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( Edward Gane ),( Amoreena C Corsa ),( Yang Liu ),( Ben C Mitchell2 ),( John F Flaherty ),( Michael D Miller ),( Kathryn M Kitrinos ),( Scott Fung ) 대한간학회 2013 춘·추계 학술대회 (KASL) Vol.2013 No.1
Background/Aim: To evaluate amino acid changes within HBV pol/RT after 96 weeks of treatment with TDF or FTC/ TDF and determine their potential association with TDF resistance. Methods: In Study GS-US-174-0121, 280 patients receiving lamivudine (LAM) with detectable LAM-resistance mutations in HBV pol/RT (LAM-R: rtM204V/I±rtL180M) were randomized 1:1 to receive blinded treatment with TDF or FTC/TDF for 96 weeks. Virologic breakthrough (VB) was defined as confirmed HBV DNA >1 log10 increase from nadir or HBV DNA ≥400 copies/mL (69 IU/mL) after <400 copies/mL. Resistance genotyping by HBV pol/RT sequencing was attempted for all patients at baseline and if viremic (HBV DNA ≥400 copies/ mL) at Week 96/study discontinuation. Results: Overall, 18 patients (9 TDF, 9 FTC/TDF) were viremic viremic at Week 96/last visit. The mean baseline HBV DNA was significantly higher for viremic patients (8.04 log10 copies/mL) compared to patients who did not qualify for genotyping (6.39 log10 copies/mL). In the TDF arm, 3 patients had conserved site changes/reversions (1 with VB), 1 had unique polymorphic site changes, 2 had no change, and 3 were unable to be genotyped. In the FTC/TDF arm, 2 patients had conserved site changes/reversions, 1 had unique polymorphic site changes, 4 had no change, and 2 were unable to be genotyped. No phenotypic resistance to TDF was observed. Four of eight (50%) patients had LAM-R reversions (rtV/I204M±rtM180L) on TDF while 1/8 (12.5%) patients on FTC/TDF had LAM-R reversions. Thirteen patients (4.6%) with prior entecavir (ETV) exposure and 25 patients (8.9%) with baseline ETV-R were enrolled; neither had an impact on viral kinetics. Conclusions: No TDF resistance has been detected through 96 weeks of treatment with either TDF or FTC/TDF in LAM-R patients. The presence of ETV-R or ETV exposure did not impact viral kinetics through 96 weeks. Resistance surveillance in this population will continue through Year 5.
Goodsitt, Mitchell M,Shenoy, Apeksha,Shen, Jincheng,Howard, David,Schipper, Matthew J,Wilderman, Scott,Christodoulou, Emmanuel,Chun, Se Young,Dewaraja, Yuni K The American Association of Physicists in Medicine 2014 Medical physics Vol.41 No.5
<P>To evaluate a three-equation three-unknown dual-energy quantitative CT (DEQCT) technique for determining region specific variations in bone spongiosa composition for improved red marrow dose estimation in radionuclide therapy.</P>
Christodoulides Alexei,Mitchell Scott,Bohnstedt Bradley N. 대한외상학회 2022 大韓外傷學會誌 Vol.35 No.3
In this report, we present a case of high cervical penetrating trauma with vertebral artery injury and outline preprocedural, procedural, and postprocedural considerations with recommendations for the treatment of similar injuries. Management involves multiple imaging modalities, including X-ray imaging, computed tomography, computed tomography angiography, magnetic resonance imaging, and catheter angiography. We recommend endovascular treatment of these injuries when possible, based on the improved ability to achieve proximal and distal control and manage hemorrhage risk.
Jung, Sook-In,Finkel, Jonathan S.,Solis, Norma V.,Chaili, Siyang,Mitchell, Aaron P.,Yeaman, Michael R.,Filler, Scott G. American Society for Microbiology 2013 EUKARYOTIC CELL Vol.12 No.3
<P>In order to colonize the host and cause disease, <I>Candida albicans</I> must avoid being killed by host defense peptides. Previously, we determined that the regulatory protein Ssd1 governs antimicrobial peptide resistance in <I>C. albicans</I>. Here, we sought to identify additional genes whose products govern susceptibility to antimicrobial peptides. We discovered that a <I>bcr1</I>Δ/Δ mutant, like the <I>ssd1</I>Δ/Δ mutant, had increased susceptibility to the antimicrobial peptides, protamine, RP-1, and human β defensin-2. Homozygous deletion of <I>BCR1</I> in the <I>ssd1</I>Δ/Δ mutant did not result in a further increase in antimicrobial peptide susceptibility. Exposure of the <I>bcr1</I>Δ/Δ and <I>ssd1</I>Δ/Δ mutants to RP-1 induced greater loss of mitochondrial membrane potential and increased plasma membrane permeability than with the control strains. Therefore, Bcr1 and Ssd1 govern antimicrobial peptide susceptibility and likely function in the same pathway. Furthermore, <I>BCR1</I> mRNA expression was downregulated in the <I>ssd1</I>Δ/Δ mutant, and the forced expression of <I>BCR1</I> in the <I>ssd1</I>Δ/Δ mutant partially restored antimicrobial peptide resistance. These results suggest that Bcr1 functions downstream of Ssd1. Interestingly, overexpression of 11 known Bcr1 target genes in the <I>bcr1</I>Δ/Δ mutant failed to restore antimicrobial peptide resistance, suggesting that other Bcr1 target genes are likely responsible for antimicrobial peptide resistance. Collectively, these results demonstrate that Bcr1 functions downstream of Ssd1 to govern antimicrobial peptide resistance by maintaining mitochondrial energetics and reducing membrane permeabilization.</P>
Management of gunshot wounds near the elbow: experiences at a high-volume level I trauma center
Umar Ghilzai,Abdullah Ghali,Aaron Singh,Thomas Wesley Mitchell,Scott A. Mitchell 대한견주관절학회 2024 대한견주관절의학회지 Vol.27 No.1
Background: Gunshot-related fractures near the elbow are challenging, and available data to guide the practitioner are lacking. This report analyzes injury patterns and treatment strategies in a case series from a high-volume urban trauma center. Methods: All periarticular gunshot fractures near the elbow treated at a level 1 trauma center from 2014 to 2018 were retrospectively reviewed. Fracture location, patient demographics, concomitant injuries, treatment modalities, and complications were analyzed. Results: Twenty-four patients were identified. All patients received prophylactic antibiotics upon admission and underwent urgent surgical debridement. Open reduction and internal fixation (ORIF) was performed with initial debridement in 22 of 24 patients. Seven patients sustained distal humerus fractures, 10 patients sustained isolated proximal ulna or proximal radius fractures, and seven had combined fracture patterns. Eleven patients presented with nerve palsy, and two had transected nerves. Two patients had vascular injury requiring repair. One patient required a temporary elbow-spanning external fixator and underwent staged debridement followed by ORIF. One patient with a grade IIIC fracture developed a deep infection that precluded ORIF. One patient required revision ORIF due to fracture displacement. Conclusions: This investigation reports on management of ballistic fractures near the elbow at a busy urban level I trauma center. Our management centered on rapid debridement, early definitive fixation, and intravenous antibiotic administration. We report on associated neurovascular injury, bone loss, and other challenges in this patient population. Level of evidence: IV.