background:Silent circulation of polioviruses complicates the polio endgame and motivates analyses that explore the probability of undetected circulation for different scenarios.A recent analysis suggested a relatively high probability of unusually long silent circulation of polioviruses in small populations(defined as 10,000 people or smaller).Methods:We independently replicated the simple,hypothetical model by Vallej. et al.(2017)and repeated their analyses to explore the model behavior,interpretation of the results,and implications of simplifying ***:We found a similar trend of increasing times between detected cases with increasing basic reproduction number(R0)and population ***,we found substantially lower estimates of the probability of at least 3 years between successive polio cases than they reported,which appear more consistent with the prior *** small and isolated populations may sustain prolonged silent circulation,our reanalysis suggests that the existing rule of thumb of less than a 5%chance of 3 or more years of undetected circulation with perfect surveillance holds for most conditions of the model used by Vallej. et *** most realistic ***:Avoiding gaps in surveillance remains critical to declaring wild poliovirus elimination with high confidence as soon as possible after the last detected poliovirus,but concern about transmission in small populations with adequate surveillance should not significantly change the criteria for the certification of wild polioviruses.

关键词： Polio Small populations Silent circulation Stochastic modeling

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The lncRNA BORG: a novel inducer of TNBC metastasis, chemoresistance, and disease recurrence

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j.urnal of Cancer Metastasis and Treatment 2019年第5期4卷 48-61页

作者： Alex j.Gooding kimberly A.Parker Saba Valadkhan William P.Schiemann Department of Pathology Case Western Reserve UniversityClevelandOH 44106USA Department of Pharmacology Case Western Reserve UniversityClevelandOH 44106USA Department of Molecular Biology and Microbiology Case Western Reserve UniversityClevelandOH 44106USA Case Comprehensive Cancer Center Case Western Reserve UniversityClevelandOH 44106USA

Although greater than 90% of breast cancer-related mortality can be attributed to metastases, the molecular mechanisms underpinning the dissemination of primary breast tumor cells and their ability to establish malignant lesions in distant tissues remain incompletely understood. Genomic and transcriptomic analyses identified a class of transcripts called long noncoding RNA (lncRNA), which interact both directly and indirectly with key components of gene regulatory networks to alter cell proliferation, invasion, and metastasis. We identified a pro-metastatic lncRNA BMP/OP-Responsive Gene (BORG) whose aberrant expression promotes metastatic relapse by reactivating proliferative programs in dormant disseminated tumor cells (DTCs). BORG expression is broadly and strongly induced by environmental and chemotherapeutic stresses, a transcriptional response that facilitates the survival of DTCs. Transcriptomic reprogramming in response to BORG resulted in robust signaling via survival and viability pathways, as well as decreased activation of cell death pathways. As such, BORG expression acts as a (1) marker capable of predicting which breast cancer patients are predisposed to develop secondary metastatic lesions;and (2) unique therapeutic target to maximize chemosensitivity of DTCs. Here we review the molecular and cellular factors that contribute to the pathophysiological activities of BORG during its regulation of breast cancer metastasis, chemoresistance, and disease recurrence.

关键词： BORG chemoresistance disease recurrence dormancy long noncoding RNA metastasis triple-negative breast cancer

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