Background Adenocarcinomas of the tongue are rare and represent the minority (20 to 25%) of saliv... more Background Adenocarcinomas of the tongue are rare and represent the minority (20 to 25%) of salivary gland tumors affecting the tongue. We investigated the utility of massively parallel sequencing to characterize an adenocarcinoma of the tongue, before and after treatment. Results In the pre-treatment tumor we identified 7,629 genes within regions of copy number gain. There were 1,078 genes that exhibited increased expression relative to the blood and unrelated tumors and four genes contained somatic protein-coding mutations. Our analysis suggested the tumor cells were driven by the RET oncogene. Genes whose protein products are targeted by the RET inhibitors sunitinib and sorafenib correlated with being amplified and or highly expressed. Consistent with our observations, administration of sunitinib was associated with stable disease lasting 4 months, after which the lung lesions began to grow. Administration of sorafenib and sulindac provided disease stabilization for an additional 3 months after which the cancer progressed and new lesions appeared. A recurring metastasis possessed 7,288 genes within copy number amplicons, 385 genes exhibiting increased expression relative to other tumors and 9 new somatic protein coding mutations. The observed mutations and amplifications were consistent with therapeutic resistance arising through activation of the MAPK and AKT pathways. Conclusions We conclude that complete genomic characterization of a rare tumor has the potential to aid in clinical decision making and identifying therapeutic approaches where no established treatment protocols exist. These results also provide direct in vivo genomic evidence for mutational evolution within a tumor under drug selection and potential mechanisms of drug resistance accrual.
Archives of Environmental & Occupational Health, 2006
Awka has been the site of increased human activities since it became a state capital in 1991. Bec... more Awka has been the site of increased human activities since it became a state capital in 1991. Because refuse dumps have hitherto been a disregarded environmental menace in Nigeria, the authors sought to find out how much of the current environmental metal pollutant load comes from refuse dumps. They investigated the metal contamination of the refuse dumps in Awka. The authors collected four soil samples (from the surface and from depths of 0.45 m, 0.90 m, and 1.35 m) from 5 dumpsites digested with nitric acid and perchloric acid, and they analyzed iron, sodium, arsenic, lead, magnesium, potassium, cobalt, zinc, nickel, copper, chromium, and cadmium by using an atomic absorption spectrophotometer. Sites A and C showed the highest levels of arsenic (2300 mg/kg) and lead (2467 mg/kg), respectively. Site D had highest level of both iron (72,200 mg/kg) and sodium (3561 mg/kg), whereas Site E had the lowest level of lead (572 mg/kg). The metal levels exceed the limits set forth by the US Environmental Protection Agency. This study suggests that the refuse dumps in Awka may increase the level of environmental heavy metals in Nigeria.
We present an analysis of a mountain bike front shock failure. The failure of the 1-year-old shoc... more We present an analysis of a mountain bike front shock failure. The failure of the 1-year-old shock occurred catastrophically as the bike was ridden off of a 1-m drop. The failure was the result of fast fracture through both shock tubes at the location where the tubes were press fit into the shock upper crown. Examination of the fracture surfaces
Nasal airway obstruction is a frequently-encountered problem, often secondary to inferior turbina... more Nasal airway obstruction is a frequently-encountered problem, often secondary to inferior turbinate hypertrophy. Medical treatment can be beneficial but is inadequate for many individuals. For these refractory cases, surgical intervention plays a key role in management. The authors evaluate the current trends in surgical management of inferior turbinate hypertrophy and review the senior author's (SS) preferred technique. A questionnaire was devised and sent to members of the American Society for Aesthetic Plastic Surgery (ASAPS) to determine their preferred methods for assessment and treatment of inferior turbinate hypertrophy. One hundred and twenty-seven physicians responded to the survey, with 85% of surveys completed fully. Of the responses, 117 (92%) respondents were trained solely in plastic surgery and 108 (86.4%) were in private practice. Roughly 81.6% of respondents employ a clinical exam alone to evaluate for airway issues. The most commonly-preferred techniques to treat inferior turbinate hypertrophy were a limited turbinate excision (61.9%) and turbinate outfracture (35.2%). Based on the results of this study, it appears that limited turbinate excision and turbinate outfracture are the most commonly-used techniques in private practice by plastic surgeons. Newer techniques such as radiofrequency coblation have yet to become prevalent in terms of application, despite their current prevalence within the medical literature. The optimal method of management for inferior turbinate reduction should take into consideration the surgeon's skill and preference, access to surgical instruments, mode of anesthesia, and the current literature.
Background Adenocarcinomas of the tongue are rare and represent the minority (20 to 25%) of saliv... more Background Adenocarcinomas of the tongue are rare and represent the minority (20 to 25%) of salivary gland tumors affecting the tongue. We investigated the utility of massively parallel sequencing to characterize an adenocarcinoma of the tongue, before and after treatment. Results In the pre-treatment tumor we identified 7,629 genes within regions of copy number gain. There were 1,078 genes that exhibited increased expression relative to the blood and unrelated tumors and four genes contained somatic protein-coding mutations. Our analysis suggested the tumor cells were driven by the RET oncogene. Genes whose protein products are targeted by the RET inhibitors sunitinib and sorafenib correlated with being amplified and or highly expressed. Consistent with our observations, administration of sunitinib was associated with stable disease lasting 4 months, after which the lung lesions began to grow. Administration of sorafenib and sulindac provided disease stabilization for an additional 3 months after which the cancer progressed and new lesions appeared. A recurring metastasis possessed 7,288 genes within copy number amplicons, 385 genes exhibiting increased expression relative to other tumors and 9 new somatic protein coding mutations. The observed mutations and amplifications were consistent with therapeutic resistance arising through activation of the MAPK and AKT pathways. Conclusions We conclude that complete genomic characterization of a rare tumor has the potential to aid in clinical decision making and identifying therapeutic approaches where no established treatment protocols exist. These results also provide direct in vivo genomic evidence for mutational evolution within a tumor under drug selection and potential mechanisms of drug resistance accrual.
Archives of Environmental & Occupational Health, 2006
Awka has been the site of increased human activities since it became a state capital in 1991. Bec... more Awka has been the site of increased human activities since it became a state capital in 1991. Because refuse dumps have hitherto been a disregarded environmental menace in Nigeria, the authors sought to find out how much of the current environmental metal pollutant load comes from refuse dumps. They investigated the metal contamination of the refuse dumps in Awka. The authors collected four soil samples (from the surface and from depths of 0.45 m, 0.90 m, and 1.35 m) from 5 dumpsites digested with nitric acid and perchloric acid, and they analyzed iron, sodium, arsenic, lead, magnesium, potassium, cobalt, zinc, nickel, copper, chromium, and cadmium by using an atomic absorption spectrophotometer. Sites A and C showed the highest levels of arsenic (2300 mg/kg) and lead (2467 mg/kg), respectively. Site D had highest level of both iron (72,200 mg/kg) and sodium (3561 mg/kg), whereas Site E had the lowest level of lead (572 mg/kg). The metal levels exceed the limits set forth by the US Environmental Protection Agency. This study suggests that the refuse dumps in Awka may increase the level of environmental heavy metals in Nigeria.
We present an analysis of a mountain bike front shock failure. The failure of the 1-year-old shoc... more We present an analysis of a mountain bike front shock failure. The failure of the 1-year-old shock occurred catastrophically as the bike was ridden off of a 1-m drop. The failure was the result of fast fracture through both shock tubes at the location where the tubes were press fit into the shock upper crown. Examination of the fracture surfaces
Nasal airway obstruction is a frequently-encountered problem, often secondary to inferior turbina... more Nasal airway obstruction is a frequently-encountered problem, often secondary to inferior turbinate hypertrophy. Medical treatment can be beneficial but is inadequate for many individuals. For these refractory cases, surgical intervention plays a key role in management. The authors evaluate the current trends in surgical management of inferior turbinate hypertrophy and review the senior author's (SS) preferred technique. A questionnaire was devised and sent to members of the American Society for Aesthetic Plastic Surgery (ASAPS) to determine their preferred methods for assessment and treatment of inferior turbinate hypertrophy. One hundred and twenty-seven physicians responded to the survey, with 85% of surveys completed fully. Of the responses, 117 (92%) respondents were trained solely in plastic surgery and 108 (86.4%) were in private practice. Roughly 81.6% of respondents employ a clinical exam alone to evaluate for airway issues. The most commonly-preferred techniques to treat inferior turbinate hypertrophy were a limited turbinate excision (61.9%) and turbinate outfracture (35.2%). Based on the results of this study, it appears that limited turbinate excision and turbinate outfracture are the most commonly-used techniques in private practice by plastic surgeons. Newer techniques such as radiofrequency coblation have yet to become prevalent in terms of application, despite their current prevalence within the medical literature. The optimal method of management for inferior turbinate reduction should take into consideration the surgeon's skill and preference, access to surgical instruments, mode of anesthesia, and the current literature.
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