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1.
Plast Reconstr Surg Glob Open ; 12(4): e5741, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38645631

ABSTRACT

Background: Venous thromboembolism (VTE) is a dangerous postoperative complication after abdominal wall reconstruction (AWR). Intraoperative core body temperature has been associated with thrombotic events in other surgical contexts. This study examines the effects of intraoperative temperature on VTE rate after AWR. Methods: A retrospective study was performed on AWR patients. Cohorts were defined by postoperative 30-day VTE. Intraoperative core body temperature was recorded as the minimum, maximum, and mean intraoperative temperatures. Study variables were analyzed with logistic regression and cutoff analysis to assess for association with VTE. Results: In total, 344 patients met inclusion criteria. Fourteen patients were diagnosed with 30-day VTE for an incidence of 4.1%. The VTE cohort had a longer median inpatient stay (8 days versus 5 days, P < 0.001) and greater intraoperative change in peak inspiratory pressure (3 mm H2O versus 1 mm H2O, P = 0.01) than the non-VTE cohort. Operative duration [odds ratio (OR) = 1.32, P = 0.01], length of stay (OR = 1.07, P = 0.001), and intraoperative PIP difference (OR = 1.18, P = 0.045) were significantly associated with 30-day VTE on univariable regression. Immunocompromised status (OR = 4.1, P = 0.023; OR = 4.0, P = 0.025) and length of stay (OR = 1.1, P < 0.001; OR = 1.1, P < 0.001) were significant predictors of 30-day VTE on two multivariable regression models. No significant associations were found between temperature metrics and 30-day VTE on cutoff point or regression analysis. Conclusions: Intraoperative core body temperature did not associate with 30-day VTE after AWR, though operative duration, length of stay, immunocompromised status, and intraoperative PIP difference did. Surgeons should remain mindful of VTE risk after AWR, and future research is warranted to elucidate all contributing factors.

2.
Plast Reconstr Surg Glob Open ; 12(3): e5629, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38486715

ABSTRACT

Background: Trigger point deactivation surgery is a safe and effective treatment for properly selected patients experiencing migraine, with 68.3%-100% experiencing symptom improvement postoperatively. However, it is still unknown why certain patients do not respond. Obesity has been shown to be associated with worsened migraine symptoms and a decreased response to select pharmacotherapies. This study aimed to determine whether obesity may also be associated with an attenuated response to surgery. Methods: A retrospective chart review was conducted to identify patients who had undergone trigger point deactivation surgery for migraine. Patients were split into obese and nonobese cohorts. Obesity was classified as a body mass index of 30 or higher per Centers for Disease Control and Prevention guidelines. Outcomes and follow-up periods were determined with respect to individual operations. Outcomes included migraine attack frequency, intensity, duration, and the migraine headache index. Differences in demographics, operative characteristics, and operative outcomes were compared. Results: A total of 62 patients were included in the study. The obese cohort comprised 31 patients who underwent 45 total operations, and the nonobese cohort comprised 31 patients who underwent 34 operations. Results from multivariable analysis showed no impact of obesity on the odds of achieving a more than 90% reduction in any individual outcome. The overall rates of improvement (≥50% reduction in any outcome) and elimination (100% reduction in all symptoms) across both cohorts were 89.9% and 65.8%, respectively. Conclusion: Obese patients have outcomes comparable to a nonobese cohort after trigger point deactivation surgery for migraine.

3.
Plast Reconstr Surg Glob Open ; 12(1): e5352, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38235350

ABSTRACT

Background: Randomized controlled trials (RCTs) are integral to the progress of evidenced-based medicine and help guide changes in the standards of care. Although results are traditionally evaluated according to their corresponding P value, the universal utility of this statistical metric has been called into question. The fragility index (FI) has been developed as an adjunct method to provide additional statistical perspective. In this study, we aimed to determine the fragility of 25 highly cited RCTs in the plastic surgery literature. Methods: A PubMed search was used to identify the 25 highest cited RCTs with statistically significant dichotomous outcomes across 24 plastic surgery journals. Article characteristics were extracted, and the FI of each article was calculated. Additionally, Altmetric scores were determined for each study to determine article attention across internet platforms. Results: The median FI score across included studies was 4 (2-7.5, interquartile range). The two highest FI scores were 208 and 58, respectively. Four studies (16%) had scores of 0 or 1. Three studies (12%) had scores of 2. All other studies (72%) had FI scores of 3 or higher. The median Altmetric score was 0 (0-3). Conclusion: The FI can provide additional perspective on the robustness of study results, but like the P value, it should be interpreted in the greater context of other study elements.

4.
J Knee Surg ; 37(6): 470-481, 2024 May.
Article in English | MEDLINE | ID: mdl-37734405

ABSTRACT

We sought to assess the current literature to present a comprehensive summary of the incidence, common pathogens, and risk factors for infection after anterior cruciate ligament (ACL) reconstruction. PubMed, CINAHL, EMBASE, and Scopus databases were searched for relevant studies reporting on infection after ACL reconstruction. Two reviewers independently screened the extracted studies for adherence to inclusion and exclusion criteria. Studies were selected if they reported on the incidence of infection, pathogens cultured from infected knees, or risk factors for infection after primary ACL reconstruction. Exclusion criteria consisted of studies with fewer than 100 patients or studies that included revision ACL reconstruction. Fifty studies met the inclusion and exclusion criteria, reporting on a total of 316,214 ACL reconstructions. Included studies evaluated between 123 and 104,255 patients. The overall incidence of infection was 0.60% (0.15-2.44%). The most common pathogens were Staphylococcus aureus, S. epidermidis, and coagulase-negative Staphylococci. Five studies reported that the use of hamstring autograft was a statistically significant risk factor for infection after ACL reconstruction, thus making hamstring autograft the most commonly reported risk factor. Other reported risk factors included male sex, use of immuno-suppressive medications or intraarticular steroid injections, prior knee surgery, and diabetes. Systematic review of the literature revealed that infection after ACL reconstruction remains an infrequent event with an incidence of 0.60% (0.15-2.44%). Furthermore, the most common pathogens are from the Staphylococcus genus of bacteria, comprising 84% of all culture-positive infections. Multiple risk factors have been reported for ACL reconstruction; however, statistical significance varied across studies. Together, these findings may help guide physicians in the prevention and treatment of infection after ACL reconstruction.


Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament Reconstruction , Humans , Male , Incidence , Anterior Cruciate Ligament Injuries/epidemiology , Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Injuries/etiology , Anterior Cruciate Ligament Reconstruction/adverse effects , Knee Joint/surgery , Risk Factors
5.
Plast Reconstr Surg Glob Open ; 11(9): e5293, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37753333

ABSTRACT

This practical review critically evaluates the evidence behind the widespread use of postoperative compression therapy intended to improve surgical outcomes, such as reduced edema, ecchymosis, pain, and seroma formation. A literature search of PubMed was conducted to identify relevant studies concerning the use of compression garments after aesthetic surgery, including rhinoplasty, facelift, neck lift, mammoplasty, abdominoplasty, limb contouring, and others. Additionally, reconstructive and therapeutic procedures closely related in anatomy or technique to these cosmetic operations, such as breast reconstruction, mastectomy, and hernia repair, were also considered to provide further perspective. After study extraction, the volume, quality, and agreement of the evidence found was highly heterogenous depending on the context of specific operations and outcomes evaluated. The most well-supported indications for the use of postoperative compression garments are to mitigate edema and ecchymosis after rhinoplasty and to reduce postoperative pain after breast and abdominal procedures, although no effect on seroma rate was demonstrated. Any potential benefit must be balanced against the associated costs and possible complications of compression, including patient discomfort, increased venous stasis, and skin defects. Thus, we encourage surgeons to critically reassess their use of compression garments. In many settings, such as brachioplasty, there is limited high-quality evidence to inform best practice, and we urge the community to continue researching this important topic so that more definitive and comprehensive guidelines may be established.

6.
J Clin Neurosci ; 115: 8-13, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37454441

ABSTRACT

Migraine headaches and obesity are both prevalent disorders, resulting in a high socioeconomic burden. To better understand the relationship between obesity and migraine, the aim of this study was to investigate the association between migraine severity, metabolic syndrome and estrogen-associated variables. A retrospective analysis of adult patients with refractory migraine seen by our senior author (J.E.J.) was performed. Patient demographics and migraine characteristics, including migraine intensity, duration, and number of headaches per month were collected from medical records. Migraine headache index (MHI) was calculated by multiplying frequency, intensity and duration of headaches. Weight and height were used to calculate body mass index (BMI) and these were divided per Center for Disease Control (CDC) classifications. Univariate linear regression models were used to evaluate associations. Patients (n = 223) were predominantly female (78%) with a mean age of 44 years at presentation. Patients with a BMI higher than 40 (class 3 obesity) had a higher MHI (p = 0.01) and experienced a higher number of migraines per month (p = 0.007), compared to patients with a healthy BMI, respectively. Migraine frequency was found to be significantly higher in post-menopausal women compared to pre-menopausal women (p = 0.02). No other significant associations were found. This study found that severe obesity (BMI > 40) is associated with increased migraine severity and frequency. Post-menopausal patients are also found to have increased migraine frequency, which could be explained by the estrogen-withdrawal hypothesis. Future studies are needed to evaluate the outcomes of individuals with obesity after nerve deactivation surgery.


Subject(s)
Migraine Disorders , Obesity, Morbid , Adult , Humans , Female , Male , Obesity, Morbid/complications , Obesity, Morbid/epidemiology , Retrospective Studies , Obesity/complications , Obesity/epidemiology , Migraine Disorders/complications , Migraine Disorders/epidemiology , Headache/complications
7.
Plast Reconstr Surg ; 2023 Jun 06.
Article in English | MEDLINE | ID: mdl-37285213

ABSTRACT

BACKGROUND: Nerve deactivation surgery for the treatment of migraine has quickly evolved over the last two decades. Studies typically report changes in migraine frequency (attacks/month), attack duration, attack intensity, and their composite score, the migraine headache index (MHI), as primary outcomes. However, the neurology literature predominantly reports migraine prophylaxis outcomes as change in monthly migraine days (MMD). Therefore, the goal of this study is to foster common communication between plastic surgeons and neurologists by assessing the effect of nerve deactivation surgery on monthly migraine days (MMD) and motivating future studies to include MMD in their reported outcomes. METHODS: An updated literature search was performed according to the PRISMA guidelines. The National Library of Medicine (PubMed), Scopus, and EMBASE were systematically searched for relevant articles. Data was extracted and analyzed from studies which met the inclusion criteria. RESULTS: A total of 19 studies were included. There was a significant overall reduction in monthly migraine days (mean difference [MD] 14.11, 95% CI 10.95 to 17.27; I2 = 92%), total migraine attacks per month (MD 8.65, 95% CI 7.84 to 9.46, I2 = 90%), migraine headache index (MD 76.59, 95% CI 60.85 to 92.32; I2 = 98%), migraine attack intensity (MD 3.84, 95% CI 3.35 to 4.33; I2 = 98%), and migraine attack duration (MD 11.80, 95% CI 6.44 to 17.16; I2 = 99%) at follow-up (range 6-38 months). CONCLUSIONS: This study demonstrates the efficacy of nerve deactivation surgery on the outcomes used in both the PRS and neurology literature.

8.
Plast Reconstr Surg Glob Open ; 11(6): e5069, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37325379

ABSTRACT

Case reports provide a salient contribution to the field of plastic surgery through the timely dissemination of knowledge on previously underreported topics. Once a time-honored hallmark of the surgical literature, the perceived value of case reports has decreased with the ongoing prioritization of higher levels of evidence. In this study, we aimed to assess long-term trends in case report publication rates and discuss the continued merits of case reports in the modern-day landscape. Methods: A PubMed search was used to identify articles published in six prominent plastic surgery journals since 1980. Articles were separated as case reports versus all other publication types. The total number of articles published by group was tracked, and citation rates were compared across groups. Additionally, the most cited articles from each journal were identified for both groups. Results: A total of 68,444 articles were included for analysis. In 1980, there were 181 case reports published compared with 413 other articles across all six journals. In 2022, there were 188 case reports published compared with 3343 other articles. When comparing citations per year of case reports versus other article types across all journals since 1980, case reports were found to be cited significantly less frequently (P < 0.001). Conclusions: Case reports have been published and cited less frequently than other types of literature over the last 42 years. However, despite these trends, they have demonstrated significant historical contributions and provide continued value as an impactful forum for highlighting novel clinical entities.

9.
Plast Reconstr Surg Glob Open ; 11(5): e4982, 2023 May.
Article in English | MEDLINE | ID: mdl-37235133

ABSTRACT

Xanthelasma palpebrarum is the most common type of xanthomatous lesion. Various methods for treating Xanthelasma palpebrarum have been reported. We conducted a systematic review to evaluate the efficacy and associated complications of different treatment methods, and we summarized these findings as a practical review designed to be clinically useful, accessible, and impactful. Methods: The PubMed and Embase databases were searched to identify clinical studies that reported on outcomes and complications of different methods of Xanthelasma treatment. The electronic databases were searched from January 1990 to October 2022. Data on study characteristics, lesion clearance, complications, and recurrences were collected. Results: Forty-nine articles (including 1329 patients) were reviewed. The studies reported on surgical excision, laser modalities, electrosurgical techniques, chemical peeling, cryotherapy, and intralesional injection. The majority of studies were retrospective (69%) and single-arm (84%). Surgical excision combined with blepharoplasty and skin grafts showed excellent outcomes for large Xanthelasma. CO2 and erbium yttrium aluminum garnet (Er:YAG) were the most commonly studied lasers and showed more than 75% improvement in over 90% and 80% of patients, respectively. Comparative studies reported better efficacy for CO2 laser than both Er:YAG laser and 30%-50% trichloroacetic acid. Dyspigmentation was the most encountered complication. Conclusions: Different methods for the treatment of Xanthelasma palpebrarum have been reported in the literature, with moderate to excellent efficacy and safety profiles depending on the size and location of the lesion. Surgery is more appropriate for larger and deeper lesions, whereas laser and electrosurgical techniques can be used in smaller and more superficial contexts. Only a limited number of comparative studies have been conducted, and novel clinical trials are necessary to further augment appropriate treatment selection.

10.
Arthroscopy ; 39(5): 1299-1309.e6, 2023 05.
Article in English | MEDLINE | ID: mdl-36690305

ABSTRACT

PURPOSE: To evaluate the association of posterior tibial slope (PTS) with anterior cruciate ligament (ACL) reinjury following primary ACL reconstruction. METHODS: PubMed, Scopus, Embase, and CINAHL databases were searched from inception through March 1, 2021, to retrieve relevant studies. Comparative studies reporting PTS measurements in a cohort of patients experiencing ACL graft failure versus patients with intact primary ACL reconstruction or studies comparing patients undergoing revision ACL reconstruction versus primary ACL reconstruction were included for analysis. A random-effects model was used to calculate the overall standardized mean difference (SMD) between groups. The following inclusion criteria were used: English language; full text available; Level I, II, or III evidence; studies in humans; and skeletally mature patients. RESULTS: After we systematically screened 1,912 studies, 15 studies met the inclusion/exclusion criteria. Radiographic measurements were used in 6 studies reporting medial PTS in 411 ACL failures versus 2808 controls. Patients with ACL failure had significantly greater medial PTS compared with controls (SMD 0.50; 95% confidence interval [CI] 0.23-0.77; P < .001). Magnetic resonance imaging (MRI) was used in 9 studies reporting lateral PTS measurements in 641 patients with a failed ACL reconstruction compared with 705 controls. Seven of the MRI studies also measured medial PTS in 552 failures versus 641 controls. Patients with ACL failure had significantly greater lateral PTS on MRI (SMD 0.58; 95% CI 0.13-1.03; P = .012) and medial PTS on MRI (SMD 0.59; 95% CI 0.23-0.96; P = .001) compared with controls. CONCLUSIONS: The present meta-analysis demonstrated that patients with elevated PTS on radiographs and MRI are at increased risk for ACL graft failure after primary ACL reconstruction. LEVEL OF EVIDENCE: Level III, meta-analysis of Level III studies.


Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament Reconstruction , Humans , Knee Joint/surgery , Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament/surgery , Tibia/surgery , Magnetic Resonance Imaging , Anterior Cruciate Ligament Reconstruction/methods , Retrospective Studies
11.
Am J Sports Med ; 51(1): 38-48, 2023 01.
Article in English | MEDLINE | ID: mdl-36412535

ABSTRACT

BACKGROUND: Elevated posterior tibial slope (PTS) has been identified as an important risk factor in anterior cruciate ligament (ACL) injuries and ACL graft failures. The cutoff value to recommend treatment with slope-reducing osteotomy remains unclear and is based on expert opinion and small case series. PURPOSE: (1) To determine whether there is a difference in PTS shown on lateral knee radiographs and magnetic resonance imaging (MRI) scans in a group of patients who experienced revision ACL graft failure versus a control group of patients who underwent successful revision ACL reconstruction, (2) to identify cutoff values of PTS measurements that predict risk of revision ACL graft failure, and (3) to examine whether there is a correlation between radiographic and MRI measurements of PTS. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A total of 38 patients who experienced revision ACL graft failure were identified from a revision ACL database. These patients were matched 1:1 by age, sex, and graft type to a group of 38 control patients who underwent revision ACL reconstruction with no evidence of graft failure at a minimum 2 years of follow-up. Medial and lateral PTS were measured by lateral knee radiographs and MRI scans of the affected limb. Demographics, surgical characteristics, and PTS were compared between the groups. The optimal cutoff values of medial and lateral PTS per radiographs and MRI scans for predicting increased risk of revision ACL graft failure were determined by receiver operating characteristic curves. Conditional multivariable logistic regression was used to assess the relative contribution of PTS cutoff values as a predictor of revision graft failure. RESULTS: The mean PTS values in the failure group were significantly higher than those in the control group on radiographs (medial, 13.2°± 2.9° vs 10.3°± 2.9°; P < .001; lateral, 12.9°± 3.0° vs 9.8°± 2.8°; P < .001) and MRI scans (medial, 7.2°± 3.1° vs 4.8°± 2.9°; P < .001; lateral, 8.4 ± 3.1° vs 5.9 ± 3.0°; P < .001). A radiographic medial PTS ≥14° had the highest increased risk of revision ACL graft failure with sensitivity equal to 50% and specificity to 92.1% (odds ratio, 18.71; 95% CI, 2.0-174.9; P = .01). CONCLUSION: Elevated PTS was a significant risk factor for revision ACL graft failure. Patients with radiographic medial PTS ≥14° had 18.7-times increased risk of revision ACL failure.


Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament , Humans , Child, Preschool , Anterior Cruciate Ligament/surgery , Case-Control Studies , Knee Joint/surgery , Anterior Cruciate Ligament Injuries/diagnostic imaging , Anterior Cruciate Ligament Injuries/surgery , Tibia/diagnostic imaging , Tibia/surgery , Cohort Studies , Magnetic Resonance Imaging , Retrospective Studies
12.
J Knee Surg ; 36(8): 820-826, 2023 Jul.
Article in English | MEDLINE | ID: mdl-35240716

ABSTRACT

We hypothesize that larger prior tunnel size is associated with an increased risk of failure of single-stage revision anterior cruciate ligament reconstruction (ACLR) as defined by the performance of a re-revision (third) ACLR on the index knee. Retrospective review identified 244 patients who underwent single-stage revision ACLR at a single center with available preoperative radiographs. Patient and surgical factors were extracted by chart review. The maximum diameter of the tibial tunnel was measured on lateral radiographs and the maximum diameter of the femoral tunnel was measured on anteroposterior radiographs. Record review and follow-up phone calls were used to identify failure of the revision surgery as defined by re-revision ACLR on the index knee. One hundred and seventy-one patients (70%) were reviewed with a mean of 3.9 years follow-up. Overall, 23 patients (13.4%) underwent re-revision surgery. Mean tibial tunnel size was 12.6 ± 2.8 mm (range: 5.7-26.9 mm) and mean femoral tunnel size was 11.7 ± 2.8 mm (range: 6.0-23.0 mm). Re-revision risk increased with tibial tunnel size. Tibial tunnels 11 mm and under had a re-revision risk of 4.2%, while tunnels > 11 mm had a risk of 17.1% (relative risk: 4.1, p = 0.025). No significant association between femoral tunnel size and re-revision risk was noted. Patients with prior tibial tunnels > 11mm in diameter at revision surgery had significantly increased risk of re-revision ACLR. Further studies are needed to explore the relationship between prior tunnel size and outcomes of revision ACLR.


Subject(s)
Anterior Cruciate Ligament Injuries , Anterior Cruciate Ligament Reconstruction , Humans , Knee Joint/diagnostic imaging , Knee Joint/surgery , Tibia/surgery , Anterior Cruciate Ligament Reconstruction/adverse effects , Femur/diagnostic imaging , Femur/surgery , Knee/surgery , Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Injuries/etiology
13.
Biomolecules ; 12(12)2022 12 12.
Article in English | MEDLINE | ID: mdl-36551285

ABSTRACT

Peripheral nerve injuries (PNI) are common and often result in lifelong disability. The peripheral nervous system has an inherent ability to regenerate following injury, yet complete functional recovery is rare. Despite advances in the diagnosis and repair of PNIs, many patients suffer from chronic pain, and sensory and motor dysfunction. One promising surgical adjunct is the application of intraoperative electrical stimulation (ES) to peripheral nerves. ES acts through second messenger cyclic AMP to augment the intrinsic molecular pathways of regeneration. Decades of animal studies have demonstrated that 20 Hz ES delivered post-surgically accelerates axonal outgrowth and end organ reinnervation. This work has been translated clinically in a series of randomized clinical trials, which suggest that ES can be used as an efficacious therapy to improve patient outcomes following PNIs. The aim of this review is to discuss the cellular physiology and the limitations of regeneration after peripheral nerve injuries. The proposed mechanisms of ES protocols and how they facilitate nerve regeneration depending on timing of administration are outlined. Finally, future directions of research that may provide new perspectives on the optimal delivery of ES following PNI are discussed.


Subject(s)
Peripheral Nerve Injuries , Animals , Peripheral Nerve Injuries/therapy , Axons , Peripheral Nerves , Nerve Regeneration , Electric Stimulation/methods
14.
Cancers (Basel) ; 14(15)2022 Jul 31.
Article in English | MEDLINE | ID: mdl-35954395

ABSTRACT

Primary tumors can communicate with the liver to establish a microenvironment that favors metastatic colonization prior to dissemination, forming what is termed the "pre-metastatic niche" (PMN). Through diverse signaling mechanisms, distant malignancies can both influence hepatic cells directly as well as recruit immune cells into the PMN. The result is a set of changes within the hepatic tissue that increase susceptibility of tumor cell invasion and outgrowth upon dissemination. Thus, the PMN offers a novel step in the traditional metastatic cascade that could offer opportunities for clinical intervention. The involved signaling molecules also offer promise as biomarkers. Ultimately, while the existence of the hepatic PMN is well-established, continued research effort and use of innovative models are required to reach a functional knowledge of PMN mechanisms that can be further targeted.

15.
Mol Cancer Res ; 19(12): 2036-2045, 2021 12.
Article in English | MEDLINE | ID: mdl-34462330

ABSTRACT

Metastatic castration-resistant prostate cancer (mCRPC) includes a subset of patients with particularly unfavorable prognosis characterized by combined defects in at least two of three tumor suppressor genes: PTEN, RB1, and TP53 as aggressive variant prostate cancer molecular signature (AVPC-MS). We aimed to identify circulating tumor cells (CTC) signatures that could inform treatment decisions of patients with mCRPC with cabazitaxel-carboplatin combination therapy versus cabazitaxel alone. Liquid biopsy samples were collected prospectively from 79 patients for retrospective analysis. CTCs were detected, classified, enumerated through a computational pipeline followed by manual curation, and subjected to single-cell genome-wide copy-number profiling for AVPC-MS detection. On the basis of immunofluorescence intensities, detected rare cells were classified into 8 rare-cell groups. Further morphologic characterization categorized CTC subtypes from 4 cytokeratin-positive rare-cell groups, utilizing presence of mesenchymal features and platelet attachment. Of 79 cases, 77 (97.5%) had CTCs, 24 (30.4%) were positive for platelet-coated CTCs (pc.CTCs) and 25 (38.5%) of 65 sequenced patients exhibited AVPC-MS in CTCs. Survival analysis indicated that the presence of pc.CTCs identified the subset of patients who were AVPC-MS-positive with the worst prognosis and minimal benefit from combination therapy. In AVPC-MS-negative patients, its presence showed significant survival improvement from combination therapy. Our findings suggest the presence of pc.CTCs as a predictive biomarker to further stratify AVPC subsets with the worst prognosis and the most significant benefit of additional platinum therapy. IMPLICATIONS: HDSCA3.0 can be performed with rare cell detection, categorization, and genomic characterization for pc.CTC identification and AVPC-MS detection as a potential predictive biomarker of mCRPC.


Subject(s)
Biomarkers, Tumor/genetics , Neoplastic Cells, Circulating/metabolism , Prostatic Neoplasms, Castration-Resistant/genetics , Humans , Male , Neoplasm Metastasis , Prostatic Neoplasms, Castration-Resistant/mortality , Prostatic Neoplasms, Castration-Resistant/pathology , Survival Analysis
16.
J Am Heart Assoc ; 7(18): e010065, 2018 09 18.
Article in English | MEDLINE | ID: mdl-30371217

ABSTRACT

Background We have reported that cytochrome P450 1B1 ( CYP 1B1), expressed in cardiovascular tissues, contributes to angiotensin II -induced vascular smooth muscle cell ( VSMC ) migration and proliferation and development of hypertension in various experimental animal models via generation of reactive oxygen species. This study was conducted to determine the contribution of CYP 1B1 to platelet-derived growth factor-BB-induced VSMC migration and proliferation in vitro and to neointimal growth in vivo. Methods and Results VSMC s isolated from aortas of male Cyp1b1 +/+ and Cyp1b1 -/- mice were used for in vitro experiments. Moreover, carotid arteries of Cyp1b1 +/+ and Cyp1b1 -/- mice were injured with a metal wire to assess neointimal growth after 14 days. Platelet-derived growth factor- BB -induced migration and proliferation and H2O2 production were found to be attenuated in VSMC s from Cyp1b1 -/- mice and in VSMC s of Cyp1b1 +/+ mice treated with 4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl, a superoxide dismutase and catalase mimetic. In addition, wire injury resulted in neointimal growth, as indicated by increased intimal area, intima/media ratio, and percentage area of restenosis, as well as elastin disorganization and adventitial collagen deposition in carotid arteries of Cyp1b1 +/+ mice, which were minimized in Cyp1b1 -/- mice. Wire injury also increased infiltration of inflammatory and immune cells, as indicated by expression of CD 68+ macrophages and CD 3+ T cells, respectively, in the injured arteries of Cyp1b1 +/+ mice, but not Cyp1b1 -/- mice. Administration of 4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl attenuated neointimal growth in wire-injured carotid arteries of Cyp1b1 +/+ mice. Conclusions These data suggest that CYP 1B1-dependent oxidative stress contributes to the neointimal growth caused by wire injury of carotid arteries of male mice.


Subject(s)
Carotid Arteries/metabolism , Carotid Artery Injuries/genetics , Cytochrome P-450 CYP1B1/genetics , Gene Expression Regulation , Neointima/metabolism , Oxidative Stress , Animals , Blotting, Western , Carotid Arteries/pathology , Carotid Artery Injuries/metabolism , Carotid Artery Injuries/pathology , Cell Proliferation , Cells, Cultured , Cytochrome P-450 CYP1B1/biosynthesis , Disease Models, Animal , Male , Mice , Mice, Inbred C57BL , Neointima/pathology , RNA/genetics
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