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Heart Valve Clinic: A Model for Treatment of Structural Heart Disease

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World Journal of Cardiovascular Surgery 2017年第1期7卷 1-9页

作者： Kendal Endicott Jacob Lambdin Jason Morrisette Amy Kirkpatrick Christian nagy Frederick Mordini Michael Greenberg gregory Trachiotis Division of Cardiology and Cardiothoracic Surgery The Heart Center Washington DC Veterans Affairs Medical Center Washington DC USA The George Washington University Washington DC USA

Background and Aim of the Study: Valvular heart disease (VHD) should be managed by a Heart Valve Team (HVT) for optimal treatment. Although the prevalence of VHD is increasing, an overall lack of universal implementation of the HVT continues to exist. Here we present our model of care within a Veteran’s Affairs Medical Center (VAMC). Materials and Methods: All patients referred to our VAMC with structural valvular disease have been managed within our multidisciplinary heart valve clinic since 2006. The heart valve clinic consists of a dedicated valve surgeon as well as both a dedicated noninvasive imaging cardiologist and cardiac MRI/CT cardiologist. Cases are reviewed on a weekly basis with multidisciplinary input to guide treatment strategy. Therapy includes medical management, facilitation of further diagnostic workup, and referral for operative intervention. Results: Between 2006 and 2015, 560 patients have been evaluated in HVC. Overall, new patient yearly volume has nearly tripled with now over 90 new consults seen yearly. Of the patients evaluated, 313 were referred for operative intervention with follow up post-operatively to affirm adequate post-procedural function. Following HVC referral trends, operative yearly volume has increased 33% over the last year years compared to the first three years of the program. The heart valve clinic has also matured to support a dedicated TAVR program. Conclusions: As the options for heart valve therapy and indications for surgery continue to evolve, a multidisciplinary team to guide decision making is imperative. We present the success and growth of our heart valve clinic within a VAMC as a structural model that can be translated into both the community and academic setting.

关键词： Acquired Disease Valve Replacement

NMR BASED STUDIES OF MECHANICALLY STRAINED ELASTIN

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NMR BASED STUDIES OF MECHANICALLY STRAINED ELASTIN

第十四届北京分析测试学术报告会暨展览会(BCEIA 2011)

作者： Cheng SUN Odingo A.mitchell Jiaxin HUANG gregory S.BOUTIS Department of Physics Brooklyn College of The City University of New York

Mechanical deformation is known to be crucial for understanding the elasticity of elastin[1].NMR spectroscopy,relaxometry and 2D T1-T2 correlation NMR are important tools to study biopolymers[2,3].Molecular dynamics(M...

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诗歌与城邦

Dietary sugars inhibit biologic functions of the pattern recognition molecule, mannose-binding lectin

作者： (美)费格拉(Thomas J. Figueira) (美)纳吉(gregory nagy)

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Open Journal of Immunology 2011年第2期1卷 41-49页

作者： Kazue Takahashi Wei-Chuan Chang Patience Moyo mitchell R. White Parool Meelu Anamika Verma gregory L. Stahl Kevan L. Hartshorn Vijay Yajnik 不详

Mannose-binding lectin (MBL), a mammalian lectin, is a pattern recognition molecule of the innate immune system and recognizes carbo-hydrates that are exposed on pathogens. In this study, we observed that fructose down regu-lates MBL-mediated innate immune mechanisms against both influenza A virus (IAV) and Staphy-lococcus aureus. These mechanisms include the lectin complement pathway and coagulation enzyme-like activities on both pathogens. Fur-thermore, fructose also reduces MBL-mediated phagocytosis of S. aureus and IAV and MBL- mediated IAV infection to epithelial cells. In contrast, sucrose inhibits MBL-mediated im-mune mechanisms against S. aureus but not IAV. Together, our studies show that dietary sugars, in particular fructose, negatively regulate the innate immunity against viral and bacterial pathogens.

关键词： Mannose-Binding Lectin Fructose Influenza A Virus Staphylococcus Aureus Complement Coagulation

Lipopolysaccharide Modified Liposomes for Amyotropic Lateral Sclerosis Therapy: Efficacy in SOD1 Mouse Model

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Advances in Nanoparticles 2012年第3期1卷 44-53页

作者： Nicholas J. Wiley A. B. Madhankumar Ryan M. mitchell Elizabeth B. Neely Elias Rizk gregory L. Douds Zachary Simmons James R. Connor Department of Neurology Pennsylvania State University College of Medicine/Milton S. Hershey Medical Center Hershey USA George M. Leader Family Laboratory Department of Neurosurgery Pennsylvania State University College of Medicine/Milton S. Hershey Medical Center Hershey USA

Activation of microglia is a histological feature observed in neurodegenerative diseases like ALS. The oral administration of minocycline has been demonstrated to have minimal neuroprotection ability in the animal models and is also associated with inadvertent toxicity due to non-specific oral absorption of the drug. Nonetheless, the drug itself shows promise in a number of disease models suggesting it could be effective if delivered optimally. Thus, we utilized LPS modified liposomes to target TLR4 receptor on the microglia in SOD1G93A mice and compared its efficacy with non- targeted nanoliposomes. The in vitro results indicate that targeting the TLR4 receptor on microglia significantly increases (p G93A mouse model of ALS, targeted and non-targeted minocycline treatment significantly increased (p G93A mice, the non- targeted nanovesicles significantly increased the latency to rotarod failure and both targeted and non-targeted nanovesicles significantly delayed disease endpoints.

关键词： Amyotrophic Lateral Sclerosis Minocycline Liposomes Microglia TLR4 Lipopolysaccharides

The Acute Physiological Effects of the Vaso-Active Drug, L-NNA, a Nitric Oxide Synthase Inhibitor, on Renal and Tumour Perfusion in Human Subjects

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Journal of Cancer Therapy 2014年第1期5卷 44-52页

作者： Kent Yip Vicky Goh Jane gregory Ian Simcock J. James Stirling N. Jane Taylor Robert Kozarski Andrew mitchell Sam Bosopem Gavin Halbert Roberto Alonzi David Miles Peter Hoskin Cancer Centre Mount Vernon Hospital Northwood UK Cancer Research UK Formulation Unit Strathclyde Institute of Pharmacy and Biomedical Sciences University of Strathclyde Glasgow UK Department of Pscyhology University of Hertfordshire College Lane Hertfordshire UK Paul Strickland Scanner Centre Mount Vernon Hospital Northwood UK The Royal Brompton & Harefield NHS Foundation Trust Harefield UK

Purpose: To assess the baseline variation in global renal and tumour blood flow, blood volume and extraction fraction, and changes in these parameters related to the acute physiological effects of a single dose of a non selective inhibitor of nitric oxide synthase, L-NNA. Materials & Methods: Ethical approval and informed consent were obtained for this Phase I clinical study. Patients with advanced solid tumours refractory to conventional therapy were recruited and given L-NNA intravenously at two different dose levels. Volumetric perfusion CT scans were carried out at 1, 24, 48 & 72 hours post L-NNA. Blood pressures were taken at regular interval for 6 hours after LNNA. Results: L-NNA was well tolerated by the four patients who received it. Blood flow (BF) and blood volume (BV) in both tumour and kidney were reduced post L-NNA administration (renal BF—20%;renal BV—19.7%;tumour BF—16.9%;tumour BV—18.6%), though the effect was more sustained in tumour vasculature. A negative correlation was found between the change in systemic blood pressure and vascular supply to the tumour within 1 hour following L-NNA (p 0.0001). Differences in response to L-NNA by separate target lesions in the same patient were observed. Conclusion: The differential effect of L-NNA on tumour and renal blood flow, and the absence of any significant toxicity in this small cohort of patients permit further dose escalation of L-NNA in future early phase trials. The predictive value of blood pressure change in relation to the acute effect of L-NNA on tumour vasculature deserves further evaluation.

关键词： L-NNA Cancer Imaging Vascular Perfusion Nitric Oxide

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企业合规有效性检测

犯罪研究 2022年第6期 41-65页

作者： [美]布兰登·加赖特 [美]格利高里·米歇尔夏菲(译) 美国杜克大学法学院威尔森科学与司法中心美国弗吉尼亚大学法学院华东政法大学

近三十年来,合规已经成为现代企业监管的核心。美国量刑指南明确对具有有效合规项目的犯罪企业从宽处罚,行业监管部门、检察官在执法时都会将企业合规作为其决定如何执法以及是否起诉的重要考量因素。但是,现有法律推动形成的是一种愿... 详细信息

近三十年来,合规已经成为现代企业监管的核心。美国量刑指南明确对具有有效合规项目的犯罪企业从宽处罚,行业监管部门、检察官在执法时都会将企业合规作为其决定如何执法以及是否起诉的重要考量因素。但是,现有法律推动形成的是一种愿望基础型合规模式,企业合规项目的有效性未得到实证检测,监管者和企业都深陷合规陷阱。只有建立强制性、秘密的合规有效性报告制度,推动企业形成合规卡特尔以及进行内部合规测试、数据挖掘分析、审计、匿名举报制度建设等,实现向循证合规模式的转变,才能真正推动有效合规项目的发展。

关键词：企业合规合规陷阱愿望基础型合规模式循证合规模式检测