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  1. Article ; Online: Novel Approaches to Ovarian Cancer Screening.

    Nebgen, Denise R / Lu, Karen H / Bast, Robert C

    Current oncology reports

    2019  Volume 21, Issue 8, Page(s) 75

    Abstract: Purpose of review: Both conventional and novel approaches to early detection of ovarian cancer are reviewed in the context of new developments in our understanding of ovarian cancer biology.: Recent findings: While CA125 as a single value lacks ... ...

    Abstract Purpose of review: Both conventional and novel approaches to early detection of ovarian cancer are reviewed in the context of new developments in our understanding of ovarian cancer biology.
    Recent findings: While CA125 as a single value lacks adequate specificity or sensitivity for screening, large studies have shown that a 2-stage strategy which tracks CA125 change over time and prompts transvaginal ultrasound (TVS) for a small subset of women with abnormally rising biomarker values achieves adequate specificity and detects a higher fraction of early-stage disease. Sensitivity could clearly be improved in both blood tests and in imaging. Metastasis can occur from ovarian cancers too small to increase blood levels of protein antigens and a significant fraction of ovarian cancers arise from the fimbriae of fallopian tubes that cannot be imaged with TVS. Autoantibodies, miRNA, ctDNA, DNA methylation in blood, and cervical mucus might improve sensitivity of the initial phase and magnetic relaxometry and autofluorescence could improve imaging in the second phase. Enhancing the sensitivity of two-stage strategies for early detection could reduce mortality from ovarian cancer.
    MeSH term(s) Biomarkers, Tumor/blood ; Early Detection of Cancer ; Fallopian Tubes/pathology ; Female ; Humans ; Ovarian Neoplasms/blood ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/diagnostic imaging ; Ovarian Neoplasms/pathology ; Papanicolaou Test ; Sensitivity and Specificity ; Ultrasonography ; Vaginal Smears
    Chemical Substances Biomarkers, Tumor
    Language English
    Publishing date 2019-07-26
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2057359-5
    ISSN 1534-6269 ; 1523-3790
    ISSN (online) 1534-6269
    ISSN 1523-3790
    DOI 10.1007/s11912-019-0816-0
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  2. Article ; Online: Abnormal Uterine Bleeding as the Presenting Symptom of Hematologic Cancer.

    Nebgen, Denise R / Rhodes, Helen E / Hartman, Cynthia / Munsell, Mark F / Lu, Karen H

    Obstetrics and gynecology

    2016  Volume 128, Issue 2, Page(s) 357–363

    Abstract: Objective: To estimate the percentage of women with a hematologic cancer who present with abnormal uterine bleeding (AUB).: Methods: We performed a retrospective analysis of the records of women with hematologic malignancies treated at our ... ...

    Abstract Objective: To estimate the percentage of women with a hematologic cancer who present with abnormal uterine bleeding (AUB).
    Methods: We performed a retrospective analysis of the records of women with hematologic malignancies treated at our institution from January 2002 through January 2016. Women with AUB as the chief presenting symptom were identified.
    Results: Of the 10,682 women with hematologic malignancies, 38 had AUB as their chief presenting symptom. These women were young (median age 34 years), premenopausal, and otherwise healthy. The top four additional presenting symptoms were fatigue, dyspnea or shortness of breath, bruising or petechiae, and fever, with means (95% confidence interval) of 58% (41-74%), 42% (26-59%), 42% (26-59%), and 24% (11-40%), respectively. The complete blood count on initial presentation with AUB revealed that 33 (87%) women had anemia (mean hemoglobin level 8.6 g/dL) and 34 (89%) had thrombocytopenia (mean platelet count 81,000/microliter). Twelve (32%) women had neutropenia, eight (21%) women had normal white blood cell counts, and 18 (47%) women had leukocytosis. Thirty-three women (87%) were diagnosed with acute leukemia, one with myelodysplastic syndrome (3%) and four (11%) with chronic leukemia.
    Conclusion: We estimate the incidence of AUB as the chief presenting symptom is 3.6 cases per 1,000 women with hematologic cancer. These young, otherwise healthy women who present with acute, new-onset heavy menstrual bleeding in conjunction with thrombocytopenia or pancytopenia should be referred to hematology for evaluation of possible hematologic malignancy.
    MeSH term(s) Adolescent ; Adult ; Aged ; Anemia/etiology ; Dyspnea/etiology ; Fatigue/etiology ; Female ; Fever/etiology ; Humans ; Leukemia/blood ; Leukemia/complications ; Leukemia/diagnosis ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis ; Leukemia, Myeloid, Acute/blood ; Leukemia, Myeloid, Acute/complications ; Leukemia, Myeloid, Acute/diagnosis ; Leukocytosis/etiology ; Middle Aged ; Myelodysplastic Syndromes/blood ; Myelodysplastic Syndromes/complications ; Myelodysplastic Syndromes/diagnosis ; Neutropenia/etiology ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis ; Purpura/etiology ; Retrospective Studies ; Thrombocytopenia/etiology ; Uterine Hemorrhage/etiology ; Young Adult
    Language English
    Publishing date 2016-07-11
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 207330-4
    ISSN 1873-233X ; 0029-7844
    ISSN (online) 1873-233X
    ISSN 0029-7844
    DOI 10.1097/AOG.0000000000001529
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  3. Article ; Online: Using Social Media to Facilitate Communication About Women's Testing: Tool Validation Study.

    Coffin, Tara / Bowen, Deborah / Lu, Karen / Swisher, Elizabeth M / Rayes, Nadine / Norquist, Barbara / Blank, Stephanie V / Levine, Douglas A / Bakkum-Gamez, Jamie Nadine / Fleming, Gini F / I Olopade, Olufunmilayo / Romero, Iris / D'Andrea, Alan / Nebgen, Denise R / Peterson, Christine / Munsell, Mark F / Gavin, Kathleen / Crase, Jamie / Polinsky, Deborah /
    Lechner, Rebecca

    JMIR formative research

    2022  Volume 6, Issue 9, Page(s) e35035

    Abstract: Background: Strong participant recruitment practices are critical to public health research but are difficult to achieve. Traditional recruitment practices are often time consuming, costly, and fail to adequately target difficult-to-reach populations. ... ...

    Abstract Background: Strong participant recruitment practices are critical to public health research but are difficult to achieve. Traditional recruitment practices are often time consuming, costly, and fail to adequately target difficult-to-reach populations. Social media platforms such as Facebook are well-positioned to address this area of need, enabling researchers to leverage existing social networks and deliver targeted information. The MAGENTA (Making Genetic Testing Accessible) study aimed to improve the availability of genetic testing for hereditary cancer susceptibility in at-risk individuals through the use of a web-based communication system along with social media advertisements to improve reach.
    Objective: This paper is aimed to evaluate the effectiveness of Facebook as an outreach tool for targeting women aged ≥30 years for recruitment in the MAGENTA study.
    Methods: We designed and implemented paid and unpaid social media posts with ongoing assessment as a primary means of research participant recruitment in collaboration with patient advocates. Facebook analytics were used to assess the effectiveness of paid and unpaid outreach efforts.
    Results: Over the course of the reported recruitment period, Facebook materials had a reach of 407,769 people and 57,248 (14.04%) instances of engagement, indicating that approximately 14.04% of people who saw information about the study on Facebook engaged with the content. Paid advertisements had a total reach of 373,682. Among those reached, just <15% (54,117/373,682, 14.48%) engaged with the page content. Unpaid posts published on the MAGENTA Facebook page resulted in a total of 34,087 reach and 3131 instances of engagement, indicating that around 9.19% (3131/34,087) of people who saw unpaid posts engaged. Women aged ≥65 years reported the best response rate, with approximately 43.95% (15,124/34,410) of reaches translating to engagement. Among the participants who completed the eligibility questionnaire, 27.44% (3837/13,983) had heard about the study through social media or another webpage.
    Conclusions: Facebook is a useful way of enhancing clinical trial recruitment of women aged ≥30 years who have a potentially increased risk for ovarian cancer by promoting news stories over social media, collaborating with patient advocacy groups, and running paid and unpaid campaigns.
    Trial registration: ClinicalTrials.gov NCT02993068; https://clinicaltrials.gov/ct2/show/NCT02993068.
    Language English
    Publishing date 2022-09-26
    Publishing country Canada
    Document type Journal Article
    ISSN 2561-326X
    ISSN (online) 2561-326X
    DOI 10.2196/35035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Care after premenopausal risk-reducing salpingo-oophorectomy in high-risk women: Scoping review and international consensus recommendations.

    Nebgen, Denise R / Domchek, Susan M / Kotsopoulos, Joanne / de Hullu, Joanne A / Crosbie, Emma J / Paramanandam, Vincent Singh / Brood-van Zanten, Monique M A / Norquist, Barbara M / Guise, Theresa / Rozenberg, Serge / Kurian, Allison W / Pederson, Holly J / Yuksel, Nese / Michaelson-Cohen, Rachel / Bober, Sharon L / da Silva Filho, Agnaldo Lopes / Johansen, Nora / Guidozzi, F / Evans, D Gareth /
    Menon, Usha / Kingsberg, Sheryl A / Powell, C Bethan / Grandi, Giovanni / Marchetti, Claudia / Jacobson, Michelle / Brennan, Donal J / Hickey, Martha

    BJOG : an international journal of obstetrics and gynaecology

    2023  Volume 130, Issue 12, Page(s) 1437–1450

    Abstract: Women at high inherited risk of ovarian cancer are offered risk-reducing salpingo-oophorectomy (RRSO) from age 35 to 45 years. Although potentially life-saving, RRSO may induce symptoms that negatively affect quality of life and impair long-term health. ... ...

    Abstract Women at high inherited risk of ovarian cancer are offered risk-reducing salpingo-oophorectomy (RRSO) from age 35 to 45 years. Although potentially life-saving, RRSO may induce symptoms that negatively affect quality of life and impair long-term health. Clinical care following RRSO is often suboptimal. This scoping review describes how RRSO affects short- and long-term health and provides evidence-based international consensus recommendations for care from preoperative counselling to long-term disease prevention. This includes the efficacy and safety of hormonal and non-hormonal treatments for vasomotor symptoms, sleep disturbance and sexual dysfunction and effective approaches to prevent bone and cardiovascular disease.
    MeSH term(s) Female ; Humans ; Adult ; Middle Aged ; Salpingo-oophorectomy ; Quality of Life ; Consensus ; Premenopause ; Ovarian Neoplasms/genetics ; Ovarian Neoplasms/prevention & control ; Ovarian Neoplasms/surgery ; Ovariectomy ; Genetic Predisposition to Disease
    Language English
    Publishing date 2023-05-02
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2000931-8
    ISSN 1471-0528 ; 0306-5456 ; 1470-0328
    ISSN (online) 1471-0528
    ISSN 0306-5456 ; 1470-0328
    DOI 10.1111/1471-0528.17511
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  5. Article ; Online: Women's preferences for cancer risk management strategies in Lynch syndrome.

    Sun, Charlotte C / Meyer, Larissa A / Daniels, Molly S / Bodurka, Diane C / Nebgen, Denise R / Burton-Chase, Allison M / Lu, Karen H / Peterson, Susan K

    Gynecologic oncology

    2019  Volume 152, Issue 3, Page(s) 514–521

    Abstract: Objective: We assessed preferences for cancer risk management strategies for Lynch syndrome (LS) in LS-affected women.: Methods: Women with LS aged ≥25 years evaluated 9 cancer risk management strategies using a visual analog scale (VAS) and modified ...

    Abstract Objective: We assessed preferences for cancer risk management strategies for Lynch syndrome (LS) in LS-affected women.
    Methods: Women with LS aged ≥25 years evaluated 9 cancer risk management strategies using a visual analog scale (VAS) and modified standard gamble (SG). For the VAS, women ranked each strategy ranging from 0 (least preferred) to 100 (most preferred). VAS scores were calculated by dividing the corresponding number by 100. Scores closer to 1.0 reflected more favorable strategies. For the SG, participants were asked to specify their expected threshold of lifetime risk of endometrial or colorectal cancer, ranging from 0 to 100%, at which they would consider undertaking each strategy. Strategies included chemoprevention, cancer screening, and preventive surgery. Cancer worry and perceived cancer risk measures were collected on a subset of participants.
    Results: Sixty-one women completed preference assessments. By VAS, annual combined screening was the most preferred, followed by annual screenings and chemoprevention with oral contraceptives. By SG, women were the most willing to endorse oral contraceptives and biannual screening strategies at the lowest threshold of lifetime risk followed by annual screening strategies. Surgical interventions were the least preferred strategies using both VAS and SG. Women with a family history of gynecologic or colorectal cancer were less likely to consider prevention or screening options compared to women without a family history. Cancer worry was higher among women with a positive family history of LS cancer.
    Conclusion: Understanding women's preferences may facilitate optimal use and adherence to cancer risk management strategies.
    MeSH term(s) Adult ; Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis ; Colorectal Neoplasms, Hereditary Nonpolyposis/psychology ; Colorectal Neoplasms, Hereditary Nonpolyposis/therapy ; Female ; Humans ; Middle Aged ; Patient Preference ; Risk Management/methods
    Language English
    Publishing date 2019-03-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2018.11.027
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  6. Article ; Online: Bilateral salpingectomy with delayed oophorectomy for ovarian cancer risk reduction: A pilot study in women with BRCA1/2 mutations.

    Nebgen, Denise R / Hurteau, Jean / Holman, Laura L / Bradford, Andrea / Munsell, Mark F / Soletsky, Beth R / Sun, Charlotte C / Chisholm, Gary B / Lu, Karen H

    Gynecologic oncology

    2018  Volume 150, Issue 1, Page(s) 79–84

    Abstract: Objective: Risk-reducing salpingo-oophorectomy (RRSO) reduces ovarian cancer risk in BRCA1/2 mutation carriers, but the adverse effects of the associated early-onset surgical menopause are problematic. Despite suggestive evidence, no data demonstrate ... ...

    Abstract Objective: Risk-reducing salpingo-oophorectomy (RRSO) reduces ovarian cancer risk in BRCA1/2 mutation carriers, but the adverse effects of the associated early-onset surgical menopause are problematic. Despite suggestive evidence, no data demonstrate whether bilateral salpingectomy alone lowers the risk of developing ovarian cancer in BRCA mutation carriers. We conducted a pilot study of bilateral salpingectomy with delayed oophorectomy (BS/DO) in BRCA mutation carriers to determine the safety and acceptability of the procedure.
    Methods: In this prospective, multicenter, non-randomized pilot study, pre-menopausal BRCA1/2 mutation carriers aged 30 to 47 years chose screening, RRSO, or BS/DO. For those undergoing BS/DO, the delayed oophorectomy was recommended at age 40 years for BRCA1 and age 45 years for BRCA2 patients. We compared surgical and psychosocial outcomes between time points and between arms.
    Results: Of the 43 patients enrolled, 19 (44%) chose BS/DO, 12 (28%) chose RRSO, and 12 (28%) chose screening. The cohort was 37% BRCA1 carriers and 63% BRCA2 carriers. One serous tubal intraepithelial carcinoma (STIC) was found in an RRSO patient, and no cases of occult ovarian cancers were found. There were no surgical complications. Twelve months after surgery, responses on the Cancer Worry Scale indicated decreased worry in the BS/DO (P < 0.0001) and RRSO (P = 0.01) arms, while responses on the State Anxiety Inventory indicated decreased anxiety in the BS/DO arm (P = 0.02) compared with preoperative responses.
    Conclusions: In this pilot study, BRCA mutation carriers who underwent bilateral salpingectomy had no intraoperative complications, were satisfied with their procedure choice, and had decreased cancer worry and anxiety after the procedure.
    MeSH term(s) BRCA1 Protein/genetics ; BRCA1 Protein/metabolism ; BRCA2 Protein/genetics ; BRCA2 Protein/metabolism ; Female ; Humans ; Ovarian Neoplasms/genetics ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Ovariectomy/methods ; Pilot Projects ; Prospective Studies ; Risk Reduction Behavior ; Salpingectomy/methods
    Chemical Substances BRCA1 Protein ; BRCA1 protein, human ; BRCA2 Protein ; BRCA2 protein, human
    Language English
    Publishing date 2018-05-04
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2018.04.564
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  7. Article ; Online: Combined colonoscopy and endometrial biopsy cancer screening results in women with Lynch syndrome.

    Nebgen, Denise R / Lu, Karen H / Rimes, Sue / Keeler, Elizabeth / Broaddus, Russell / Munsell, Mark F / Lynch, Patrick M

    Gynecologic oncology

    2014  Volume 135, Issue 1, Page(s) 85–89

    Abstract: Objective: Endometrial biopsy (EMBx) and colonoscopy performed under the same sedation is termed combined screening and has been shown to be feasible and to provide a less painful and more satisfactory experience for women with Lynch syndrome (LS). ... ...

    Abstract Objective: Endometrial biopsy (EMBx) and colonoscopy performed under the same sedation is termed combined screening and has been shown to be feasible and to provide a less painful and more satisfactory experience for women with Lynch syndrome (LS). However, clinical results of these screening efforts have not been reported. The purpose of this study was to evaluate the long-term clinical outcomes and patient compliance with serial screenings over the last 10.5 years.
    Methods: We retrospectively analyzed the data for 55 women with LS who underwent combined screening every 1-2 years between 2002 and 2013. Colonoscopy and endometrial biopsy were performed by a gastroenterologist and a gynecologist, with the patient under conscious sedation.
    Results: Out of 111 screening visits in these 55 patients, endometrial biopsies detected one simple hyperplasia, three complex hyperplasia, and one endometrioid adenocarcinoma (FIGO Stage 1A). Seventy-one colorectal polyps were removed in 29 patients, of which 29 were tubular adenomas. EMBx in our study detected endometrial cancer in 0.9% (1/111) of surveillance visits, and premalignant hyperplasia in 3.6% (4/111) of screening visits. No interval endometrial or colorectal cancers were detected.
    Conclusions: Combined screening under sedation is feasible and less painful than EMBx alone. Our endometrial pathology detection rates were comparable to yearly screening studies. Our results indicate that screening of asymptomatic LS women with EMBx every 1-2 years, rather than annually, is effective in the early detection of (pre)cancerous lesions, leading to their prompt definitive management, and potential reduction in endometrial cancer.
    MeSH term(s) Adult ; Aged ; Biopsy ; Colonic Polyps/pathology ; Colonoscopy ; Colorectal Neoplasms, Hereditary Nonpolyposis/pathology ; Early Detection of Cancer/methods ; Endometrial Neoplasms/pathology ; Endometrium/pathology ; Female ; Humans ; Hyperplasia/pathology ; Middle Aged ; Retrospective Studies
    Language English
    Publishing date 2014-08-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 801461-9
    ISSN 1095-6859 ; 0090-8258
    ISSN (online) 1095-6859
    ISSN 0090-8258
    DOI 10.1016/j.ygyno.2014.08.017
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  8. Article ; Online: The incidence, attitudes and practices of the removal of pubic hair as a body modification.

    Bercaw-Pratt, Jennifer L / Santos, Xiomara M / Sanchez, Judith / Ayensu-Coker, Leslie / Nebgen, Denise R / Dietrich, Jennifer E

    Journal of pediatric and adolescent gynecology

    2012  Volume 25, Issue 1, Page(s) 12–14

    Abstract: Objective: To evaluate the incidence, attitudes, and practices of the removal of pubic hair as a body modification.: Design: A voluntary, anonymous survey was conducted among adolescents and young women 12-20 years of age seen in gynecology clinics ... ...

    Abstract Objective: To evaluate the incidence, attitudes, and practices of the removal of pubic hair as a body modification.
    Design: A voluntary, anonymous survey was conducted among adolescents and young women 12-20 years of age seen in gynecology clinics in Houston, Texas.
    Results: There were a total of 171 adolescent participants surveyed, of whom 70.4% of reported routinely shaving or waxing their pubic hair. More traditional body modification methods were evaluated, and 3.5% reported tattoos and 57.1% reported piercings. Sexually active participants were more likely to remove pubic hair routinely. The areas of the body where the participants felt there was "too much" hair included the genital area, upper lip, and abdomen. Of total respondents, 14.7% reported feeling "pressure" from friends or family to participate in body modification such as tattooing, piercing, or removal of pubic hair. The decision to participate in body modification was mostly influenced by friends and family.
    Conclusion: Based on this study, removal of pubic hair as a body modification is common. The results of this study demonstrated that removal of pubic hair was more common in sexually active participants compared to non-sexually active participants. Therefore, providers should additionally be aware that removal of pubic hair may be a warning sign of sexual behaviors or impending sexual activity.
    MeSH term(s) Abdomen ; Adolescent ; Body Piercing ; Child ; Female ; Groin ; Hair Removal/methods ; Humans ; Incidence ; Lip ; Sexual Behavior ; Surveys and Questionnaires ; Texas ; Young Adult
    Language English
    Publishing date 2012-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1325079-6
    ISSN 1873-4332 ; 1083-3188
    ISSN (online) 1873-4332
    ISSN 1083-3188
    DOI 10.1016/j.jpag.2011.06.015
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  9. Article ; Online: Downregulation of Endothelial Cell Thrombospondin 1 Enhances in vitro Angiogenesis

    DiPietro, Luisa A. / Nebgen, Denise R. / Polverini, Peter J.

    Journal of Vascular Research - Incorporating 'International Journal of Microcirculation'

    1994  Volume 31, Issue 3, Page(s) 178–185

    Abstract: Vascular endothelial cells are an established source of thrombospondin 1 (TSP1), a multifunctional extracellular matrix molecule. TSP1 appears to play an important role in modulating endothelial cell functions such as proliferation, migration, and ... ...

    Abstract Vascular endothelial cells are an established source of thrombospondin 1 (TSP1), a multifunctional extracellular matrix molecule. TSP1 appears to play an important role in modulating endothelial cell functions such as proliferation, migration, and capillary morphogenesis. In addition, TSP1 has recently been reported to potently inhibit angiogenesis both in vitro and in vivo. To better understand the mechanism underlying the antiangiogenic property of TSP1, endogenous TSP1 production was disrupted in bovine aortic endothelial cells (BAEC) by stable transfection with a vector expressing a TSP1 anti-sense RNA. Stable transfectants in which the antisense vector caused a decrease in TSP1 production were assayed for their ability to form capillarylike cords on gelled basement membrane matrix and for their responsiveness to the angiogenic/chemotactic mediator basic fibroblast growth factor. BAEC in which TSP1 production was disrupted exhibited a ten-fold increase over control BAEC in chemotactic activity to basic fibroblast growth factor and a twofold increase over control cells in the number of capillary-like cords that formed on gelled basement membrane matrix. Thus, the down-regulation of endogenous TSP1 appears to facilitate endothelial cell chemotaxis and capillary morphogenesis. These studies suggest that the modulation of TSP1 production is an important component of the angiogenic response, and support the idea that soluble TSP1 inhibits angiogenesis by interfering with endothelial cell chemotaxis and capillary formation.
    Keywords Angiogenesis ; Antisense RNA ; Endothelial cells ; Extracellular matrix ; Thrombospondin
    Language English
    Publisher S. Karger AG
    Publishing place Basel
    Publishing country Switzerland
    Document type Article ; Online
    ZDB-ID 1105259-4
    ISSN 1423-0135 ; 1018-1172 ; 1018-1172
    ISSN (online) 1423-0135
    ISSN 1018-1172
    DOI 10.1159/000319585
    Database Karger publisher's database

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