18 results on '"Driscoll JA"'
Search Results
2. Is it safe to prescribe hormonal contraception and replacement therapy to patients with premalignant and malignant uterine cervices?
- Author
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Sadan, O, primary, Frohlich, RP, additional, Driscoll, JA, additional, Apostoleris, A, additional, Savage, N, additional, and Zakut, H, additional
- Published
- 1990
- Full Text
- View/download PDF
3. Multiomic analysis of uterine leiomyomas in self-described Black and White women: molecular insights into health disparities.
- Author
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Bateman NW, Abulez T, Tarney CM, Bariani MV, Driscoll JA, Soltis AR, Zhou M, Hood BL, Litzi T, Conrads KA, Jackson A, Oliver J, Ganakammal SR, Schneider F, Dalgard CL, Wilkerson MD, Smith B, Borda V, O'Connor T, Segars J, Shobeiri SA, Phippen NT, Darcy KM, Al-Hendy A, Conrads TP, and Maxwell GL
- Subjects
- Adult, Female, Humans, Middle Aged, Extracellular Matrix Proteins genetics, Health Status Disparities, Mutation, Black or African American genetics, Leiomyoma diagnostic imaging, Leiomyoma ethnology, Leiomyoma genetics, Mediator Complex genetics, Uterine Neoplasms diagnostic imaging, Uterine Neoplasms ethnology, Uterine Neoplasms genetics, White genetics
- Abstract
Background: Black women are at an increased risk of developing uterine leiomyomas and experiencing worse disease prognosis than White women. Epidemiologic and molecular factors have been identified as underlying these disparities, but there remains a paucity of deep, multiomic analysis investigating molecular differences in uterine leiomyomas from Black and White patients., Objective: To identify molecular alterations within uterine leiomyoma tissues correlating with patient race by multiomic analyses of uterine leiomyomas collected from cohorts of Black and White women., Study Design: We performed multiomic analysis of uterine leiomyomas from Black (42) and White (47) women undergoing hysterectomy for symptomatic uterine leiomyomata. In addition, our analysis included the application of orthogonal methods to evaluate fibroid biomechanical properties, such as second harmonic generation microscopy, uniaxial compression testing, and shear-wave ultrasonography analyses., Results: We found a greater proportion of MED12 mutant uterine leiomyomas from Black women (>35% increase; Mann-Whitney U, P<.001). MED12 mutant tumors exhibited an elevated abundance of extracellular matrix proteins, including several collagen isoforms, involved in the regulation of the core matrisome. Histologic analysis of tissue fibrosis using trichrome staining and secondary harmonic generation microscopy confirmed that MED12 mutant tumors are more fibrotic than MED12 wild-type tumors. Using shear-wave ultrasonography in a prospectively collected cohort, Black patients had fibroids that were firmer than White patients, even when similar in size. In addition, these analyses uncovered ancestry-linked expression quantitative trait loci with altered allele frequencies in African and European populations correlating with differential abundance of several proteins in uterine leiomyomas independently of MED12 mutation status, including tetratricopeptide repeat protein 38., Conclusion: Our study shows that Black women have a higher prevalence of uterine leiomyomas harboring mutations in MED12 and that this mutational status correlates with increased tissue fibrosis compared with wild-type uterine leiomyomas. Our study provides insights into molecular alterations correlating with racial disparities in uterine leiomyomas and improves our understanding of the molecular etiology underlying uterine leiomyoma development within these populations., (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Published
- 2024
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- View/download PDF
4. Mapping three-dimensional intratumor proteomic heterogeneity in uterine serous carcinoma by multiregion microsampling.
- Author
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Hunt AL, Bateman NW, Barakat W, Makohon-Moore SC, Abulez T, Driscoll JA, Schaaf JP, Hood BL, Conrads KA, Zhou M, Calvert V, Pierobon M, Loffredo J, Wilson KN, Litzi TJ, Teng PN, Oliver J, Mitchell D, Gist G, Rojas C, Blanton B, Darcy KM, Rao UNM, Petricoin EF, Phippen NT, Maxwell GL, and Conrads TP
- Abstract
Background: Although uterine serous carcinoma (USC) represents a small proportion of all uterine cancer cases, patients with this aggressive subtype typically have high rates of chemotherapy resistance and disease recurrence that collectively result in a disproportionately high death rate. The goal of this study was to provide a deeper view of the tumor microenvironment of this poorly characterized uterine cancer variant through multi-region microsampling and quantitative proteomics., Methods: Tumor epithelium, tumor-involved stroma, and whole "bulk" tissue were harvested by laser microdissection (LMD) from spatially resolved levels from nine USC patient tumor specimens and underwent proteomic analysis by mass spectrometry and reverse phase protein arrays, as well as transcriptomic analysis by RNA-sequencing for one patient's tumor., Results: LMD enriched cell subpopulations demonstrated varying degrees of relatedness, indicating substantial intratumor heterogeneity emphasizing the necessity for enrichment of cellular subpopulations prior to molecular analysis. Known prognostic biomarkers were quantified with stable levels in both LMD enriched tumor and stroma, which were shown to be highly variable in bulk tissue. These USC data were further used in a comparative analysis with a data generated from another serous gynecologic malignancy, high grade serous ovarian carcinoma, and have been added to our publicly available data analysis tool, the Heterogeneity Analysis Portal ( https://lmdomics.org/ )., Conclusions: Here we identified extensive three-dimensional heterogeneity within the USC tumor microenvironment, with disease-relevant biomarkers present in both the tumor and the stroma. These data underscore the critical need for upfront enrichment of cellular subpopulations from tissue specimens for spatial proteogenomic analysis., (© 2024. The Author(s).)
- Published
- 2024
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5. Causes of Early Hip Revision Vary by Age and Gender: Analysis of Data From a Statewide Quality Registry.
- Author
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Markel JF, Driscoll JA, Zheng TH, Hughes RE, Moore DD, Hallstrom BR, and Markel DC
- Subjects
- Aged, Female, Humans, Male, Prosthesis Design, Prosthesis Failure, Registries, Reoperation, Risk Factors, Arthroplasty, Replacement, Hip, Hip Prosthesis adverse effects
- Abstract
Background: While total hip arthroplasty (THA) is extremely successful, early failures do occur. The purpose of this study was to determine the cause of revision in specific patient demographic groups at 3 time points to potentially help decrease the revision risk., Methods: Data for cases performed between 2012 and 2018 from a statewide, quality improvement arthroplasty registry were used. The database included 79,205 THA cases and 1,433 revisions with identified etiology (1,584 in total). All revisions performed at <5 years from the primary THA were reviewed. Six groups, men/women, <65, 65-75, and >75 years, were compared at revision time points <6 months, <1 year, and <5 years., Results: There were obvious and significant differences between subgroups based on demographics and time points (P < .0001). Seven hundred and fifty-six (53%) of all revisions occurred within 6 months. The most common etiologies within 6 months (756 revisions) were fracture (316, 41.8%), dislocation/instability (194, 25.7%), and infection (98, 12.9%). At this early time point, the most common revision cause was fracture for all age/gender-stratified groups, ranging from 27.6% in young men to 60% in older women. Joint instability became the leading cause for revision after 1 year in all groups., Conclusion: This quality improvement project demonstrated clinically meaningful differences in the reason for THA revision between gender, age, and time from surgery. Strategies based on these data should be employed by surgeons to minimize the factors that lead to revision., (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Published
- 2022
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6. Influence of Geometry and Architecture on the In Vivo Success of 3D-Printed Scaffolds for Spinal Fusion.
- Author
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Hallman M, Driscoll JA, Lubbe R, Jeong S, Chang K, Haleem M, Jakus A, Pahapill R, Yun C, Shah R, Hsu WK, Stock SR, and Hsu EL
- Subjects
- Animals, Female, Printing, Three-Dimensional, Rats, Rats, Sprague-Dawley, Tissue Scaffolds, X-Ray Microtomography, Spinal Fusion
- Abstract
We previously developed a recombinant growth factor-free, three-dimensional (3D)-printed material comprising hydroxyapatite (HA) and demineralized bone matrix (DBM) for bone regeneration. This material has demonstrated the capacity to promote re-mineralization of the DBM particles within the scaffold struts and shows potential to promote successful spine fusion. Here, we investigate the role of geometry and architecture in osteointegration, vascularization, and facilitation of spine fusion in a preclinical model. Inks containing HA and DBM particles in a poly(lactide-co-glycolide) elastomer were 3D-printed into scaffolds with varying relative strut angles (90° vs. 45° advancing angle), macropore size (0 μm vs. 500 μm vs. 1000 μm), and strut alignment (aligned vs. offset). The following configurations were compared with scaffolds containing no macropores: 90°/500 μm/aligned, 45°/500 μm/aligned, 90°/1000 μm/aligned, 45°/1000 μm/aligned, 90°/1000 μm/offset, and 45°/1000 μm/offset. Eighty-four female Sprague-Dawley rats underwent spine fusion with bilateral placement of the various scaffold configurations ( n = 12/configuration). Osteointegration and vascularization were assessed by using microComputed Tomography and histology, and spine fusion was assessed via blinded manual palpation. The 45°/1000 μm scaffolds with aligned struts achieved the highest average fusion score (1.61/2) as well as the highest osteointegration score. Both the 45°/1000 μm/aligned and 90°/1000 μm/aligned scaffolds elicited fusion rates of 100%, which was significantly greater than the 45°/500 μm/aligned iteration ( p < 0.05). All porous scaffolds were fully vascularized, with blood vessels present in every macropore. Vessels were also observed extending from the native transverse process bone, through the protrusions of new bone, and into the macropores of the scaffolds. When viewed independently, scaffolds printed with relative strut angles of 45° and 90° each allowed for osteointegration sufficient to stabilize the spine at L4-L5. Within those parameters, a pore size of 500 μm or greater was generally sufficient to achieve unilateral fusion. However, our results suggest that scaffolds printed with the larger pore size and with aligned struts at an advancing angle of 45° may represent the optimal configuration to maximize osteointegration and fusion capacity. Overall, this work suggests that the HA/DBM composite scaffolds provide a conducive environment for bone regeneration as well as vascular infiltration. This technology, therefore, represents a novel, growth-factor-free biomaterial with significant potential as a bone graft substitute for use in spinal surgery. Impact statement We previously developed a recombinant growth factor-free, three-dimensional (3D)-printed composite material comprising hydroxyapatite and demineralized bone matrix for bone regeneration. Here, we identify a range of 3D geometric and architectural parameters that support the preclinical success of the scaffold, including efficient vascularization, osteointegration, and, ultimately, spinal fusion. Our results suggest that this material holds great promise as a clinically translatable biomaterial for use as a bone graft substitute in orthopedic procedures requiring bone regeneration.
- Published
- 2021
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7. 3D-Printed Ceramic-Demineralized Bone Matrix Hyperelastic Bone Composite Scaffolds for Spinal Fusion.
- Author
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Driscoll JA, Lubbe R, Jakus AE, Chang K, Haleem M, Yun C, Singh G, Schneider AD, Katchko KM, Soriano C, Newton M, Maerz T, Li X, Baker K, Hsu WK, Shah RN, Stock SR, and Hsu EL
- Subjects
- Animals, Durapatite chemistry, Humans, Rats, Rats, Sprague-Dawley, X-Ray Microtomography, Bone Substitutes chemistry, Printing, Three-Dimensional, Spinal Fusion methods
- Abstract
Although numerous spinal biologics are commercially available, a cost-effective and safe bone graft substitute material for spine fusion has yet to be proven. In this study, "3D-Paints" containing varying volumetric ratios of hydroxyapatite (HA) and human demineralized bone matrix (DBM) in a poly(lactide-co-glycolide) elastomer were three-dimensional (3D) printed into scaffolds to promote osteointegration in rats, with an end goal of spine fusion without the need for recombinant growth factor. Spine fusion was evaluated by manual palpation, and osteointegration and de novo bone formation within scaffold struts were evaluated by laboratory and synchrotron microcomputed tomography and histology. The 3:1 HA:DBM composite achieved the highest mean fusion score and fusion rate (92%), which was significantly greater than the 3D printed DBM-only scaffold (42%). New bone was identified extending from the host transverse processes into the scaffold macropores, and osteointegration scores correlated with successful fusion. Strikingly, the combination of HA and DBM resulted in the growth of bone-like spicules within the DBM particles inside scaffold struts. These spicules were not observed in DBM-only scaffolds, suggesting that de novo spicule formation requires both HA and DBM. Collectively, our work suggests that this recombinant growth factor-free composite shows promise to overcome the limitations of currently used bone graft substitutes for spine fusion. Impact Statement Currently, there exists a no safe, yet highly effective, bone graft substitute that is well accepted for use in spine fusion procedures. With this work, we show that a three-dimensional printed scaffold containing osteoconductive hydroxyapatite and osteoinductive demineralized bone matrix that promotes new bone spicule formation, osteointegration, and successful fusion (stabilization) when implemented in a preclinical model of spine fusion. Our study suggests that this material shows promise as a recombinant growth factor-free bone graft substitute that could safely promote high rates of successful fusion and improve patient care.
- Published
- 2020
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8. Time-dependent density functional study of field emission from nanotubes composed of C, BN, SiC, Si, and GaN.
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Driscoll JA, Bubin S, French WR, and Varga K
- Abstract
Field emission from various types of nanotubes is studied by propagating the electronic density in real space and time using time-dependent density functional theory. Capped (5, 5) C, BN, SiC, Si, and GaN nanotubes are considered. The GaN, SiC, and Si nanotubes were found to be significantly better field emitters than C and BN nanotubes, both in terms of current magnitude and sharpness of peaks in the energy spectra. By analyzing the electronic structure of the various systems it is seen that the nanotubes with the highest currents have electron densities that extend significantly from the nanotube in the emission direction.
- Published
- 2011
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9. Temporal relationship between primary and motile ciliogenesis in airway epithelial cells.
- Author
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Jain R, Pan J, Driscoll JA, Wisner JW, Huang T, Gunsten SP, You Y, and Brody SL
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- Aging metabolism, Aging pathology, Animals, Cell Line, Cell Proliferation, Cells, Cultured, Cilia ultrastructure, Dogs, Epithelial Cells pathology, Epithelial Cells ultrastructure, Forkhead Transcription Factors metabolism, Humans, Lung Injury metabolism, Lung Injury pathology, Mice, Models, Biological, TRPP Cation Channels metabolism, Time Factors, Cilia metabolism, Epithelial Cells metabolism, Movement physiology, Organogenesis, Trachea cytology, Trachea embryology
- Abstract
Cilia are traditionally classified as motile or primary. Motile cilia are restricted to specific populations of well-differentiated epithelial cells, including those in the airway, brain ventricles, and oviducts. Primary cilia are nonmotile, solitary structures that are present in many cell types, and often have sensory functions such as in the retina and renal tubules. Primary cilia were also implicated in the regulation of fundamental processes in development. Rare depictions of primary cilia in embryonic airways led us to hypothesize that primary cilia in airway cells are temporally related to motile ciliogenesis. We identified primary cilia in undifferentiated, cultured airway epithelial cells from mice and humans and in developing lungs. The solitary cilia in the airways express proteins considered unique to primary cilia, including polycystin-1 and polycystin-2. A temporal analysis of airway epithelial cell differentiation showed that cells with primary cilia acquire markers of motile ciliogenesis, suggesting that motile ciliated cells originate from primary ciliated cells. Whereas motile ciliogenesis requires Foxj1, primary ciliogenesis does not, and the expression of Foxj1 was associated with a loss of primary cilia, just before the appearance of motile cilia. Primary cilia were not found in well-differentiated airway epithelial cells. However, after injury, they appear in the luminal layer of epithelium and in basal cells. The transient nature of primary cilia, together with the temporal and spatial patterns of expression in the development and repair of airway epithelium, suggests a critical role of primary cilia in determining outcomes during airway epithelial cell differentiation.
- Published
- 2010
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10. Molecular order in Langmuir-Blodgett monolayers of metal-ligand surfactants probed by sum frequency generation.
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Jayathilake HD, Driscoll JA, Bordenyuk AN, Wu L, da Rocha SR, Verani CN, and Benderskii AV
- Abstract
Molecular organization of Langmuir-Blodgett (LB) monolayers of novel copper-containing metal-ligand surfactants was characterized by the surface-selective vibrational sum frequency generation (SFG) spectroscopy. The orientational and conformational order inferred from the SFG peak amplitudes and line shapes were correlated with the two-dimensional phases of the monolayers observed in the compression isotherms. The octadecyl-pyridin-2-ylmethyl-amine (L(PyC18)) ligand by itself shows good amphiphilic properties, as indicated by the high monolayer collapse pressure at the air/water interface, but its LB films transferred onto fused silica exhibit a high degree of trans-gauche conformational disorder in the alkyl tails. Coordination of copper(II) ions to the chelating head group enhances the molecular alignment and reduces the fraction of gauche defects of the alkyl chains. Monolayers of single-tail (L(PyC18)Cu(II)Cl(2)) and double-tail [(L(PyC18))(2)Cu(II)]Cl(2) metallosurfactants show distinctly different behavior of their molecular organization as a function of the area per molecule. Our observations suggest metal-ligand interactions as a pathway to induce molecular order in LB monolayer films.
- Published
- 2009
- Full Text
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11. Influence of the apical ligand in the thermotropic mesomorphism of cationic copper-based surfactants.
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Driscoll JA, Keyes PH, Heeg MJ, Heiney PA, and Verani CN
- Abstract
A new pyridine-based bidentate ligand L (PyC18) was used to develop copper-containing surfactants that exhibit mesomorphism. Complexes [(L (PyC18)) 2Cu (II)Y]Y were synthesized, where Y is an anionic ligand bromo ( 1), nitrato ( 2), or perchlorato ( 3). The nature of these apical ligands determines the mesogenic behavior of 1- 3: The smallest bromo-substituted species 1 shows a metastable liquid crystalline phase at 110 degrees C, the nitrato-substituted 2 increases the transition temperature to 136 degrees C, and the bulky perchlorato-substituted 3 shows reversible mesophases at 153 degrees C. The behavior of these complexes shows similarities and suggests that at low temperatures the crystals of these compounds are bilayered structures with interdigitated alkyl tails. At higher temperatures the tails undergo rapid conformational changes that force these layers to swell until the opposing alkyl chains are separated from each other, and the mesophase is a monolayer smectic A. Small changes in the geometry of cationic mesogens can be imposed by the presence of apically coordinated anions, allowing for tuning in the properties of the resulting mesophases.
- Published
- 2008
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12. Autosomal dominant polycystic kidney disease is associated with an increased prevalence of radiographic bronchiectasis.
- Author
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Driscoll JA, Bhalla S, Liapis H, Ibricevic A, and Brody SL
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- Animals, Bronchiectasis epidemiology, Bronchiectasis etiology, Cells, Cultured, Cilia metabolism, Cilia pathology, Disease Models, Animal, Follow-Up Studies, Gene Expression, Humans, Immunoblotting, Lung diagnostic imaging, Lung metabolism, Lung pathology, Mice, Mice, Inbred C57BL, Polycystic Kidney, Autosomal Dominant diagnostic imaging, Polycystic Kidney, Autosomal Dominant genetics, Polymerase Chain Reaction, Prevalence, RNA genetics, Respiratory Mucosa metabolism, Respiratory Mucosa pathology, Retrospective Studies, TRPP Cation Channels metabolism, Tomography, X-Ray Computed, Trachea metabolism, Trachea pathology, Bronchiectasis diagnostic imaging, Polycystic Kidney, Autosomal Dominant complications
- Abstract
Background: Autosomal dominant polycystic kidney disease (ADPKD) is a common disease with several known extrarenal manifestations, although no known pulmonary features. The formation of renal cysts in ADPKD has been attributed to dysfunction of primary cilia and the primary cilia-related proteins polycystin-1 (in 85% of cases) and polycystin-2 in renal epithelial cells. The goals of this study were to characterize the normal expression of polycystin-1 in the motile cilia of airway epithelial cells and to evaluate lung structure in ADPKD patients., Methods: Airway epithelium from non-ADPKD patients was immunostained to localize polycystin-1 expression, and lung tissue from ADPKD patients was examined for pathologic changes. CT scans from ADPKD patients (n = 95) and a control group of non-ADPKD chronic kidney disease patients (n = 95) were retrospectively reviewed for the presence of bronchiectasis using defined criteria., Results: Immunostaining revealed polycystin-1 expression in the motile cilia of non-ADPKD airway epithelial cells. Lung tissue from one of five available ADPKD patient autopsies revealed histologic changes of bronchiectasis. Review of CT scans revealed a threefold-increased prevalence of bronchiectasis in the ADPKD group compared to the control group (37% vs 13%, p = 0.002)., Conclusions: ADPKD patients demonstrate an increased prevalence of radiographic bronchiectasis, a previously unrecognized manifestation of the disease. This association suggests that patients with primary cilia-associated diseases may be at risk for airway disease.
- Published
- 2008
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13. Medical therapy for pulmonary arterial hypertension.
- Author
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Driscoll JA and Chakinala MM
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- Drug Therapy, Combination, Epoprostenol analogs & derivatives, Exercise Therapy, Health Behavior, Humans, Hypertension, Pulmonary pathology, Hypertension, Pulmonary physiopathology, Antihypertensive Agents therapeutic use, Endothelin A Receptor Antagonists, Epoprostenol therapeutic use, Hypertension, Pulmonary therapy, Phosphodiesterase Inhibitors therapeutic use, Pulmonary Artery pathology
- Abstract
Recent advances in the understanding of pulmonary arterial hypertension have led to new therapeutic options, although the disease remains incurable and continues to cause substantial morbidity and mortality. Disease-specific therapies have been approved for use in the US, including epoprostenol and its various analogs, endothelin receptor antagonists, and phosphodiesterase 5 inhibitors. The use of combination therapy with agents from more than one of these drug classes is becoming increasingly common, although guidelines establishing optimal combinations are lacking. Meanwhile, potential future therapeutic options are actively being pursued.
- Published
- 2008
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14. Interfacial behavior and film patterning of redox-active cationic copper(II)-containing surfactants.
- Author
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Driscoll JA, Allard MM, Wu L, Heeg MJ, da Rocha SR, and Verani CN
- Subjects
- Cations chemistry, Models, Molecular, Molecular Structure, Oxidation-Reduction, Spectrometry, Mass, Electrospray Ionization, Copper chemistry, Surface-Active Agents chemistry
- Abstract
Herein, we describe the synthesis and characterization of a novel series of single-tail amphiphiles LPyCn (Py=pyridine, Cn=C18, C16, C14, C10) and their copper(II)-containing complexes, which are of relevance for patterned films. The N-(pyridine-2-ylmethyl)alkyl-1-amine ligands and their complexes [CuIICl2(LPyC18)] (1), [CuIICl2(LPyC16)] (2), [CuIICl2(LPyC14)] (3), [CuIIBr2(LPyC18)] (4), [CuIIBr2(LPyC16)] (5), and [CuIIBr2(LPyC10)] (6) were synthesized, isolated, and characterized by means of mass spectrometry, IR and NMR spectroscopies, and elemental analysis. Complexes 1, 2, 3, and 6 had their molecular structure solved by X-ray diffraction methods, which showed that the local geometry around the metal center is distorted square planar. With the aim of using these species as precursors for redox-responsive films, an assessment of their electrochemical properties involved cyclic voltammetry in different solvents, with different supporting electrolytes and scan rates. Density functional theory calculations of relevant species in bulk and at interfaces were used to evaluate their electronic structure and dipole moments. The morphology and order of the resulting films at the air/water interface were studied by isothermal compression and Brewster angle microscopy. Biphasic patterned Langmuir films were observed for all complexes except 3 and 6, and dependence on the chain length and the nature of the halogen coligand determine the characteristics of the isotherms and their intricate topology. Complexes 3 and 6, which have shorter chain lengths, failed to exhibit organization. These results exemplify the first comprehensive study of the behavior of single-tail metallosurfactants, which are likely to lead to high-end technological applications based on their patterned films.
- Published
- 2008
- Full Text
- View/download PDF
15. The epidemiology, pathogenesis and treatment of Pseudomonas aeruginosa infections.
- Author
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Driscoll JA, Brody SL, and Kollef MH
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- Anti-Bacterial Agents administration & dosage, Cross Infection drug therapy, Cross Infection epidemiology, Drug Resistance, Multiple, Bacterial, Humans, Infection Control, Microbial Sensitivity Tests, Pseudomonas Infections epidemiology, Pseudomonas aeruginosa pathogenicity, Virulence, Anti-Bacterial Agents therapeutic use, Cystic Fibrosis complications, Pseudomonas Infections drug therapy, Pseudomonas aeruginosa drug effects
- Abstract
Pseudomonas aeruginosa is an important bacterial pathogen, particularly as a cause of infections in hospitalised patients, immunocompromised hosts and patients with cystic fibrosis. Surveillance of nosocomial P. aeruginosa infections has revealed trends of increasing antimicrobial resistance, including carbapenem resistance and multidrug resistance. Mechanisms of antimicrobial resistance include multidrug efflux pumps, ss-lactamases and downregulation of outer membrane porins. Mechanisms of virulence include secreted toxins and the ability to form biofilms. The effective treatment of infections caused by P. aeruginosa includes prevention when possible, source control measures as necessary and prompt administration of appropriate antibacterial agents. Antibacterial de-escalation should be pursued in patients with an appropriate clinical response, especially when antibacterial susceptibilities are known. Multidrug-resistant P. aeruginosa may require treatment with less commonly used antibacterials (e.g. colistin), but newer anti-pseudomonal antibacterials are expected to be available in the near future.
- Published
- 2007
- Full Text
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16. Is it safe to prescribe hormonal contraception and replacement therapy to patients with premalignant and malignant uterine cervices?
- Author
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Sadan O, Frohlich EP, Driscoll JA, Apostoleris A, Savage N, and Zakut H
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- Adolescent, Adult, Cervix Uteri analysis, Estrogens adverse effects, Female, Humans, Hysterectomy, Middle Aged, Neoplasm Staging, Reference Values, Uterine Cervical Dysplasia analysis, Uterine Cervical Dysplasia surgery, Uterine Cervical Neoplasms analysis, Uterine Cervical Neoplasms surgery, Contraceptives, Oral adverse effects, Estrogens therapeutic use, Receptors, Estrogen analysis, Receptors, Progesterone analysis, Uterine Cervical Dysplasia pathology, Uterine Cervical Neoplasms pathology
- Abstract
The levels of estrogen and progesterone receptors in normal and abnormal uterine cervices were determined. The study group consisted of 14 patients with cervical intraepithelial neoplasia (CIN III) and 7 patients with invasive carcinoma of the cervix (stage IB-IIA). The control group included 23 patients who underwent total abdominal hysterectomy for menorrhagia, leiomyoma, etc. The concentration of total estrogen receptors in premalignant and malignant cervices did not differ from the patients with benign conditions of the cervix. The concentration of progesterone receptors was significantly higher in the nonaffected cervices than in the patients with preinvasive and invasive carcinoma of the cervix (P less than 0.05). We have shown that estrogen receptor concentrations do not differ between women with normal and abnormal uterine cervices. Therefore, we feel that the contraceptive pill is not contraindicated in women who have been treated for CIN III. We also maintain that hormone replacement therapy should be given, when indicated, to women who have been castrated following surgery and/or radiotherapy for invasive carcinoma of the cervix.
- Published
- 1989
- Full Text
- View/download PDF
17. Cord prolapse--can we save more babies? Case reports.
- Author
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Driscoll JA, Sadan O, Van Gelderen CJ, and Holloway GA
- Subjects
- Adult, Delivery, Obstetric, Female, Fetal Death etiology, Fetal Diseases diagnosis, Fetal Monitoring, Humans, Infant, Newborn, Male, Pregnancy, Ultrasonography, Fetal Death diagnosis, Obstetric Labor Complications, Umbilical Cord
- Published
- 1987
- Full Text
- View/download PDF
18. OVARIAN FIBROMA.
- Author
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DRISCOLL JA
- Subjects
- Female, Humans, Ascites, Castration, Fibroma, Leiomyoma, Neoplasms epidemiology, Ovarian Neoplasms, Ovary, Torsion Abnormality
- Published
- 1963
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