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Clarke M, Dumon S, Ward C, Jäger R, Freeman S, Dawood B, Sheriff L, Lorvellec M, Kralovics R, Frampton J, García P. MYBL2 haploinsufficiency increases susceptibility to age-related haematopoietic neoplasia. Leukemia 2012; 27:661-70. [PMID: 22910183 PMCID: PMC3593183 DOI: 10.1038/leu.2012.241] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The haematopoietic system is prone to age-related disorders ranging from deficits in functional blood cells to the development of neoplastic states. Such neoplasms often involve recurrent cytogenetic abnormalities, among which a deletion in the long arm of chromosome 20 (del20q) is common in myeloid malignancies. The del20q minimum deleted region contains nine genes, including MYBL2, which encodes a key protein involved in the maintenance of genome integrity. Here, we show that mice expressing half the normal levels of Mybl2 (Mybl2+/Δ) develop a variety of myeloid disorders upon ageing. These include myeloproliferative neoplasms, myelodysplasia (MDS) and myeloid leukaemia, mirroring the human conditions associated with del20q. Moreover, analysis of gene expression profiles from patients with MDS demonstrated reduced levels of MYBL2, regardless of del20q status and demonstrated a strong correlation between low levels of MYBL2 RNA and reduced expression of a subset of genes related to DNA replication and checkpoint control pathways. Paralleling the human data, we found that these pathways are also disturbed in our Mybl2+/Δ mice. This novel mouse model, therefore, represents a valuable tool for studying the initiation and progression of haematological malignancies during ageing, and may provide a platform for preclinical testing of therapeutic approaches.
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Ward C, Corns R, Offa-Jones B, Cheserem J, Hardwidge C. Cerebellar Infarction Following Division of Dandy's Vein in Microvascular Decompression for Trigeminal Neuralgia. J Neurol Surg B Skull Base 2012. [DOI: 10.1055/s-0032-1314292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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D'Urso P, Ward C, Walsh D. Intraoperative Indocyanine Green Video Angiography for Resection of Spinal Cord Hemangioblastomas. J Neurol Surg A Cent Eur Neurosurg 2012. [DOI: 10.1055/s-0032-1316236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Cropper J, Edwards L, Hearst D, Durling E, Ward C, Albon H, Roberts C, Thorpe S, Murray J. Factors associated with a difficult induction of general anaesthesia. Cochlear Implants Int 2012; 12 Suppl 2:S30-2. [PMID: 21917215 DOI: 10.1179/146701011x13074645127397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Many children experiencing a procedure under general anaesthetic (GA), including those having surgery for cochlear implantation, display behaviours indicative of distress during induction of anaesthesia. It would be useful to ascertain which factors in the pre-operative period are related to the presence of distress at induction in order to target appropriate psychological preparation. METHODS The families of 84 children aged 4-7 years undergoing a procedure under GA (including insertion of a cochlear implant) completed three questionnaires assessing temperament, behavioural difficulties, and pre-operative worries. Demographic variables were also recorded. The outcome measure was the amount of behavioural distress at induction. RESULTS Statistically significant relationships with the outcome measure of distress at induction were obtained for three factors; an emotional or sociable temperament, and the number of previous procedures. Further, children receiving inhalation inductions displayed greater distress than those receiving intravenous inductions. CONCLUSION Undergoing cochlear implantation under GA is a major life event for many recipients. Psychologically preparing children for this has been found to be efficacious, but is not currently available to all children. It is suggested that preparation can be targeted at children, as identified in this study, who have elevated emotionality or sociability scores or who have previous experience of procedures under general anaesthesia. This is of particular current relevance as children are increasingly likely to require re-implantation as they grow older and as unilaterally implanted children are now being offered a sequential bilateral implant, both necessitating further surgery.
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Scott A, Orsi A, Ward C, Bradford R. Genotoxicity testing of a Hoodia gordonii extract. Food Chem Toxicol 2012; 50 Suppl 1:S34-40. [DOI: 10.1016/j.fct.2011.01.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 01/06/2011] [Accepted: 01/25/2011] [Indexed: 01/25/2023]
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Anderson B, Moray A, Karl T, Provenzano S, Justo R, Ward C. Small Pulmonary Artery Stents: Single Centre Experience. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Anderson B, Justo R, Fox S, Ward C. Atrial Septal Stent Fenestration in the Management of Idiopathic Pulmonary Hypertension. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.709] [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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Macintosh KA, Jordan P, Cassidy R, Arnscheidt J, Ward C. Low flow water quality in rivers; septic tank systems and high-resolution phosphorus signals. THE SCIENCE OF THE TOTAL ENVIRONMENT 2011; 412-413:58-65. [PMID: 22061159 DOI: 10.1016/j.scitotenv.2011.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 10/03/2011] [Accepted: 10/09/2011] [Indexed: 05/31/2023]
Abstract
Rural point sources of phosphorus (P), including septic tank systems, provide a small part of the overall phosphorus budget to surface waters in agricultural catchments but can have a disproportionate impact on the low flow P concentration of receiving rivers. This has particular importance as the discharges are approximately constant into receiving waters and these have restricted dilution capacity during ecologically sensitive summer periods. In this study, a number of identified high impact septic systems were replaced with modern sequential batch reactors in three rural catchments during a monitoring period of 4 years. Sub-hourly P monitoring was conducted using bankside-analysers. Results show that strategic replacement of defective septic tank systems with modern systems and polishing filters decreased the low flow P concentration of one catchment stream by 0.032 mg TPL(-1) (0.018 mg TRPL(-1)) over the 4 years. However two of the catchment mitigation efforts were offset by continued new-builds that increased the density of septic systems from 3.4 km(-2) to 4.6 km(-2) and 13.8 km(-2) to 17.2 km(-2) and subsequently increased low flow P concentrations. Future considerations for septic system mitigation should include catchment carrying capacity as well as technology changes.
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Ward C, Rydell-Tormanen K, Westergren-Thorsson G, Eriksson LT, Walters H. Infection and remodelling: a 21st century model of bronchiectasis? Eur Respir J 2011; 38:758-60. [DOI: 10.1183/09031936.00072811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Lawrence M, Menting J, Kong G, Margetts M, Ward C. First view of insulin bound to its primary binding site on the insulin receptor. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311096401] [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] Open
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Robertson AGN, Krishnan A, Ward C, Pearson JP, Small T, Corris PA, Dark JH, Karat D, Shenfine J, Griffin SM. Anti-reflux surgery in lung transplant recipients: outcomes and effects on quality of life. Eur Respir J 2011; 39:691-7. [PMID: 21778169 DOI: 10.1183/09031936.00061811] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Fundoplication may improve survival after lung transplantation. Little is known about the effects of fundoplication on quality of life in these patients. The aim of this study was to assess the safety of fundoplication in lung transplant recipients and its effects on quality of life. Between June 1, 2008 and December 31, 2010, a prospective study of lung transplant recipients undergoing fundoplication was undertaken. Quality of life was assessed before and after surgery. Body mass index (BMI) and pulmonary function were followed up. 16 patients, mean ± sd age 38 ± 11.9 yrs, underwent laparoscopic Nissen fundoplication. There was no peri-operative mortality or major complications. Mean ± SD hospital stay was 2.6 ± 0.9 days. 15 out of 16 patients were satisfied with the results of surgery post fundoplication. There was a significant improvement in reflux symptom index and DeMeester questionnaires and gastrointestinal quality of life index scores at 6 months. Mean BMI decreased significantly after fundoplication (p = 0.01). Patients operated on for deteriorating lung function had a statistically significant decrease in the rate of lung function decline after fundoplication (p = 0.008). Laparoscopic fundoplication is safe in selected lung transplant recipients. Patient benefit is suggested by improved symptoms and satisfaction. This procedure is acceptable, improves quality of life and may reduce deterioration of lung function.
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Rafii MS, Walsh S, Little JT, Behan K, Reynolds B, Ward C, Jin S, Thomas R, Aisen PS. A phase II trial of huperzine A in mild to moderate Alzheimer disease. Neurology 2011; 76:1389-94. [PMID: 21502597 DOI: 10.1212/wnl.0b013e318216eb7b] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Huperzine A is a natural cholinesterase inhibitor derived from the Chinese herb Huperzia serrata that may compare favorably in symptomatic efficacy to cholinesterase inhibitors currently in use for Alzheimer disease (AD). METHODS We assessed the safety, tolerability, and efficacy of huperzine A in mild to moderate AD in a multicenter trial in which 210 individuals were randomized to receive placebo (n = 70) or huperzine A (200 μg BID [n = 70] or 400 μg BID [n = 70]), for at least 16 weeks, with 177 subjects completing the treatment phase. The primary analysis assessed the cognitive effects of huperzine A 200 μg BID (change in Alzheimer's Disease Assessment Scale-cognitive subscale [ADAS-Cog] at week 16 at 200 μg BID compared to placebo). Secondary analyses assessed the effect of huperzine A 400 μg BID, as well as effect on other outcomes including Mini-Mental State Examination, Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change scale, Alzheimer's Disease Cooperative Study Activities of Daily Living scale, and Neuropsychiatric Inventory (NPI). RESULTS Huperzine A 200 μg BID did not influence change in ADAS-Cog at 16 weeks. In secondary analyses, huperzine A 400 μg BID showed a 2.27-point improvement in ADAS-Cog at 11 weeks vs 0.29-point decline in the placebo group (p = 0.001), and a 1.92-point improvement vs 0.34-point improvement in the placebo arm (p = 0.07) at week 16. Changes in clinical global impression of change, NPI, and activities of daily living were not significant at either dose. CONCLUSION The primary efficacy analysis did not show cognitive benefit with huperzine A 200 μg BID. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that huperzine A 200 μg BID has no demonstrable cognitive effect in patients with mild to moderate AD.
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Brodlie M, McKean MC, Johnson GE, Anderson AE, Hilkens CMU, Fisher AJ, Corris PA, Lordan JL, Ward C. Raised interleukin-17 is immunolocalised to neutrophils in cystic fibrosis lung disease. Eur Respir J 2011; 37:1378-85. [PMID: 21109552 DOI: 10.1183/09031936.00067110] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Interleukin (IL)-17 is pivotal in orchestrating the activity of neutrophils. Neutrophilic inflammation is the dominant pathology in cystic fibrosis (CF) lung disease. We investigated IL-17 protein expression in the lower airway in CF, its cellular immunolocalisation and the effects of IL-17 on CF primary bronchial epithelial cells. Immunohistochemistry was performed on explanted CF lungs and compared with the non-suppurative condition pulmonary hypertension (PH). Airway lavages and epithelial cultures were generated from explanted CF lungs. Immunoreactivity for IL-17 was significantly increased in the lower airway epithelium in CF (median 14.1%) compared with PH (2.95%, p=0.0001). The number of cells staining positive for IL-17 in the lower airway mucosa was also increased (64 cells·mm(-1) compared with 9 cells·mm(-1) basement membrane, p=0.0005) and included both neutrophils in addition to mononuclear cells. IL-17 was detectable in airway lavages from explanted CF lungs. Treatment of epithelial cultures with IL-17 increased production of IL-8, IL-6 and granulocyte macrophage colony-stimulating factor. In conclusion, immunoreactive IL-17 is raised in the lower airway of people with CF and localises to both neutrophils and mononuclear cells. IL-17 increases production of pro-neutrophilic mediators by CF epithelial cells, suggesting potential for a positive feedback element in airway inflammation.
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Leelarathna L, Ward C, Davenport K, Donald S, Housden A, Finucane FM, Evans M. Reduced insulin requirements during participation in the DAFNE (dose adjustment for normal eating) structured education programme. Diabetes Res Clin Pract 2011; 92:e34-6. [PMID: 21269721 DOI: 10.1016/j.diabres.2011.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 12/19/2010] [Accepted: 01/04/2011] [Indexed: 10/18/2022]
Abstract
Dose adjustment for normal eating (DAFNE) is a well-established structured education programme for patients with type 1 diabetes. We conducted a retrospective analysis of insulin dose changes associated with DAFNE training. Our results show significant reductions in total, quick acting and basal insulin doses in patients undergoing DAFNE training.
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Rehwagen C, Ward C. Excellence in healthcare education: top picks for 2011. West J Med 2011. [DOI: 10.1136/bmj.d1728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Brodlie M, Lordan J, Ward C. Can cells other than Th17 lymphocytes be important sources of IL-17 in the lungs? Thorax 2011; 66:1096; author reply 1096-7. [DOI: 10.1136/thx.2010.157941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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117
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Russell ALR, Charlton S, Mooney ER, Ward C, Russell RIR. P80 Pre-operative assessment of children undergoing scoliosis surgery. Thorax 2010. [DOI: 10.1136/thx.2010.150979.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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118
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Borthwick LA, Brodlie M, Johnson GE, Ward C, Perry J, Corris PA, De-Soyza A, Fisher AJ. S122 The M1 macrophage phenotype accentuates TGF- 1 driven epithelial to mesenchymal transition (EMT) via the secretion of TNF. Thorax 2010. [DOI: 10.1136/thx.2010.150946.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dhar R, Anwar GA, Bourke SC, Doherty L, Middleton P, Ward C, Rutherford RM. Efficacy of nebulised colomycin in patients with non-cystic fibrosis bronchiectasis colonised with Pseudomonas aeruginosa. Thorax 2010; 65:553. [PMID: 20522858 DOI: 10.1136/thx.2008.112284] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Borthwick LA, Sunny SS, Oliphant V, Perry J, Brodlie M, Johnson GE, Ward C, Gould K, Corris PA, De Soyza A, Fisher AJ. Pseudomonas aeruginosa accentuates epithelial-to-mesenchymal transition in the airway. Eur Respir J 2010; 37:1237-47. [DOI: 10.1183/09031936.00088410] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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121
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Aboud M, Morel-Kopp MC, Ward C, Coyle L. False-negative or false-positive: laboratory diagnosis of lupus anticoagulant at the time of commencement of anticoagulant. J Thromb Haemost 2010; 8:2070-3. [PMID: 20553379 DOI: 10.1111/j.1538-7836.2010.03946.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
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Ward C. Peripheral arterial disease. MEDSURG NURSING : OFFICIAL JOURNAL OF THE ACADEMY OF MEDICAL-SURGICAL NURSES 2010; 19:247-248. [PMID: 20860253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Buckley T, Bartrop R, McKinley S, Ward C, Bramwell M, Roche D, Mihailidou AS, Morel-Kopp MC, Spinaze M, Hocking B, Goldston K, Tennant C, Tofler G. Prospective study of early bereavement on psychological and behavioural cardiac risk factors. Intern Med J 2010; 39:370-8. [PMID: 19460057 DOI: 10.1111/j.1445-5994.2009.01879.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Increasing evidence supports the role of emotional stress in the onset of cardiovascular disease. Although bereavement is a major emotional stress with both acute and more long-term features, the mechanism of its association with cardiovascular risk is not well understood, in particular because of limited studies of acute bereavement. The aim of the study was to identify psychological and behavioural changes in acute bereavement and potential modifiers of these changes. METHODS Bereaved (n= 62) and non-bereaved individuals (n= 50) were evaluated within 2 weeks and at 6 months following loss using the Centre for Epidemiologic Studies -- Depression, Spielberger State Anxiety and Anger, Social Support Questionnaire and changes in appetite, cigarette and alcohol consumption, cortisol and lipids. RESULTS Compared with non-bereaved, acutely bereaved had increased symptoms of depression (26.7 +/- 1.7 vs 5.9 +/- 0.7, P < 0.001), anxiety (47.4 +/- 2.0 vs 28.2 +/- 1.4, P < 0.001) and anger (median 16.0 vs 15.0, P < 0.001). Greater depressive symptoms were associated with being unprepared for the death, decreased sleep duration and younger age. Acutely, bereaved slept less than non-bereaved (5.8 +/- 0.2 vs 7.2 +/- 0.2 h, P < 0.001). Reduced sleep time was associated with increased anger and depression and decreased satisfaction with social support. Compared with the non-bereaved, the acutely bereaved had higher cortisol (median 306 vs 266, P= 0.003), reduced appetite (P < 0.001) and lower total cholesterol (median 4.9 vs 5.4, P= 0.006) and low-density lipoprotein (median 2.4 vs 2.9, P < 0.001). CONCLUSION These results offer insight into the psychological, behavioural and physical changes that may contribute to cardiovascular risk in bereavement.
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Borthwick LA, McIlroy EI, Gorowiec MR, Brodlie M, Johnson GE, Ward C, Lordan JL, Corris PA, Kirby JA, Fisher AJ. Inflammation and epithelial to mesenchymal transition in lung transplant recipients: role in dysregulated epithelial wound repair. Am J Transplant 2010; 10:498-509. [PMID: 20055810 DOI: 10.1111/j.1600-6143.2009.02953.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Epithelial to mesenchymal transition (EMT) has been implicated in the pathogenesis of obliterative bronchiolitis (OB) after lung transplant. Although TNF-alpha accentuates TGF-beta1 driven EMT in primary human bronchial epithelial cells (PBECs), we hypothesized that other acute pro-inflammatory cytokines elevated in the airways of patients with OB may also accentuate EMT and contribute to dysregulated epithelial wound repair. PBECs from lung transplant recipients were stimulated with TGF-beta1+/-IL-1beta, IL-8, TNF-alpha or activated macrophages in co-culture and EMT assessed. The quality and rate of wound closure in a standardized model of lung epithelial injury was assessed in response to above stimuli. Co-treatment with TGF-beta1+TNF-alpha or IL-1beta significantly accentuates phenotypic and some functional features of EMT compared to TGF-beta1 alone. Co-treatment with TGF-beta1+TNF-alpha or IL-1beta accelerates epithelial wound closure however the quality of repair is highly dysregulated. Co-treatment with TGF-beta1+IL-8 has no significant effect on EMT or the speed or quality of wound healing. Activated macrophages dramatically accentuate TGF-beta1-driven EMT and cause dysregulated wound repair. Crosstalk between macrophage-derived acute inflammation in the airway and elevated TGF-beta1 may favor dysregulated airway epithelial repair and fibrosis in the lung allograft via EMT.
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Murphy DM, Forrest IA, Curran D, Ward C. Macrolide antibiotics and the airway: antibiotic or non-antibiotic effects? Expert Opin Investig Drugs 2010; 19:401-14. [DOI: 10.1517/13543781003636480] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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