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Leahy A. Principles and practice of surgical laparoscopy S. Paterson-Brown, O. J. Garden. 233 × 150 mm. Pp 619. Illustrated. 1994. London: WB Sounders Company. £45. Br J Surg 2005. [DOI: 10.1002/bjs.1800820162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Barry MC, Mackle T, Joyce L, Kelly C, McGrath F, Bouchier-Hayes D, Leahy A. Endoluminal graft stenting of peripheral aneurysms: questionable results compared with conventional surgery. Surgeon 2003; 1:42-4. [PMID: 15568424 DOI: 10.1016/s1479-666x(03)80008-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Popliteal and femoral aneurysms can be treated by endoluminal graft stenting, instead of conventional surgery. Results in four cases suggest, however, that long-term results do not justify an endovascular approach.
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Connolly EM, Kelly CJ, Chen G, O'grady T, Kay E, Leahy A, Bouchier-Hayes DJ. Pharmacological induction of HSP27 attenuates intimal hyperplasia in vivo. Eur J Vasc Endovasc Surg 2003; 25:40-7. [PMID: 12525810 DOI: 10.1053/ejvs.2002.1793] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES intimal hyperplasia (IH) is a major cause of re-stenosis post-vascular intervention. Induction of heat shock proteins (HSPs), by thermal pre-conditioning, reduces IH. Our aim was to investigate the effect of the pharmacological HSP inducer herbimycin A on IH in the rat carotid balloon injury model. MATERIALS AND METHODS thirty male Sprague-Dawley rats were randomized into three groups. All groups underwent balloon injury to the left carotid artery. Stress proteins were induced 18 h pre-operatively by heat shock or herbimycin A. Two weeks post-operatively, animals were sacrificed and carotid intima/media area ratio (I/M ratio) calculated using computerized planimetry. Neo-intimal proliferation was assessed immunohistochemically with PCNA (proliferating cell nuclear antigen). Western blot and immunohistochemistry for arterial HSP70 and HSP27 were performed. RESULTS heat stress and herbimycin significantly reduced the I/M ratio (p < 0.05 vs balloon injury alone). Neo-intimal proliferation was significantly reduced in the heat stress and herbimycin groups (p < 0.05 vs balloon injury alone). Heat stress induced arterial HSP70 and HSP27. Herbimycin A increased arterial HSP27. CONCLUSION herbimycin A significantly attenuates IH after balloon injury. HSP27 may be the HSP involved in mediating this response. Pharmacological inducers of HSPs may have a therapeutic role to play in preventing re-stenosis post-vascular intervention.
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O'Grady HL, Leahy A, McCormick PH, Fitzgerald P, Kelly CK, Bouchier-Hayes DJ. Oral folic acid improves endothelial dysfunction in cigarette smokers. J Surg Res 2002; 106:342-5. [PMID: 12175990 DOI: 10.1006/jsre.2002.6467] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Endothelial dysfunction is an early manifestation of the atheromatous process and is evident without overt clinical signs or symptoms of the disease. Cigarette smoking has been shown to be associated with endothelial dysfunction in otherwise healthy adults. Although cessation of smoking is the ideal objective, it is not always attainable, and therefore any strategy to prevent early endothelial dysfunction is desirable. Folic acid is currently under review as a rational therapeutic agent in hyperhomocysteinemia. However, folic acid may modify endothelial function independent of its effect on homocysteine. We therefore investigated the effect of folic acid on endothelial function in young otherwise healthy cigarette smokers. METHODS Volunteer cigarette smokers (n = 10) and control lifelong nonsmokers were enrolled in the study. Baseline folate, vitamin B12, homocysteine, and cholesterol levels were analyzed. Flow-mediated dilatation, an endothelial-dependent phenomenon, was assessed using ultrasonography. This scan was performed at baseline and following 4 weeks of folic acid supplementation (5 mg/day). RESULTS There were no significant differences in the baseline hematological investigations between the groups. Homocysteine levels were within normal limits in both groups and did not change following folic acid supplementation. Cigarette smokers demonstrated significant endothelial dysfunction compared to controls (P < 0.005). This difference was significantly attenuated by folic acid supplementation (P < 0.005). CONCLUSION Folic acid significantly improves endothelial function in otherwise healthy cigarette smokers. This provides a potential therapeutic tool in attenuating the atheromatous process in this group.
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Abstract
BACKGROUND An increased plasma level of homocysteine has been proposed as an independent risk factor for atherosclerosis; this review examines the evidence. METHODS A Medline search was undertaken for English language articles on homocysteine and vascular disease. Further papers were identified by cross-referencing from the reference lists of relevant major articles. RESULTS Although much interest has been generated about homocysteine and atherosclerotic disease, contradictory data exist regarding its role in disease progression. There is insufficient current evidence to regard increased homocysteine level as a causative factor in atherosclerotic disease. CONCLUSION It is not known whether lowering plasma homocysteine concentration will reduce cardiovascular risk in the long term. Until such data become available, there is no evidence for the widespread use of folic acid therapy to reduce cardiovascular disease risk.
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Jin K, Mao XO, Batteur SP, McEachron E, Leahy A, Greenberg DA. Caspase-3 and the regulation of hypoxic neuronal death by vascular endothelial growth factor. Neuroscience 2002; 108:351-8. [PMID: 11734367 DOI: 10.1016/s0306-4522(01)00154-3] [Citation(s) in RCA: 131] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Vascular endothelial growth factor (VEGF) has neurotrophic and neuroprotective as well as angiogenic properties, but the pathways involved in VEGF-mediated neuronal survival have not been identified. We found previously that VEGF protects cultured neural cells from death induced by serum withdrawal or hypoxia via the activation of VEGF-2/fetal liver kinase-1 receptors, phosphatidylinositol 3'-kinase, Akt and nuclear factor-kappa B. We now report that in mouse cortical neuron cultures subjected to hypoxia, the neuroprotective effect of VEGF involves suppression of cell-death pathways mediated by caspase-3. Exposure to hypoxia for 24 h caused the death of 71+/-4% of cultured neurons; this was reduced to 40+/-1% by VEGF (n=3, P<0.005) and to 44+/-1% by the caspase-3 inhibitor benzyloxycarbonyl-DEVD-fluoromethyl ketone (n=3, P<0.005). VEGF inhibited the activation of caspase-3 as measured by the 17-20-kDa caspase-3 cleavage product, and immunolocalization of VEGF and activated caspase-3 showed segregated expression in separate neuronal populations. An antisense, but not sense, oligodeoxyribonucleotide directed against VEGF increased the proportion of neurons expressing activated caspase-3, and correspondingly reduced the viability of hypoxic neurons by 37+/-2% (n=3, P<0.005). These findings suggest that VEGF protects neurons from hypoxic injury by inhibiting the activation of caspase-3, and could therefore act as an endogenous neuroprotective factor in cerebral ischemia.
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Arumugasamy M, McGreal G, O'Connor A, Kelly C, Bouchier-Hayes D, Leahy A. The technique of transilluminated powered phlebectomy -- a novel, minimally invasive system for varicose vein surgery. Eur J Vasc Endovasc Surg 2002; 23:180-2. [PMID: 11863340 DOI: 10.1053/ejvs.2001.1553] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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File SE, Fluck E, Leahy A. Nicotine has calming effects on stress-induced mood changes in females, but enhances aggressive mood in males. Int J Neuropsychopharmacol 2001; 4:371-6. [PMID: 11806862 DOI: 10.1017/s1461145701002577] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 11/12/2000] [Indexed: 11/06/2022] Open
Abstract
In a double-blind, placebo-controlled study, we examined the effects of nicotine (2 mg administered by inhalator) on the cognitive performance of male and female non-smoking students and on mood changes following a moderately stressful task. The groups were matched for age and IQ, and did not differ in pre-test measures of anxiety, depression, extroversion and neuroticism or in their weekly alcohol or daily caffeine intake. Nicotine did not change performance in tests of attention and memory. Exposure to moderate stress significantly increased ratings of anxiety, discontent and aggression and nicotine blocked these mood changes in females, but enhanced them in males. This suggests that young women may start regular smoking as a form of stress self-medication, which implies that preventative and smoking cessation programmes would be more successful in women if they addressed issues of stress and anxiety, which may be core factors underlying initiation and maintenance of regular smoking.
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Joyce M, Kelly C, Winter D, Chen G, Leahy A, Bouchier-Hayes D. Pravastatin, a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, attenuates renal injury in an experimental model of ischemia-reperfusion. J Surg Res 2001; 101:79-84. [PMID: 11676559 DOI: 10.1006/jsre.2001.6256] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Renal dysfunction due to ischemia-reperfusion (IR) injury is a common problem following renovascular surgery or kidney transplantation. There is a lot of emerging evidence that statins, 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors, have anti-inflammatory properties and exert direct beneficial effects on the vascular endothelium. The aim of this study was to determine if pretreatment with pravastatin would attenuate the acute renal dysfunction that occurs following IR injury in an experimental model. MATERIALS AND METHODS Male Sprague-Dawley rats were randomized into four groups (n = 7 per group): control, uninephrectomy, IR group, and IR group pretreated with pravastatin (0.4 mg/kg/day for the preceding 5 days). Following a left nephrectomy the IR injury was induced by cross-clamping the right vascular pedicle for 30 min followed by reperfusion for 2 h. In a separate experiment (n = 6 per group) renal function was assessed 12 and 24 h after reperfusion. RESULTS IR injury causes significant renal dysfunction characterized by oliguria, 0.11 (0.05) ml/h, decreased glomerular filtration rate (GFR), 0.02 (0.01) ml/min; and marked protein leakage, 7.21 (1.3) g/L, 2 h postreperfusion. This renal dysfunction was also evident 12 and 24 h postreperfusion. This was in contrast to values of 0.61 (0.13) ml/h, 0.23 (0.01) ml/min, and 1.67 (0.12) g/L in the uninephrectomy-only group and values of 2 ml/h, 7.3 ml/min, and 0.72 g/L for uninjured time-matched controls. Pretreatment with pravastatin significantly attenuated IR-induced renal injury, improving urine production to 0.62 (0.2) ml/h and GFR to 0.14 (0.02) ml/min and diminishing protein leakage to 3.76 (0.7) g/L at the 2-h time point. This renoprotective effect was also evident 12 and 24 h postreperfusion. This renal protection was associated with an upregulation of constitutive endothelial nitric oxide synthase in the pravastatin-treated group. CONCLUSION These results show that pravastatin may play a role in modulating renal impairment following aortic or transplantation surgery, allowing earlier recovery from an IR injury.
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Leahy A, Epstein O. Non-pharmacological treatments in the irritable bowel syndrome. World J Gastroenterol 2001; 7:313-6. [PMID: 11819782 PMCID: PMC4688714 DOI: 10.3748/wjg.v7.i3.313] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2001] [Revised: 04/03/2001] [Accepted: 04/15/2001] [Indexed: 02/06/2023] Open
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Kumar SM, Wang JC, Barry MC, Farrell L, Kelly CJ, Fitzgerald PH, Leahy A, Hayes DB. Carotid Stump Syndrome: Outcome from Surgical Management. Eur J Vasc Endovasc Surg 2001; 21:214-9. [PMID: 11352679 DOI: 10.1053/ejvs.2000.1292] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES in patients with occluded internal carotid arteries the carotid stump is a potential source of microemboli resulting in the persistence of retinal or cerebral ischaemic symptoms. We report 25 patients who had persistent cerebral and retinal ischaemic symptoms with an occluded ipsilateral ICA and a carotid stump who underwent surgical exclusion of the stump. METHODS between January 1988 and January 1998, 332 patients underwent carotid endarterectomy. Twenty-five patients (20 males: five females; mean age 58.9 (range 44-78 years)) had carotid stump exclusion. Indications for surgery were transient ischaemic attack (22), amaurosis fugax (eight) and cerebrovascular accident (13). Three patients had undergone contralateral carotid endarterectomy and 12 had significant contralateral stenosis. Twenty patients were being treated with aspirin and four with warfarin at the time of presentation. RESULTS the diagnosis of carotid stump was made in 22 patients by angiography. In the remaining three patients duplex alone was diagnostic in two patients. In the third case duplex was combined with magnetic resonance angiography (MRA) to confirm the diagnosis. Stump exclusion was carried out by oversewing the ICA origin. All but one patient remained symptom free at follow-up. CONCLUSION carotid stump syndrome should be considered as a likely clinical entity in patients with an occluded ICA and persisting cerebral and retinal microembolic symptoms. Surgical exclusion of the carotid stump is a safe and effective method of treatment.
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Chen G, Kelly C, Chen H, Leahy A, Bouchier-Hayes D. Thermotolerance protects against endotoxin-mediated microvascular injury. J Surg Res 2001; 95:79-84. [PMID: 11162029 DOI: 10.1006/jsre.2000.5896] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An early event in endotoxin-induced tissue injury is adhesion and migration of leukocytes through the endothelium. This is a three-stage process, initially low-grade selectin-mediated adhesion, seen as a decrease in rolling velocity, followed by integrin-mediated adhesion and transmigration. Thermotolerance has been shown to reduce tissue injury and mortality induced by endotoxin. The aim of this study was to investigate the effect of thermotolerance on leukocyte-endothelial interactions. Intravital video microscopy was used to examine hemodynamic parameters, leukocyte rolling, adhesion, and migration in rat mesenteric postcapillary venules. Sprague-Dawley rats were randomized into control, lipopolysaccharide (LPS), and thermotolerance + LPS groups. Thermotolerance was induced 18 h prior to administration of LPS by elevating core body temperature to 41 + 0.5 degrees C for 15 min. LPS (055:B5 15 mg/kg) was administered via the jugular vein after baseline recording. Leukocyte rolling velocity and the number of adherent and migrated leukocytes were measured by intravital microscopy at baseline 0 min and 10, 30, 60, and 90 min after LPS administration. Heat shock protein 72 (HSP72) expression in tissues was determined by Western immunoblotting. The results indicated that LPS administration significantly decreased leukocyte rolling velocity during endotoxemia and increased leukocyte adhesion (10.3 +/- 1.67, 13.2 +/- 1.40, and 10.0 +/- 1.57/100 microm) and migration (5.7 +/- 1.02 and 8.3 +/- 1.76/field) at 30, 60, and 90 min after LPS injection (P < 0.01 vs baseline and control group). Thermotolerance maintained leukocyte rolling velocity and significantly reduced leukocyte adhesion (5.7 +/- 0.88 and 4.0 +/- 0.68/100 microm) and migration (2.8 +/- 0.32 and 3.0 +/- 0.68/field) at 30 and 60 min after LPS administration (P < 0.01 and 0.05 vs LPS group). Expression of HSP72 was induced in mesentery, gut, and lung by thermotolerance. This study indicates that thermotolerance attenuated LPS-induced microvascular injury by decreasing leukocyte-endothelial adhesion and migration.
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Leahy A, Besherdas K, Clayman C, Mason I, Epstein O. Gastric dysrhythmias occur in gastro-oesophageal reflux disease complicated by food regurgitation but not in uncomplicated reflux. Gut 2001; 48:212-5. [PMID: 11156642 PMCID: PMC1728202 DOI: 10.1136/gut.48.2.212] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIM To investigate gastric pacemaker activity in gastro-oesophageal reflux disease using the electrogastrogram. PATIENTS Forty patients with gastro-oesophageal reflux disease (20 with acid reflux, 20 with the additional symptom of food regurgitation) and 30 asymptomatic controls. METHODS Patients were studied using an electrogastrogram, oesophageal manometry, and 24 hour ambulatory oesophageal pH analysis. RESULTS An abnormal electrogastrogram was recorded in two (7%) controls, two (10%) patients with acid reflux, and 10 (50%) patients with food regurgitation. Food regurgitators had significantly more gastric dysrhythmias (tachygastrias) both before (p<0.02) and after (p<0.01) a test meal. Gastric pacemaker activity was also significantly less stable following the test meal in food regurgitators (p<0.003). Patients with food regurgitation and an abnormal electrogastrogram had higher oesophageal acid exposure than those with a normal electrogastrogram (p<0.05). CONCLUSIONS The electrogastrogram is usually normal in gastro-oesophageal reflux disease but an abnormal rhythm occurred in half of our patients with the additional symptom of food regurgitation. Furthermore, an abnormal electrogastrogram is associated with increased oesophageal acid exposure.
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Chen G, Kelly C, Chen H, Leahy A, Bouchier-Hayes D. Thermotolerance preserves endothelial vasomotor function during ischemia/reperfusion. J Surg Res 2000; 94:13-7. [PMID: 11038297 DOI: 10.1006/jsre.2000.5934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Ischemia/reperfusion (I/R) results in endothelial dysfunction, seen as loss of endothelium-dependent vasodilatation. In prolonged ischemia, this can result in marked vasospasm or no reflow in the microvasculature. Thermotolerance (T) attenuates I/R-induced microvascular injury. The aim of this study was to investigate the effect of thermotolerance on I/R-induced vasomotor changes and "no reflow." Sprague-Dawley rats were randomized into an ischemia/reperfusion group (I/R group) and a group in which thermotolerance (41 + 0.5 degrees C for 15 min 18 h prior to I/R) was induced (T + I/R group). IR injury was established by occlusion of the superior mesenteric and celiac vascular pedicle for 30 min, followed by 60 min of reperfusion. Vasomotor function [arteriolar constriction:dilatation (C:D) ratio] measured by response to acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent) and "no-reflow" phenomenon were determined in mesenteric arterioles by intravital microscopy. Data are expressed as means +/- SEM and were analyzed using ANOVA and chi(2) test. I/R caused a significant decrease in endothelium-dependent vasodilatation (C:D = 1.37+/-0.31 in IR group vs. 2.06+/-0.20 in baseline, P<0.01) and no reflow in arterioles in 16 of 28 unheated rats. Endothelium-independent dilatation was not altered by I/R. Thermotolerance attenuated this impairment of endothelium-dependent dilatation (P<0.01 vs. IR; C:D = 1.95+/-0.19) and reduced no-reflow phenomenon to 4 of 16 rats (P<0.05 vs. IR). This study demonstrated that thermotolerance preserves endothelial vasomotor function and markedly reduces "no reflow" in arterioles.
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Belton O, Byrne D, Kearney D, Leahy A, Fitzgerald DJ. Cyclooxygenase-1 and -2-dependent prostacyclin formation in patients with atherosclerosis. Circulation 2000; 102:840-5. [PMID: 10952950 DOI: 10.1161/01.cir.102.8.840] [Citation(s) in RCA: 257] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The formation of prostacyclin (PGI(2)), thromboxane (TX) A(2), and isoprostanes is markedly enhanced in atherosclerosis. We examined the relative contribution of cyclooxygenase (COX)-1 and -2 to the generation of these eicosanoids in patients with atherosclerosis. METHODS AND RESULTS The study population consisted of 42 patients with atherosclerosis who were undergoing surgical revascularization. COX-2 mRNA was detected in areas of atherosclerosis but not in normal blood vessel walls, and there was evidence of COX-1 induction. The use of immunohistochemical studies localized the COX-2 to proliferating vascular smooth muscle cells and macrophages. Twenty-four patients who did not previously receive aspirin were randomized to receive either no treatment or nimesulide at 24 hours before surgery and then for 3 days. Eighteen patients who were receiving aspirin were continued on a protocol of either aspirin alone or a combination of aspirin and nimesulide. Urinary levels of 11-dehydro-TXB(2) and 2,3-dinor-6-keto-PGF(1alpha), metabolites of TXA(2) and PGI(2), respectively, were elevated in patients with atherosclerosis compared with normal subjects (3211+/-533 versus 679+/-63 pg/mg creatinine, P<0.001; 594+/-156 versus 130+/-22 pg/mg creatinine, P<0.05, respectively), as was the level of the isoprostane 8-iso-PGF(2alpha). Nimesulide reduced 2, 3-dinor-6-keto-PGF(1alpha) excretion by 46+/-5% (378.3+/-103 to 167+/-37 pg/mg creatinine, P<0.01) preoperatively and blunted the increase after surgery. Nimesulide had no significant effect on 11-dehydro-TXB(2) before (2678+/-694 to 2110+/-282 pg/mg creatinine) or after surgery. The levels of both products were lower in patients who were taking aspirin, and no further reduction was seen with the addition of nimesulide. None of the treatments influenced urinary 8-iso-PGF(2alpha) excretion. CONCLUSIONS Both COX-1 and -2 are expressed and contribute to the increase in PGI(2) in patients with atherosclerosis, whereas TXA(2) is generated by COX-1.
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Xiong JW, Leahy A, Stuhlmann H. Retroviral promoter-trap insertion into a novel mammalian septin gene expressed during mouse neuronal development. Mech Dev 1999; 86:183-91. [PMID: 10446280 DOI: 10.1016/s0925-4773(99)00113-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We have characterized a retroviral promoter-trap insertion into a novel mammalian septin gene, Sep3. Its predicted amino acid sequence shares significant homology to that of Saccharomyces cerevisiae CDC3, CDC10, CDC11, CDC12, the Drosophila genes Pnut, Sep1, Sep2, and the mammalian genes BH5, CDC10, Nedd5, Diff6, and Sep2, which are implicated in cytokinesis and cell polarity. Sep3 encodes a protein of 465 amino acids, and contains an evolutionary conserved ATP/GTP-binding motif, two coiled-coil domains, and a highly hydrophobic domain at the C terminus. Alkaline phosphatase reporter gene expression in transgenic embryos was first detected at E8.5 in the neural fold, and high levels of expression continued throughout embryogenesis in the neural tube and brain. In addition, a low level of transient expression was detected in the somites, gut, and branchial arches of mouse embryos. Overall, reporter gene expression recapitulated Sep3 mRNA expression during mouse embryogenesis. In adults, Sep3 transcripts were only detected in the brain and testis. Zoo blot analysis revealed that Sep3-related sequences exist in several vertebrate species including zebrafish, frog, chicken, mouse and human. Consistent with the retroviral insertion into the 3' UTR of the Sep3 gene, no obvious phenotypes associated with the promoter trap were detected in transgenic embryos or adult mice. In summary, we report the first isolation of a novel full-length Sep3 cDNA and extensive characterization of its expression during mouse embryogenesis and in adult tissues.
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Leahy A, Xiong JW, Kuhnert F, Stuhlmann H. Use of developmental marker genes to define temporal and spatial patterns of differentiation during embryoid body formation. THE JOURNAL OF EXPERIMENTAL ZOOLOGY 1999; 284:67-81. [PMID: 10368935 DOI: 10.1002/(sici)1097-010x(19990615)284:1<67::aid-jez10>3.0.co;2-o] [Citation(s) in RCA: 165] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Mouse embryonic stem cells are pluripotent cells that are derived from the inner cell mass of blastocysts. When induced to synchronously enter a program of differentiation in vitro, they form embryoid bodies that contain cells of the mesodermal, hematopoietic, endothelial, muscle, and neuronal lineages. Here, we used a panel of marker genes with early expression within the germ layers (oct-3, Brachyury T, Fgf-5, nodal, and GATA-4) or a variety of lineages (flk-1, Nkx-2.5, EKLF, and Msx3) to determine how progressive differentiation of embryoid bodies in culture correlated with early postimplantation development of mouse embryos. Using RNA in situ hybridization, we found that the temporal and spatial relationships existing between these marker genes in vivo were maintained also in vitro. Studying the onset of marker gene expression allowed us also to determine the time course of differentiation during the formation of embryoid bodies. Thus, stages equivalent to embryogenesis between implantation and the beginning of gastrulation (4.5-6.5 d.p.c.) occur within the first two days of embryoid body differentiation. Between days 3 and 5, embryoid bodies contain cell lineages found in embryos during gastrulation at 6.5 to 7.0 d.p.c., and after day 6 in culture, embryoid bodies are equivalent to early organogenesis-stage embryos (7.5 d.p.c.). In addition, we demonstrate that the panel of developmental markers can be applied in a screen for stage- or lineage-specific genes. Reporter gene expression from entrapment vector insertions can be co-localized with expression of specific markers within the same cell during embryoid body formation as well as during embryogenesis. Our results thus demonstrate the power of embryoid body formation as an in vitro model system to study early lineage determination and organogenesis in mammals, and indicate that they will prove to be useful tools for identifying developmental genes whose expression is restricted to particular lineages.
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Kearns SR, Kelly CJ, Barry M, Abdih H, Condron C, Leahy A, Bouchier-Hayes D. Vitamin C reduces ischaemia-reperfusion-induced acute lung injury. Eur J Vasc Endovasc Surg 1999; 17:533-6. [PMID: 10375489 DOI: 10.1053/ejvs.1999.0833] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVES to evaluate vitamin C supplementation in the prevention of ischaemia-reperfusion (I-R) induced acute lung injury. DESIGN Sprague-Dawley rats (n =6/group) were randomised into Control, I-R and I-R pretreated with vitamin C (3.3 g over 5 days). Ischaemia-reperfusion injury was induced by 30 minutes infrarenal aortic cross-clamping and 120 minutes reperfusion. METHODS pulmonary microvascular injury was measured by broncho-alveolar lavage protein concentration, pulmonary neutrophil infiltration by tissue myeloperoxidase activity and bronchoalveolar lavage neutrophil counts. In a second experiment (n =5/group) neutrophil respiratory burst activity was measured in Control and vitamin C groups. RESULTS ischaemia-reperfusion resulted in a significant increase in both microvascular leakage and pulmonary neutrophil infiltration as measured by bronchoalveolar lavage protein concentration and pulmonary myeloperoxidase activity respectively. Pretreatment with vitamin C significantly attenuated both microvascular leakage and neutrophil infiltration. Neutrophil respiratory burst activity was significantly reduced in the vitamin C group (13.02 m.c.f.+/-0.3) compared with Control (19.04 m.c.f.+/-1. 9),p <0.02. CONCLUSION these data suggest that oral vitamin C therapy protects against ischaemia-reperfusion-induced acute lung injury, possibly by attenuating neutrophil respiratory burst activity.
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Leahy A, Besherdas K, Clayman C, Mason I, Epstein O. Abnormalities of the electrogastrogram in functional gastrointestinal disorders. Am J Gastroenterol 1999; 94:1023-8. [PMID: 10201477 DOI: 10.1111/j.1572-0241.1999.01007.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Cutaneous electrogastrography records gastric electrical activity and detects gastric arrhythmias. Abnormalities of the electrogastrogram have been described in a variety of disorders, but their specificity and their prevalence in patients with functional gastrointestinal disorders has not been reported. The aim of this study was to assess the specificity of electrogastrography as well as the prevalence and pattern of abnormalities in functional dyspepsia and irritable bowel syndrome. METHODS Electrogastrography was performed in 170 patients with functional dyspepsia, 70 patients with irritable bowel syndrome, 20 patients with gastroesophageal reflux disease, and 30 asymptomatic controls. The abnormal electrogastrogram was defined as <70% normal electrical activity either before or after a test meal. RESULTS The electrogastrogram was abnormal in 36% of patients with functional dyspepsia and in 25% with irritable bowel syndrome who complained of concurrent dyspepsia. The electrogastrogram was normal in 93% of asymptomatic controls, 90% of patients with gastroesophageal reflux, and 92% of patients with irritable bowel syndrome who did not complain of dyspepsia. As a group, functional dyspepsia patients had a greater degree of tachygastrias both before (p < 0.02) and after (p < 0.01) a test meal. The electrical frequency after the test meal was also more unstable (p < 0.003). CONCLUSIONS The electrogastrogram is abnormal in approximately 36% of functional dyspepsia patients and has a specificity of approximately 93%. Electrogastrography defines a subgroup of patients with functional dyspepsia and electrical rhythm disturbance. In irritable bowel syndrome, the electrogastrogram is usually abnormal only if concurrent dyspepsia is present.
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Xiong JW, Leahy A, Lee HH, Stuhlmann H. Vezf1: A Zn finger transcription factor restricted to endothelial cells and their precursors. Dev Biol 1999; 206:123-41. [PMID: 9986727 DOI: 10.1006/dbio.1998.9144] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Using retroviral entrapment vectors, we identified a novel mouse gene whose expression is restricted to vascular endothelial cells and their precursors in the yolk sac blood islands. A 3.68-kb cDNA corresponding to the endogenous transcript was isolated using genomic DNA flanking the entrapment vector insertion as a probe. We have named this gene Vezf1 for vascular endothelial zinc finger 1. Vezf1 encodes a protein with a predicted molecular mass of 56 kDa and that contains six putative zinc finger domains and shows high homology to a previously identified human gene, DB1, that is believed to be involved in regulating expression of cytokine genes such as interleukin-3. In situ hybridization analysis revealed the onset of expression in advanced primitive streak-stage embryos being located in the extraembryonic mesodermal component of the visceral yolk sac and in the anteriormost mesoderm of the embryo proper. During head-fold and somite stages, expression was restricted to vascular endothelial cells that arise during both vasculogenesis and angiogenesis. Vezf1-related sequences were found to be highly conserved among higher vertebrate species that have acquired extraembryonic yolk sac membranes during evolution. The Vezf1 locus mapped to the proximal part of mouse chromosome 2, a region which has homology to human chromosome 9q. Vezf1 expression correlates temporally and spatially with the early differentiation of angioblasts into the endothelial cell lineage and the proliferation of endothelial cells of the embryonic vascular system. Thus, Vezf1 may play an important role in the endothelial lineage determination and may have an additional role during later stages of embryonic vasculogenesis and angiogenesis.
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Kuze K, Graves P, Leahy A, Wilson P, Stuhlmann H, You G. Heterologous expression and functional characterization of a mouse renal organic anion transporter in mammalian cells. J Biol Chem 1999; 274:1519-24. [PMID: 9880528 DOI: 10.1074/jbc.274.3.1519] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Organic anion transporters play an essential role in eliminating a wide range of organic anions including endogenous compounds, xenobiotics, and their metabolites from kidney, thereby preventing their potentially toxic effects within the body. The goal of this study was to extend our previous study on the functional characterization and post-translational modification of a mouse kidney organic anion transporter (mOAT), in a mammalian cell system, COS-7 cells. The transporter-mediated p-aminohippurate (PAH) uptake was saturable, probenecid-sensitive, and inhibited by a wide range of organic anions including vitamins, anti-hypertensive drugs, anti-tumor drugs, and anti-inflammatory drugs. Tunicamycin, an inhibitor of asparagine-linked glycosylation, significantly inhibited the transport activity. Immunofluorescence provided evidence that most of the protein remained in the intracellular compartment in tunicamycin-treated cells. Diethyl pyrocarbonate (DEPC), a histidine residue-specific reagent, completely blocked PAH transport. The inhibitory effect by DEPC was significantly protected (90%) by pretreating the cells with excess unlabeled PAH, suggesting that the histidine residues may be close to the PAH binding sites. Finally, in situ mRNA localization was studied in postnatal mouse kidney. The expression was observed in proximal tubules throughout development. We conclude that COS-7 cells may be useful in pharmacological and molecular biological studies of this carrier. The carbohydrate moieties are necessary for the proper trafficking of mOAT to the plasma membrane, and histidine residues appear to be important for the transport function.
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Leahy A, Clayman C, Mason I, Lloyd G, Epstein O. Computerised biofeedback games: a new method for teaching stress management and its use in irritable bowel syndrome. JOURNAL OF THE ROYAL COLLEGE OF PHYSICIANS OF LONDON 1998; 32:552-6. [PMID: 9881312 PMCID: PMC9662981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVES To develop and test a computer biofeedback game designed to teach deep relaxation to patients with a stress related disorder and to assess whether relaxation can improve symptomatic episodes. STUDY DESIGN AND SETTING An open, prospective, single centre study. Department of Gastroenterology, Royal Free Hospital, London. SUBJECTS Forty patients with irritable bowel syndrome refractory to conventional medical treatment. MAIN OUTCOME MEASURES Development of a computer aided biofeedback apparatus directed at the gut for teaching relaxation to patients with irritable bowel syndrome. The patients' ability to complete a computer game involving biofeedback modulated by a physiological loop that related changes in stress (monitored by electrodermal activity) to animated computer graphics. The degree to which deep relaxation was achieved was measured numerically by a progressive reduction in the sensitivity level of the biofeedback loop. The success of relaxation in ameliorating physical symptoms of irritable bowel syndrome was assessed by daily diaries in which global and weighted bowel symptom scores were entered. RESULTS A computer biofeedback game based on animated gut imagery was successfully developed. Most patients learned to achieve progressively deeper levels of relaxation after four 30 minute biofeedback sessions (mean difference in sensitivity level 2.0 (95% confidence interval 0.96 to 2.93), p < 0.001). Use of 'dosed' relaxation when bowel symptoms were troublesome was helpful in 50% of patients. It reduced the global symptom score (mean difference 0.5 (0.02 to 0.32), p < 0.04) and the bowel symptom score (mean difference 0.8 (0.04 to 1.58), p < 0.04). At long term follow up, 64% of patients who had been helped by dosed relaxation continued to use the technique, although they had had no further contact with the hospital. CONCLUSIONS This computer biofeedback game taught deep relaxation rapidly and effectively. Half the patients with refractory irritable bowel syndrome found the technique helpful on most occasions on which it was used. Computer biofeedback games may offer a simple, inexpensive strategy for managing other stress related medical disorders.
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Barry MC, Mealy K, Sheehan SJ, Burke PE, Cunningham AJ, Leahy A, Bouchier Hayes D. The effects of recombinant human growth hormone on cardiopulmonary function in elective abdominal aortic aneurysm repair. Eur J Vasc Endovasc Surg 1998; 16:311-9. [PMID: 9818008 DOI: 10.1016/s1078-5884(98)80050-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Cardiorespiratory complications are the predominant source of morbidity in patients undergoing major surgery. Recombinant human growth hormone (rhGH) has previously been shown to be effective in improving respiratory and cardiac function in compromised patients. DESIGN The aim of this study was to assess the effects of perioperative rhGH on cardiac function in 33 patients undergoing elective infrarenal abdominal aortic aneurysm repair. METHODS Patients were randomised to one of three groups: placebo for 6 days before and after surgery (control, n = 12); genotropin (GH) 0.3 units/kg/day for 6 days before and after surgery (pre and postop GH, n = 10) and placebo for 6 days before and GH (0.3 units/kg/day) for 6 days after surgery (postop EH, n = 11). Patients were assessed on days 7 and 1 before and days 7, 14 and 50 after operation. Intraoperative cardiac index (CI) was measured after induction of anaesthesia, before and after aortic cross-clamping, after aortic unclamping and at the end of surgery. RESULTS Pretreatment with GH resulted in a significantly higher heart rate during surgery and was associated with a trend towards higher cardiac index (CI) (p < 0.067) at all stages of surgery. Mean arterial blood pressure at the stage of aortic unclamping was significantly higher in patients treated with GH preoperatively. CONCLUSIONS Larger studies are required to evaluate the beneficial effects of GH in aortic surgery. However, data from this pilot study suggests that perioperative GH administration may result in improved cardiac performance during aortic surgery.
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McAlinden MG, Magowan J, Wilson DJ, Insley G, Ferris P, Prendergast PJ, Rice J, Blayney AW, Dalstra M, Walsh M, McGloughlin T, Grace P, Colgan D, Bray D, McCormack BAO, Reilly R, Tancred D, Carr AJ, McCormack BAO, Leyland NS, Meenan J, Boyd A, Akay M, O’Dwyer B, McCormack BAO, Dunne NJ, Ryan K, Orr JF, Stungo B, Brennan EG, O’Hare NJ, Walsh MJ, Jordan MF, Rasheed AM, Kelly C, Kay E, Bouchier-Hayes DJ, Leahy A, Maher SA, O’Reilly D, Foley J, Gillan MA, Cole JS, Raghunathan S, O’Reilly MJG, Kenny T, Foley J, Hourigan TF, Lyons GM, Cox SL, Kernohan WG, Fitzpatrick C, Kernohan WG, Dempsey GJ, Millar I, Kelly S, Charlwood AP, O’Brien S, Beverland DE, Kavanagh A, McGloughlin T, Neligan MF, McKenna J, Laracy P, Moran D, O’Beirne J, Charlwood AP, Kelly S, Nixon JR, Beverland DE, Kenny P, Maher SA, Murphy LA, Prendergast PJ, O’Rourke SK, O’Donoghue D, Gilchrist MD, Caulfield B, O’Brien B, Simms C, Lyons CG, Brady CL, Badran S, Clifford PM, Burden DJ, Orr JF, Taylor D, Hill R, Griffin S, De Barra E, Brook I, Reytil P, Blades M, O’Reilly JP, Masterson BF, Macauley D, Toner M, Walker J, Gillan J, Boyd A, Meenan J, Akay M, Leyland NS, Murphy H, McNamara P, Jones E, Kelly P, Rajah L, Dhaif B, Colville J, Waide DV, Waide DV, Lawlor G, McCormack A, Carr AJ, McCartney W, McNamara BP, Connolly P, Devitt A, McElwaine J, O’Reilly P, Maher SA, Eames MHA, Cosgrove AP, Baker RJ, Condron J, Coyle E, Nugent D, Webb J, Black ND, Mclntyre M, Lowery M, O’Malley M, Vaughan L, Sweeney PC, Lyons GM, McGiven R, Collins AD, Gibson MJ, Lyons GM, Clernon GF, Wilcox DJ, Shanahan A, Buckley PJ, Hanna S, McGrellis N, Orr JF, Fennel B, Hill R, Akinmade A, Mitchell A, Pintado MR, Douglas WH, Ryan EE, Savage EJ, Orr JF, Mitchell E, Silbermann M, Mullett H, Ranjith P, Burke T, Hill R, Dorreil P, Watters EP, Spedding PL, Grimshaw J, M Bowler DJ, Felle P, Allen D, McCormack BAO, Moran R, Lennon AB, McCormack BAO, Prendergast PJ, Thompson NS, Cosgrove AP, Baker RJ, Saunders JL, Taylor T, Grimson J, Grimson W, Azuaje F, Black ND, Adamson K, Lopes P, Dubitzky W, Wu X, White J, Murtagh F, Campbell JG, Adamson K, O’Tiarnaigh RI, Cormack WA, Hume A, Starck JL, Lardillier P, Kernohan WG, Mao WE, Bell D, Chambers MGA, McCammon C, Leane GE, Lyons GM, Lyons DJ, Lacrox D, Murphy LA, Prendergast PJ, FitzPatrick DP, McClorey M, Meenen J, O’Brien FJ, Lee TC, Pellegrini F, Dickson GR, Taylor D. Royal academy of medicine in Ireland section of bioengineering. Ir J Med Sci 1998. [DOI: 10.1007/bf02937426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hill ADK, Brady MS, Coit DG, Brennan M, Aherne N, Mukherjee A, Sarkar A, Coss A, Waldron R, Egan B, Grant DC, Barry MK, Gallagher CM, Traynor O, Hyland JMP, Younis F, Farah N, Lowry S, Gilooly M, Lee M, Walsh TN, Carton E, Mulligan ED, Caldwell MTP, Rana D, Ryan B, Mahmud N, Keeling N, Tanner WA, Keane FBV, McDonald G, Reynolds JV, McLaughlin R, Kelly CJ, Kay E, Bouchier-Hayes D, O’Neill S, Conroy E, O’Neill A, O’Connell R, Delaney C, Fitzpatrick JM, Watson RWG, Rasheed AM, Chen G, Kelly C, McDowell I, Cottel D, Bouchier-Hayes DJ, Leahy A, Kavanagh EG, Kell MR, Lyons A, Saporoschet I, Rodrick ML, Mannick JA, Lederer JA, McCourt M, Wang JH, Sookhai S, Neary P, Redmond HP. Waterford surgical october club and surgical section, royal academy of medicine joint surgical symposium at: Waterford regional hospital. Ir J Med Sci 1998. [DOI: 10.1007/bf02937973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Besherdas K, Leahy A, Mason I, Harbord M, Epstein O. The effect of cisapride on dyspepsia symptoms and the electrogastrogram in patients with non-ulcer dyspepsia. Aliment Pharmacol Ther 1998; 12:755-9. [PMID: 9726389 DOI: 10.1046/j.1365-2036.1998.00369.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The electrogastrogram (EGG), which records gastric myoelectrical activity, is abnormal in one-third of adult patients with non-ulcer dyspepsia (NUD). AIM To observe the effects of cisapride on EGG in adults with NUD. METHODS Twenty-seven NUD patients who had undergone a pre- and post-prandial EGG were entered into an open study. All patients completed a dyspepsia symptom questionnaire and were then treated with cisapride 10 mg t.d.s. The dyspepsia questionnaire was repeated in all those completing 4 weeks of treatment. Those with an initial abnormal EGG (< 70% of slow wave activity at 2-4 cycles per minute) had a repeat EGG at the end of the study. RESULTS Treatment with cisapride was associated with a significant improvement in the post-prandial EGG (P = 0.007). After 4 weeks of treatment, 7 of 13 abnormal EGGs normalized. Symptom scores improved significantly in the 13 patients with an abnormal EGG who completed treatment (P < 0.0003), but not in NUD patients with a normal EGG (P = 0.48). CONCLUSION In this open study, treatment of NUD with cisapride was associated with significant symptom improvement in patients with an abnormal pre-treatment EGG, but not those with a normal EGG, with a significant improvement of the post-prandial EGG.
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Javadpour M, Kelly CJ, Chen G, Stokes K, Leahy A, Bouchier-Hayes DJ. Thermotolerance induces heat shock protein 72 expression and protects against ischaemia-reperfusion-induced lung injury. Br J Surg 1998; 85:943-6. [PMID: 9692569 DOI: 10.1046/j.1365-2168.1998.00722.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Ischaemia-reperfusion injury is mediated by neutrophil-endothelial interaction. Induction of heat shock proteins attenuates neutrophil-endothelial interactions. The aim of this study was to determine whether thermal preconditioning could have a protective effect on neutrophil-mediated lung injury in an animal model of lower torso ischaemia-reperfusion. METHODS Sprague-Dawley rats were randomized into: control, ischaemia-reperfusion, and ischaemia-reperfusion preconditioned with hyperthermia groups. Ischaemia-reperfusion injury was induced by infrarenal aortic clamping for 30 min and reperfusion for 120 min. Thermotolerance was induced by raising the core body temperature to 40.5-41.5 degrees C for 15 min, 18 h before ischaemia-reperfusion. Wet:dry lung (W:D) weight ratio, bronchoalveolar lavage protein (BALprot) concentration, tissue myeloperoxidase (MPO) activity and bronchoalveolar lavage polymorphonuclear neutrophil (BAL PMN) count were measured. Heat shock protein 72 (hsp72) expression in lung, intestine and mesentery was measured using Western immunoblotting. RESULTS Ischaemia-reperfusion resulted in a significant increase in tissue oedema (W:D weight ratio) and BALprot concentration. In addition there was a marked increase in tissue neutrophil infiltration (MPO activity, BAL PMN concentration). Preconditioning with hyperthermia resulted in increased expression of hsp72 and significantly reduced tissue oedema and neutrophil infiltration. CONCLUSION Thermal preconditioning protects against neutrophil-mediated ischaemia-reperfusion-induced lung injury, possibly by increasing the expression of heat shock proteins.
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Xiong JW, Battaglino R, Leahy A, Stuhlmann H. Large-scale screening for developmental genes in embryonic stem cells and embryoid bodies using retroviral entrapment vectors. Dev Dyn 1998; 212:181-97. [PMID: 9626494 DOI: 10.1002/(sici)1097-0177(199806)212:2<181::aid-aja4>3.0.co;2-d] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Mammalian development is orchestrated by a variety of cellular proteins with expression that is regulated precisely. Although some of the genes encoding these factors have been identified, largely by homology to those of simpler organisms, the majority of them presumably remain unknown. We report here on the results of a large-scale genetic screen that can potentially lead to the identification of many of these unidentified genes in mice. The method we developed takes advantage of the fact that many of the factors that regulate early development are expressed at highly specific stages of early embryogenesis. We therefore established a method for tagging candidate developmental genes by virtue of their expression in a stage-specific manner during formation of embryoid bodies without a bias for their expression in undifferentiated embryonic stem (ES) cells. Of 2,400 ES cell clones with random insertions of retroviral vectors carrying a human placental alkaline phosphatase reporter gene (AP), 41 clones exhibited stage-specific reporter gene expression during embryoid body formation. The majority of these insertions were in genes that are not expressed in undifferentiated ES cells. Eleven ES cell clones with characteristic patterns of AP reporter gene expression in vitro were chosen for further examination in vivo for AP expression in developing embryos. Ten ES cell clones exhibited AP expression between day 7.5 and day 10.5 of development. Clones that showed restricted reporter gene expression in vitro also exhibited similar temporally and spatially restricted AP expression in vivo. Sequence analysis of genomic DNA flanking several vector insertions and corresponding cDNAs suggested that several of the insertions identified a previously unidentified gene. Thus, screening for reporter gene expression during embryoid body formation provides an efficient means of enriching clones that contain vector insertions into potentially novel genes that are important for regulating different stages of early postimplantation development.
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Willison HJ, Lastovica AJ, Prendergast MM, Moran AP, Walsh C, Flitcroft I, Eustace P, McMahon C, Smith J, Smith OP, Lakshmandass G, Taylor MRH, Holland CV, Cox D, Good B, Kearns GM, Gaffney P, Shark K, Frauenshuh M, Ortmann W, Messner R, King R, Rich S, Behrens T, Mahmud N, Molloy A, McPartlin J, Scott JM, Weir DG, Walsh KM, Thorburn D, Mills P, Morris AJ, Good T, Cameron S, McCruden EAB, Bennett MW, O’Connell J, Brady C, Roche D, Collins JK, Shanahan F, O’Sullivant GC, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, McGonagle D, Gibbon W, O’Connor P, Emery P, Murphy M, Watson R, Casey E, Naidu E, Murphy M, Watson R, Barnes L, McCann S, Murphy M, Watson R, Barnes L, Sweeney E, Barrett EJ, Graham H, Cunningham RT, Johnston CF, Curry WJ, Buchanan KD, Courtney CH, McAllister AS, McCance DR, Hadden DR, Bell PM, Leslie H, Sheridan B, Atkinson AB, Kilbane MT, Smith DF, Murray MJ, Shering SG, McDermott EWM, O’Higgins NJ, Smyth PPA, McEneny J, Trimble ER, Young IS, Sharpe P, Mercer C, McMaster D, Young IS, Evans AE, Young IS, Cundick J, Hasselwander O, McMaster D, McGeough J, Savage D, Maxwell AP, Evans AE, Kee F, Larkin CJ, Watson RGP, Johnston C, Ardill JES, Buchanan KD, McNamara DA, Walsh TN, Bouchier-Hayes DJ, Madden C, Timon C, Gardiner N, Lawler M, O’Riordan J, Duggan C, McCann SR, Gowing H, Braakman E, Lawler M, Byrne C, Martens ACM, Hagenbeek A, McCann SR, Kinsella N, Cusack S, Lawler M, Baker H, White B, Smith OP, Lawler M, Gardiner N, Molloy K, Gowing H, Wogan A, McCann SR, McElwaine S, Lawler M, Hollywood D, McCann SR, Mcmahon C, Merry C, Ryan M, Smith O, Mulcahy FM, Murphy C, Briones J, Gardiner N, McCann SR, Lawler M, White B, Lawler M, Cusack S, Kinsella N, Smith OP, Lavin P, McCaffrey M, Gillen P, White B, Smith OP, Thompson L, Lalloz M, Layton M, Barnes L, Corish C, Kennedy NP, Flood P, Mulligan S, McNamara E, Kennedy NP, Flood P, Mathias PM, Ball E, Duiculescu D, Calistru P, O’Gorman N, Kennedy NP, Abuzakouk M, Feighery C, Brannigan M, Pender S, Keeling F, Varghese J, Lee M, Colreavy M, Gaffney R, Hone S, Herzig M, Walsh M, Dolan C, Wogan A, Lawler M, McCann SR, Hollywood D, Donovan D, Harmey J, Bouchier-Hayes DJ, Haverty A, Wang JH, Harmey JH, Redmond HP, Bouchier-Hayes DJ, McGreal G, Shering SG, Moriarty MJ, Shortt A, Kilbane MT, Smith DF, McDermott EWM, O’Higgins NJ, Smyth PPA, McNamara DA, Harmey J, Wang JH, Donovan D, Walsh TN, Bouchier-Hayes DJ, Kay E, Pidgeon G, Harmey J, McNamara DA, Bouchier-Hayes DJ, Dunne P, Lambkin H, Russell JM, O’Neill AJ, Dunne BM, O’Donovan M, Lawler M, Gaffney EF, Gillan JE, Cotter TG, Horan J, Jones D, Biswas SK, Mulkerrin EC, Brady H, O’Donnell J, Neary J, Healy E, Watson A, Keogh B, Ryan M, Cassidy C, Ward S, Stokes E, Keoghan F, Barrett A, O’Connell P, Ryall N, O’Connell PA, Jenkinson A, O’Brien T, O’Connell PG, Harrison R, Barrett T, Bailey DMD, Butler A, Barton DE, Byrne C, McElwaine S, McCann SR, Lawler M, Cusack S, Lawler M, White B, Smith OP, Daly G, Gill M, Heron S, Hawi Z, Fitzgerald M, Hawi Z, Mynett-Johnson L, Shiels D, Kendler K, McKeon P, Gill M, Straub R, Walsh D, Ryan F, Barton DE, McCabe D, Murphy R, Segurado R, Mulcahy T, Larson B, Comerford C, O’Connell R, O’Mahony E, Gill M, Donnelly J, Minahan F, O’Neill D, Farrell Z, O’Neill D, Jones D, Horan J, Glynn C, Biswas SK, Mulkerrin E, Brady H, Lennox SE, Murphy A, Rea IM, McNulty H, McMeel C, O’Neill D, McEvoy H, Freaney R, McKenna MJ, Crowe M, Keating D, Colreavy M, Hone S, Norman G, Widda S, Viani L, Galvin, Nolan CM, Hardiman O, Hardiman O, Brett F, Droogan O, Gallagher P, Harmey M, King M, Murphy J, Perryrnan R, Sukumaran S, Walsh J, Farrell MA, Hughes G, Cunningham C, Walsh JB, Coakley D, O’Neill D, Hurson M, Flood P, McMonagle P, Hardiman O, Ryan F, O’Sullivan S, Merry C, Dodd P, Redmond J, Mulcahy FM, Browne R, Keating S, O’Connor J, Cassidy BP, Smyth R, Sheppard NP, Cullivan R, Crown J, Walsh N, Denihan A, Bruce I, Radic A, Coakley D, Lawlor BA, Bridges PK, O’Doherty M, Farrington A, O’Doherty M, Farragher B, Fahy S, Kelly R, Carey T, Owens J, Gallagher O, Sloan D, McDonough C, Casey P, Horgan A, Elneihum A, O’Neill C, McMonagle T, Quinn J, Meagher D, Murphy P, Kinsella A, Mullaney J, Waddington JL, Rooney S, Rooney S, Bamford L, Sloan D, O’Connor JJ, Franklin R, O’Brien K, Fitzpatrick G, Laffey JG, Boylan JF, Laffey J, Coleman M, Boylan J, Laffey JG, McShane AJ, Boylan JF, Loughrey JPR, Gardiner J, McGinley J, Leonard I, Carey M, Neligan P, O’Rourke J, Cunningham A, Fennessy F, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes DJ, Kellett J, Laffey J, Murphy D, Regan J, O’Keeffe D, Mahmud A, Hemeryck L, Feely J, Mahmud A, Hemeryck L, Hall M, Feely J, Menown IBA, Mathew TP, Nesbitt GS, Syme M, Young IS, Adgey AAJ, Menown IBA, Turtle F, Allen J, Anderson J, Adgey AAJ, O’Hanlon R, Codd MB, Walkin S, McCann HA, Sugrue DD, Rasheed AM, Chen G, Kelly C, Bouchier-Hayes DJ, Leahy A, Rasheed AM, Kay E, Jina S, Bouchier-Hayes DJ, Leahy A, McDowell I, Rasheed AM, Wang JH, Wo Q, Kelly C, Bouchier-Hayes DJ, Leahy A, Shuhaibar MN, McGovern E, Turtle F, Menown IBA, Manoharan G, Kirkpatrick R, Campbell NPS, Walkin S, Codd MB, O’Hanlon R, McCarthy C, McCann HA, Sugrue DD, Wen Y, Killalea S, Hall M, Hemeryck L, Feely J, Fahy CJ, Griffith A, McGinley J, McCabe D, Fraser A, Casey E, Ryan T, Murphy R, Browne M, Fenton J, Hughes J, Timon CI, Fenton J, Curran A, Smyth D, Viani L, Walsh M, Hughes JP, Fenton J, Lee P, Kelly A, Timon CI, Hughes JP, Fenton J, Shine N, Blayney A, McShane DP, Timon CI, Hussey J, Howlett M, Langton A, McEvoy A, Slevin J, Fitzpatrick C, Turner MJ, Enright F, Goggin N, Costigan C, Duff D, Osizlok P, Wood F, Watson R, Fitzsimons RB, Flanagan N, Enright F, Barnes L, Watson R, Molloy E, Griffin E, Deasy PF, Sheridan M, White MJ, Moore R, Gray A, Hill J, Glasgow JFT, Middleton B, Slattery D, Donoghue V, McMahon A, Murphy J, Slattery D, McCarthy A, Oslislok P, Duff D, Colreavy M, Keogh I, Hone S, Walsh M, Henry M, Koston S, McMahon K, MacNee W, FitzGerald MX, O’Connor CM, Russell KJ, Henry M, Fitzgerald MX, O’Connor CM, Kavanagh PV, McNamara SM, Feely J, Barry M, O’Brien JE, McCormick P, Molony C, Doyle RM, Walsh JB, Coakley D, Codd MB, O’Connell PR, Dowey LC, McGlynn H, Thurnham DI, Elborn SJ, Flynn L, Carton J, Byrne B, O’Farrelly C, Kelehan P, O’Herlihy C, O’Hara AM, Moran AP, Orren A, Fernie BA, Merry C, Clarke S, Courtney G, de Gascun C, Mulcahy FM, Merry C, Ryan M, Barry M, Mulcahy FM, Merry C, Ryan M, Barry M, Mulcahy FM, Byrne M, Moylett E, Murphy H, Butler K, Nourse C, Thaker H, Barry C, Russell J, Sheehan G, Boyle B, Hone R, Conboy B, Butler C, Moris D, Cormican M, Flynn J, McCormack O, Corbally N, Murray A, Kirrane S, O’Keane C, Hone R, Lynch SM, Cryan B, Whyte D, Morris D, Butler C, Cormican M, Flynn J, Corbett-Feeney G, Murray A, Corbally N, Hone R, Mackle T, Colreavy M, Perkins J, Saidlear C, Young A, Eustace P, Wrigley M, Clifford J, Waddington JL, Tighe O, Croke DT, Drago J, Sibley DR, Feely J, Kelly A, Carvalho M, Hennessy M, Kelly M, Feely J, Hughes C, Hanlon M, Feely J, Sabra K, Keane T, Egan D, Ryan M, Maerry C, Ryan M, Barry M, Mulcahy FM, Maerry C, Ryan M, Barry M, Mulcahy FM, Sharma SC, Williams D, Kelly A, Carvalho M, Feely J, Williams D, Kelly A, Carvalho M, Feely J, Codd MB, Mahon NG, McCann HA, Sugrue DD, Sayers GM, Johnson Z, McNamara SM, Kavanagh PV, Feely J. National scientific medical meeting 1997 abstracts. Ir J Med Sci 1998. [DOI: 10.1007/bf02937234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Relihan N, McGreal G, Murray M, McDermott EW, O’Higgins NJ, Duffy MJ, McNamara DA, Harmey J, Wang JH, Donovan D, Walsh TN, Bouchier-Hayes DJ, Kay E, Kelly JD, Weir HP, Keane PF, Johnston SR, Williamson KE, Hamilton PW, McManus D, Morrin M, Delaney PV, Winter DC, Harvey BJ, Geibel JP, O’Sullivan GC, Delaney CP, Coffey R, Gorey TF, Fitzpatrick JM, Fanning NF, Kirwan W, Cotter T, Bouchier-Hayes D, Redmond HP, McNamara DA, Pidgeon G, Harmey J, Walsh TN, Bouchier-Hayes DJ, Redmond HP, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes D, Delaney CP, Flavin R, Coffey R, Gorey TF, Fitzpatrick JM, Rasheed AM, Wang JH, Kelly C, Bouchier-Hayes DJ, Leahy A, Lang EE, Caldwell MTP, Tanner WA, Kiely PD, O’Reilly M, Tierney S, Barry M, Delaney PV, Drumm J, Grace PA, Gallagher CM, Grant DC, Connell P, Barry MK, Traynor O, Hyland JMP, O’Sullivan MJ, Evoy D, Redmond HP, Kirwan WO, Cannon B, Kenny-Walshe L, Whelton MJ, O’Grady H, O’Neill S, Grant DC, Barry MK, Traynor O, Hyland JM, Teh SH, O’Ceallaigh S, O’Donohoe MK, Tanner WA, Keane FB, O’Toole GC, Grant DC, Barry MK, Hyland JMP, Calleary J, Basso L, Amjad SB, Khan Z, McMullin L, Joyce WP, Balfe PJ, Caldwell MT, Keane FB, Tanner WA, Teahan S, Al-Brekeit K, Tierney S, Rasheed A, Bouchier-Hayes D, Leahy A, O’Neill S, Delaney CP, Gorey TF, Fitzpatrick JM, Cullen A, O’Keane C, Fennessy F, Kelly C, Bouchier-Hayes D, Fennessy F, Wang JH, Kelly C, Bouchier-Hayes DJ, Winter DC, MacFarlane J, Harvey BJ, O’Sullivan GC, Walsh M, McGloughlin T, Grace P, Colgan D, Madhavan P, Sultan S, Colgan MP, Moore D, Shanik G, McEniff N, Molloy M, Eguare E, Fiuza C, Grace P, Burke P, Maher R, Creamer M, Cronin CJ, Sigurdsso HH, Kim W, Linklater G, Cross KS, Simpson WG, Shaw JAM, Pearson DWM, Fitzgerald P, Quinn P, Tierney S, Bouchier-Hayes D, Brady CM, Shah SMA, Ehtisham M, Khan MS, Flood HD, Loubani M, Sweeney K, Lenehan B, Lynch V, Joy A, McGreal G, Reidy D, Mahalingam K, Cashman W, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, O’Halloran D, McGreal G, McDermott EW, O’Higgins NJ, Neary P, Hamilton D, Haider N, Aherne N, Watson RGK, Walsh D, Murphy M, Joyce M, Johnston S, Clinton O, Given HF, Brannigan A, O’Donohoe M, Donohoe J, Corrigan T, Bresnihan M, O’Donohoe MK, Feeley TM, Sultan S, Madhavan P, Colgan MP, Moore D, Shanik G, McMonagle MP, Quinlan D, Kelly D, Hegarty PK, Tan B, Cronin C, Brady MP, Zeeshan M, McAvinchey DJ, Aherne N, Mooney C, Coyle D, Haider N, Hamilton D, Neary P, Watson RGK, Khayyat G, Masterson E, Thambi-Pillai T, Farah K, Delaney CP, Codd MB, Fitzpatrick JM, Gorey TF, Barry MK, Tsiotos GG, Johnson CD, Sarr MG, Kell MR, Lynch M, Ryan D, O’Donovan A, Winter DC, Redmond HP, Delaney CP, Cassidy M, Doyle M, Fulton G, O’Connell PR, Kingston R, Dillon M, Barry M, Tierney S, Grace PA, McGreal G, Lenehan B, Murray M, McDermott E, O’Higgins N, Kell MR, O’Sullivan RG, Tan B, O’Donnell JA. Sylvester o’halloran surgical scientific meeting. Ir J Med Sci 1998. [DOI: 10.1007/bf02937403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Barry MC, Burke PE, Sheehan S, Leahy A, Broe PJ, Bouchier-Hayes DJ. An "all comers" policy for ruptured abdominal aortic aneurysms: how can results be improved? THE EUROPEAN JOURNAL OF SURGERY = ACTA CHIRURGICA 1998; 164:263-70. [PMID: 9641367 DOI: 10.1080/110241598750004481] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To review our experience of a non-selective policy for the treatment of ruptured abdominal aortic aneurysm to see if the policy was justified, and to identify any preoperative risk factors that adversely influenced outcome. DESIGN Retrospective study. SETTING Teaching hospital, Republic of Ireland. SUBJECTS 258 patients admitted with abdominal aortic aneurysms between January 1982 and December 1993. INTERVENTIONS Definitive surgical treatment. MAIN OUTCOME MEASURES Morbidity, mortality, and risk factors. RESULTS In-hospital mortality for all patients was 43% (110/258). Overall, women did worse than men (28/44, 64%, died, compared with 96/214, 45%, p=0.03). The mortality among patients over the age of 80 (23/45, 51%) was not significantly different from that among younger patients (97/202, 48%). Blood pressure, platelet count, and haemoglobin concentration were all significantly lower preoperatively among those who died (p < 0.05). CONCLUSIONS Age alone cannot be used to justify witholding definitive surgical treatment. Treatment should be aimed towards reversing haematological and haemodynamic abnormalities preoperatively to try to improve outcome.
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Cubbin S, Leahy A. Attention deficit hyperactivity in adults. Br J Psychiatry 1998; 172:366. [PMID: 9715347 DOI: 10.1192/bjp.172.4.366b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Clarke G, Ryan E, O’Keane JC, Crowe J, McMathuna P, Moriarty D, Ettarh R, Sheahan K, Hyland J, O’Donoghue DP, Baird AW, Clarke G, Ryan E, Gormley G, Keane JCO, Crowe J, MacMathuna P, Wang JH, Wu QD, Redmond HP, Condron C, Bouchier-Hayes D, Nally K, Newton F, O’Connell J, O’Sullivan GC, Morgan J, Collins JK, Shanahan F, Goode C, O’Connell J, O’Sullivan GC, Collins JK, Shanahan F, Winter DC, Taylor CT, Skelly MM, O’Donoghue DP, O’Sullivan GC, Baird AW, Harvey BJ, Varghese JC, Farrell MA, McGrath FP, Murray FE, Osborne H, Lee MJ, Ryan E, Sullivan A, O’Keane JC, Crowe J, Ryan AE, O’Keane JC, Crowe J, Donovan AN, McCormick PA, Kenny B, Somers S, Bohan A, Gibney RG, Marcaccio M, Malone DE, Doyle M, Delaney CP, Gorey TF, McEntee GP, O’Sullivan GC, Clarke A, Stuart R, Kelly J, Kiely MD, Collins JK, Shanahan F, O’Sullivan M, Lovett E, Mahmud N, Kelleher D, O’Morain CA, Larkin CJ, Watson RGP, Sloan JM, Ardill JES, Johnston CF, Buchanan KD, Heaney A, Collins JSA, Watson GRP, Kalin RM, Heaney A, Collins JSA, Tham TCK, Watson RGP, McFarland RJ, Bamford KB, Cróinín TÓ, Clyne M, Drumm B, Rowland M, Kumar D, O’Connor P, Daly LE, Drumm B, O’Toole DL, Long A, Murphy AM, O’Neill L, Weir DG, Kelleher D, Heaney A, Collins JSA, Watson RGP, Hopkins AM, Moynagh P, O’Donoghue DP, Baird AW, Brennan C, Harmey J, Stapleton PP, Redmond HP, Bouchier-Hayes D, Rasheed AM, Chen G, Kelly C, Bouchier-Hayes DJ, Leahy A, Gallagher M, Grace A, Xin Y, Leader M, Kay E, Whelan A, Pattison U, Willoughby R, Wallace E, Weir D, Feighery C, Bennett MW, O’Connell J, O’Sullivan GC, Brady C, Roche D, Collins JK, Shanahan F, Mahmud N, Molloy A, McPartlin J, Scott JM, Weir DG, Acheson AG, Lee J, Khosraviani K, Irwin ST, McDaid J, McCormick PA, Docherty JR, O’Grady A, Kay E, Mabruk M, Grace A, Leader M, Lee J, Acheson AG, Irwin ST, Larkin CJ, Johnston C, Curry W, Ardill J, Cunningham R, Buchanan KD, Watson RGP, McDougall NI, Coyle PV, Callender ME, Ouinn AM, Warner R, Stevens FM, Chakravarthi PIS, Kearns M, Bourke M, Hassan A, McWeeney J, Stevens FM, McCarthy CF, Casey M, O’Donoghue J, Eustace-Ryan AM, O’Regan P, Feighery L, Jackson J, Cronin N, Shanahan F, Quane K, Feighery C, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, Mulligan ED, Purcell T, Dunne B, Griffin M, Noonan N, Hollywood D, Keeling N, Reynolds JV, Hennessy TPJ, O’Sulhvan M, Harman I, Breslin NP, Clayton N, O’Morain CA, Hogan S, Donovan B, Hayes D, Kiely M, Eustace-Ryan AM, O’Regan P, Goulding CA, Albloushi SS, O’Connor J, Courtney MG, Murray FE, Albloushi SS, Goulding CA, Kay E, Royston D, Leader M, Courtney MG, Murray FE, Albloushi SS, Kay E, Goulding CA, Grace A, O’Connor J, Shattock AG, Courtney MG, Murray FE, Albloushi SS, Stack A, Kay E, Goulding CA, Carmody M, Murray FE, Courtney MG, Barrett S, Ryan E, O’Keane JC, Crowe J, Hennigan A, Delaney CP, Young L, Shields CJ, O’Keane C, Gorey TF, Fitzpatrick JM, Rasheed AM, Wang JH, Kelly C, Bouchier-Hayes DJ, Leahy A, Doyle MM, Stephens RB, Daly PA, Bennett MW, O’Connell J, O’Sullivan GC, Brady C, Roche D, Collins JK, Shanahan F, Briggs GM, McCrory D, Briggs GM, McCrory D, O’Neill S, O’Grady H, Grant DC, Barry K, Traynor O, Hyland JMP, O’Toole GC, Grant DC, Barry MK, Hyland JMP, Johnston SD, Ritchie CM, Robinson TJ, Johnston SD, Kirby JM, Mackle EM, Robinson TJ, Haider N, Aherne N, McNichol F, Hamilton D, Neary P, Hegarty S, Connor JO, Watson RGK, Drudy D, Alwan A, Fenelon L, O’Farrelly C, Hyland J, Byrne B, Madrigal L, Carton J, Collins C, O’Donoghue D, O’Farrelly C, Gannon N, Hickey A, O’Boyle CA, Byrne R, Albloushi S, Murray F. Irish society of gastroenterology. Ir J Med Sci 1998. [DOI: 10.1007/bf02937896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Shannon FJ, Boyle TJ, Grant DC, Clyne OJ, Hyland JMP, Mulligan ED, Purcell T, Lawlor P, Reynolds JV, Byrne PJ, Hennessy TPJ, Duff M, Hill ADK, Shering SG, McDermott EW, O’Higgins NJ, Harte M, Corrigan J, Khurana S, Manning F, Kierce B, Corbally M, McNamara DA, Dimitriadis E, Kay E, Redmond HP, Harmey J, Bouchier-Hayes DJ, Chen G, Kelly C, Chen H, Leahy A, Bouchier-Hayes J, Winter DC, Nally K, O’Callaghan J, Harvey BJ, Shanahan F, O’Sullivan GC, Wang H, Wu QD, Redmond HP, Condron C, Bouchier-Hayes D. Waterford surgical October club and surgical section, Royal Academy of Medicine Joint Surgical Symposium. Ir J Med Sci 1998. [DOI: 10.1007/bf02937558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Barry MC, Merriman B, Wiley M, Kelly CJ, Broe P, Hayes DB, Leahy A. Ruptured abdominal aortic aneurysm--can treatment costs and outcomes be predicted by using clinical or physiological parameters? Eur J Vasc Endovasc Surg 1997; 14:487-91. [PMID: 9467525 DOI: 10.1016/s1078-5884(97)80129-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Mortality rates for patients undergoing surgery for ruptured abdominal aortic aneurysm (RAAA) remain high. The high cost of providing care for these patients mandates that proposed treatment protocols be evaluated for their cost-effectiveness. This study assessed costs related to outcome in different groups of patients with RAAA. From July 1987 to December 1993, 140 patients underwent emergency surgery for RAAA. Complete data on preoperative haemodynamic status, blood transfusion requirements, intensive care unit (ICU) stay and other hospital costs was available for 94 patients. Seventy-seven males (mean age 71.6(6)) and 17 females (mean age 77.2(6)) underwent surgery. Known risk factors including age (< or > 70 years), shock on admission (systolic blood pressure (BP) < or > 90 mm Hg), sex, and acute renal failure were analysed. For the purpose of comparison, costs (Pounds) were assessed by the ESRI (Economic and Social Research Institute of Ireland) based on 1992 prices. The overall survival rate was 48%: 53% among males and 24% among females (p < 0.05, Chi-squared test). In addition to having a significantly worse outcome than males, female patients with RAAA also had longer hospital and ICU stays and this was reflected in significantly greater expenditure. Similarly, male patients > 70 years old presenting with haemodynamic instability had significantly longer hospital and ICU stays than younger male patients. The average cost per RAAA survival (12,945 Pounds) in this series is not prohibitive, and the greater cost in high risk groups should not discourage intervention.
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Chen G, Kelly C, Stokes K, Wang JH, Leahy A, Bouchier-Hayes D. Induction of heat shock protein 72kDa expression is associated with attenuation of ischaemia-reperfusion induced microvascular injury. J Surg Res 1997; 69:435-9. [PMID: 9224420 DOI: 10.1006/jsre.1997.5059] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Leukocyte-endothelial interaction is a pivotal step in the pathogenesis of ischemia-reperfusion (I/R) injury. Exposure of cells to a subcritical heat stress may protect cells from subsequent I/R injury, through induction of a 72-kDa heat shock protein (HSP72). The aim of this study was to investigate the effect of thermotolerance on leukocyte adherence and migration during an I/R period in rat mesenteric postcapillary venules. Sprague-Dawley rats were randomized into control (sham I/R), I/R, and thermotolerance+I/R groups. Thermotolerance was induced 18 hr prior to I/R, which was in turn established by occlusion of the superior mesenteric vascular pedicle for 10 mins, followed by 60 mins of reperfusion. The blood flow, leukocyte rolling velocity, and the number of adherent and migrated leukocytes in postcapillary venules were measured by intravital microscopy. I/R significantly decreased the rolling velocity of leukocytes; increased the number of adherent leukocytes at 10, 30, and 60 mins after reperfusion; and also increased the number of migrated leukocytes at 60 mins after reperfusion. Thermotolerance induction expression of HSP72 in pulmonary, intestinal, and mesenteric tissues was determined by Western immunoblotting. Thermotolerance significantly prevented the I/R-induced decrease in rolling velocity of leukocytes, the increase in the number of adherent leukocytes at 30 and 60 mins, and the increase in the number of migrated leukocytes at 60 mins. This results suggest that thermotolerance attenuates I/R injury by modulating leukocyte-endothelial interaction in vivo, possibly by increasing tissue expression of HSP72.
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Dover SJ, Leahy A, Foreman D. Parental psychiatric disorder: clinical prevalence and effects on default from treatment. Child Care Health Dev 1994; 20:137-43. [PMID: 8062408 DOI: 10.1111/j.1365-2214.1994.tb00376.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In a retrospective case note study, 36% of 253 consecutive cases seen and treated at a community child and adolescent clinic had at least one caretaker with a concurrent psychiatric disorder. The most common diagnosis in caretakers was depression (20% of the sample). Both, psychiatric disorder in general, and depression in particular, were significantly related to default from treatment. The relevance of these results to all aspects of child health care is discussed. It is concluded that more research into the impact of parental psychiatric disorder on the treatment of children across various clinical settings is needed.
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Joyce WP, Geraghy I, Leahy A, Osborne H. Re-laparoscopic inguinal hernia repair. ENDOSCOPIC SURGERY AND ALLIED TECHNOLOGIES 1993; 1:207-10. [PMID: 8050022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Grace PA, Qureshi A, Burke P, Leahy A, Brindley N, Osborne H, Lane B, Broe P, Bouchier-Hayes D. Selective cholangiography in laparoscopic cholecystectomy. Br J Surg 1993; 80:244-6. [PMID: 8443670 DOI: 10.1002/bjs.1800800243] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Laparoscopic cholecystectomy is now the method of choice for removing the diseased gallbladder. Asymptomatic common bile duct stones occur in approximately 6 per cent of patients. Controversy exists, however, as to whether selective or routine peroperative cholangiography should be performed during laparoscopic cholecystectomy. Over a 21-month period 300 consecutive laparoscopic cholecystectomies without routine cholangiography were attempted. There were 28 conversions. In all, 229 patients did not undergo cholangiography and in this group there were two common duct injuries. These were both identified and dealt with by open operation. Five patients underwent peroperative cholangiography, none of whom was found to have common duct pathology. Endoscopic retrograde cholangiopancreatography was performed in 38 patients. Of 27 who had this investigation performed before operation, common duct stones were diagnosed in seven (26 per cent). Two common duct stones were discovered in 11 patients who underwent the investigation after operation. Thus only two of 240 patients (0.8 per cent) who did not undergo preoperative or peroperative cholangiography subsequently had symptomatic duct stones. Peroperative cholangiography may be indicated in selected patients who have had symptoms of common bile duct stones or in those in whom the biliary anatomy is unclear. However, routine preoperative or peroperative cholangiography is unnecessary during laparoscopic cholecystectomy.
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Paterson IS, Watson RJ, Davies M, England PC, Egleston CV, Woods AE, Gorey TF, McGovern EM, MacDonald A, Baxter JN, Bessent RG, Gray HW, Finlay IG, O’Donoghue JM, Doyle J, Flynn JR, Connolly K, Gallagher M, Butler P, Salman S, Leahy A, Keeling P, Winslet MC, Mohsen Y, Hallissey M, Fielding JWL, Griffith J, Adams I, Sue-Ling H, Finan PJ, McMahon MJ, Johnston D. GAstro-Intestinal. Ir J Med Sci 1992. [DOI: 10.1007/bf02943722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Brannigan A, Williams NN, Grahn M, Williams NS, Fitzpatrick JM, O’Connell PR, Soong CV, Blair P, Halliday MI, Hood JM, Rowlands BJ, D’sa AABB, Cahill RJ, Beattie S, Hamilton H, O’Morain C, Kelly SJ, O’Malley KE, Stack WA, O’Donoghue D, Baird AW, Cronin KJ, Kerin MJ, Crowe J, MacMathuna P, Lennon J, Gorey TF, Chua A, O’Kane V, Dinan TG, Keeling PWN, Mulligan E, Cronin KL, Dervan P, Ireland A, Murphy D, O’Sullivan G, Ryan E, Kelly P, Gilvarry J, Sant S, Fan XJ, Chua A, Shahi CN, O’Connell M, Weir DG, Kelleher D, McDevitt J, O’Donoghue JM, Horgan PG, Byrne WJ, McGuire M, Given HF, Daw MA, Kavanagh P, O’Mahony P, Joy T, Gleeson F, Mullan A, Gibney M, Mannion A, Stevens FM, McCarthy CF, Killeen AA, Murchan PM, Reynolds JV, Leonard N, Marks P, Keane FBV, Tanner WA, O’Connell MA, Corridan B, Collins R, Shannon R, Cahill R, Joyce WP, Goggin M, O’Donoghue D, Hyland J, Traynor O, Qureshi A, DaCosta M, Brindley N, Burke P, Grace P, Bouchier-Hayes D, Leahy AL, Courtney G, Osbome H, O’Donovan N, O’Donoghue M, Collins JK, Morrissey D, McCarthy JE, Redmond HP, Hill ADK, Grace PA, Naama H, Austin OM, Bouchier-Hayes DM, Daly JM, Mulligan E, Fitzpatrick JM, Breslin D, Delaney CP, O’Sullivan ST, O’Sullivan GC, Kirwan WO, Weir CD, McGrath LT, Maynard S, Anderson NH, Halliday MI, D’sa AABB, Gokulan C, O’Gorman TA, Breshihan E, Lam PY, Skehill R, Grimes H, McKeever JA, Stokes MA, Mehigan D, Keaveny TV, Meehan J, Molloy A, Q’Farrelly C, Scott J, Dudeney MS, Leahy A, Grace. PA, McEntee G, Hcaton ND, Douglas V, Mondragon R, O’Grady J, Williams R, Tan KC, Xia HX, Keane CT, O’Morain CA, O’Mahony A, O’Sullivan GC, Corbett A, O’Mahony A, Ireland A, Harte P, Mulcahy H, Patchett S, Stack W, Gallagher M, Connolly K, Doyle J, Flynn JR, Maher M, Hehir D, Horgan A, Stuart R, Brady MP, Johnston PW, Johnston BT, Collins BJ, Collins JSA, Love AHG, Marshall SG, Parks TG, Spence RAJ, O’Connor HJ, Cunnane K, Duggan M, MacMalhuna P, Delaney CP, Kerin M, Gorey TF, Attwood SEA, Viani L, Jeffers M, Walsh TN, Byrne PJ, Frazer I, Hennessy TPJ, Hill GL, Dickey W, McMillan SA, Bharucha C, Porter KG, Rolfe H, Thornton J, Attwood SEA, Coleman J, Stephens RB, Hone S, Holmes K, Kelly IP, Corrigan TP, McCrory D, McCaigue M, Barclay GR, Stack WA, Quirke M, Hegarty JE, O’Donoghue DP, O’Hanlon D, Byrne J. Irish society of gastroenterology. Ir J Med Sci 1992. [DOI: 10.1007/bf02942367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Coulter J, Molloy RG, Moran KT, Waldron R, Kirwan WO, O’Suilleabhain C, Horgan A, Mealy K, Burke P, Hyland J, Horgan AF, Sheehan M, Browne RM, Austin O, Clery AP, Deasy JM, Sulaiman-Shoaib S, Soeda J, O’Briain DS, Puri P, Coveney EC, McAllister V, McDermott EWM, O’Higgins NJ, Maher M, Caldwell MTP, Murchan P, Beesley W, Feeley TM, Tanner WA, Keane FBV, Abbasakoor F, Attwood SEA, McGrath LP, Stephens RB, O’Broin E, Davies MG, McGinley J, Mannion C, Gupta S, Shine MF, Lennon F, Ninan G, Fitzgerald RJ, Guiney EJ, O’Donnell B, O’Donnell AF, Luke D, Wood AE, Murphy PG, Walsh TN, Hill ADK, Li H, Hennessy TPJ, Noonan N, Breslin B, Keeling PWN, Curran AJ, Gough DB, Davidson IR, Keeling P, O’Leary DP, Smythe A, Bird NC, Johnson AG, Nicholson P, Traynor O, Dawson K, Aitken J, Cooke BA, Parbhoo SP, N.Williams N, Daly JM, Herlyn M, Bouchier-Hayes D, Stuart RC, Allen MJ, Thompson WD, Peel ALG, Hehir DT, Cronin K, McCann A, Dervan PA, Heffernan SJ, Hederman WP, Galea MH, Dilks B, Gilmour A, Ellis LO, Elston CW, Blarney RW, O’Rourke S, Mookens A, Carter R, Parkin D, Couse NF, Delaney CP, Horgan PG, Fitzpatrick JM, Gorey TF, O’Byrne JM, McCabe JP, Stephens M, McManus F, L.Mangan J, Barr DA, Mulvenna GJ, Maginn P, Kernohan WG, Mollan RAB, O’Flanagan SJ, Stack JP, Dervan P, Hurson B, Tierney S, Fitzgerald P, O’Sullivan T, Grace P, Wyatt JP, Evans RJ, Cusack SP, McGowan S, McGovem E, Schwaitzberg SD, Connolly RJ, Sullivan RP, Mortimer G, Geraghty JG, O’Dwyer PJ, McGlone BS, O’Brien DP, Younis HA, Given HF, Phelan C, Byrne J, Barry K, Gough D, Hanrahan L, Given F, Sweeney JP, Korebrits AM, Reynolds JV, Gorey TF, O’Hanlon DM, Stokes MA, Redmond HP, McCarthy J, Daly JM, Losty P, Murphy M, Butler PEM, Grace PG, Novell JR, Hobbs SK, Smith O, Hazlehurst G, Brozovic B, Rolles K, Burroughs A, Mallett S, Mehta A, Buckley D, Waldron D, O’Brien D, Curran C, Given F, Grey L, Leahy A, Darzi A, Leader D, Broe P, Geoghegan JG, Cheng CA, Lawson DC, Pappas TN, O’Sullivan D, Lieber MM, Colby TV, Barrett DM, Rogers E, Greally J, Bredin HC, Corcoran MO, Kenny M, Horgan P, Headon D, Grace A, Grace PA, Bouchier-Hayes D, Cross S, Hehir D, O’Briain S, Hartigan P, Colgan MP, Moore D, Shanik G, Zaidi SZ, Hehir DJ, Cross KS, Colgan MP, Moore DJ, Shanik DG, Lacy P, Cross S, Hehir D, Moore D, Shanik G, Coleman JE, McEnroe CS, Gelfand JA, O’Donnell TF, Callow AD, Buckley DJ, O’Riordain DS, O’Donnell JA, Meagher P, Boos K, Gillen P, Corrigan T, Vashisht R, Sian M, Sharp EJ, O’Malley MK, Kerin MJ, Wilkinson D, Parkin A, Kester RC, Maher MM, Waldron RP, Waldron DJ, Brady MP, Allen M, Lyncy TH, Waymont B, Emtage L, Blackledge GR, Hughes MA, Wallace DMA, O’Sullivan D, Mynderse L, Barrett DM, Rogers E, Grimes H, Chambers F, Lowe D, Bredin HC, Corcoran MO, Waldron DJ, Prasad B, O’Sullivan DC, Gillen MBP, McNicholas M, Traynor O, Bredin H, O’Dowd TH, Corcoran M, O’Donoghue JM, Corcoran M, McGuire M, McNamara A, Creagh T, Grainger R, McDermott TBD, Butler MR, Gleeson M, Creagh T, Grainger R, McDermott TED, Hurley JP, Hone R, Neligan M, Hurley J, White M, McDonagh P, Phelan D, McGovern E, Quinn F, Breatnach F, O’Meara A, McGrath JP, McCann SR, Gaffney EF, Hennessy A, Leader M, Taleb FS, McKiernan MV, Leyden PJ, McCann JJ, Coleman J, Quereshi A, Ajayi N, McEntee G, Osborne H, Bouchier-Hayes DJ, Johnston S, O’Malley K, Smyth E, Bouchier-Hayes DL, Darzi A, Quereshi A, McEntee G, O’Connell PR, Gorey T, McAnena OJ, Reed MW, Duncan JL, Reilly CS, McGibney C, Lawlor P, Lawless B, McGuinness E, Leahy S. Sixteenth sir peter freyer memorial lecture and surgical symposium September 13th & 14th, 1991 Session I. Ir J Med Sci 1992. [DOI: 10.1007/bf02942125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Cotter LA, Healy M, Buckley M, O’Morain C, Keane C, O’Moore RR, Dickey W, Roberts G, Orr G, Porter K, McCrory D, Halliday MI, Hoper M, Crockard A, Rowlands BJ, Chua A, Dinan T, Dunbar B, Weir DG, Keeling PWN, Johnston BT, Collins JSA, McFarland RJ, Love AHG, Darzi A, Speakman CTN, Spigelman A, Henry MM, fnTanner WA, fnMcEntee GP, fnKeane FB, Tighe O, Bennett M, Mulcahy H, Williams NN, Duignan JP, Bouchier-Hayes D, O’Donoghue D, Croke DT, Hill AD, Walsh TN, Hennessy TPJ, Goggin M, Joyce WP, Prendergast C, Gibney E, Traynor OJ, Hyland J, O’Brien S, Fitzgerald MX, Hegarty JE, Leahy A, Grace P, Qureshi A, Leader M, Broe P, Eustace S, Blake N, McDevitt J, Feighery CF, O’Farrelly C, Kelleher D, O’Connell MA, Stokes MA, Hill GL, Gaffney P, O’Leary J, Doyle C, Hogan J, Gaffney A, Attwood SEA, Murphy P, Stephens RB, Wilson RH, Gilliland R, Kee F, Sloan JM, Moorehead RJ, ’Suilleabhain G, Horgan A, Kirwan WO, Deans GT, Heatley M, Williamson K, Parks TG, Rowland BJ, Spence RAJ, Mealy K, Burke P, Herlyn M, Redmond HP, Clery AP, Deasy JM, Austin O, Meenan J, Canili RJ, Mathias PM, Beattie S, Hamilton H, Geoghegan JG, Cheng CA, Lawson DC, Pappas TN, Collins R, Beatie S, Collins JK, O’Sullivan G, Corbett A, Clements WDB, MacMathuna P, Lombard M, Gimson A, Westaby D, Williams R, Duggan M, Lennon J, Crowe J, Ritchie AJ, Johnston F, McGuigan J, Gibbons JRP, Buchanan KD, Gilvarry JM, Robinson R, Fielding JF, Lawler M, Humphries P, Sheils O, O’Briain DS, McCarthy J, McDermott M, Hourihane D, Gallagher H, Barry M, Lennon F, Hederman WP, O’Connell PR, Gorey TF, Fitzpatrick JM, Daly JM, Carthy JE, Redmond H, Croake D, Grace PA, Campbell G, Maguire O, Lynch S, Atwood J, Madrigal L, Attwood J, Murphy A, Shovlin P, Hegarty J, Egleston V, Mealy K, MacErlean DP, Johnston S, O’Malley K, McEntee G, Smyth E, Moran B, Plant G, Rees M, Brindley N, Osborne H, Lane B, Lynch G, Geraghty J, Murphy D, O’Brien M, Harte P. Irish Society of Gastroenterology. Abstracts. Ir J Med Sci 1992; 161:81-97. [PMID: 1517062 DOI: 10.1007/bf02983720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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94
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Shanik GD, Moore DJ, Leahy A, Grouden MC, Colgan MP. Asymptomatic carotid stenosis: a benign lesion? EUROPEAN JOURNAL OF VASCULAR SURGERY 1992; 6:10-5. [PMID: 1555661 DOI: 10.1016/s0950-821x(05)80087-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Recent reports of the risk of asymptomatic carotid stenosis have been compromised by flawed patient selection or the performance of a large number of carotid endarterectomies during follow-up. We report the natural history of a randomly selected group of asymptomatic patients (n = 188; 114 males and 74 females) with documented carotid artery disease who were prospectively followed without intervention for up to 8 years. Risk factors included ischaemic heart disease in 17%, diabetes in 10%, hypertension in 46% and 88% were smokers. The degree of internal carotid stenosis was classified by duplex scanning and a total of 259 vessels had evidence of atherosclerosis. Study end-points included TIA, CVA and death. At mean follow-up of 4 years 3% of the 96 patients with internal carotid artery stenosis of less than 50% had died and 2% suffered a stroke. Six per cent of patients with a stenosis of 50-79% had died and 4% and 2% had suffered a CVA and TIA, respectively. In the 59 patients with greater than 80% stenosis 7% had suffered a TIA and an additional 7% a CVA, while 2% had died. None of the patients suffering a stroke had an antecedent TIA. Though the incidence of ischaemic events is significantly higher in patients with greater than 80% stenosis the incidence of unheralded stroke remains low. We therefore continue to recommend a conservative approach to the management of asymptomatic carotid stenosis.
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95
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Grace PA, Leahy A, McEntee G, Bouchier-Hayes D. Laparoscopic cholecystectomy in the scarred abdomen. Surg Endosc 1991; 5:118. [PMID: 1837186 DOI: 10.1007/bf02653215] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Laparoscopic cholecystectomy is rapidly becoming the definitive method for treating symptomatic gallbladder stones. Previous upper abdominal surgery is a relative contraindication to this technique. We describe a method for safely placing the trocars in a scarred abdomen, thus facilitating laparoscopic cholecystectomy in a wider group of patients.
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96
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Grace P, Quereshi A, Darzi A, McEntee G, Leahy A, Osborne H, Lynch G, Lane B, Broe P, Bouchier-Hayes D. Laparoscopic cholecystectomy: a hundred consecutive cases. IRISH MEDICAL JOURNAL 1991; 84:12-4. [PMID: 1828460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Laparoscopic cholecystectomy is a new, minimaly invasive technique for removing the gallbladder which has several advantages over the traditional laparotomy cholecystectomy. We reviewed our initial experience with 100 consecutive patients in whom laparoscopic cholecystectomy was attempted. The indications for operation were biliary colic, chronic cholecystitis, acute gallbladder and gallstone pancreatitis. Laparoscopic cholecystectomy was successfully performed in 87 patients. Anaesthesia time was 144 +/- 52 min. There was no mortality while overall morbidity was 14%. One patient had a retained common bile duct stone. Postoperative hospital stay was 4.1 +/- 2.2 days and the mean time to full activity in a random sample of 25 patients was 13.7 +/- 11.7 days. Laparoscopic cholecystectomy is a safe effective procedure which removes the gallbladder. We suggest that this technique be considered in all patients undergoing cholecystectomy.
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97
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Etwebi AB, Comerford FR, Callaghan M, Mulherin D, Whelan A, Feighery C, FitzGerald MX, Bresnihan B, Bell AL, Markey GM, Alexander HD, Morris M, McNally JA, O’Byrne S, Hall M, Cuffe JT, Feely J, Casey EB, de Paor A, Reilly R, Casey E, McCormack B, Kearns G, Beirne C, Ryan D, Kearns GD, Casey EB, Nuallain EM, Reen DJ, Kelleher D, Murphy A, Feighery C, Casey EB, Cullen D, Kelleher D, Murphy A, Keams G, Feighery C, Casey EB, Foley-Nolan D, Brady A, Stack J, Barry C, Ennis J, Coughlan RJ, Foley-Nolan D, Murray P, Campbell E, Keogh B, Coughlan RJ, O’Donoghue J, Foley-Nolan D, Woods R, Choudhry L, Byrne P, Barry C, Coughlan RJ, McCarthy CJ, Regan M, Coughlan RJ, Barry C, McCarthy J, Coughlin RJ, Barry C, McCarthy C, Foley-Nolan D, Coughlan R, Barry C, Sant TJ, Healy S, Casey EB, Healy E, Sant S, Tyrrell J, Casey EB, Sant S, Barry M, Murphy G, Sant S, Barry M, Murphy G, Veale D, Rogers S, Barnes L, FitzGerald O, Cooney J, Veale D, McQuillan R, Leahy A, Barton J, McMahon M, Bouchier-Hayes C, Courtney G, Doyle JS, FitzGerald O, Taggart AJ, McEvoy F, Heylings D, McMillin P, Hassan J, Yarani G, Feighery C, Bresnihan B, Whelan A, Doherty E, Bresnihan B, Harden C, Feighery C, Jackson J, Yanni G, Whelan A, Feighery C, Bresnihan B, Yanni G, Whelan A, Feighery C, FitzGerald O, Breshihan B, Shaw B, FitzGerald O. Irish association of Rheumatology & Rehabilitation. Ir J Med Sci 1991. [DOI: 10.1007/bf02944730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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98
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Darzi A, Leahy A, O'Morain C, Tanner WA, Keane FB. Gallstone clearance: a randomized study of extracorporeal shock wave lithotripsy and chemical dissolution. Br J Surg 1990; 77:1265-7. [PMID: 2253006 DOI: 10.1002/bjs.1800771121] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Following extracorporeal shock wave lithotripsy it is not known whether gallstone fragments are cleared from the gallbladder without the use of oral dissolution therapy. To assess the efficacy of lithotripsy and dissolution therapy, alone or in combination, 35 patients were randomized to one of three treatment groups: lithotripsy alone, dissolution therapy alone or combined lithotripsy and dissolution therapy. All patients had symptomatic gallstones, functioning gallbladders and comparable stone profiles. Lithotripsy was administered using a piezoelectric lithotripter. Dissolution therapy consisted of combined bile acid and terpene. Clearance was assessed at 6 months using ultrasound and oral cholecystography. Patients with less than 50 per cent stone clearance at the end of 6 months were considered failures. The number of patients with total or partial clearance in the combined group (7/10) was significantly greater than those in the lithotripsy alone group (0/10, P less than 0.002). Gallstone clearance following lithotripsy appears to be dependent upon dissolution therapy.
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Myers DH, Leahy A, Shoeb H, Ryder J. The patients' view of life in a psychiatric hospital. A questionnaire study and associated methodological considerations. Br J Psychiatry 1990; 156:853-60. [PMID: 2207516 DOI: 10.1192/bjp.156.6.853] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In any assessment of hospital life, the patients' view is indispensable, but there is no generally accepted way of seeking it. In this study, the views of 258 patients in four 'traditional' English psychiatric hospitals were obtained by a questionnaire of 45 items supplemented by freehand comments. Their experience of fellow patients, the staff and the material and institutional aspects of hospital care were explored. Some of the benefits and problems of questionnaire use in this realm are discussed.
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100
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O'Gorman S, O'Brien A, Leahy A, Butler MR, Keane FB. Rectovesical fistula due to indwelling catheter. BRITISH JOURNAL OF UROLOGY 1990; 65:424. [PMID: 2340381 DOI: 10.1111/j.1464-410x.1990.tb14774.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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