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Rheumatology & Autoimmunity 2022年第2期2卷 98-101页

作者： Shawn Mathew Rohan Goyal Nealansh Gupta Rauno Joks Internal Medicine Ringgold Standard InstitutionSUNY Downstate Health Sciences UniversityBrooklynNew YorkUSA suny downstate medical center College of Medicine Ringgold Standard InstitutionBrooklynNew YorkUSA Allergy and Immunology Center for Allergy and Asthma ResearchSUNY Downstate Health Sciences UniversityBrooklynNew YorkUSA

Objective:To explore a possible association between systemic immunoglobulin A(IgA)vasculitis and RS3PE syndrome and to investigate specific treatment regimens for adults who present with IgA vasculitis with renal involvement.Methods:The patient was treated with plasmapheresis and fresh frozen plasma(FFP)every other day with 1g methylprednisolone daily for three days followed by oral prednisone taper.Mycophenolate mofetil twice daily and trimethoprim‐sulfamethoxazole for Pneumocystis jirovecii prophylaxis was started.In total the patient received two cycles of plasmapheresis and fresh frozen plasma.Results:The patient's renal function drastically improved with resolution of both abdominal pain and nausea.Conclusion:We illustrate a possible association between systemic IgA vasculitis and RS3PE syndrome,and this case demonstrates IgA vasculitis with renal involvement that acutely resolved with high‐dose glucocorticoids and plasmapheresis.Additionally,our specific treatment regimen can be a potential standard of care for adults who present with IgA vasculitis with renal involvement.

关键词： IgA vasculitis plasmapheresis RS3PE syndrome

Gut microbiota links with cognitive impairment in amyotrophic lateral sclerosis: A multi-omics study

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The Journal of Biomedical Research 2023年第2期37卷 125-137页

作者： Zhenxiang Gong Li Ba Jiahui Tang Yuan Yang Zehui Li Mao Liu Chun Yang Fengfei Ding Min Zhang Department of Neurology and Psychiatry Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China Department of Neurology SUNY Downstate Medical CenterNY 11226USA Department of Anesthesiology and Perioperative Medicine the First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Department of Pharmacology School of Basic Medical SciencesFudan UniversityShanghai 200032China

Recently, cognitive impairments(CI) and behavioral abnormalities in patients with amyotrophic lateral sclerosis(ALS) have been reported. However, the underlying mechanisms have been poorly understood. In the current study, we explored the role of gut microbiota in CI of ALS patients. We collected fecal samples from 35ALS patients and 35 healthy controls. The cognitive function of the ALS patients was evaluated using the Edinburgh Cognitive and Behavioral ALS Screen. We analyzed these samples by using 16S rRNA gene sequencing as well as both untargeted and targeted(bile acids) metabolite mapping between patients with CI and patients with normal cognition(CN). We found altered gut microbial communities and a lower ratio of Firmicutes/Bacteroidetes in the CI group, compared with the CN group. In addition, the untargeted metabolite mapping revealed that 26 and 17 metabolites significantly increased and decreased, respectively, in the CI group, compared with the CN group. These metabolites were mapped to the metabolic pathways associated with bile acids. We further found that cholic acid and chenodeoxycholic acid were significantly lower in the CI group than in the CN group. In conclusion, we found that the gut microbiota and its metabolome profile differed between ALS patients with and without CI and that the altered bile acid profile in fecal samples was significantly associated with CI in ALS patients. These results need to be replicated in larger studies in the future.

关键词： amyotrophic lateral sclerosis cognitive decline gut microbiota fecal metabolites bile acids

Bilateral diffuse grade 5 radiation pneumonitis after intensity modulated radiation therapy for localized lung cancer

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World Journal of Clinical Oncology 2017年第3期8卷 285-288页

作者： Virginia W Osborn Andrea Leaf Anna Lee Elizabeth Garay Joseph Safdieh David Schwartz David Schreiber Veterans Affairs New York Harbor Healthcare System suny downstate medical center

We are reporting a case of fatal radiation pneumonitis that developed six months following chemoradiation for limited stage small cell lung cancer.The patient was a 67-year-old man with a past medical history of Hashimoto's thyroiditis and remote suspicion for CREST,neither of which were active in the years leading up to treatment.He received 6600 cG y delivered in 200 cG y daily fractions via intensity modulated radiation therapy with concurrent cisplatin/etoposide followed by additional chemotherapy with dosereduced cisplatin/etoposide and carboplatin/etoposide and then received prophylactic cranial irradiation.The subsequent months were notable for progressively worsening episodes of respiratory compromise despite administration of prolonged steroids and he ultimately expired.Imaging demonstrated bilateral interstitial and airspace opacities.Autopsy findings were consistent with pneumonitis secondary to chemoradiation as well as lymphangitic spread of small cell carcinoma.The process was diffuse bilaterally although his radiation was delivered focally to the right lung and mediastinum.

关键词： Radiation Pneumonitis Small cell lung cancer Intensity modulated radiation therapy

Sepsis during short bowel syndrome hospitalizations:Identifying trends,disparities,and clinical outcomes in the United States

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World Journal of Gastrointestinal Pathophysiology 2024年第1期15卷 26-36页

作者： Dushyant Singh Dahiya Jennifer Wachala Shantanu Solanki Dhanshree Solanki Asim Kichloo Samantha Holcomb Uvesh Mansuri Khwaja Saad Haq Hassam Ali Manesh Kumar Gangwani Yash R Shah Teresa Varghese Hafiz Muzaffar Akbar Khan Simon Peter Horslen Thomas D Schiano Syed-Mohammed Jafri Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Internal Medicine Samaritan Medical CenterWatertownNY 13601United States Division of Gastroenterology Hepatology&Nutrition The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Medicine Institute for Foreign Medical Graduate EducationHoustonTX 77030United States Department of Internal Medicine MedStar Harbor HospitalBaltimoreMD 21225United States Department of Internal Medicine WellStar Spalding Regional HospitalGriffinGA 30224United States Division of Gastroenterology Hepatology and NutritionEast Carolina University/Brody School of MedicineGreenvilleNC 27858United States Department of Gastroenterology and Hepatology University of Arkansas for Medical SciencesLittle RockAR 72205United States Department of Internal Medicine Trinity Health Oakland/Wayne State UniversityPontiacMI 48341United States Division of Gastroenterology and Hepatology SUNY Upstate Medical UniversitySyracuseNY 13210United States Department of Pediatrics School of Medicine and UPMC Children’s Hospital of PittsburghUniversity of PittsburghPittsburghPA 15219United States Division of Liver Diseases Icahn School of Medicine at Mount SinaiNew YorkNY 10029United States Division of Gastroenterology and Hepatology Henry Ford HospitalDetroitMI 48202United States

BACKGROUND Short bowel syndrome(SBS)hospitalizations are often complicated with sepsis.There is a significant paucity of data on adult SBS hospitalizations in the United States and across the globe.AIM To assess trends and outcomes of SBS hospitalizations complicated by sepsis in the United States.METHODS The National Inpatient Sample was utilized to identify all adult SBS hospitalizations between 2005-2014.The study cohort was further divided based on the presence or absence of sepsis.Trends were identified,and hospitalization characteristics and clinical outcomes were compared.Predictors of mortality for SBS hospitalizations complicated with sepsis were assessed.RESULTS Of 247097 SBS hospitalizations,21.7%were complicated by sepsis.Septic SBS hospitalizations had a rising trend of hospitalizations from 20.8%in 2005 to 23.5%in 2014(P trend<0.0001).Compared to non-septic SBS hospitalizations,septic SBS hospitalizations had a higher proportion of males(32.8%vs 29.3%,P<0.0001),patients in the 35-49(45.9%vs 42.5%,P<0.0001)and 50-64(32.1%vs 31.1%,P<0.0001)age groups,and ethnic minorities,i.e.,Blacks(12.4%vs 11.3%,P<0.0001)and Hispanics(6.7%vs 5.5%,P<0.0001).Furthermore,septic SBS hospitalizations had a higher proportion of patients with intestinal transplantation(0.33%vs 0.22%,P<0.0001),inpatient mortality(8.5%vs 1.4%,P<0.0001),and mean length of stay(16.1 d vs 7.7 d,P<0.0001)compared to the non-sepsis cohort.A younger age,female gender,White race,and presence of comorbidities such as anemia and depression were identified to be independent predictors of inpatient mortality for septic SBS hospitalizations.CONCLUSION Septic SBS hospitalizations had a rising trend between 2005-2014 and were associated with higher inpatient mortality compared to non-septic SBS hospitalizations.

关键词： Short bowel syndrome Sepsis Outcomes Mortality Trends

Saporin Conjugated Monoclonal Antibody to the Transcobalamin Receptor TCblR/CD320 Is Effective in Targeting and Destroying Cancer Cells

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Journal of Cancer Therapy 2013年第6期4卷 1074-1081页

作者： Edward V. Quadros Yasumi Nakayama Jeffrey M. Sequeira Department of Medicine SUNY-Downstate Medical Center Brooklyn USA

Cobalamin uptake into cells is mediated by the CD320 receptor for transcobalamin-bound cobalamin. Optimum receptor expression is associated with proliferating cells and therefore, in many cancers this receptor expression is up regulated. Delivering drugs or toxins via this receptor provides increased targeting to cancer cells while minimizing toxicity to the normal tissues. Saporin conjugated monoclonal antibodies to the extracellular domain of TCblR were effectively internalized to deliver a toxic dose of Saporin to some cancer cell lines propagating in culture. Antibody concentration of 2.5 nM was effective in producing optimum inhibition of cell proliferation. The cytotoxic effect of mAb-Saporin appears to be dictated primarily by the level of receptor expression and therefore normal primary cells expressing low levels of CD320 were spared while tumor cell lines with higher CD320 expression were destroyed. Targeting the pathway for cellular uptake of vitamin B12 via the CD320 receptor with toxin-antibody conjugates appears to be a viable treatment strategy for certain cancers that over expresses this receptor.

关键词： Transcobalamin Receptor CD320 Gene Cobalamin Cancer Toxin

MicroRNA signature and function in retinal neovascularization

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World Journal of Biological Chemistry 2014年第1期5卷 1-11页

作者： Saloni Agrawal Brahim Chaqour Department of Cell Biology State University of New York (SUNY) Downstate Medical Center Department of Cell Biology and Ophthalmology and SUNY Eye Institute Downstate Medical Center

Ischemic retinopathies are clinically well-defined chronic microvascular complications characterized by gradually progressive alterations in the retinal microvasculature and a compensatory aberrant neovascularization of the eye. The subsequent metabolic deficiencies result in structural and functional alterations in the retina which is highly susceptible to injurious stimuli such as diabe-tes, trauma, hyperoxia, inflammation, aging and dys-plipidemia. Emerging evidence indicates that an effec-tive therapy may require targeting multiple components of the angiogenic pathway. Conceptually, mircoRNA(miRNA)-based therapy provides the rationale basis for an effective antiangiogenic treatment. miRNAs are an evolutionarily conserved family of short RNAs, each regulating the expression of multiple protein-coding genes. The activity of specific miRNAs is important for vascular cell signaling and blood vessel formation and function. Recently, important progress has been made in mapping the miRNA-gene target network andmiRNA-mediated gene expression control. Here wehighlight the latest findings on angiogenic and antian-giogenic miRNAs and their targets as well as potentiaimplications in ocular neovascular diseases. Emphasis isplaced on how specific vascular-enriched miRNAs regu-late cell responses to various cues by targeting severafactors, receptors and/or signaling molecules in orderto maintain either vascular function or dysfunction. Fur-ther improvement of our knowledge in not only miRNAspecificity, turnover, and transport but also how miRNAsequences and functions can be altered will enhancethe therapeutic utility of such molecules.

关键词： MircoRNA Angiogenesis Retinal neovascu-larization Vascular endothelial growth factor Ischemia Endothelial cell

Screening for asymptomatic chlamydia and gonorrhea in adolescent males in an urban pediatric emergency department

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World Journal of Clinical Pediatrics 2017年第3期6卷 154-160页

作者： Megan E Maraynes Jennifer H Chao Konstantinos Agoritsas Richard Sinert Shahriar Zehtabchi Ochsner medical center University of Queensland suny downstate medical center and the Kings County Hospital center

AIM To determine the prevalence of Chlamydia trachomatis(CT) and Neisseria gonorrhea(GC) in young men seeking care in the emergency department(ED) for non-sexually transmitted infection(STI) related symptoms.METHODS This was a prospective, cross-sectional study in an urban ED. The main outcome was the rate of positive CT and GC on urine nucleic acid amplification testing in males aged 16-21 presenting with non-STI related complaints. RESULTS Two hundred and eighty-four patients were enrolled, 271 were included in the final data analysis [age range 16-21, median: 18(quartiles 16-18, 19-21)]. Overall, 17(6.3%, 95%CI: 4%-10%) tested positive for CT and 0%(95%CI: 0%-2%) were found to have GC. The proportion of sexually active subjects was 71%(95%CI: 65%-76%) and 2%(95%CI: 0.6%-4%) reported sex with men. Previous STI testing was reported in 46%(95%CI: 43%-54%) and 13%(95%CI: 8%-20%) of those patients previously tested had a history of STI. Of the patients who tested positive for CT in the ED, 88%(95%CI: 64%-98%) were successfully followed up. CONCLUSION The prevalence of CT infection found by screening was 6.3%. Screening and follow-up from the ED was successful. The findings justify routine STI screening in male adolescents presenting to the ED with non-STI related complaints.

关键词： Chlamydia Gonorrhea Adolescent Public health Emergency department Pediatric

Gastric amyloidoma in patient after remission of Non-Hodgkin's Lymphoma

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World Journal of Gastrointestinal Oncology 2009年第1期1卷 93-96页

作者： Charles Philip Koczka Adam J Goodman Department of Medicine SUNY Downstate Medical Center

Amyloidosis is commonly systemic,occasionally organlimited,and rarely a solitary localized mass.The latter,commonly referred to as tumoral amyloidosis,is described as occurring in nearly every organ/tissue.Only a few reports of gastric amyloidosis exist today.We describe a 72 year-old black male from Barbados presenting with 3 d of diffuse abdominal pain.His medical history included Non-Hodgkin's Lymphoma diagnosed five years ago,status-post six rounds of cyclophosphamide,adriamycin,vincristine,prednisone chemotherapy,and currently was in remission.On computed tomography scan of the abdomen,thickening and calcification of the gastric wall was noted along with pneumatosis.On esophagogastroduodenoscopy,a large circumferential friable mass was seen from the gastroesophageal junction to the body.A large nonbleeding 3 cm polyp was also seen in post bulbar area of duodenum.Biopsies were stained with Congo red and gave green birefringence under polarized light,consistent with tumoral amyloidosis.Positron emission tomography scan revealed diffuse gastric mucosa uptake compatible with gastric malignancy without metastatic foci.Treatment for gastric amyloidomas has presently been one of observation or,at most,resection of the amyloid mass.It is not known if our patient required the same approach or if this warranted the re-institutionof chemotherapy for Non-Hodgkin's Lymphoma.Until more reports of tumoral amyloidosis are made known,treatment as well as prognosis remain uncertain.

关键词： Amyloidoma Non-Hodgkin Lymphoma Stomach Duodenum

Regulation of hepatic micro RNA expression by hepatocyte nuclear factor 4 alpha

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World Journal of Hepatology 2017年第4期9卷 191-208页

作者： Hong Lu Xiaohong Lei Jerry Liu Curtis Klaassen Department of Pharmacology SUNY Upstate Medical University Department of Medicine University of Kansas Medical Center

AIM To uncover the role of hepatocyte nuclear factor 4 alpha(HNF4α) in regulating hepatic expression of micro RNAs.METHODS Microarray and real-time PCR were used to determine hepatic expression of micro RNAs in young-adult mice lacking Hnf4α expression in liver(Hnf4α-Liv KO). Integrative genomics viewer software was used to analyze the public chromatin immunoprecipitation-sequencing datasets for DNA-binding of HNF4α, RNA polymerase-Ⅱ, and histone modifications to loci of micro RNAs in mouse liver and human hepatoma cells. Dual-luciferase reporter assay was conducted to determine effects of HNF4α on the promoters of mouse and human micro RNAs as well as effects of micro RNAs on the untranslated regions(3'UTR) of two genes in human hepatoma cells. RESULTS Microarray data indicated that most micro RNAs remained unaltered by Hnf4α deficiency in Hnf4α-Liv KO mice. However, certain liver-predominant micro RNAs were down-regulated similarly in young-adult male and female Hnf4α-Liv KO mice. The down-regulation of mi R-101, mi R-192, mi R-193 a, mi R-194, mi R-215, mi R-802, and mi R-122 as well as induction of mi R-34 and mi R-29 in male Hnf4α-Liv KO mice were confirmed by real-timePCR. Analysis of public chromatin immunoprecipitationsequencing data indicates that HNF4α directly binds to the promoters of mi R-101, mi R-122, mi R-194-2/mi R-192 and mi R-193, which is associated with histone marks of active transcription. Luciferase reporter assay showed that HNF4α markedly activated the promoters of mouse and human mi R-101b/mi R-101-2 and the mi R-194/mi R-192 cluster. Additionally, mi R-192 and mi R-194 significantly decreased activities of luciferase reporters for the 3'UTR of histone H3F3 and chromodomain helicase DNA binding protein 1(CHD1), respectively, suggesting that mi R-192 and mi R-194 might be important in chromosome remodeling through directly targeting H3F3 and CHD1.CONCLUSION HNF4α is essential for hepatic basal expression of a group of liver-enriched micro RNAs, including mi R-101, mi R-192, mi R-193 a, m

关键词：肝 Hepatocyte 原子因素 4 alpha 大美人老鼠人 miR-122 miR-192 miR-194 miR-101 miR-802

Post-Natal Spontaneous Resolution of a Congenital Pulmonary Airway Malformation in an Infant: Plain Radiographic and CT Manifestations

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Open Journal of medical Imaging 2012年第2期2卷 47-49页

作者： John Amodio Agnes Perenyi Jonathan Zember Matthew Smith Department of Pediatrics SUNY Downstate Medical Center New York USA Department of Radiology SUNY Downstate Medical Center New York USA

We present a case of a near-term infant who developed respiratory distress, shortly after birth. Chest X-ray showed a right sided tension pneumothorax (PTX) with a large air containing structure at the base of the right hemithorax. The pneumothorax was partially evacuated with needle aspiration at which time the patient became asymptomatic, despite a small residual pneumothorax. CT scan of the chest confirmed a multilocular air-filled structure within the right lower lobe, most likely consistent with a congenital pulmonary airway malformation (CPAM). Subsequently, there was spontaneous resolution of the PTX and CPAM prior to surgical intervention. This case illustrates post-natal spontaneous resolution of a CPAM, thus obviating the need for surgical removal.

关键词： Congenital Cystic Pulmonary Malformation Spontaneous Resolution Pneumothorax Infant