Publications by authors named "Trang T Nguyen"

64 Publications

"I am not a good enough caregiver, and it is my fault": The complex self-concept of Vietnamese female caregivers in dementia care.

Authors:
Trang T Nguyen

Dementia (London) 2021 Feb 17:1471301221994359. Epub 2021 Feb 17.

5783Tulane University, LA, USA; Vietnam National University, Hanoi, Vietnam.

In Vietnam, the majority of dementia caregivers are women. They play multiple social roles, confronting role conflicts, and caregiving burdens with insufficient social supports. Dementia caregiving alters their self-concepts, or who and how good they think they are. This secondary analysis study aims to explore self-concepts of Vietnamese female caregivers of people with dementia. In total, data of 21 face-to-face, semi-structured interviews, including six follow-up interviews, conducted with 13 Vietnamese female caregivers of people with dementia, were drawn from a larger study for analysis following the thematic coding procedure. Results showed that the self-concepts of female caregivers in dementia care were complex, contextualized, and manifested in different aspects. First, the guided self and the performed self emerged from the data as the key themes consistently shared by female caregivers. Their guided self was the self that their social norms and cultural traditions told them about who they should be, while their performed self was the self they demonstrated to the outside world. The mismatch between these two types of self (self-discrepancy) caused distress among caregivers. Second, caregivers' self-concept was the combination of the three key types of the self: the moral self (a filial daughter or a responsible wife); the feminine self (a patient and graceful women); and the worthy self (a devoted and helpful caregiver). Understanding Vietnamese female caregivers' self-concepts, self-discrepancy, and its impacts on their well-being can be used to inform the development of interventions and social services for this underserved group.
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http://dx.doi.org/10.1177/1471301221994359DOI Listing
February 2021

Effects of Fermentation Conditions Using Lactobacillus plantarum on the Charantin, Stigmasterol Glucoside and β-sitosterol Glucoside Contents of Bitter Gourd (Momordica charantia L.) Juice.

Plant Foods Hum Nutr 2020 Dec 3;75(4):656-658. Epub 2020 Oct 3.

Food Technology Department, Biotechnology School, International University, Ho Chi Minh City, 700000, Vietnam.

Bitter gourd fruits contain high amounts of charantin, stigmasterol glucoside and β-sitosterol glucoside, which have been shown to provide health benefits for humans. However, the bitterness of the fruit means they are rarely consumed. This study aimed to assess the effects of Lactobacillus plantarum fermentation, which has previously been reported to effectively reduce bitterness, on the contents of these compounds. The current results suggest that Lactobacillus plantarum fermentation should be considered as a potential approach to enhance the levels of these compounds in bitter gourd juice.
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http://dx.doi.org/10.1007/s11130-020-00860-wDOI Listing
December 2020

Secondary metabolites in a neotropical shrub: spatiotemporal allocation and role in fruit defense and dispersal.

Ecology 2020 12 7;101(12):e03192. Epub 2020 Oct 7.

Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, 24061, USA.

Deciphering the ecological roles of plant secondary metabolites requires integrative studies that assess both the allocation patterns of compounds and their bioactivity in ecological interactions. Secondary metabolites have been primarily studied in leaves, but many are unique to fruits and can have numerous potential roles in interactions with both mutualists (seed dispersers) and antagonists (pathogens and predators). We described 10 alkenylphenol compounds from the plant species Piper sancti-felicis (Piperaceae), quantified their patterns of intraplant allocation across tissues and fruit development, and examined their ecological role in fruit interactions. We found that unripe and ripe fruit pulp had the highest concentrations and diversity of alkenylphenols, followed by flowers; leaves and seeds had only a few compounds at detectable concentrations. We observed a nonlinear pattern of alkenylphenol allocation across fruit development, increasing as flowers developed into unripe pulp then decreasing as pulp ripened. This pattern is consistent with the hypothesis that alkenylphenols function to defend fruits from pre-dispersal antagonists and are allocated based on the contribution of the tissue to the plant's fitness, but could also be explained by non-adaptive constraints. To assess the impacts of alkenylphenols in interactions with antagonists and mutualists, we performed fungal bioassays, field observations, and vertebrate feeding experiments. In fungal bioassays, we found that alkenylphenols had a negative effect on the growth of most fungal taxa. In field observations, nocturnal dispersers (bats) removed the majority of infructescences, and diurnal dispersers (birds) removed a larger proportion of unripe infructescences. In feeding experiments, bats exhibited an aversion to alkenylphenols, but birds did not. This observed behavior in bats, combined with our results showing a decrease in alkenylphenols during ripening, suggests that alkenylphenols in fruits represent a trade-off (defending against pathogens but reducing disperser preference). These results provide insight into the ecological significance of a little studied class of secondary metabolites in seed dispersal and fruit defense. More generally, documenting intraplant spatiotemporal allocation patterns in angiosperms and examining mechanisms behind these patterns with ecological experiments is likely to further our understanding of the evolutionary ecology of plant chemical traits.
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http://dx.doi.org/10.1002/ecy.3192DOI Listing
December 2020

Epigenetic Targeting of Mcl-1 Is Synthetically Lethal with Bcl-xL/Bcl-2 Inhibition in Model Systems of Glioblastoma.

Cancers (Basel) 2020 Aug 1;12(8). Epub 2020 Aug 1.

Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY 10032, USA.

Apoptotic resistance remains a hallmark of glioblastoma (GBM), the most common primary brain tumor in adults, and a better understanding of this process may result in more efficient treatments. By utilizing chromatin immunoprecipitation with next-generation sequencing (CHIP-seq), we discovered that GBMs harbor a super enhancer around the Mcl-1 locus, a gene that has been known to confer cell death resistance in GBM. We utilized THZ1, a known super-enhancer blocker, and BH3-mimetics, including ABT263, WEHI-539, and ABT199. Combined treatment with BH3-mimetics and THZ1 led to synergistic growth reduction in GBM models. Reduction in cellular viability was accompanied by significant cell death induction with features of apoptosis, including disruption of mitochondrial membrane potential followed by activation of caspases. Mechanistically, THZ1 elicited a profound disruption of the Mcl-1 enhancer region, leading to a sustained suppression of Mcl-1 transcript and protein levels, respectively. Mechanism experiments suggest involvement of Mcl-1 in the cell death elicited by the combination treatment. Finally, the combination treatment of ABT263 and THZ1 resulted in enhanced growth reduction of tumors without induction of detectable toxicity in two patient-derived xenograft models of GBM in vivo. Taken together, these findings suggest that combined epigenetic targeting of Mcl-1 along with Bcl-2/Bcl-xL is potentially therapeutically feasible.
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http://dx.doi.org/10.3390/cancers12082137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464325PMC
August 2020

An allosteric pocket for inhibition of bacterial Enzyme I identified by NMR-based fragment screening.

J Struct Biol X 2020 21;4:100034. Epub 2020 Jul 21.

Department of Chemistry, Iowa State University, Ames, IA 50011, USA.

Enzyme I (EI), which is the key enzyme to activate the bacterial phosphotransferase system, plays an important role in the regulation of several metabolic pathways and controls the biology of bacterial cells at multiple levels. The conservation and ubiquity of EI among different types of bacteria makes the enzyme a potential target for antimicrobial research. Here, we use NMR-based fragment screening to identify novel inhibitors of EI. We identify three molecular fragments that allosterically inhibit the phosphoryl transfer reaction catalyzed by EI by interacting with the enzyme at a surface pocket located more than 10 Å away from the substrate binding site. Interestingly, although the three molecules share the same binding pocket, we observe that two of the discovered EI ligands act as competitive inhibitors while the third ligand acts as a mixed inhibitor. Characterization of the EI-inhibitor complexes by NMR and Molecular Dynamics simulations reveals key interactions that perturb the fold of the active site and provides structural foundation for the different inhibitory activity of the identified molecular fragments. In particular, we show that contacts between the inhibitor and the side-chain of V292 are crucial to destabilize binding of the substrate to EI. In contrast, mixed inhibition is caused by additional contacts between the inhibitor and ⍺-helix 2 that perturb the active site structure and turnover in an allosteric manner. We expect our results to provide the basis for the development of second generation allosteric inhibitors of increased potency and to suggest novel molecular strategies to combat drug-resistant infections.
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http://dx.doi.org/10.1016/j.yjsbx.2020.100034DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385036PMC
July 2020

Minimally invasive mitral valve replacement and concomitant Cox-Maze IV procedure using radiofrequency energy in situs inversus totalis: A case report.

Int J Surg Case Rep 2020 18;73:285-288. Epub 2020 Jul 18.

University Medical Center Ho Chi Minh City, Viet Nam; University of Medicine and Pharmacy At Ho Chi Minh City, Viet Nam.

Introduction: Situs inversus totalis (SIT) is an uncommon congenital condition characterized by total transposition of abdominal and thoracic viscera. Performing minimally invasive cardiac surgery on individuals with SIT requires different surgical planning because of the unfamiliar positions of the heart and great vessels.

Presentation Of Case: A 52-year-old female was admitted to our center with palpitations and dyspnea on exertion. Chest X-ray showed dextrocardia. Echocardiography and chest computerized tomography (CT) revealed SIT with severe rheumatic mitral valve disease.

Discussion: Pre-operative three-dimensional (3D) chest CT reconstruction was helpful in surgical planning and management of cardiopulmonary bypass (CPB). Mitral valve replacement and concomitant atrial fibrillation (AF) ablation using radiofrequency (RF) energy via left mini-thoracotomy was successfully performed on the patient.

Conclusion: Minimally invasive approach can be safely and effectively employed in patients with SIT.
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http://dx.doi.org/10.1016/j.ijscr.2020.07.053DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388168PMC
July 2020

SIRT7 deficiency suppresses inflammation, induces EndoMT, and increases vascular permeability in primary pulmonary endothelial cells.

Sci Rep 2020 07 27;10(1):12497. Epub 2020 Jul 27.

Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.

Acute lung injury (ALI), a common condition in critically ill patients, has limited treatments and high mortality. Aging is a risk factor for ALI. Sirtuins (SIRTs), central regulators of the aging process, decrease during normal aging and in aging-related diseases. We recently showed decreased SIRT7 expression in lung tissues and fibroblasts from patients with pulmonary fibrosis compared to controls. To gain insight into aging-related mechanisms in ALI, we investigated the effects of SIRT7 depletion on lipopolysaccharide (LPS)-induced inflammatory responses and endothelial barrier permeability in human primary pulmonary endothelial cells. Silencing SIRT7 in pulmonary artery or microvascular endothelial cells attenuated LPS-induced increases in ICAM1, VCAM1, IL8, and IL6 and induced endomesenchymal transition (EndoMT) with decreases in VE-Cadherin and PECAM1 and increases in collagen, alpha-smooth muscle actin, TGFβ receptor 1, and the transcription factor Snail. Loss of endothelial adhesion molecules was accompanied by increased F-actin stress fibers and increased endothelial barrier permeability. Together, these results show that an aging phenotype induced by SIRT7 deficiency promotes EndoMT with impaired inflammatory responses and dysfunction of the lung vascular barrier.
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http://dx.doi.org/10.1038/s41598-020-69236-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385158PMC
July 2020

Inhibition of HDAC1/2 Along with TRAP1 Causes Synthetic Lethality in Glioblastoma Model Systems.

Cells 2020 07 10;9(7). Epub 2020 Jul 10.

Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY 10032, USA.

The heterogeneity of glioblastomas, the most common primary malignant brain tumor, remains a significant challenge for the treatment of these devastating tumors. Therefore, novel combination treatments are warranted. Here, we showed that the combined inhibition of TRAP1 by gamitrinib and histone deacetylases (HDAC1/HDAC2) through romidepsin or panobinostat caused synergistic growth reduction of established and patient-derived xenograft (PDX) glioblastoma cells. This was accompanied by enhanced cell death with features of apoptosis and activation of caspases. The combination treatment modulated the levels of pro- and anti-apoptotic Bcl-2 family members, including BIM and Noxa, Mcl-1, Bcl-2 and Bcl-xL. Silencing of Noxa, BAK and BAX attenuated the effects of the combination treatment. At the metabolic level, the combination treatment led to an enhanced reduction of oxygen consumption rate and elicited an unfolded stress response. Finally, we tested whether the combination treatment of gamitrinib and panobinostat exerted therapeutic efficacy in PDX models of glioblastoma (GBM) in mice. While single treatments led to mild to moderate reduction in tumor growth, the combination treatment suppressed tumor growth significantly stronger than single treatments without induction of toxicity. Taken together, we have provided evidence that simultaneous targeting of TRAP1 and HDAC1/2 is efficacious to reduce tumor growth in model systems of glioblastoma.
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http://dx.doi.org/10.3390/cells9071661DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407106PMC
July 2020

Mitral prosthetic size predictor in minimally invasive mitral valve replacement.

J Cardiothorac Surg 2020 Jun 18;15(1):147. Epub 2020 Jun 18.

Cardiovascular surgery department, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh city, 215 Hong Bang St - District 05, Ho Chi Minh City, Vietnam.

Background: Minimally invasive mitral valve replacement has become popular across the world. However, annular rupture and patient - prosthetic mismatch (PPM) are still problematic, particularly in the Asian population. To avoid this, a predictor model could be beneficial. Our study aimed to assess the value of mitral valve diameters measured on TTE and CT scan on predicting the actual mitral prostheses.

Methods: From January 2018 to December 2019, a total number of 96 patients underwent minimally invasive mitral valve replacement. The association between imaging measurements and the outcome was checked by scatter plot and Pearson's correlation coefficient. Univariable linear regression was used to build the prediction model.

Results: The three strongest correlations for the whole population are the following features: Mean TTE diameter (0.702), mean diameter on CT lowest plane through the mitral annulus (0.679), and area-derived diameter on CT highest plane through the mitral annulus (0.665). The prosthetic size of the tissue valve group was more correlated to the calculated annulus diameters than that of the mechanical valve group. Tissue valve size predictor models based on these calculated diameters were 16.19 + 0.27 × d (r = 0.744), 12.74 + 0.44 × d (r = 0.756) and 12.79 + 0.38 × d (r = 0.730), respectively.

Conclusion: Mitral prosthetic size could be predicted based on the mitral diameters measured on TTE and CT scan. The overall correlation coefficient varied from 0.665 (CT Scan) to 0.702 (TTE). These models performed better when applied to bioprosthesis.
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http://dx.doi.org/10.1186/s13019-020-01197-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301474PMC
June 2020

Allelopathic Potential of Rice and Identification of Published Allelochemicals by Cloud-Based Metabolomics Platform.

Metabolites 2020 Jun 15;10(6). Epub 2020 Jun 15.

College of Agriculture and Applied Biosciences-Can Tho University, Can Tho 94000, Vietnam.

The methanol extracts of nine popular cultivated Vietnamese rice cultivars ( L.cv. OM 2395, 5451, 6976, 380, 5930, 4498, 3536, N406, and 7347) were used to explore their allelopathic potential on barnyardgrass ( L.). At 0.1 g mL, OM 5930, OM 4498, and OM 6976 correlatively possessed greatest phytotoxicity on barnyardgrass shoot (98.77%, 90.75%, and 87.17%) and root (99.39%, 92.83%, and 86.56%) growth. The following study aimed to detect previously-known allelochemicals in those rice using XCMS online cloud-based metabolomics platform. Twenty allelochemicals were semi-quantified and seven of them were detected predominantly and five was putatively confirmed in OM 5930 (mg/ 100g fresh rice) as salicylic acid (5.0076), vanillic acid (0.1246), -coumaric acid (0.1590), 2,4-dimethoxybenzoic acid (0.1045), and cinnamic acid (3.3230). These compounds were active at concentrations greater than 0.5 mM and the average EC were 1.24 mM. The results indicated that OM 5930 may use as promising candidates in weed biological control for rice production.
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http://dx.doi.org/10.3390/metabo10060244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344986PMC
June 2020

Hybrid Thermophilic/Mesophilic Enzymes Reveal a Role for Conformational Disorder in Regulation of Bacterial Enzyme I.

J Mol Biol 2020 07 3;432(16):4481-4498. Epub 2020 Jun 3.

Department of Chemistry, Iowa State University, Ames, IA 50011, USA; Roy J. Carver Department of Biochemistry, Biophysics and Molecular Biology, Iowa State University, Ames, IA 50011, USA. Electronic address:

Conformational disorder is emerging as an important feature of biopolymers, regulating a vast array of cellular functions, including signaling, phase separation, and enzyme catalysis. Here we combine NMR, crystallography, computer simulations, protein engineering, and functional assays to investigate the role played by conformational heterogeneity in determining the activity of the C-terminal domain of bacterial Enzyme I (EIC). In particular, we design chimeric proteins by hybridizing EIC from thermophilic and mesophilic organisms, and we characterize the resulting constructs for structure, dynamics, and biological function. We show that EIC exists as a mixture of active and inactive conformations and that functional regulation is achieved by tuning the thermodynamic balance between active and inactive states. Interestingly, we also present a hybrid thermophilic/mesophilic enzyme that is thermostable and more active than the wild-type thermophilic enzyme, suggesting that hybridizing thermophilic and mesophilic proteins is a valid strategy to engineer thermostable enzymes with significant low-temperature activity.
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http://dx.doi.org/10.1016/j.jmb.2020.05.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7963438PMC
July 2020

Investigation on the Growth Mechanism of Cu MoS Nanotube, Nanoplate and its use as a Catalyst for Hydrogen Evolution in Water.

Chem Asian J 2020 Jun 28;15(12):1873-1880. Epub 2020 May 28.

University of Science and Technology of Hanoi, Vietnam Academy of Science and Technology, 18 Hoang Quoc Viet, Hanoi, Vietnam.

Cu MoS is a ternary transition-metal sulfide that shows great potential in the field of energy conversion and storage, namely catalytic H evolution in water and Li-, Na- or Mg-ion battery. In this work, we report on a growth mechanism of the single-crystalline Cu MoS nanotube from (NH ) MoS salt and Cu O nanoparticle. By probing the nature and morphology of solid products generated in function of reaction conditions we find that the crystalline Cu(NH )MoS nanorod is first generated at ambient conditions. The nanorod is then converted into Cu MoS nanotube under hydrothermal treatment due to the Kirkendall effect or a selective etching of the Cu MoS core. Extending the hydrothermal treatment causes a collapse of nanotube generating Cu MoS nanoplate. The catalytic activities of these sulfides are investigated. The Cu MoS shows superior catalytic activity to that of Cu(NH )MoS . Catalytic performance of the former largely depends on its morphology. The nanoplate shows superior catalytic activity to the nanotube, thanks to its higher specific electrochemical surface area.
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http://dx.doi.org/10.1002/asia.202000344DOI Listing
June 2020

Regulation of Lipid Membrane Partitioning of Tamoxifen by Ionic Strength and Cholesterol.

Pharm Res 2020 Feb 10;37(3):53. Epub 2020 Feb 10.

School of Biotechnology, International University, Block 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, Vietnam.

Purpose: The purpose of this study was to inspect the interactions between an anti-breast cancer, TAM, with model of lipid membranes composed of either zwitterionic DPPC LUVs or anionic DPPG LUVs and how they depend on ionic strength and cholesterol.

Methods: The K of TAM into DPPC and DPPG LUVs were determined at three different NaCl concentrations by second derivative UV-Vis spectrophotometry. The effect of cholesterol incorporated into these LUVs on TAM's K was also assessed. The ATR-FTIR measurements were carried out to verify structural changes within the acyl chain and head group regions of the liposomes upon TAM partitioning.

Results: Increasing salt concentration produced negligible impact on the partitioning of TAM into DPPC bilayer as its K remained unaffected whilst induced outstanding reduction of TAM's K into DPPG liposomes. Furthermore, TAM was found to disorder the lipids' acyl chains, which could result in an increase in the membrane fluidity, a necessary piece of information to refer to when prescribing TAM dosage for administration. Additionally, cholesterol showed astoundingly opposite contribution to the partitioning of TAM into the LUVs, as its K value reduced in DPPC/Chol bilayer yet increased in DPPG/Chol liposomes.

Conclusion: Ionic strength and cholesterol play a noteworthy role in regulation of TAM partitioning into lipid membranes as they could obstruct or promote such action.
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http://dx.doi.org/10.1007/s11095-020-2771-8DOI Listing
February 2020

Contrasting effects of stored allogeneic red blood cells and their supernatants on permeability and inflammatory responses in human pulmonary endothelial cells.

Am J Physiol Lung Cell Mol Physiol 2020 03 8;318(3):L533-L548. Epub 2020 Jan 8.

Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland.

Transfusion of red blood cells (RBCs) is a common life-saving clinical practice in severely anemic or hemorrhagic patients; however, it may result in serious pathological complications such as transfusion-related acute lung injury. The factors mediating the deleterious effects of RBC transfusion remain unclear. In this study, we tested the effects of washed long-term (RBC-O; >28 days) versus short-term (RBC-F; <14 days) stored RBCs and their supernatants on lung endothelial (EC) permeability under control and inflammatory conditions. RBCs enhanced basal EC barrier function as evidenced by an increase in transendothelial electrical resistance and decrease in permeability for macromolecules. RBCs also attenuated EC hyperpermeability and suppressed secretion of EC adhesion molecule ICAM-1 and proinflammatory cytokine IL-8 in response to LPS or TNF-α. In both settings, RBC-F had slightly higher barrier protective effects as compared with RBC-O. In contrast, supernatants from both RBC-F and RBC-O disrupted the EC barrier. The early phase of EC permeability response caused by RBC supernatants was partially suppressed by antioxidant -acetyl cysteine and inhibitor of Src kinase family PP2, while addition of heme blocker and inhibition of NOD-like receptor family pyrin domain containing protein 3 (NLRP3), stress MAP kinases, receptor for advanced glycation end-products (RAGE), or Toll-like receptor-4 (TLR4) signaling were without effect. Morphological analysis revealed that RBC supernatants increased LPS- and TNF-α-induced breakdown of intercellular junctions and formation of paracellular gaps. RBC supernatants augmented LPS- and TNF-α-induced EC inflammation reflected by increased production of IL-6, IL-8, and soluble ICAM-1. These findings demonstrate the deleterious effects of RBC supernatants on EC function, which may have a major impact in pathological consequences associated with RBC transfusion.
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http://dx.doi.org/10.1152/ajplung.00025.2019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7099434PMC
March 2020

Outcomes of Head and Neck Microvascular Reconstruction in Hypercoagulable Patients.

J Reconstr Microsurg 2020 May 13;36(4):271-275. Epub 2019 Dec 13.

Department of Plastic Surgery, University of Kansas Medical Center, Kansas City, Kansas.

Background:  Inherited coagulopathies and previous thrombotic events are often considered relative contraindications to microvascular reconstruction. We hypothesize that with planning, head and neck microvascular reconstruction can be successfully performed in hypercoagulable individuals.

Methods:  A retrospective review was conducted of subjects with coagulopathies or previous thrombotic events who underwent microvascular head and neck reconstruction. Outcomes studied were "flap-related complications" (arterial/venous compromise or flap loss) and "patient-related complications" (hematoma, deep venous thrombosis, pulmonary embolism, infection, stroke, or death).

Results:  One hundred thirty-four microvascular flaps were performed in 117 subjects. Twenty-four subjects (20.5%) had a preoperative hypercoagulable condition and underwent 28 microvascular reconstructions. Twenty-three of 24 subjects had a previous thrombotic event, with five subjects identified with an inherited or acquired coagulopathy. All microvascular reconstructions were successful; however, complications occurred in 12 of 28 reconstructions (42.9%). Complications were "flap related" in four reconstructions (14.3%), "patient related" in nine reconstructions (32.1%), and both in one reconstruction (3.6%). Flap-related complications included small partial flap loss ( = 2), arterial compromise ( = 1), and venous compromise ( = 1), with all undergoing successful salvage. Patient-related complications included hematoma ( = 3), pulmonary embolism ( = 2), infection ( = 2), deep venous thrombosis ( = 1), and death ( = 1). Statistical analysis demonstrated that complications were more common in subjects with inferior vena cava filters ( = 0.06) and hematomas were associated with the use of therapeutic heparin infusion ( = 0.04).

Conclusion:  Microvascular head and neck reconstruction can be successfully performed in hypercoagulable subjects. However, patient-related complications remain a concern in these subjects.
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http://dx.doi.org/10.1055/s-0039-3401846DOI Listing
May 2020

Novel IDH1-Targeted Glioma Therapies.

CNS Drugs 2019 12;33(12):1155-1166

Department of Pathology and Cell Biology, Columbia University Medical Center, 630 West 168th Street, P&S Rm. 15-415, New York, NY, 10032, USA.

Mutations in the isocitrate dehydrogenase (IDH) 1 gene are commonly found in human glioma, with the majority of low-grade gliomas harboring a recurrent point mutation (IDH1 R132H). Mutant IDH reveals an altered enzymatic activity leading to the synthesis of 2-hydroxyglutarate, which has been implicated in epigenetic mechanisms of oncogenesis. Nevertheless, it is unclear exactly how IDH mutations drive glioma initiation and progression, and it is also not clear why tumors with this mutation generally have a better prognosis than IDH wild-type tumors. Recognition of the high frequency of IDH mutations in glioma [and also in other malignancies, including acute myeloid leukemia (AML) and cholangiocarcinoma] have led to the development of a number of targeted agents that can inhibit these enzymes. Enasidenib and ivosidenib have both gained regulatory approval for IDH mutant AML. Both agents are still in early clinical phases for glioma therapy, as are a number of additional candidates (including AG-881, BAY1436032, and DS1001). A marked clinical problem in the development of these agents is overcoming the blood-brain barrier. An alternative approach to target the IDH1 mutation is by the induction of synthetic lethality with compounds that target poly (ADP-ribose) polymerase (PARP), glutamine metabolism, and the Bcl-2 family of proteins. We conclude that within the last decade, several approaches have been devised to therapeutically target the IDH1 mutation, and that, potentially, both IDH1 inhibitors and synthetic lethal approaches might be relevant for future therapies.
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http://dx.doi.org/10.1007/s40263-019-00684-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027940PMC
December 2019

MET Inhibition Elicits PGC1α-Dependent Metabolic Reprogramming in Glioblastoma.

Cancer Res 2020 01 6;80(1):30-43. Epub 2019 Nov 6.

Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York.

The receptor kinase c-MET has emerged as a target for glioblastoma therapy. However, treatment resistance emerges inevitably. Here, we performed global metabolite screening with metabolite set enrichment coupled with transcriptome and gene set enrichment analysis and proteomic screening, and identified substantial reprogramming of tumor metabolism involving oxidative phosphorylation and fatty acid oxidation (FAO) with substantial accumulation of acyl-carnitines accompanied by an increase of PGC1α in response to genetic (shRNA and CRISPR/Cas9) and pharmacologic (crizotinib) inhibition of c-MET. Extracellular flux and carbon tracing analyses (U-C-glucose, U-C-glutamine, and U-C-palmitic acid) demonstrated enhanced oxidative metabolism, which was driven by FAO and supported by increased anaplerosis of glucose carbons. These findings were observed in concert with increased number and fusion of mitochondria and production of reactive oxygen species. Genetic interference with PGC1α rescued this oxidative phenotype driven by c-MET inhibition. Silencing and chromatin immunoprecipitation experiments demonstrated that cAMP response elements binding protein regulates the expression of PGC1α in the context of c-MET inhibition. Interference with both oxidative phosphorylation (metformin, oligomycin) and β-oxidation of fatty acids (etomoxir) enhanced the antitumor efficacy of c-MET inhibition. Synergistic cell death was observed with c-MET inhibition and gamitrinib treatment. In patient-derived xenograft models, combination treatments of crizotinib and etomoxir, and crizotinib and gamitrinib were significantly more efficacious than single treatments and did not induce toxicity. Collectively, we have unraveled the mechanistic underpinnings of c-MET inhibition and identified novel combination therapies that may enhance its therapeutic efficacy. SIGNIFICANCE: c-MET inhibition causes profound metabolic reprogramming that can be targeted by drug combination therapies.
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http://dx.doi.org/10.1158/0008-5472.CAN-19-1389DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6942623PMC
January 2020

Minimally invasive aortic valve reconstruction with autologous pericardium: how we do it.

Ann Cardiothorac Surg 2019 May;8(3):444-446

Department of Surgery, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.

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http://dx.doi.org/10.21037/acs.2019.05.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6562072PMC
May 2019

Distributions of Extracellular Peptidases Across Prokaryotic Genomes Reflect Phylogeny and Habitat.

Front Microbiol 2019 5;10:413. Epub 2019 Mar 5.

Department of Microbiology, Oregon State University, Corvallis, OR, United States.

Proteinaceous compounds are abundant forms of organic nitrogen in soil and aquatic ecosystems, and the rate of protein depolymerization, which is accomplished by a diverse range of microbial secreted peptidases, often limits nitrogen turnover in the environment. To determine if the distribution of secreted peptidases reflects the ecological and evolutionary histories of different taxa, we analyzed their distribution across prokaryotic lineages. Peptidase gene sequences of 147 archaeal and 2,191 bacterial genomes from the MEROPS database were screened for secretion signals, resulting in 55,072 secreted peptidases belonging to 148 peptidase families. These data, along with their corresponding 16S rRNA sequences, were used in our analysis. Overall, had a much wider collection of secreted peptidases, higher average numbers of secreted peptidases per genome, and more unique peptidase families than . We found that the distribution of secreted peptidases corresponded to phylogenetic relationships among and and often segregated according to microbial lifestyles, suggesting that the secreted peptidase complements of microbial taxa are optimized for the environmental microhabitats they occupy. Our analyses provide the groundwork for examining the specific functional role of families of secreted peptidases in relationship to the organisms and the corresponding environments in which they function.
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http://dx.doi.org/10.3389/fmicb.2019.00413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6411800PMC
March 2019

Minimally Invasive Ozaki Procedure in Aortic Valve Disease: The Preliminary Results.

Innovations (Phila) 2018 Sep/Oct;13(5):332-337

Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

Objective: The Ozaki procedure for aortic valve reconstruction was reported in 2014 with low mortality, a highly reproducible rate and a good midterm result. However, the procedure still requires conventional sternotomy to be accomplished. The aim of the study was to start an initial evaluation for the feasibility of the minimally invasive approach in combination with the Ozaki technique.

Methods: From January 06, 2017, to January 12, 2017, nine patients with severe aortic valve diseases underwent minimally invasive Ozaki procedure through an upper ministernotomy. The pericardium was harvested endoscopically using three trocars in different intercostal spaces. Then, a ministernotomy was performed and the Ozaki procedure was accomplished in a similar manner to the conventional technique. We analyzed the in-hospital mortality and complications of this group.

Results: The mean age was 47.4 years and 55.6% patients were female. The predominant pathology was chronic rheumatic valve disease (66.7%) and other patients were diagnosed with a bicuspid aortic valve. The mean aortic cross-clamp time was 106.8 minutes, the mean cardiopulmonary bypass time was 153.6 minutes, the mean ventilation time was 8.4 hours, and the mean intensive care unit time was 1.6 days. No mortality was recorded in our series, no conversion to full sternotomy was required, one patient experienced right hemothorax requiring drainage, and one patient required valve replacement. Intraoperative transesophageal echocardiography and predischarge transthoracic echocardiography showed five competent valves and three valves with trivial regurgitation, and no stenosis was detected.

Conclusions: Ministernotomy combined with Ozaki procedure might be feasible, as well as an alternative to conventional sternotomy. This approach is associated with low mortality and morbidity and may be beneficial in younger populations.
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http://dx.doi.org/10.1097/IMI.0000000000000556DOI Listing
March 2019

Active Site Breathing of Human Alkbh5 Revealed by Solution NMR and Accelerated Molecular Dynamics.

Biophys J 2018 11 11;115(10):1895-1905. Epub 2018 Oct 11.

Department of Chemistry, Biophysics and Molecular Biology, Iowa State University, Ames, Iowa; Roy J. Carver Department of Biochemistry, Biophysics and Molecular Biology, Iowa State University, Ames, Iowa. Electronic address:

AlkB homolog 5 (Alkbh5) is one of nine members of the AlkB family, which are nonheme Fe/α-ketoglutarate-dependent dioxygenases that catalyze the oxidative demethylation of modified nucleotides and amino acids. Alkbh5 is highly selective for the N-methyladenosine modification, an epigenetic mark that has spawned significant biological and pharmacological interest because of its involvement in important physiological processes, such as carcinogenesis and stem cell differentiation. Herein, we investigate the structure and dynamics of human Alkbh5 in solution. By using N and C relaxation dispersion and N-R and R NMR experiments, we show that the active site of apo Alkbh5 experiences conformational dynamics on multiple timescales. Consistent with this observation, backbone amide residual dipolar couplings measured for Alkbh5 in phage pf1 are inconsistent with the static crystal structure of the enzyme. We developed a simple approach that combines residual dipolar coupling data and accelerated molecular dynamics simulations to calculate a conformational ensemble of Alkbh5 that is fully consistent with the experimental NMR data. Our structural model reveals that Alkbh5 is more disordered in solution than what is observed in the crystal state and undergoes breathing motions that expand the active site and allow access to α-ketoglutarate. Disordered-to-ordered conformational changes induced by sequential substrate/cofactor binding events have been often invoked to interpret biochemical data on the activity and specificity of AlkB proteins. The structural ensemble reported in this work provides the first atomic-resolution model of an AlkB protein in its disordered conformational state to our knowledge.
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http://dx.doi.org/10.1016/j.bpj.2018.10.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6303414PMC
November 2018

Metabolic Reprogramming by Dual AKT/ERK Inhibition through Imipridones Elicits Unique Vulnerabilities in Glioblastoma.

Clin Cancer Res 2018 11 23;24(21):5392-5406. Epub 2018 Jul 23.

Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York.

The goal of this study is to enhance the efficacy of imipridones, a novel class of AKT/ERK inhibitors that displayed limited therapeutic efficacy against glioblastoma (GBM). Gene set enrichment, LC/MS, and extracellular flux analyses were used to determine the mechanism of action of novel imipridone compounds, ONC206 and ONC212. Orthotopic patient-derived xenografts were utilized to evaluate therapeutic potency. Imipridones reduce the proliferation of patient-derived xenograft and stem-like glioblastoma cell cultures and in multiple xenograft models ONC212 displayed the highest potency. High levels of c-myc predict susceptibility to growth inhibition and apoptosis induction by imipridones and increased host survival in orthotopic patient-derived xenografts. As early as 1 hour, imipridones elicit on-target inhibition, followed by dephosphorylation of GSK3β at serine 9. GSK3β promotes phosphorylation of c-myc at threonine 58 and enhances its proteasomal degradation. Moreover, inhibition of c-myc by BRD4 antagonists sensitizes for imipridone-induced apoptosis in stem-like GBM cells and Imipridones affect energy metabolism by suppressing both glycolysis and oxidative phosphorylation, which is accompanied by a compensatory activation of the serine-one carbon-glycine (SOG) pathway, involving the transcription factor ATF4. Interference with the SOG pathway through novel inhibitors of PHGDH results in synergistic cell death induction and These results suggest that c-myc expression predicts therapeutic responses to imipridones and that imipridones lead to suppression of tumor cell energy metabolism, eliciting unique metabolic vulnerabilities that can be exploited for clinical relevant drug combination therapies. .
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http://dx.doi.org/10.1158/1078-0432.CCR-18-1040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6214769PMC
November 2018

Abnormal Gastroesophageal Flap Valve Is Associated With High Gastresophageal Reflux Disease Questionnaire Score and the Severity of Gastroesophageal Reflux Disease in Vietnamese Patients With Upper Gastrointestinal Symptoms.

J Neurogastroenterol Motil 2018 Apr;24(2):226-232

Health Service Center, Hiroshima University, Higashihiroshima, Japan.

Background/aims: There have been no studies investigating the distribution of abnormal gastroesophageal flap valve (GEFV) among patients with dyspepsia, non-erosive reflux disease (NERD), and reflux esophagitis (RE) in the same set of patients. The aims of this study are to investigate (1) the association between GEFV and gastroesophageal reflux disease questionnaire (GERDQ) score, and (2) the distribution of abnormal GEFV in Vietnamese patients presenting with upper gastrointestinal symptoms.

Methods: Three hundred and thirty-one patients recruited in this prospective cross-sectional study were classified into 3 groups: reflux esophagitis (RE), non-erosive reflux disease (NERD) (GERDQ score ≥ 8, no endoscopic mucosal injury), and dyspepsia (GERDQ score < 8, no endoscopic mucosal injury). The GEFV was graded endoscopically according to the Hill classification. GEFV grades I and II were regarded as normal, while grades III and IV were regarded as abnormal GEFV.

Results: There were 215 (65.0%) patients with dyspepsia, 55 (16.6%) patients with NERD, and 61 (18.4%) patients with RE. Abnormal GEFV was an independent risk factor for GERD (OR, 2.93; CI 95%, 1.76-4.88) and RE (OR, 3.41; CI 95%, 1.78-6.53). The mean GERDQ score of patients with abnormal GEFV was significantly higher than that of patients with normal GEFV (5.7 ± 2.4 vs 4.9 ± 2.7, = 0.011). The prevalence of abnormal GEFV gradually increased in patients with dyspepsia (27.4%), NERD (43.6%), grade A RE (56.8%), and grades B/C RE (80.0%) ( < 0.001).

Conclusions: Abnormal GEFV was significantly associated with high GERDQ score. Its prevalence gradually increased in patients with dyspepsia, NERD, and RE, respectively.
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http://dx.doi.org/10.5056/jnm17088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5885721PMC
April 2018

Acute retrograde type A intramural hematoma treated with an endovascular approach.

Asian Cardiovasc Thorac Ann 2018 May 27;26(4):308-310. Epub 2018 Mar 27.

1 Cardiovascular Surgery Department, University Medical Center, 377386 Ho Chi Minh City University of Medicine and Pharmacy , Ho Chi Minh City, Vietnam.

A 71-year-old woman was admitted with sudden onset of severe chest pain. Computed tomography demonstrated acute type A intramural hematoma with an entry tear in the first part of the descending aorta. The patient refused an operation. Endovascular repair was performed to prevent conversion to a typical dissection of the ascending aorta. At the 1-year follow-up, computed tomography showed total resolution of the intramural hematoma.
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http://dx.doi.org/10.1177/0218492318766791DOI Listing
May 2018

The oligomerization state of bacterial enzyme I (EI) determines EI's allosteric stimulation or competitive inhibition by α-ketoglutarate.

J Biol Chem 2018 02 9;293(7):2631-2639. Epub 2018 Jan 9.

From the Department of Chemistry and

The bacterial phosphotransferase system (PTS) is a signal transduction pathway that couples phosphoryl transfer to active sugar transport across the cell membrane. The PTS is initiated by phosphorylation of enzyme I (EI) by phosphoenolpyruvate (PEP). The EI phosphorylation state determines the phosphorylation states of all other PTS components and is thought to play a central role in the regulation of several metabolic pathways and to control the biology of bacterial cells at multiple levels, for example, affecting virulence and biofilm formation. Given the pivotal role of EI in bacterial metabolism, an improved understanding of the mechanisms controlling its activity could inform future strategies for bioengineering and antimicrobial design. Here, we report an enzymatic assay, based on Selective Optimized Flip Angle Short Transient (SOFAST) NMR experiments, to investigate the effect of the small-molecule metabolite α-ketoglutarate (αKG) on the kinetics of the EI-catalyzed phosphoryl transfer reaction. We show that at experimental conditions favoring the monomeric form of EI, αKG promotes dimerization and acts as an allosteric stimulator of the enzyme. However, when the oligomerization state of EI is shifted toward the dimeric species, αKG functions as a competitive inhibitor of EI. We developed a kinetic model that fully accounted for the experimental data and indicated that bacterial cells might use the observed interplay between allosteric stimulation and competitive inhibition of EI by αKG to respond to physiological fluctuations in the intracellular environment. We expect that the mechanism for regulating EI activity revealed here is common to several other oligomeric enzymes.
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http://dx.doi.org/10.1074/jbc.RA117.001466DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818175PMC
February 2018

On the interaction between fluoxetine and lipid membranes: Effect of the lipid composition.

Spectrochim Acta A Mol Biomol Spectrosc 2018 Feb 20;191:50-61. Epub 2017 Sep 20.

School of Biotechnology, International University, Vietnam National University in HCMC, Block 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, Viet Nam. Electronic address:

Molecular interaction between the antidepressant fluoxetine and lipid bilayers was investigated in order to provide insights into the drug's incorporation to lipid membranes. In particular, the effects of lipid's unsaturation degree and cholesterol content on the partitioning of fluoxetine into large unilamellar vesicles (LUVs) comprised of unsaturated 1,2-dioleoyl-sn-glycero-3-phosphocholine (DOPC) and saturated 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) were evaluated using second derivative spectrophotometry and Attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR). It was found that fluoxetine partitioned to a greater extent into the liquid-crystalline DOPC LUVs than into the solid-gel DPPC LUVs. The lipid physical state dependence of drug partitioning was verified by increasing the temperature in which the partition coefficient of fluoxetine significantly increased upon the change of the lipid phase from solid-gel to liquid-crystalline. The incorporation of 28mol% cholesterol into the LUVs exerted a significant influence on the drug partitioning into both DOPC and DPPC LUVs. The ATR-FTIR study revealed that fluoxetine perturbed the conformation of DOPC more strongly than that of DPPC due to the cis-double bonds in the lipid acyl chains. Fluoxetine possibly bound to the carbonyl moiety of the lipids through the hydrogen bonding formation while displaced some water molecules surrounding the PO regions of the lipid head groups. Cholesterol, however, could lessen the interaction between fluoxetine and the carbonyl groups of both DOPC and DPPC LUVs. These findings provided a better understanding of the role of lipid structure and cholesterol on the interaction between fluoxetine and lipid membranes, shedding more light into the drug's therapeutic action.
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http://dx.doi.org/10.1016/j.saa.2017.09.050DOI Listing
February 2018

sIgM-FcμR Interactions Regulate Early B Cell Activation and Plasma Cell Development after Influenza Virus Infection.

J Immunol 2017 09 26;199(5):1635-1646. Epub 2017 Jul 26.

Center for Comparative Medicine, University of California Davis, Davis, CA 95616;

Previous studies with mice lacking secreted IgM (sIgM) due to a deletion of the splice region ( ) had shown sIgM involvement in normal B cell development and in support of maximal Ag-specific IgG responses. Because of the changes to B cell development, it remains unclear to which extent and how sIgM directly affects B cell responses. In this study, we aimed to explore the underlying mechanisms of sIgM-mediated IgG response regulation during influenza virus infection. Generating mice with normally developed μs-deficient B cells, we demonstrate that sIgM supports IgG responses by enhancing early Ag-specific B cell expansion, not by altering B cell development. Lack of FcμR expression on B cells, but not lack of Fcα/μR expression or complement activation, reduced antiviral IgG responses to the same extent as observed in μs mice. B cell-specific mice lacked robust clonal expansion of influenza hemagglutinin-specific B cells early after infection and developed fewer spleen and bone marrow IgG plasma cells and memory B cells, compared with controls. However, germinal center responses appeared unaffected. Provision of sIgM rescued plasma cell development from μs but not B cells, as demonstrated with mixed bone marrow chimeric mice. Taken together, the data suggest that sIgM interacts with FcμR on B cells to support early B cell activation and the development of long-lived humoral immunity.
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http://dx.doi.org/10.4049/jimmunol.1700560DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568459PMC
September 2017

Effect of electrostatic interaction between fluoxetine and lipid membranes on the partitioning of fluoxetine investigated using second derivative spectrophotometry and FTIR.

Chem Phys Lipids 2017 10 3;207(Pt A):10-23. Epub 2017 Jul 3.

School of Biotechnology, International University, Vietnam National University in HCMC, Block 6, Linh Trung Ward, Thu Duc District, Ho Chi Minh City, Viet Nam. Electronic address:

The interaction between a drug molecule and lipid bilayers is highly important regarding the pharmaceutical activity of the drug. In this study, the interaction of fluoxetine, a well-known selective serotonin reuptake inhibitor antidepressant and lipid bilayers composed of 1,2-dipalmitoyl-sn-glycero-3-phospho-(1'-rac-glycerol) (DPPG) and 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) was studied from the aspect of electrostatics using second derivative spectrophotometry and Fourier transform infrared spectroscopy (FTIR) in order to provide insights into the drug behavior. Changing pH from 7.4 to 9.5 to increases the neutral state of fluoxetine, the partitioning of fluoxetine into the zwitterionic DPPC large unilamellar vesicles (LUVs) was increased whereas it was reduced into the negatively charged DPPG LUVs. Fluoxetine was found to exhibit a disordering effect on the acyl chains of DPPC and DPPG bilayers upon its partitioning. In addition, increasing concentration of NaCl lessened the binding of fluoxetine into DPPG bilayers due to the reduction in electrostatic attraction between positively charged fluoxetine and negatively charged DPPG LUVs. In addition, the FTIR study revealed that increasing the NaCl concentration could trigger the shift to higher frequency of the CH stretching as well as the notable blue shift in the PO regions of DPPG, indicating that fluoxetine had deeper penetration into DPPG LUVs. The differences in the NaCl concentration showed a negligible effect on the incorporation of fluoxetine into the zwitterionic DPPC LUVs. In summary, the electrostatic interaction plays an important role on the partitioning of a cationic amphiphilic SSIR drug into the lipid bilayers and the drug partitioning induces the lipids' conformational change. These imply a possible influence on the drug pharmacology.
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http://dx.doi.org/10.1016/j.chemphyslip.2017.07.001DOI Listing
October 2017

Yellow Pattern 577-nm Micropulse Laser: Treatment of Macular Edema from Radiation Retinopathy - A Case Report.

Case Rep Ophthalmol 2017 Jan-Apr;8(1):81-86. Epub 2017 Feb 2.

Strathfield Retina Clinic, Sydney, NSW, Australia.

We report a case of a 60-year-old Asian male who developed radiation retinopathy 23 years after initial radiotherapy for nasopharyngeal carcinoma and was successfully treated with yellow pattern 577-nm micropulse laser. Secondary macular edema and visual acuity improved following a single treatment session with minimal scarring. Yellow pattern micropulse laser is a safe and effective treatment for macular edema secondary to radiation retinopathy.
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http://dx.doi.org/10.1159/000456028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346916PMC
February 2017

Errors in the Administration Technique of Insulin Pen Devices: A Result of Insufficient Education.

Diabetes Ther 2017 Apr 4;8(2):221-226. Epub 2017 Mar 4.

University of Oklahoma College of Pharmacy, Oklahoma, USA.

Insulin is a high-alert medication in both inpatient and outpatient settings. Insulin can cause significant harm when administered in error. Despite advancements in insulin pen technology, errors in the administration technique remain an issue. Although various factors can contribute to administration errors, lack of education on how to operate these devices is one of the most common reasons they occur. As such, the mechanical technique used by the patient needs to be continually assessed in order to reinforce education where needed. We describe three unique patient cases that depict incorrect administration techniques when using pen devices and the consequences that could have resulted from these errors. These cases involve the use of a syringe instead of a pen needle, injecting without removing the inner cap, and dialing the pen back down instead of pushing the plunger. Although pen devices are relatively simple to use, this article reinforces the need for continual assessment of and education about insulin administration. The teach-back method is an approach that can be used to assess a patient's technique and re-educate them at every available opportunity to reduce the risk of administration errors, which can result in complications and hospitalizations.
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http://dx.doi.org/10.1007/s13300-017-0242-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5380504PMC
April 2017