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Search Results: 1 - 10 of 8975 matches for " Anne Kessinger "
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Outcome of Combined Hepatocellular and Cholangiocarcinoma of the Liver
Jue Wang,Fenwei Wang,Anne Kessinger
Journal of Oncology , 2010, DOI: 10.1155/2010/917356
Abstract: Background. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of combined hepatocellular and cholangiocarcinoma (cHCC-CC) using population-based registry. Methods. The Surveillance, Epidemiology, and End Results Program database (1973–2004) was used to identify cases of cHCC-CC. Multivariable logistic regression was used to evaluate factors associated with cancer-directed surgery (CDS). The influence of CDS on cancer specific survival was evaluated using Kaplan-Meier curves and Cox proportional hazards modeling. Results. A total of 380 cases of cHCC-CC were identified, which account for approximately 0.87% of primary liver tumors. Of all patients, 69.8% of patients had regional or distant stage; 65.6% of patients had poorly or undifferentiated histology. Only 44.9% of patients with localized disease, received CDS. By logistic regression analysis, being widowed, advanced stage, and earlier diagnosis year were associated with lower rate of utilization of CDS. In multivariate analysis, tumor stage, receipt of CDS, and recent year of diagnosis were found to be significant predictors for cancer-specific survival. Conclusions. Patients with localized cHCC-CC who are selected for CDS were strongly associated with improved survival. However, many patients with localized tumors did not receive potentially curative cancer-directed surgery. Further study is warranted to address the barriers to the delivery of appropriate care to these patients. 1. Introduction Combined hepatocellular and cholangiocarcinoma (cHCC-CC) is an uncommon subtype of primary liver cancer [1, 2]. The disease was first described in 1949 by Allen and Lisa and has been defined as the intimate intermingling of both a HCC component and CC component Two histopathological classification schemes have been proposed Allen and Lisa [1] described three groups, type A with HCC and CC present at different sites within the same liver, and type B with HCC and CC present at adjacent sites and mingle with continued growth, and type C with HCC and CC are combined in the same tumor. Goodman et al. [2] categorized cHCC-CC into three types: collision type, transitional type, and fibrolamellar type. Kim et al. [3] and Zhang et al. [4] proposed that cHCC-CC is a distinct type of primary liver carcinoma, which is morphologically and phenotypically intermediate between HCC and CC and may be derived from hepatic progenitor cells with the bipotential to differentiate into both hepatocytic and cholangiocytic lineages. Because of the rarity of cHCC-CC, previously
The Natural History and Outcomes of the Patients with Carcinosarcoma Involving Kidney and Renal Pelvis
Jue Wang,Fen Wei Wang,Anne Kessinger
Advances in Urology , 2011, DOI: 10.1155/2011/693964
Abstract: Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP) using population-based registry. Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER) database and reviewed. Results. 79% of all patients with known SEER stage were classified as having regional or distant stage; almost all the patients with known histology grade had poorly or undifferentiated histology. The median cancer specific survival was 6 months (95% CI 4–9). The 1-year cancer-specific survival rate for entire cohort was 30.2%. There were no differences in terms of age at diagnosis, histological grade, tumor stage on presentation, and frequency of nephrectomy between carcinosarcoma of kidney (CSK) or renal pelvis (CSP). In multivariate analysis, age at diagnosis, tumor stage, and year of diagnosis were found to be significant predictors for cancer-specific survival. Conclusion. CSKP commonly presented as high-grade, advanced stage disease, and was associated with a poor prognosis regardless of location. 1. Background Carcinosarcoma (CS) is a highly aggressive tumor composed of mixed malignant epithelial and mesenchymal components [1]. Carcinosarcoma of the kidney or renal pelvis (CSKP) is a rare malignancy of the genitourinary system. To date, fewer than 20 well-documented cases have been reported in the medical literature [2–10]. Most of the reported cases were carcinosarcoma of the renal pelvis (CSP) [2, 4–9]; only few cases were from kidney (CSK) [3, 10]. The histogenesis of carcinosarcomas remains a matter of controversy [3, 5, 8, 11]. Two main mechanisms were suggested: the “collision” or “multiclonal” hypothesis posits that the epithelial and mesenchymal components are distinct coexisting populations with different cells of origin [3]. The alternative “monoclonal” hypothesis suggests that carcinosarcoma arises from a single multipotent stem cell that differentiates along epithelial and mesenchymal pathways [11]. Due to the rareness of the disease, current literature on carcinosarcoma of the genitourinary system predominantly consists of a single case report and histopathological studies [2–10], the demographic features and clinical behavior of these tumors remain ill-defined; in addition, the survival of CSK and CSP was never directly compared. In this study, a comprehensive analysis was performed to examine the epidemiology, natural
Clinicopathologic characteristics of primary pleural epithelioid hemangioendothelioma
Chad A. Reade,Apar Kishor Ganti,Anne Kessinger
Oncology Reviews , 2011, DOI: 10.4081/68
Abstract: Epithelioid hemangioendothelioma (EHE) is a rare vascular-derived malignancy. Within the thorax, EHE originating in the pleura is less often reported than EHE originating in the lung. Pulmonary EHE has been referred to as a borderline or low-grade malignancy that exhibits an unpredictable course. It often is associated with a long life expectancy and occasional spontaneous remission. Because the natural history of pleural EHE is less well understood, a literature review was conducted to investigate the characteristics of the disease. Twenty-two cases of pleural EHE were identified. The disease occurred more often in men than women, appeared in the right thorax more often than the left, exhibited a virulent course, was usually refractory to systemic therapy, and was often associated with a short survival. These characteristics differ substantially from those of pulmonary EHE and suggest that the clinician should approach pleural EHE anticipating an especially aggressive malignancy which likely will not respond to current therapeutic measures.
Clinical Features of Sarcomatoid Carcinoma (Carcinosarcoma) of the Urinary Bladder: Analysis of 221 Cases
Jue Wang,Fen Wei Wang,Chad A. LaGrange,George P. Hemstreet III,Anne Kessinger
Sarcoma , 2010, DOI: 10.1155/2010/454792
Abstract: Background. Urinary bladder sarcomatoid carcinoma (carcinosarcoma) is rare. The objective of this study was to examine the epidemiology, natural history, and prognostic factors of urinary bladder carcinosarcoma using population-based registry. Methods. The Surveillance, Epidemiology, and End Results (SEER) Program database was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined. Results. A total of 221 histology confirmed cases were identified between 1973 and 2004, this accounted for approximately 0.11% of all primary bladder tumors during the study period. Median age of the patients was 75 years (range 41–96). Of the patients with a known tumor stage (=204), 72.5% had a regional or distant stage; 98.4% of patients with known histology grade (=127), had poorly or undifferentiated histology. Multiple primary tumors were indentified in about 40% of study subjects. The majority of patients (95.9%) received cancer directed surgery, 35.8% had radical or partial cystectomy, 15.8% of patients received radiation therapy combination with surgery. The median overall survival was 14 months (95% CI 7–21 months). 1-, 5-, and 10-year cancer specific survival rate were 53.9%, 28.4% and 25.8%. In a multivariate analysis, only tumor stage was found to be a significant prognostic factor for disease-specific survival. Conclusions. Urinary bladder carcinosarcoma commonly presented as high grade, advanced stage and aggressive behavior with a poor prognosis. Emphasis on early detection, including identification of risk factors is needed to improve the outcome for patients with this malignancy.
Inferring HIV escape rates from multi-locus genotype data
Taylor A. Kessinger,Alan S. Perelson,Richard A. Neher
Quantitative Biology , 2013, DOI: 10.3389/fimmu.2013.00252
Abstract: Cytotoxic T-lymphocytes (CTLs) recognize viral protein fragments displayed by major histocompatibility complex (MHC) molecules on the surface of virally infected cells and generate an anti-viral response that can kill the infected cells. Virus variants whose protein fragments are not efficiently presented on infected cells or whose fragments are presented but not recognized by CTLs therefore have a competitive advantage and spread rapidly through the population. We present a method that allows a more robust estimation of these escape rates from serially sampled sequence data. The proposed method accounts for competition between multiple escapes by explicitly modeling the accumulation of escape mutations and the stochastic effects of rare multiple mutants. Applying our method to serially sampled HIV sequence data, we estimate rates of HIV escape that are substantially larger than those previously reported. The method can be extended to complex escapes that require compensatory mutations. We expect our method to be applicable in other contexts such as cancer evolution where time series data is also available.
Coalescence, genetic diversity in sexual populations under selection
Richard A. Neher,Taylor A. Kessinger,Boris I. Shraiman
Quantitative Biology , 2013, DOI: 10.1073/pnas.1309697110
Abstract: In sexual populations, selection operates neither on the whole genome, which is repeatedly taken apart and reassembled by recombination, nor on individual alleles that are tightly linked to the chromosomal neighborhood. The resulting interference between linked alleles reduces the efficiency of selection and distorts patterns of genetic diversity. Inference of evolutionary history from diversity shaped by linked selection requires an understanding of these patterns. Here, we present a simple but powerful scaling analysis identifying the unit of selection as the genomic "linkage block" with a characteristic length determined in a self-consistent manner by the condition that the rate of recombination within the block is comparable to the fitness differences between different alleles of the block. We find that an asexual model with the strength of selection tuned to that of the linkage block provides an excellent description of genetic diversity and the site frequency spectra when compared to computer simulations. This linkage block approximation is accurate for the entire spectrum of strength of selection and is particularly powerful in scenarios with many weakly selected loci. The latter limit allows us to characterize coalescence, genetic diversity, and the speed of adaptation in the infinitesimal model of quantitative genetics.
Investigation of In Vivo Targeting Kinetics of αvβ3-Specific Superparamagnetic Nanoprobes by Time-Resolved MRI
Chase W. Kessinger, Osamu Togao, Chalermchai Khemtong, Gang Huang, Masaya Takahashi, Jinming Gao
Theranostics , 2011,
Abstract: Nanoparticulate imaging probes have become an increasingly important arsenal in the visualization of molecular markers for early diagnosis and post-therapy assessment of diseases. Surface functionalization of these nanoparticles has led to the development of a variety of targeted nanoprobes for various imaging modalities (e.g. PET, MRI, optical). Despite these advances, detailed understanding of the nanoparticle targeting kinetics, particularly at the early time points immediately after injection, is still lacking. In this study, we report the combination of a T2*-weighted time-resolved-MRI (TR-MRI) method with ultra-sensitive superparamagnetic polymeric micelle (SPPM) nanoprobes to quantify the targeting kinetics of cyclic (RGDfK) (cRGD)-encoded SPPM to angiogenic endothelium in subcutaneous human tumor xenograft models in mice. TR-MRI analyses of the αvβ3-targeted and non-targeted SPPMs allowed for the subtraction of blood volume and extravascular signal components from the cRGD-SPPM data, resulting in a specific measurement of the accumulation kinetics of nanoprobes in lung, breast and brain cancer preclinical models. In all three models, αvβ3-specific accumulation of SPPM nanoprobes was observed in the first 5 mins after intravenous injection (first order rate constants were in the range of 0.22-0.24 min-1). Similar αvβ3-targeting kinetics was observed for cRGD-SPPM nanoprobes in different tumor xenograft models, consistent with the targeting of mouse angiogenic endothelium despite tumor inoculation from different human cancer cell lines. Results from this study offer new opportunities in the quantitative characterization of the targeting kinetics of cancer-specific nanoparticles to their intended biological targets in an intact animal, which provides fundamental insights on molecular recognition processes in vivo for further development of these nanoprobes.
The Occurrence of Cryptosporidium and Giardia Infections Among Patients Reporting Diarrheal Disease in Chobe District, Botswana  [PDF]
Kathleen Anne Alexander, Joel Herbein, Anne Zajac
Advances in Infectious Diseases (AID) , 2012, DOI: 10.4236/aid.2012.24023
Abstract: Diarrheal disease is a chronic public health problem in Chobe District, Botswana. Acute diarrheal outbreaks occur annually with a bimodal seasonal pattern coinciding with major hydrological phenomena. Information is lacking regarding the etiology of reoccurring outbreaks. Cryptosporidium and Giardia are recognized as important waterborne causes of diarrheal disease with Cryptosporidium transmission potentially involving zoonotic reservoirs. In Chobe District, municipal water is obtained from the Chobe River after it exits the Chobe National Park where high concentrations of wildlife occur. Using the Giardia/Cryptosporidium QUIK CHEK rapid antigen cartridge test, we evaluate the occurrence of Giardia and Cryptosporidium among patients (n = 153) presenting to medical facilities in Chobe District with diarrhea (August 2011-July 2012). Cryptosporidium was only identified in children less than two years of age (10%, n = 42, 95% CI 3% - 23%), with positive cases occurring during diarrheal outbreak periods. Infections were not identified in adults despite the high level of human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) in the region (n = 117). Although not significant, cases were predominately identified in the wet season outbreak (p = 0.94, 25%, n = 12, 95% CI 5% - 57%, dry season outbreaks 3%, n = 30, CI 95% 0% - 17%). Giardia infections occurred across age groups and seasons (7%, n = 153, 95% CI 4% - 10%). This is the first published report of human infections with Cryptosporidium and Giardia in this area of Africa. This study suggests that Cryptosporidium may be a potentially important cause of diarrheal disease in children less than 2 years of age in this region. Further research is required to identify pathogen transmission and persistence dynamics and public health implications, particularly the role of HIV/AIDS and vulnerability to waterborne disease.
VIX and VIX Futures Pricing Algorithms: Cultivating Understanding  [PDF]
Hancock G. D’Anne
Modern Economy (ME) , 2012, DOI: 10.4236/me.2012.33038
Abstract: This article reviews the development of the S&P 500 volatility index and uses market information to develop algorithms which aid in clarifying some of the salient points in the determination of an index value. Understanding the pertinent points provides insight into the interpretation and limitations of the usefulness of the VIX and other VIX-type contracts.
The general motor programmer: its specialization for speech perception & movement  [PDF]
Anne Maria Keane
World Journal of Neuroscience (WJNS) , 2012, DOI: 10.4236/wjns.2012.23024
Abstract: A common neural mechanism—the General Motor Programmer—is proposed by Keane (1999) to underlie both the perception of speech and the initiation of hand movement. A proposal to investigate the specific aspect of cognitive functioning this mechanism is specialized for, namely the timing or place of articulation, is outlined.
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