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1.
Phytomedicine ; 104: 154255, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35738116

ABSTRACT

BACKGROUND: Diabetic cardiomyopathy (DC) is one of the major lethal complications in patients with diabetes mellitus (DM); however, no specific strategy for preventing or treating DC has been identified. PURPOSE: This study aimed to investigate the effects of ß-lapachone (Lap), a natural compound that increases antioxidant activity in various tissues, on DC and explore the underlying mechanisms. STUDY DESIGN AND METHODS: As an in vivo model, C57BL/6 mice were fed with the high-fat diet (HF) for 10 weeks to induce type 2 DM. Mice were fed Lap with the HF or after 5 weeks of HF treatment to investigate the protective effects of Lap against DC. RESULTS: In the two in vivo models, Lap decreased heart weight, increased heart function, reduced oxidative stress, and elevated mitochondrial content under the HF. In the in vitro model, palmitic acid (PA) was used to mimic the effects of an HF on the differentiated-cardiomyoblast cell line H9c2. The results demonstrated that Lap reduced PA-induced ROS production by increasing the expression of antioxidant regulators and enzymes, inhibiting inflammation, increasing mitochondrial activity, and thus reducing cell damage. Via the use of specific inhibitors and siRNA, the protective effects of Lap were determined to be mediated mainly by NQO1, Sirt1 and mitochondrial activity. CONCLUSION: Heart damage in DM is usually caused by excessive oxidative stress. This study showed that Lap can protect the heart from DC by upregulating antioxidant ability and mitochondrial activity in cardiomyocytes. Lap has the potential to serve as a novel therapeutic agent for both the prevention and treatment of DC.


Subject(s)
Diabetes Mellitus , Diabetic Cardiomyopathies , Naphthoquinones , Animals , Antioxidants/metabolism , Antioxidants/pharmacology , Diabetic Cardiomyopathies/drug therapy , Diabetic Cardiomyopathies/metabolism , Mice , Mice, Inbred C57BL , Mitochondria , NAD(P)H Dehydrogenase (Quinone)/metabolism , Naphthoquinones/pharmacology , Oxidative Stress
2.
Biol Lett ; 18(6): 20220183, 2022 06.
Article in English | MEDLINE | ID: mdl-35765809

ABSTRACT

Biodiversity is measured from various perspectives. One of them, functional diversity, quantifies the heterogeneity in species traits and roles in an ecosystem. One important aspect of species roles is their interactions with other species, i.e. their network role. We therefore investigate here functional diversity from the network perspective. Species differ in their network positions in a food web, having different interaction patterns. We developed a measure for quantifying the diversity in species interaction patterns in a food web. We examined the relationship between interaction diversity and several global network properties for 92 food webs. Our results showed that high interaction diversity occurs in sparsely connected and less cohesive food webs. High interaction diversity also occurred in food webs with more clusters and high network modularity. We also quantified several conventional functional diversity indices and demonstrate that they show little or no correlation with interaction diversity. Our proposed diversity index therefore provides a measure complementary to current concepts of functional diversity.


Subject(s)
Ecosystem , Food Chain , Biodiversity
3.
Phytomedicine ; 101: 154094, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35447421

ABSTRACT

BACKGROUND: Cisplatin (CDDP) is a first-line chemotherapeutic drug for treating various cancers. However, CDDP also damages normal cells and causes many side effects. Recently, CDDP has been demonstrated to kill cancer cells by targeting mitochondria. Protecting mitochondria might be a potential therapeutic strategy for CDDP-induced side effects. ß-Lapachone (ß-lap), a recognized NAD+ booster, has been reported to regulate mitochondrial activity. However, it remains unclear whether maintaining mitochondrial activity is the key factor in the protective effects of ß-lap in CDDP-treated normal cells. PURPOSE: In this study, the protective effects of ß-lap on mitochondria against CDDP cytotoxicity in normal cells were evaluated. STUDY DESIGN: In vitro cell models were used in this study, including 3T3 fibroblasts, human dermal fibroblasts, MCF-7 breast cancer cells, and MDA-MB-231 breast cancer cells. METHODS: Cells were treated with CDDP and ß-lap, and cell survival, NAD+, mitochondrial activity, autophagy, and ATP production were measured. Various inhibitors and siRNAs were used to confirm the key signal underlying the protective effects of ß-lap. RESULTS: The results demonstrated that ß-lap significantly decreased CDDP cytotoxicity in normal fibroblasts. With various inhibitors and siRNAs, ß-lap reduced CDDP-induced damage to normal fibroblasts by maintaining mitochondrial activity and increasing autophagy through the NQO1/NAD+/SIRT1 axis. Most importantly, the protective effects of ß-lap in fibroblasts did not affect the therapeutic effects of CDDP in cancer cells. This study indicated that mitochondrial activity, energy production, and NQO1 levels might be crucial responses separating normal cells from cancer cells under exposure to CDDP and ß-lap. CONCLUSION: ß-lap could be a good synergistic drug for reducing the side effects of CDDP without affecting the anticancer drug effect.


Subject(s)
Antineoplastic Agents , Breast Neoplasms , Naphthoquinones , Antineoplastic Agents/pharmacology , Cell Line, Tumor , Cisplatin/pharmacology , Female , Humans , Mitochondria , NAD , NAD(P)H Dehydrogenase (Quinone) , Naphthoquinones/pharmacology
4.
Comput Inform Nurs ; 37(11): 573-582, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31449141

ABSTRACT

Digitalizing the nursing process has become a trend in medical care. The purpose of this study was to evaluate implementation of the Standardized Computerized Nursing Process Documentation System and patient outcomes. We analyzed hospitalized patients' electronic health record database with a total of 19 659 patients in 2015. The analysis focused on nurses' selection of nursing care plans for patients with a high risk of falls or pressure injuries through admission assessments. The effectiveness of implemented nursing care plans following falls or pressure injuries was explored. The results reveal that 55% of the hospitalized patients had a risk of falling, and 27.85% of patients were at risk of pressure injuries. Patients receiving nursing care plan who experienced falls or pressure injuries were significantly higher than those without a nursing care plan (P < .001). This study could not provide direct evidence for the effect of nursing care plans on reducing the incidence of falls and pressure injuries, which may be attributable to patient characteristics. Furthermore, an analysis on data from 2007 to 2017 using a run chart revealed that the mean incidence rate for pressure injuries decreased, whereas that for falls remained stable. The results indicate that the system did not increase the occurrence of such incidences.


Subject(s)
Accidental Falls/statistics & numerical data , Documentation/standards , Electronic Health Records/standards , Nursing Process/standards , Outcome Assessment, Health Care/standards , Pressure Ulcer/diagnosis , Aged , Aged, 80 and over , Documentation/methods , Electronic Health Records/instrumentation , Female , Humans , Male , Middle Aged , Outcome Assessment, Health Care/statistics & numerical data , Pressure Ulcer/epidemiology , Retrospective Studies
5.
PLoS One ; 13(6): e0199512, 2018.
Article in English | MEDLINE | ID: mdl-29928003

ABSTRACT

In this study, we investigated temporal changes in galanin receptor type 2 (GalR2) expression in NF200-, galanin-, neuropeptide Y (NPY)-, and neuronal nitric oxide synthase (nNOS)-like immunoreactive (LI) dorsal root ganglion (DRG) neurons after median nerve chronic constriction injury (CCI), and the effects of GalR2 on c-Fos expression in the cuneate nucleus (CN). Double immunofluorescence labeling methods were used to appraise changes in GalR2 expression in NF200-LI, galanin-LI, NPY-LI, and nNOS-LI DRG neurons after CCI. The von Frey assay was used to assess the efficiency of intraplantar administration of saline, M871 (a GalR2 antagonist), or AR-M1896 (a GalR2 agonist) on neuropathic signs of rats with CCI. The effects of alterations in c-Fos expression were assessed in all treatments. The percentage of GalR2-LI neurons in lesioned DRGs increased and peaked at 1 week after CCI. We further detected that percentages of GalR2-LI neurons labeled for NF200, galanin, NPY, and nNOS significantly increased following CCI. Furthermore, M871 remarkably attenuated tactile allodynia, but the sensation was slightly aggravated by AR-M1896 after CCI. Consequentially, after electrical stimulation of the CCI-treated median nerve, the number of c-Fos-LI neurons in the cuneate nucleus (CN) was significantly reduced in the M871 group, whereas it increased in the AR-M1896 group. These results suggest that activation of GalR2, probably through NPY or nitric oxide, induces c-Fos expression in the CN and transmits mechanical allodynia sensations to the thalamus.


Subject(s)
Hyperalgesia/metabolism , Median Nerve/injuries , Median Nerve/metabolism , Receptor, Galanin, Type 2/metabolism , Animals , Chronic Disease , Constriction, Pathologic , Galanin , Ganglia, Spinal/metabolism , Hyperalgesia/pathology , Male , Median Nerve/pathology , Nerve Tissue Proteins/metabolism , Neurons/metabolism , Rats, Sprague-Dawley , Receptor, Galanin, Type 2/agonists , Receptor, Galanin, Type 2/antagonists & inhibitors
6.
Ann Neurol ; 78(2): 272-83, 2015 Aug.
Article in English | MEDLINE | ID: mdl-25973863

ABSTRACT

OBJECTIVE: Autonomic neuropathy is a major component of familial amyloid polyneuropathy (FAP) due to mutated transthyretin, with sudomotor failure as a common manifestation. This study aimed to investigate the pathology and clinical significance of sudomotor denervation. METHODS: Skin biopsies were performed on the distal leg of FAP patients with a follow-up duration of 3.8 ± 1.6 years. Sudomotor innervation was stained with 2 markers: protein gene product 9.5 (PGP 9.5), a general neuronal marker, and vasoactive intestinal peptide (VIP), a sudomotor nerve functional marker, followed by quantitation according to sweat gland innervation index (SGII) for PGP 9.5 (SGIIPGP 9.5) and VIP (SGIIVIP). RESULTS: There were 28 patients (25 men) with Ala97Ser transthyretin and late onset (59.9 ± 6.0 years) disabling neuropathy. Autonomic symptoms were present in 22 patients (78.6%) at the time of skin biopsy. The SGIIPGP 9.5 and SGIIVIP of FAP patients were significantly lower than those of age- and gender-matched controls. The reduction of SGIIVIP was more severe than that of SGIIPGP 9.5 (p = 0.002). Patients with orthostatic hypotension or absent sympathetic skin response at palms were associated with lower SGIIPGP 9.5 (p = 0.019 and 0.002, respectively). SGIIPGP 9.5 was negatively correlated with the disability grade at the time of skin biopsy (p = 0.004), and was positively correlated with the interval from the time of skin biopsy to the time of wheelchair usage (p = 0.029). INTERPRETATION: This study documented the pathological evidence of sudomotor denervation in FAP. SGIIPGP 9.5 was functionally correlated with autonomic symptoms, autonomic tests, ambulation status, and progression of disability.


Subject(s)
Amyloid Neuropathies, Familial/metabolism , Autonomic Nervous System Diseases/metabolism , Epidermis/innervation , Sweat Glands/innervation , Ubiquitin Thiolesterase/metabolism , Vasoactive Intestinal Peptide/metabolism , Aged , Amyloid Neuropathies, Familial/genetics , Amyloid Neuropathies, Familial/pathology , Autonomic Nervous System Diseases/genetics , Autonomic Nervous System Diseases/pathology , Biomarkers/metabolism , Biopsy , Epidermis/metabolism , Epidermis/pathology , Female , Humans , Immunohistochemistry , Leg , Male , Middle Aged , Prealbumin/genetics , Skin/innervation , Skin/metabolism , Skin/pathology , Sweat Glands/metabolism
7.
Biol Lett ; 8(4): 570-3, 2012 Aug 23.
Article in English | MEDLINE | ID: mdl-22357938

ABSTRACT

Identifying important species for maintaining ecosystem functions is a challenge in ecology. Since species are components of food webs, one way to conceptualize and quantify species importance is from a network perspective. The importance of a species can be quantified by measuring the centrality of its position in a food web, because a central node may have greater influence on others in the network. A species may also be important because it has a unique network position, such that its loss cannot be easily compensated. Therefore, for a food web to be robust, we hypothesize that central species must be functionally redundant in terms of their network position. In this paper, we test our hypothesis by analysing the Prince William Sound ecosystem. We found that species centrality and uniqueness are negatively correlated, and such an observation is also carried over to other food webs.


Subject(s)
Biota , Ecology/methods , Food Chain , Animals , Models, Biological , Population Dynamics , Predatory Behavior , Species Specificity , Statistics, Nonparametric
8.
Ann Agric Environ Med ; 17(2): 327-30, 2010.
Article in English | MEDLINE | ID: mdl-21186778

ABSTRACT

Exposure to bacterial endotoxin and fungal ß-(1,3)-glucan in the indoor environment can induce respiratory symptoms. Automobiles are an exposure source of allergens but it is not known if, and how much exposure there is to endotoxin and fungal ß-(1,3)-glucan. The objective of the study was to determine whether automobiles are a potential source of exposure to these microbial products. Dust was sampled from the passenger seats of 40 automobiles. Specific Limulus amoebocyte kinetic assays were used to measure endotoxin and ß-(1,3)-glucan, respectively. Endotoxin and ß-(1,3)-glucan was detected in all samples ranging from 19.9-247.0 EU/mg and 1.6-59.8 µg/g, respectively. There were no significant differences in endotoxin levels between automobiles of smokers and non-smokers, but ß-(1,3)-glucan levels were about two-fold higher in the automobiles of non-smokers. In conclusion, endotoxin and ß-(1,3)-glucan exposure in automobiles at levels found in our study may be of importance for asthmatics.


Subject(s)
Air Pollution, Indoor/analysis , Automobiles , Endotoxins/analysis , Environmental Exposure/analysis , beta-Glucans/analysis , Pilot Projects , Prospective Studies , Statistics, Nonparametric
9.
Hum Reprod ; 21(11): 2794-800, 2006 Nov.
Article in English | MEDLINE | ID: mdl-16982660

ABSTRACT

BACKGROUND: Cryopreservation of ovarian tissue is valuable for fertility preservation. We develop an innovative vitrification method using less concentrated cryoprotectants and direct application of liquid nitrogen to the ovarian tissue (direct cover vitrification, DCV) to improve its efficiency. METHODS: Ovaries of 5- to 6-week-old C57BL/6J mice were randomly allocated to four groups: DCV, conventional vitrification, slow-freezing and non-frozen controls. Experiment 1: observing the follicle morphology. Experiment 2: assessing viability. Experiment 3: investigating the ultrastructure. Experiment 4: examining the follicle number after grafting. Experiment 5: ascertaining pregnancy potential by allogeneic orthotopic transplantation. RESULTS: The percentages of morphologically normal or viable follicles from DCV were significantly greater than those achieved from conventional vitrification and slow freezing (P < 0.01). The ultrastructure of primordial follicles from DCV appeared better than that achieved from conventional vitrification and slow freezing. After grafting, the follicle number from DCV was greater than conventional vitrification (P = 0.001) and slow freezing (P = 0.021). The pregnancy rate of DCV was higher than conventional vitrification (P < 0.01). The litter size from DCV was comparable with that from non-frozen graft and was significantly greater than that achieved from conventional vitrification and slow freezing (P < 0.01). CONCLUSIONS: DCV is highly efficient for cryopreservation of ovarian tissue. Using less concentrated cryoprotectants appears to reduce toxicity. Direct cover by liquid nitrogen maximizes cooling that could facilitate vitrification and prevent ice crystal injury.


Subject(s)
Cryopreservation/methods , Ovarian Follicle/cytology , Ovary/cytology , Pregnancy, Animal/physiology , Animals , Cell Survival , Female , Mice , Mice, Inbred C57BL , Ovarian Follicle/ultrastructure , Ovary/ultrastructure , Pregnancy
10.
Acta Cytol ; 48(2): 155-60, 2004.
Article in English | MEDLINE | ID: mdl-15085746

ABSTRACT

OBJECTIVE: To elucidate 3-dimensional (3-D) cytomorphology in fine needle aspiration biopsy (FNAB) of subacute thyroiditis. STUDY DESIGN: Ultrasound-guided FNAB was performed on the inflamed area of the thyroid from 4 patients with subacute thyroiditis. The aspirates were stained and observed under a light microscope (LM). The aspirates were also fixed, dehydrated, critical point dried, spattered with gold ions and observed with a scanning electron microscope (SEM). For transmission electron microscopy (TEM), the specimen was fixed, dehydrated, embedded in an Epon mixture, cut with an ultramicrotome, mounted on copper grids, electron doubly stained with uranium acetate and lead citrate, and observed with TEM. Findings with SEM were correlated with those with LM and TEM. RESULTS: Under SEM, 3-D cytomorphology of subacute thyroiditis displayed loss of a uniform, honeycomb cellular arrangement; variation in size; and decrease or shortening of microvilli in follicular cells, which corresponded to varying degrees of cellular degeneration under TEM. Giant cells that were round or ovoid were also noted with SEM. CONCLUSION: Loss of a uniform, honeycomb cellular arrangement; variation in size and decrease or shortening of microvilli in follicular cells; and appearance of round or ovoid giant cells were characteristic 3-D cytomorphology findings in FNAB of subacute thyroiditis.


Subject(s)
Epithelial Cells/pathology , Thyroid Gland/pathology , Thyroiditis, Subacute/pathology , Adult , Biopsy, Fine-Needle , Cell Nucleus/pathology , Cell Nucleus/ultrastructure , Epithelial Cells/ultrastructure , Female , Humans , Imaging, Three-Dimensional , Microscopy, Electron , Microscopy, Electron, Scanning , Microvilli/pathology , Microvilli/ultrastructure , Middle Aged , Thyroid Gland/ultrastructure
11.
J Clin Endocrinol Metab ; 88(7): 3021-6, 2003 Jul.
Article in English | MEDLINE | ID: mdl-12843138

ABSTRACT

Although only 1% of differentiated thyroid cancers transform into anaplastic thyroid cancer, this disease is always fatal. Differentiation therapy may provide a new therapeutic approach to increasing the survival rate in such patients. 3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are reported to promote cellular apoptosis and differentiation in many cancer cells; these effects are unrelated to lipid reduction. Recently, we found that TNFalpha induces cytomorphological differentiation in anaplastic thyroid cancer cells and increases thyroglobulin expression; however, TNF is cytotoxic for normal human tissue. The aim of this study was to determine whether lovastatin, an HMG-CoA reductase inhibitor, could induce apoptosis and differentiation in anaplastic thyroid cancer cells. Anaplastic thyroid cancer cells were treated with lovastatin, then examined for cellular apoptosis and cytomorphological differentiation by DNA fragmentation, phosphatidylserine externalization/flow cytometry, and electron microscopy. Thyroglobulin levels in the culture medium were also measured. Our results showed that at a higher dose (50 micro M), lovastatin induced apoptosis of anaplastic thyroid cancer cells, whereas at a lower dose (25 micro M), it promoted 3-dimensional cytomorphological differentiation. It also induced increased secretion of thyroglobulin by anaplastic cancer cells. Our results show that lovastatin not only induces apoptosis, but also promotes redifferentiation in anaplastic thyroid cancer cells, and suggest that it and other HMG-CoA reductase inhibitors merit further investigation as differentiation therapy for the treatment of anaplastic thyroid cancer.


Subject(s)
Apoptosis/drug effects , Carcinoma , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology , Lovastatin/pharmacology , Thyroid Neoplasms , Cell Differentiation/drug effects , Cell Survival/drug effects , Humans , Microscopy, Electron, Scanning , Protein Prenylation , Radioimmunoassay , Thyroglobulin/metabolism , Tumor Cells, Cultured/drug effects , Tumor Cells, Cultured/ultrastructure
12.
Acta Cytol ; 46(6): 1037-42, 2002.
Article in English | MEDLINE | ID: mdl-12462079

ABSTRACT

OBJECTIVE: To elucidate three-dimensional (3-D) cytomorphology in fine needle aspiration biopsy (FNAB) of parathyroid lesions. STUDY DESIGN: Ultrasound-guided FNAB was performed on parathyroid lesions from 10 patients with hyperparathyroidism. The aspirates were stained and observed under a light microscope (LM). The aspirates were also fixed, dehydrated, critical point dried, spattered with gold ions and observed with a scanning electron microscope (SEM). Findings under SEM were correlated with the appearances under LM as well as with serum parathyroid hormone (PTH) concentrations. RESULTS: Under LM, nine cases displayed isokaryosis and one case, anisokaryosis. These appearances corresponded to isocytosis or anisocytosis under SEM. Under SEM, 3-D cytomorphology of parathyroid lesions displayed isocytotic, scattered cells in five cases, uniform cellular arrangements in four cases and anisocytotic, scattered cells in one case. The cell surface was rather smooth in five cases. The other five cases had significant granules on the cell surfaces; these all had serum PTH concentrations > or = 268 pg/mL. CONCLUSION: 3-D cytomorphology in FNAB of parathyroid lesions was a rather smooth cell surface in cases with low serum PTH and a granular cell surface in cases with significantly increased serum PTH. These characteristics and the absence of microvilli might be helpful in the differential diagnosis between parathyroid and follicular thyroid lesions.


Subject(s)
Adenoma/pathology , Hyperparathyroidism/pathology , Imaging, Three-Dimensional , Parathyroid Neoplasms/pathology , Adenoma/ultrastructure , Adult , Aged , Biopsy, Needle , Diagnosis, Differential , Female , Humans , Hyperplasia/pathology , Male , Microscopy, Electron, Scanning , Middle Aged , Parathyroid Hormone/blood , Parathyroid Neoplasms/ultrastructure
13.
Cancer ; 95(9): 1827-33, 2002 Nov 01.
Article in English | MEDLINE | ID: mdl-12404274

ABSTRACT

BACKGROUND: Anaplastic thyroid carcinoma is almost uniformly fatal. Microvilli are an important three-dimensional (3-D) cytomorphologic feature of thyrocyte differentiation, because fewer microvilli are seen in less differentiated tumors. Differentiation therapies, such as retinoic acid and somatostatin, have been tested previously in experimental models of differentiated thyroid carcinoma but not in anaplastic thyroid carcinoma. The objective of this study was to determine whether tumor necrosis factor alpha (TNF-alpha) is capable of inducing 3-D cytomorphologic differentiation of anaplastic thyroid carcinoma cells, and, if so, to investigate the mechanism involved. METHODS: Anaplastic thyroid carcinoma cells were treated with TNF-alpha and examined for evidence of cytomorphologic differentiation using electron microscopy. To study the mechanism of differentiation, immunoblotting was used to analyze inhibitory kappaB (I-kappaB) proteins and electrophoretic mobility shift assays to analyze nuclear factor kappaB (NF-kappaB) activation. The effect of NF-kappaB SN50, a NF-kappaB translocation inhibitor, on cytomorphologic changes induced in anaplastic thyroid carcinoma cells by TNF-alpha also was studied. In addition, levels of thyroglobulin and vascular endothelial growth factor (VEGF) secreted into the culture medium were measured. RESULTS: The results showed that TNF-alpha can induce activation of NF-kappaB and that the activation and translocation of NF-kappaB into the nucleus is responsible for promoting the 3-D cytomorphologic differentiation of anaplastic thyroid carcinoma cells, which was inhibited by the NF-kappaB translocation inhibitor, NF-kappaB SN50. TNF-alpha also induced increased thyroglobulin secretion and reduced VEGF secretion by anaplastic tumor cells. CONCLUSIONS: The current data suggest that TNF-alpha can induce thyrocyte differentiation in anaplastic thyroid carcinoma cells through NF-kappaB and that it merits investigation as differentiation therapy for the treatment of patients with anaplastic thyroid carcinoma. The authors also found that microvilli were useful markers for studying thyrocyte differentiation in anaplastic thyroid carcinoma cells.


Subject(s)
Carcinoma/ultrastructure , Microvilli/ultrastructure , NF-kappa B/metabolism , Thyroid Neoplasms/ultrastructure , Tumor Necrosis Factor-alpha/pharmacology , Carcinoma/metabolism , Endothelial Growth Factors/metabolism , Humans , Intercellular Signaling Peptides and Proteins/metabolism , Lymphokines/metabolism , Microscopy, Electron , Microscopy, Electron, Scanning , NF-kappa B/antagonists & inhibitors , Peptides/pharmacology , Thyroglobulin/metabolism , Thyroid Neoplasms/metabolism , Tumor Cells, Cultured/drug effects , Tumor Cells, Cultured/metabolism , Tumor Cells, Cultured/pathology , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors
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