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Warshavsky A, Dorman A, Carmel-Neiderman NN, Leider-Trejo L, Muhanna N, Kampel L, Ianculovici C, Horowitz G. Pre-resection Intraoperative Core Biopsies in Oral Tongue Cancer-A Pilot Study. Laryngoscope 2023; 133:2232-2236. [PMID: 36576073 DOI: 10.1002/lary.30546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 11/14/2022] [Accepted: 12/03/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To assess a novel intraoperative core biopsy technique to provide enhanced guidance in partial glossectomies. METHODS All patients diagnosed with squamous cell carcinoma of the oral tongue were eligible for study participation. Following anesthesia, the planned resection and three points midway between the gross tumor and the intended ablation were marked. A core biopsy was performed with a needle spring on each point and sent for frozen sections. The initially planned resection was executed if the cores returned free of tumor. In case of a positive core biopsy, a new 1-1.5 cm margin was marked around that point. The main outcome measure was the closest final margin diameter, especially the deep ones. Other outcome measures were the core biopsies' sensitivity, specificity, and negative predictive value. Complications were recorded. RESULTS The final margins of 10 patients undergoing intraoperative core biopsies and 20 matched controls were analyzed. One patient had two positive cores and final negative margins after modifying the resection accordingly. Another patient had a positive biopsy diagnosed only on final pathology, and one close final margin. Patients that were operated with the new technique had larger margins compared to the controls: median (interquartile range) closest margin 5.95 (3.97; 9.63) mm versus 4 (2.25; 5) mm (p = 0.074) and median deep margin 8.6 (6.16; 10) mm versus 5 (3;10) mm (p = 0.411), respectively. There were no complications. CONCLUSION A novel pre-resection intraoperative biopsy technique is presented. Core biopsies taken during glossectomies have the potential to prevent inadequate margins. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2232-2236, 2023.
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Affiliation(s)
- Anton Warshavsky
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Alexandra Dorman
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Narin Nard Carmel-Neiderman
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Leonora Leider-Trejo
- The Department of Pathology, Tel-Aviv Sourasky Medical Center, School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nidal Muhanna
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Liyona Kampel
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Clariel Ianculovici
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gilad Horowitz
- The Department of Otolaryngology, Head & Neck Surgery and Maxillofacial Surgery, School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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MOOLLAN N, Dorman A, Magee C, Durcan L. POS-473 A FLARE OF LUPUS NEPHRITIS LEADING TO A DIAGNOSIS OF POLYCYSTIC KIDNEY DISEASE. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Dorman A, Binenbaum I, Abu-Toamih Atamni HJ, Chatziioannou A, Tomlinson I, Mott R, Iraqi FA. Genetic mapping of novel modifiers for Apc Min induced intestinal polyps' development using the genetic architecture power of the collaborative cross mice. BMC Genomics 2021; 22:566. [PMID: 34294033 PMCID: PMC8299641 DOI: 10.1186/s12864-021-07890-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 07/14/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Familial adenomatous polyposis is an inherited genetic disease, characterized by colorectal polyps. It is caused by inactivating mutations in the Adenomatous polyposis coli (Apc) gene. Mice carrying a nonsense mutation in the Apc gene at R850, which is designated ApcMin/+ (Multiple intestinal neoplasia), develop intestinal adenomas. Several genetic modifier loci of Min (Mom) were previously mapped, but so far, most of the underlying genes have not been identified. To identify novel modifier loci associated with ApcMin/+, we performed quantitative trait loci (QTL) analysis for polyp development using 49 F1 crosses between different Collaborative Cross (CC) lines and C57BL/6 J-ApcMin/+mice. The CC population is a genetic reference panel of recombinant inbred lines, each line independently descended from eight genetically diverse founder strains. C57BL/6 J-ApcMin/+ males were mated with females from 49 CC lines. F1 offspring were terminated at 23 weeks and polyp counts from three sub-regions (SB1-3) of small intestinal and colon were recorded. RESULTS The number of polyps in all these sub-regions and colon varied significantly between the different CC lines. At 95% genome-wide significance, we mapped nine novel QTL for variation in polyp number, with distinct QTL associated with each intestinal sub-region. QTL confidence intervals varied in width between 2.63-17.79 Mb. We extracted all genes in the mapped QTL at 90 and 95% CI levels using the BioInfoMiner online platform to extract, significantly enriched pathways and key linker genes, that act as regulatory and orchestrators of the phenotypic landscape associated with the ApcMin/+ mutation. CONCLUSIONS Genomic structure of the CC lines has allowed us to identify novel modifiers and confirmed some of the previously mapped modifiers. Key genes involved mainly in metabolic and immunological processes were identified. Future steps in this analysis will be to identify regulatory elements - and possible epistatic effects - located in the mapped QTL.
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Affiliation(s)
- Alexandra Dorman
- Department of Clinical Microbiology & Immunology, Sackler Faculty of Medicine, Ramat Aviv, 69978 Tel-Aviv, Israel
| | - Ilona Binenbaum
- Department of Biology, University of Patras, Patras, Greece
- Center of Systems Biology, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Hanifa J. Abu-Toamih Atamni
- Department of Clinical Microbiology & Immunology, Sackler Faculty of Medicine, Ramat Aviv, 69978 Tel-Aviv, Israel
| | | | - Ian Tomlinson
- Cancer Research UK Edinburgh Centre, Charles and Ethel Barr Chair of Cancer Research, University of Edinburgh, Edinburgh, UK
| | - Richard Mott
- Department of Genetics, University Collage of London, London, UK
| | - Fuad A. Iraqi
- Department of Clinical Microbiology & Immunology, Sackler Faculty of Medicine, Ramat Aviv, 69978 Tel-Aviv, Israel
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Cohen D, Atsmon J, Artaud C, Meron-Sudai S, Gougeon ML, Bialik A, Goren S, Asato V, Ariel-Cohen O, Reizis A, Dorman A, Hoitink CWG, Westdijk J, Ashkenazi S, Sansonetti P, Mulard LA, Phalipon A. Safety and immunogenicity of a synthetic carbohydrate conjugate vaccine against Shigella flexneri 2a in healthy adult volunteers: a phase 1, dose-escalating, single-blind, randomised, placebo-controlled study. The Lancet Infectious Diseases 2021; 21:546-558. [DOI: 10.1016/s1473-3099(20)30488-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 03/11/2020] [Accepted: 05/20/2020] [Indexed: 12/17/2022]
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Kampel L, Dorman A, Horowitz G, Fliss DM, Gutfeld O, Muhanna N. Surgically Treated Advanced Cutaneous Squamous Cell Carcinoma of the Head and Neck: Outcome Predictors and the Role of Adjuvant Radiation Therapy. Ann Otol Rhinol Laryngol 2021; 130:1016-1023. [PMID: 33514267 DOI: 10.1177/0003489421990182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Advanced cutaneous squamous cell carcinoma of the head and neck (CSCCHN) is associated with poor outcome despite multimodality therapy. Comprehensive risk stratification may pinpoint the most suitable adjuvant treatment. This study aimed to evaluate the outcomes of surgically treated locoregional CSCCHN and to identify prognostic indicators of treatment outcomes. METHODS We retrospectively analyzed disease variables, pathologic characteristics, and management in association with treatment outcomes of all consecutive advanced CSCCHN patients who underwent surgical resection at Tel Aviv Sourasky Medical Center. RESULTS From 2008 to 2018, 74 patients met the inclusion criteria. Only perineural invasion (PNI) was significantly associated with worse overall survival (OS) (P = .001). Location within the facial "mask areas" was significantly associated with pathologically negative cervical disease (P = .001). Forty-seven patients underwent adjuvant radiation therapy (RT) which significantly improved OS and disease-free survival versus surgery alone (P = .025 and P = 0.035, respectively). CONCLUSION PNI was associated with worse OS in surgically treated advanced CSCCHN. Adjuvant RT conferred better outcomes despite high risk features.
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Affiliation(s)
- Liyona Kampel
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Alexandra Dorman
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Gilad Horowitz
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Dan M Fliss
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Orit Gutfeld
- Institute of Radiation Therapy, Division of Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Nidal Muhanna
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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6
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Amsalem D, Gothelf D, Dorman A, Goren Y, Tene O, Shelef A, Horowitz I, Dunsky LL, Rogev E, Klein EH, Mekori-Domachevsky E, Fischel T, Levkovitz Y, Martin A, Gross R. Reducing Stigma Toward Psychiatry Among Medical Students: A Multicenter Controlled Trial. Prim Care Companion CNS Disord 2020; 22. [PMID: 32135042 DOI: 10.4088/pcc.19m02527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 12/03/2019] [Indexed: 10/24/2022] Open
Abstract
Objective To examine the effect of a novel antistigma intervention curriculum (ASIC) in reducing stigma toward psychiatry among medical students. Methods Medical students from 8 hospitals in central Israel were divided into intervention (n = 57) and control (n = 163) arms. The students completed the 30-item Attitudes Toward Psychiatry (ATP-30) and the Attitudes Toward Mental Illness (AMI) scales at psychiatry rotation onset and conclusion. The ASIC was designed to target prejudices and stigma through direct informal encounters with people with serious mental illness (SMI) during periods of remission and recovery. Supervised small-group discussions followed those encounters to facilitate processing of thoughts and emotions that ensued and to discuss salient topics in psychiatry. The study was conducted between November 2017 and July 2018. Results Significant between-group differences were found at endpoint for attitudes toward psychiatry and psychiatric patients (P < .001). Although changing attitudes toward psychiatry as a career choice was not part of the ASIC, a significant between-group difference emerged by endpoint (P < .001). Conclusions Implementation of an ASIC that includes contact with individuals with lived SMI experience followed by supervised small-group discussions is effective in reducing stigma in medical students' perceptions of people with mental illness and psychiatry. Further evaluation is warranted with regard to the long-term destigmatizing effects of an ASIC. Trial Registration ClinicalTrials.gov identifier: NCT03907696.
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Affiliation(s)
- Doron Amsalem
- Child Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, 52621, Tel Hashomer, Israel. .,Child Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Doron Gothelf
- Child Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Alexandra Dorman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yaron Goren
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Geha Mental Health Center, Petah Tikva, Israel
| | - Oren Tene
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Tel Aviv Medical Center, Tel Aviv, Israel
| | - Assaf Shelef
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Abarbanel Mental Health Center, Bat Yam, Israel
| | - Itai Horowitz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Beer-Ya'akov-Ness-Ziona-Maban Mental Health Center, Israel
| | - Liora Libman Dunsky
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Psychogeriatrics Department, Holocaust Survivor Hostel, Lev Hasharon Medical Health Center, Pardesiya, Israel
| | - Eldor Rogev
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Tel Aviv Brüll Community Mental Health Center, Clalit Health Services, Tel Aviv, Israel
| | - Efrat Hirsh Klein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Shalvata Mental Health Center, Hod Hasharon, Israel
| | - Ehud Mekori-Domachevsky
- Child Psychiatry Division, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tsvi Fischel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Geha Mental Health Center, Petah Tikva, Israel
| | - Yechiel Levkovitz
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Beer-Ya'akov-Ness-Ziona-Maban Mental Health Center, Israel
| | - Andres Martin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | - Raz Gross
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel
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Cormican S, Connaughton DM, Kennedy C, Murray S, Živná M, Kmoch S, Fennelly NK, O'Kelly P, Benson KA, Conlon ET, Cavalleri G, Foley C, Doyle B, Dorman A, Little MA, Lavin P, Kidd K, Bleyer AJ, Conlon PJ. Autosomal dominant tubulointerstitial kidney disease (ADTKD) in Ireland. Ren Fail 2020; 41:832-841. [PMID: 31509055 PMCID: PMC6746258 DOI: 10.1080/0886022x.2019.1655452] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a rare genetic cause of renal impairment resulting from mutations in the MUC1, UMOD, HNF1B, REN, and SEC61A1 genes. Neither the national or global prevalence of these diseases has been determined. We aimed to establish a database of patients with ADTKD in Ireland and report the clinical and genetic characteristics of these families. Methods: We identified patients via the Irish Kidney Gene Project and referral to the national renal genetics clinic in Beaumont Hospital who met the clinical criteria for ADTKD (chronic kidney disease, bland urinary sediment, and autosomal dominant inheritance). Eligible patients were then invited to undergo genetic testing by a variety of methods including panel-based testing, whole exome sequencing and, in five families who met the criteria for diagnosis of ADTKD but were negative for causal genetic mutations, we analyzed urinary cell smears for the presence of MUC1fs protein. Results: We studied 54 individuals from 16 families. We identified mutations in the MUC1 gene in three families, UMOD in five families, HNF1beta in two families, and the presence of abnormal MUC1 protein in urine smears in three families (one of which was previously known to carry the genetic mutation). We were unable to identify a mutation in 4 families (3 of whom also tested negative for urinary MUC1fs). Conclusions: There are 4443 people with ESRD in Ireland, 24 of whom are members of the cohort described herein. We observe that ADTKD represents at least 0.54% of Irish ESRD patients.
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Affiliation(s)
- S Cormican
- Nephrology Department, Beaumont Hospital , Dublin , Ireland
| | - D M Connaughton
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Boston Children's Hospital, Harvard Medical School , Boston , MA , USA.,Trinity Health Kidney Centre, Trinity Translational Medicine Institute , Dublin , Ireland
| | - C Kennedy
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| | - S Murray
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| | - M Živná
- Department of Pediatrics and Adolescent Medicine, Research Unit for Rare Diseases, First Faculty of Medicine, Charles University , Prague , Czech Republic
| | - S Kmoch
- Department of Pediatrics and Adolescent Medicine, Research Unit for Rare Diseases, First Faculty of Medicine, Charles University , Prague , Czech Republic
| | - N K Fennelly
- Pathology Department, Beaumont Hospital , Dublin , Ireland
| | - P O'Kelly
- Nephrology Department, Beaumont Hospital , Dublin , Ireland
| | - K A Benson
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| | - E T Conlon
- Nephrology Department, Beaumont Hospital , Dublin , Ireland
| | - G Cavalleri
- Department of Medicine, Royal College of Surgeons , Dublin , Ireland
| | - C Foley
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute , Dublin , Ireland.,Clinical Research Centre, Royal College of Surgeons , Dublin , Ireland
| | - B Doyle
- Pathology Department, Beaumont Hospital , Dublin , Ireland
| | - A Dorman
- Pathology Department, Beaumont Hospital , Dublin , Ireland
| | - M A Little
- Trinity Health Kidney Centre, Trinity Translational Medicine Institute , Dublin , Ireland.,Trinity Health Kidney Centre, Tallaght Hospital , Dublin , Ireland
| | - P Lavin
- Trinity Health Kidney Centre, Tallaght Hospital , Dublin , Ireland
| | - K Kidd
- Section on Nephrology, Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - A J Bleyer
- Section on Nephrology, Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - P J Conlon
- Nephrology Department, Beaumont Hospital , Dublin , Ireland.,Department of Medicine, Royal College of Surgeons , Dublin , Ireland
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Amsalem D, Gothelf D, Soul O, Dorman A, Ziv A, Gross R. Single-Day Simulation-Based Training Improves Communication and Psychiatric Skills of Medical Students. Front Psychiatry 2020; 11:221. [PMID: 32265762 PMCID: PMC7099001 DOI: 10.3389/fpsyt.2020.00221] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 03/06/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Use of standardized (or simulated) patients (SP) is considered an effective teaching method for improving clinical and communication skills. This study assesses the effect of a single-day simulated patients (SP)-based training course on medical students' communication and basic skills in clinical psychiatry during their psychiatry rotation in a university-affiliated tertiary medical center. METHODS Forty-two third-year medical students participated. Communication and basic skills in clinical psychiatry were evaluated by a modified Four Habits Coding Scale (4HCS) and the psychiatric interview coding scale before and after SP training. An actual patient interview by the students 1 week after the training was evaluated by an attending psychiatrist blinded to the student's score during the SP-based training. Self-report questionnaires on satisfaction from the training and its impact on their self-confidence were administered at the end of training. FINDINGS The mean pre-training 4HCS score of 33.9 increased to 52.3 post-training (p < 0.001). The mean psychiatric interview coding scale score increased from 4.33 to 5.36 (p = 0.002). The self-report questionnaire yielded a mean score of 4.21 on a 1-5 Likert scale, implying high levels of satisfaction and self-confidence. CONCLUSIONS A single SP-based training course of medical students sufficed to improve clinical and communication skills in psychiatric settings and enhance their subjective perception of those skills.
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Affiliation(s)
- Doron Amsalem
- The Child Psychiatry Division, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,MSR-Israel Center for Medical Simulation, Sheba Medical Center, Tel Hashomer, Israel
| | - Doron Gothelf
- The Child Psychiatry Division, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,MSR-Israel Center for Medical Simulation, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Omer Soul
- The Child Psychiatry Division, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alexandra Dorman
- Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Amitai Ziv
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,MSR-Israel Center for Medical Simulation, Sheba Medical Center, Tel Hashomer, Israel.,Sheba Medical Center, Tel Hashomer, Israel
| | - Raz Gross
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel
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Keeling E, Murray S, Williams Y, Sexton D, O'Kelly P, Deady S, O'Leary E, Dorman A, Roche M, Ni Raghallaigh S, McCormick A, Moloney F, O'Neill J, Conlon P. Merkel cell carcinoma in kidney transplant recipients in Ireland 1964–2018. Br J Dermatol 2019; 181:1314-1315. [DOI: 10.1111/bjd.18218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- E. Keeling
- Department of Dermatology Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - S.L. Murray
- Department of Nephrology & Transplantation Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - Y. Williams
- Department of Nephrology & Transplantation Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - D.J. Sexton
- Department of Nephrology & Transplantation Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - P. O'Kelly
- Department of Nephrology & Transplantation Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - S. Deady
- National Cancer Registry Ireland
| | | | - A. Dorman
- Department of Pathology Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - M. Roche
- Department of Dermatology Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - S. Ni Raghallaigh
- Department of Dermatology Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - A. McCormick
- Department of Hepatology & Liver Transplant St Vincent's Hospital Dublin Ireland
| | - F.J. Moloney
- Department of Dermatology Mater University Hospital Dublin Ireland
| | - J.P. O'Neill
- Department of Otolaryngology Head & Neck Surgery, Beaumont Hospital Dublin Ireland
| | - P.J. Conlon
- Department of Nephrology & Transplantation Head & Neck Surgery, Beaumont Hospital Dublin Ireland
- Department of Medicine Royal College of Surgeons in Ireland Dublin Ireland
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10
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Gilmore J, Dorman A, Archie R, Goh S. Does GP-initiated knee MRI improve management of knee pain in adults over 40 years? An assessment by epidemiology and treatment mapping of the role of pre-referral knee MRI in general orthopaedic outpatient setting in metropolitan Australia. Asia Pac J Sports Med Arthrosc Rehabil Technol 2018. [DOI: 10.1016/j.asmart.2018.06.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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11
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Nachshon A, Abu-Toamih Atamni HJ, Steuerman Y, Sheikh-Hamed R, Dorman A, Mott R, Dohm JC, Lehrach H, Sultan M, Shamir R, Sauer S, Himmelbauer H, Iraqi FA, Gat-Viks I. Dissecting the Effect of Genetic Variation on the Hepatic Expression of Drug Disposition Genes across the Collaborative Cross Mouse Strains. Front Genet 2016; 7:172. [PMID: 27761138 PMCID: PMC5050206 DOI: 10.3389/fgene.2016.00172] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/09/2016] [Indexed: 12/26/2022] Open
Abstract
A central challenge in pharmaceutical research is to investigate genetic variation in response to drugs. The Collaborative Cross (CC) mouse reference population is a promising model for pharmacogenomic studies because of its large amount of genetic variation, genetic reproducibility, and dense recombination sites. While the CC lines are phenotypically diverse, their genetic diversity in drug disposition processes, such as detoxification reactions, is still largely uncharacterized. Here we systematically measured RNA-sequencing expression profiles from livers of 29 CC lines under baseline conditions. We then leveraged a reference collection of metabolic biotransformation pathways to map potential relations between drugs and their underlying expression quantitative trait loci (eQTLs). By applying this approach on proximal eQTLs, including eQTLs acting on the overall expression of genes and on the expression of particular transcript isoforms, we were able to construct the organization of hepatic eQTL-drug connectivity across the CC population. The analysis revealed a substantial impact of genetic variation acting on drug biotransformation, allowed mapping of potential joint genetic effects in the context of individual drugs, and demonstrated crosstalk between drug metabolism and lipid metabolism. Our findings provide a resource for investigating drug disposition in the CC strains, and offer a new paradigm for integrating biotransformation reactions to corresponding variations in DNA sequences.
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Affiliation(s)
- Aharon Nachshon
- Department of Cell Research and Immunology, Faculty of Life Sciences, Tel-Aviv University Tel-Aviv, Israel
| | - Hanifa J Abu-Toamih Atamni
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel- Aviv University Tel-Aviv, Israel
| | - Yael Steuerman
- Department of Cell Research and Immunology, Faculty of Life Sciences, Tel-Aviv University Tel-Aviv, Israel
| | - Roa'a Sheikh-Hamed
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel- Aviv University Tel-Aviv, Israel
| | - Alexandra Dorman
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel- Aviv University Tel-Aviv, Israel
| | - Richard Mott
- Genetics Institute, University College of London London, UK
| | - Juliane C Dohm
- Genomics Unit, Center for Genomic RegulationBarcelona, Spain; Universitat Pompeu FabraBarcelona, Spain; Department of Biotechnology, University of Natural Resources and Life Sciences Vienna (BOKU)Vienna, Austria
| | - Hans Lehrach
- Department of Vertebrate Genomics, Max Planck Institute for Molecular Genetics Berlin, Germany
| | - Marc Sultan
- Department of Vertebrate Genomics, Max Planck Institute for Molecular Genetics Berlin, Germany
| | - Ron Shamir
- The Blavatnik School of Computer Science, Tel Aviv University Tel Aviv, Israel
| | - Sascha Sauer
- Department of Vertebrate Genomics, Max Planck Institute for Molecular GeneticsBerlin, Germany; CU Systems Medicine, University of WürzburgWürzburg, Germany
| | - Heinz Himmelbauer
- Genomics Unit, Center for Genomic RegulationBarcelona, Spain; Universitat Pompeu FabraBarcelona, Spain; Department of Biotechnology, University of Natural Resources and Life Sciences Vienna (BOKU)Vienna, Austria
| | - Fuad A Iraqi
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel- Aviv University Tel-Aviv, Israel
| | - Irit Gat-Viks
- Department of Cell Research and Immunology, Faculty of Life Sciences, Tel-Aviv University Tel-Aviv, Israel
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Dorman A, Baer D, Tomlinson I, Mott R, Iraqi FA. Genetic analysis of intestinal polyp development in Collaborative Cross mice carrying the Apc (Min/+) mutation. BMC Genet 2016; 17:46. [PMID: 26896154 PMCID: PMC4761170 DOI: 10.1186/s12863-016-0349-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 02/05/2016] [Indexed: 11/28/2022] Open
Abstract
Background Colorectal cancer is an abnormal tissue development in the colon or rectum. Most of CRCs develop due to somatic mutations, while only a small proportion is caused by inherited mutations. Familial adenomatous polyposis is an inherited genetic disease, which is characterized by colorectal polyps. It is caused by inactivating mutations in the Adenomatous polyposis coli gene. Mice carrying and non-sense mutation in Adenomatous polyposis coli gene at site R850, which designated ApcR850X/+ (Min), develop intestinal adenomas, while the bulk of the disease is in the small intestine. A number of genetic modifier loci of Min have been mapped, but so far most of the underlying genes have not been identified. In our previous studies, we have shown that Collaborative Cross mice are a powerful tool for mapping loci responsible for phenotypic variation. As a first step towards identification of novel modifiers of Min, we assessed the phenotypic variation between 27 F1 crosses between different Collaborative cross mice and C57BL/6-Min lines. Results Here, C57BL/6-Min male mice were mated with females from 27 Collaborative cross lines. F1 offspring were terminated at 23 weeks old and multiple phenotypes were collected: polyp counts, intestine length, intestine weight, packed cell volume and spleen weight. Additionally, in eight selected F1 Collaborative cross-C57BL/6-Min lines, body weight was monitored and compared to control mice carry wildtype Adenomatous polyposis coli gene. We found significant (p < 0.05) phenotypic variation between the 27 F1 Collaborative cross-C57BL/6-Min lines for all the tested phenotypes, and sex differences with traits; Colon, body weight and intestine length phenotypes, only. Heritability calculation showed that these phenotypes are mainly controlled by genetic factors. Conclusions Variation in polyp development is controlled, an appreciable extent, by genetic factors segregating in the Collaborative cross population and suggests that it is suited for identifying modifier genes associated with ApcMin/+ mutation, after assessing sufficient number of lines for quantitative trait loci analysis. Electronic supplementary material The online version of this article (doi:10.1186/s12863-016-0349-6) contains supplementary material, which is available to authorized users.
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Baker RC, Spence RAJ, Boohan M, Dorman A, Stevenson M, Kirk SJ, McGlade K. A novel approach to improve undergraduate surgical teaching. Ulster Med J 2015; 84:30-6. [PMID: 25964701 PMCID: PMC4330803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/13/2014] [Indexed: 10/28/2022]
Abstract
BACKGROUND Undergraduate surgery is at an important crossroads. Many departments report significant difficulties delivering effective teaching. Our student feedback indicated a dated surgical curriculum lacking structure, quality and uniformity. We report on a new "blended" approach employing a combination of professional DVDs, case based discussions, online material and traditional bedside teaching designed to provide structure, standardization, and equality of learning . METHODS Year 4 students who had undertaken the new course and year 5 students who had participated in the traditional teaching programme were compared. Students completed a 20 item questionnaire about their experiences of the surgical teaching programme. RESULTS One hundred and seventy-one year 4 (70%) and 148 year 5 students (66%) responded. Domains relating to "Overall Satisfaction with the course", "Approval of innovative teaching methods and interactivity" and "Satisfaction with the clarity of course information" showed improvements when comparing the new and old programmes. However bedside teaching was not rated as highly in the new programme (p<0.05). CONCLUSION This blended approach has resulted in improved student understanding and engagement. The apparent compromise of bedside teaching may be a reflection of higher expectations. We believe that a similar blended approach has the potential to re-invigorate surgical teaching elsewhere.
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Iraqi FA, Athamni H, Dorman A, Salymah Y, Tomlinson I, Nashif A, Shusterman A, Weiss E, Houri-Haddad Y, Mott R, Soller M. Heritability and coefficient of genetic variation analyses of phenotypic traits provide strong basis for high-resolution QTL mapping in the Collaborative Cross mouse genetic reference population. Mamm Genome 2014; 25:109-19. [PMID: 24445421 DOI: 10.1007/s00335-014-9503-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
Abstract
Most biological traits of human importance are complex in nature; their manifestation controlled by the cumulative effect of many genetic factors interacting with one another and with the individual's life history. Because of this, mouse genetic reference populations (GRPs) consisting of collections of inbred lines or recombinant inbred lines (RIL) derived from crosses between inbred lines are of particular value in analysis of complex traits, since massive amounts of data can be accumulated on the individual lines. However, existing mouse GRPs are derived from inbred lines that share a common history, resulting in limited genetic diversity, and reduced mapping precision due to long-range gametic disequilibrium. To overcome these limitations, the Collaborative Cross (CC) a genetically highly diverse collection of mouse RIL was established. The CC, now in advanced stages of development, will eventually consist of about 500 RIL derived from reciprocal crosses of eight divergent founder strains of mice, including three wild subspecies. Previous studies have shown that the CC indeed contains enormous diversity at the DNA level, that founder haplotypes are inherited in expected frequency, and that long-range gametic disequilibrium is not present. We here present data, primarily from our own laboratory, documenting extensive genetic variation among CC lines as expressed in broad-sense heritability (H(2)) and by the well-known "coefficient of genetic variation," demonstrating the ability of the CC resource to provide unprecedented mapping precision leading to identification of strong candidate genes.
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Affiliation(s)
- Fuad A Iraqi
- Department of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel,
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15
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O'Seaghdha CM, McQuillan R, Moran AM, Lavin P, Dorman A, O'Kelly P, Mohan DM, Little P, Hickey DP, Conlon PJ. Higher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection. Clin Transplant 2009; 23:462-8. [PMID: 19681975 DOI: 10.1111/j.1399-0012.2009.01021.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We analyzed the association between whole-blood trough tacrolimus (TAC) levels in the first days post-kidney transplant and acute cellular rejection (ACR) rates. Four hundred and sixty-four consecutive, deceased-donor kidney transplant recipients were included. All were treated with a combination of TAC, mycophenolate mofetil and prednisolone. Patients were analyzed in four groups based on quartiles of the mean TAC on days 2 and 5 post-transplant: Group 1: median TAC 11 ng/mL (n = 122, range 2-13.5 ng/mL), Group 2: median 17 ng/mL (n = 123, range 14-20 ng/mL), Group 3: median 24 ng/mL (n = 108, range 20.5-27 ng/mL) and Group 4: median 33.5 ng/mL (n = 116, range 27.5-77.5 ng/mL). A graded reduction in the rates of ACR was observed for each incremental days 2-5 TAC. The one-yr ACR rate was 24.03% (95% CI 17.26-32.88), 22.20% (95% CI 15.78-30.70), 13.41% (95% CI 8.15-21.63) and 8.69% (95% CI 4.77-15.55) for Groups 1-4, respectively (p = 0.003). This study suggests that higher early TACs are associated with reduced rates of ACR at one yr.
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Affiliation(s)
- C M O'Seaghdha
- Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland
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16
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Abstract
Substance abuse is prevalent in Ireland. The potential sequelae for abuser and carer are many. In pregnancy there are further problems. We assessed the prevalence of substance abuse in our antenatal population using an anonymous questionnaire and urine toxicology screening. We examined 522 women and 18 (3.4%) had positive urine toxicology. The anonymous questionnaire failed to identify all of these women. No typical patient profile emerged when the demographic features were studied. We believe that our study has underestimated the true prevalence of substance abuse in our antenatal population and many factors may have contributed to this. Substance abuse in pregnancy remains a difficult problem to quantify and for the future the main focus of attention must be on education and prevention.
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Affiliation(s)
- F Lyons
- Rotunda Hospital, Dublin, Ireland
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17
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Malone A, McConkey S, Dorman A, Lavin P, Gopthanian D, Conlon P. Mycobacterium tuberculosis in a renal transplant transmitted from the donor. Ir J Med Sci 2007; 176:233-5. [PMID: 17624503 DOI: 10.1007/s11845-007-0048-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Accepted: 05/09/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Disease caused by Mycobacterium tuberculosis (MTB) is a well-recognised complication of renal transplantation worldwide due to immunosuppression. It is more common in developing countries. Infection isolated to a renal allograft is rare and infection transmitted by the allograft is also very rare. AIM To describe the first reported case of MTB in a renal transplant transmitted from the donor in Ireland and review the literature. RESULTS A 53-year-old male 29 months after allogenic renal transplant for adult polycystic kidney disease with no other risk factors for MTB presented with deteriorating renal function. Pathological examination of a renal biopsy specimen showed caseating granulomata. MTB was confirmed by culture of early morning urine. CONCLUSIONS MTB isolated to a renal transplant is rare in the developed world. Such an infection should always be considered as our donor pool becomes increasingly more travelled particularly to endemic areas. The new interferon gamma release assays (IGRA) may be a viable alternative screening method to the tuberculin skin test (TST).
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Affiliation(s)
- A Malone
- Department of Medicine, Beaumont Hospital, Dublin, Ireland.
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18
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Little MA, Dupont P, Campbell E, Dorman A, Walshe JJ. Severity of primary MPGN, rather than MPGN type, determines renal survival and post-transplantation recurrence risk. Kidney Int 2006; 69:504-11. [PMID: 16395262 DOI: 10.1038/sj.ki.5000084] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Previous studies suggested that membranoproliferative glomerulonephritis (MPGN) type II has a worse renal survival and an unacceptable risk of recurrence post transplantation. We hypothesised that other factors may determine this risk. We analysed all cases (n=70) of MPGN diagnosed by renal biopsy in Ireland from 1972 to 1995. We used Cox regression analysis to determine factors that were independently predictive of renal failure. MPGN II had more crescent formation and mesangial proliferation (P<0.05). Mean follow-up duration was 13.8 years, during which time 41 (58.6%) developed end-stage renal failure (ESRF). The median time to ESRF was 8.3 years (95% confidence interval 5.7-10.9) and 5-, 10-, and 20-year probabilities of ESRF were 32, 54, and 70%, respectively. Multivariate analysis revealed that severity of interstitial fibrosis (P<0.05), crescent formation (P<0. 01) and mesangial proliferation (P<0.05) were independently associated with ESRF. Decade of diagnosis, age, MPGN type, and creatinine or complement level at baseline did not predict renal survival in this model. In 21 (49%) of the 43 renal transplants, MPGN recurred. Younger age at initial diagnosis (P<0.01) and the presence of crescents on the original biopsy (P<0.005) were independently associated with recurrence on multivariate analysis. MPGN type was not associated with recurrence in this model. Contrary to previous reports, after controlling for crescent formation, MPGN II was not associated with more ESRF or recurrence in the allograft. It is therefore the more aggressive glomerular changes associated with MPGN II, rather than the disease type per se, that determine outcome.
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Affiliation(s)
- M A Little
- Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
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19
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Giblin L, Hollander M, Little D, Hickey D, Donohoe J, Walshe JJ, Dorman A, O'Kelly P, Conlon PJ. Renal transplantation in the elderly — the Irish experience. Ir J Med Sci 2005; 174:9-13. [PMID: 16094906 DOI: 10.1007/bf03169122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this paper was to evaluate patient and kidney graft survival rates in renal transplant recipients and compare the outcomes between the different patient age groups. METHODS A retrospective review of all adult renal transplants performed at Beaumont Hospital between the years 1986-2001 was carried out. Patients were defined as 'elderly' if they were 65 years of age or older and 'younger' if less than 65 years at the time of transplantation. Patient and transplant graft survival rates were analysed for each age group. RESULTS Data were analysed on 1462 'younger' patients and 105 'elderly' renal transplant recipients. Estimated patient survival at 1, 5 and 10 years were 96%, 87% and 74% in the younger patient group compared to 85%, 59% and 33% in the elderly group. The adjusted graft survival rates (adjusted for death due to other causes and with a functioning graft in situ) for the younger group were 89%, 77% and 64% at one, five and ten years respectively, while for the elderly group, adjusted one, five and ten year survival rates were 89%, 83% and 70% respectively. CONCLUSIONS Although the elderly have a shorter life expectancy than the younger population they do benefit from renal transplantation similar to the younger recipients.
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Affiliation(s)
- L Giblin
- Irish Renal Transplant Registry, Department of Nephrology, Beaumont Hospital, Beaumont Road, Dublin 9
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20
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Abstract
Although circulating plasma levels of endothelin (ET)-1 are elevated in endotoxemia, little is known about the myocardial expression of the ET system in endotoxic shock. We assessed the temporal mRNA expression pattern of key components of the ET system (pre-pro ET (ppET) -1, -2, ET-converting enzyme-1, ET(A) and ET(B) receptors) by reverse transcription polymerase chain reaction in a rat model of early endotoxic shock. Lipopolysaccharide (5 mg/kg, i.p.) caused a transient increase (p < 0.05) in inducible nitric oxide synthase mRNA expression. ppET-1 mRNA expression was increased at 2 h (approximately 12-fold increase; p < 0.05) in the lipopolysaccharide compared with the saline group and ppET-2 mRNA expression was unaltered. ET-converting enzyme-1, ET(A), and ET(B) receptor mRNA expression was unaltered in the lipopolysaccharide compared with the saline group. While ppET-1 mRNA expression is selectively upregulated in ventricular myocardium of lipopolysaccharide-treated rats, an absence of alteration in ET-converting enzyme-1 mRNA expression suggests an excess capacity of ET-converting enzyme-1 to cope with the increased expression of ET-1. At the level of the receptor, endotoxic shock did not affect the expression of either ET(A) or ET(B) receptor mRNA. These data are consistent with the increased expression of myocardial ET-1 as an acute-phase response due to hemodynamic instability associated with the early stages of endotoxic shock.
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Affiliation(s)
- J P Spiers
- Department of Physiology, The Queen's University of Belfast, Northern Ireland.
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21
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Flynn MF, Power RE, Murphy DM, Dorman A, Abraham KA, Walshe JJ, Hickey DP. Successful transplantation of kidneys from a donor with HELLP syndrome-related death. Transpl Int 2001; 14:108-10. [PMID: 11370163 DOI: 10.1007/s001470050856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report on the successful use of kidneys procured from a donor with HELLP syndrome. The use of organs from a donor with HELLP syndrome has not been reported previously, perhaps because of the renal complications associated with it. Both recipients have been doing well since renal transplantation, with immediate graft function and acceptable graft function at 2 years of follow-up. In view of the continuing shortage of cadaveric kidneys for transplantation, this report highlights how organs from "marginal" donors should not be discarded without worthy consideration.
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Affiliation(s)
- M F Flynn
- Department of Transplantation, Beaumont Hospital, Dublin 9, Ireland
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Flynn MF, Power RE, Murphy DM, Hickey DP, Dorman A, Abraham KA, Walshe JJ. Successful transplantation of kidneys from a donor with HELLP syndrome-related death. Transpl Int 2001. [DOI: 10.1111/j.1432-2277.2001.tb00023.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The significance of IgM on immunofluorescence in renal biopsy specimens remains unclear. This retrospective case study was conducted to define the clinical features, response to therapy and outcome of patients with Mesangioproliferative Glomerulonephritis (MGN) with diffuse IgM deposition. Of 1919 native renal biopsies performed over a ten-year period, 139 (7.2%) had light microscopic features of MGN and manifested IgM as the dominant immunoglobulin. When exclusion criteria (more than a trace of IgA or IgG, segmental IgM, evidence of SLE, vasculitis, FSGS or Alport's syndrome and pregnant patients) were applied, 60 patients (3.1%) remained. Follow-up data were available for 54 cases with a mean age of 26.5 years (range 1.7-63). Mean follow-up period was 7.4 years (range 4.7-22.2). Forty-one per cent presented with nephrotic syndrome (NS), 26% with asymptomatic proteinuria (>250mg/24hr), 18% with macroscopic hematuria and 15% with isolated microscopic hematuria. Twenty-one percent of patients were hypertensive at presentation. Creatinine was initially <120 (mol/L in all but one patient. Only four patients (7.4%), all nephrotic, suffered a decline in renal function despite treatment; all 4 developed ESRF after a mean of 5.6 years (range 2-8.3). Two of these were subsequently re-biopsied and found to have FSGS. No patients with isolated microscopic / macroscopic hematuria or asymptomatic proteinuria suffered a decline in renal function. Protein excretion rate fell into the normal range in 63% of those receiving steroids, with 82% becoming steroid dependent. Of those treated with cyclosporine (48%) or cyclophosphamide (52%) only 9.5% and 14.5% respectively remained in prolonged remission after discontinuing treatment. It is concluded that MGN with IgM deposition carries a very favorable prognosis except in patients with NS who develop FSGS. However there is a high incidence of steroid dependence and resistance in the proteinuric group.
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Affiliation(s)
- M A Little
- Dept of Nephrology, Beaumont Hospital, Dublin, Ireland
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Wong AC, Shkolny D, Dorman A, Willingham D, Roe BA, McDermid HE. Two novel human RAB genes with near identical sequence each map to a telomere-associated region: the subtelomeric region of 22q13.3 and the ancestral telomere band 2q13. Genomics 1999; 59:326-34. [PMID: 10444334 DOI: 10.1006/geno.1999.5889] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Two closely related genes have been identified at 2q13 and 22q13.3. These genes show similarity to members of the RAB family of small GTPases. RABL2A and RABL2B differ by three conservative amino acid changes over a total of 228 residues. Both are expressed in all tissues tested. Northern analysis showed that a 2.5-kb transcript is expressed in all tissues tested while a 1.4-kb transcript is specifically expressed only in muscle. The size difference between these two transcripts is the result of differential splicing of an intron within the 3' UTR. RABL2B is located within the subtelomeric region of 22q13.3. RABL2A maps to 2q13, the site of an ancestral telomere fusion event, suggesting that it also may be a subtelomeric gene.
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Affiliation(s)
- A C Wong
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, T6G 2E9, Canada
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Abstract
The aim of the study was to measure HIV prevalence and risk behaviour in 185 Irish Intravenous Drug Misusers. Information was obtained by application of a standardised WHO questionnaire covering HIV risk behaviour in the preceding 6 months. HIV serostatus was obtained by saliva/blood sample testing. One hundred and 3 (55.7 per cent) shared and 114 (61.6 per cent) lent used injecting equipment in the previous 6 months. 97 (94.2 per cent) of those who shared always cleaned the needles before use but only 48 (49.5 per cent) of these always cleaned in an efficient manner. One hundred and 14 (79.2 per cent) males and 28 (68.3 per cent) females reported heterosexual activity in the preceding 6 months. On examination sexual risk behaviour was found to be high. 50.5 per cent of males and 63 per cent of females never used condoms with regular partners. 32.6 per cent of males never used condoms with casual partners. The large majority of partners of male I.D.U'.s (both regular and casual) were non injectors. Therefore there is potential for sexual spread of HIV into the non-injecting heterosexual population. Conversely the vast majority of partners of female IDU's were injectors. This suggests that female IDU's are at higher risk of HIV infection than their male counterparts. HIV prevalence in the study group was 8.4 per cent. Implications of results for future intervention are discussed.
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Affiliation(s)
- A Dorman
- Drug Treatment Centre Board, Dublin
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Flint J, Bates GP, Clark K, Dorman A, Willingham D, Roe BA, Micklem G, Higgs DR, Louis EJ. Sequence comparison of human and yeast telomeres identifies structurally distinct subtelomeric domains. Hum Mol Genet 1997; 6:1305-13. [PMID: 9259277 DOI: 10.1093/hmg/6.8.1305] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We have sequenced and compared DNA from the ends of three human chromosomes: 4p, 16p and 22q. In all cases the pro-terminal regions are subdivided by degenerate (TTAGGG)n repeats into distal and proximal sub-domains with entirely different patterns of homology to other chromosome ends. The distal regions contain numerous, short (<2 kb) segments of interrupted homology to many other human telomeric regions. The proximal regions show much longer (approximately 10-40 kb) uninterrupted homology to a few chromosome ends. A comparison of all yeast subtelomeric regions indicates that they too are subdivided by degenerate TTAGGG repeats into distal and proximal sub-domains with similarly different patterns of identity to other non-homologous chromosome ends. Sequence comparisons indicate that the distal and proximal sub-domains do not interact with each other and that they interact quite differently with the corresponding regions on other, non-homologous, chromosomes. These findings suggest that the degenerate TTAGGG repeats identify a previously unrecognized, evolutionarily conserved boundary between remarkably different subtelomeric domains.
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Affiliation(s)
- J Flint
- Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford, UK.
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Bosio P, Keenan E, Gleeson R, Dorman A, Clarke T, Darling M, O'Connor J. The prevalence of chemical substance and alcohol abuse in an obstetric population in Dublin. Ir Med J 1997; 90:149-150. [PMID: 9267096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To determine the prevalence of illicit drug abuse and alcohol use in an obstetric population based in an urban maternity hospital. SETTING A collaborative study between the Rotunda Hospital, Dublin and the Irish National Drug Advisory & Treatment Centre. DESIGN A prospective study consisting of anonymous, unlinked urine testing of 504 'first visit' antenatal patients and a separate group of 515 patients six weeks after delivery. METHODS & OUTCOME MEASURES Toxicological screening using enzyme-linked immunoassay techniques, with all positive samples being reanalysed. Drug histories were taken and samples were tested for alcohol and six of the most commonly abused drugs. The pre- and postnatal prevalence of abuse was matched with demographic data. RESULTS The prevalence of chemical substance misuse in the antenatal population was 2.8% and 5.6% in the postnatal population. Substances identified included benzodiazepines, cannabis, amphetamines, opiates and cocaine. Less than 2% of samples tested positive for alcohol. None of the women yielding positive samples had been pre-identified on the basis of history. A significant proportion of the women were in the high risk categories with regard to age and socio-economic status. CONCLUSION The prevalence of drug misuse antenatally was nearly 3% and postnatally almost 6%. Substance abusers in pregnancy are more likely to be single, unemployed, and to have had a previous pregnancy.
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Abstract
During a one year period from August 1992 to August 1993, 272 injecting drug users attending the National Drug Treatment Centre were tested for antibody to Hepatitis C Virus with a second generation EIA test. The overall sero-prevalence was 84% (N = 229). A significantly greater proportion of females tested positive than males (Female: Male, 94% v 80%, p < 0.012). Looking at sero-prevalence of Hepatitis C in relation to duration of intravenous drug misuse, we found that in those patients with a duration of misuse of greater than two years (N = 156) the sero-prevalence was 95% and in those with a duration of intravenous drug misuse of less than two years (N = 116) the sero-prevalence was 70%. We conclude that needle sharing continues to occur among injecting drug users during their first two years of injecting, despite the existence of harm minimization programmes. Our results would suggest that female injecting drug users are involved in greater at risk behaviour in relation to Hepatitis C than their male counterparts.
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Affiliation(s)
- R Smyth
- Drug Treatment Board, Dublin 2
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Abstract
A case of a middle aged woman with weight loss, ascites, and a pleural effusion is presented where a clinical diagnosis of ovarian cancer was made. Her CA 125 was greatly increased at 873 IU/ml and the ascites was a lymphocytic exudate but cytology failed to show malignant cells. Operative biopsy showed numerous noncaseating granulomas in the omentum but no mycobacterial organisms were seen. Empiric antituberculous treatment was started before positive culture results were received and when treatment had ended both the ascites and pleural effusion had resolved and the CA 125 had fallen to 7 IU/ml. Review of published works showed several other examples of tuberculous peritonitis associated with increased CA 125 and the possible cause of raised CA 125 in this condition is discussed.
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Ali AA, Wilson E, Moorhead JF, Amlot P, Abdulla A, Fernando ON, Dorman A, Sweny P. Minimal-change glomerular nephritis. Normal kidneys in an abnormal environment? Transplantation 1994; 58:849-52. [PMID: 7940721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- A A Ali
- Department of Nephrology, Royal Free Hospital London, United Kingdom
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Abstract
In this comparative study with a control group of prisoners, psychiatric morbidity was measured in two groups of sentenced prisoners, each group completing the GHQ-30 and 21-item Beck Depression Inventory (BDI). Group 1 consisted of 40 segregated HIV-positive prisoners and group 2 a matched control group in the main prison who had no history of HIV seropositivity. All members of group 1 had a history of intravenous drug abuse. The mean GHQ-30 and BDI scores were significantly higher in group 1, and 90% of group 1 were psychiatric 'cases' compared with just over 42% of group 2. Levels of psychiatric morbidity present in a third group, consisting of HIV-positive prisoners who had not been segregated (prison authorities were unaware of their seropositivity) are an interesting pointer for further research.
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Affiliation(s)
- A Dorman
- Central Mental Hospital, Dundrum, Dublin, Republic of Ireland
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Abstract
Forty five pregnant addicts had attended the National Drug Treatment Centre between 1984-1986. At that time they received intensive counselling, low dose Methadone maintenance and both ante natal and post natal care. Our aim was to follow these women six years later focusing on their drug use and outcome of their children. The women were followed up by chart review, individual interviews and liaison with the social and probation services. Results indicate that a high proportion of the women abused chaotically (50%). There is a worrying high incidence of HIV positive patients (53.4%) and a mortality figure of 15.5% (7). However only 13 women (28.6%) have had further children and 22 women (49%) are currently using some form of contraception. Only 23 women (51.1%) have had further contact with probation services. Five children (11.3%) are under formal care order and 4 children have become HIV positive in their own right. In conclusion, while these women have benefitted in certain areas e.g. family planning, contact with probation services, in other areas they have remained chaotic e.g. continued drug abuse or HIV risk taking behaviour. Thus the authors believe that future programmes should concentrate more directly on detoxification and rehabilitation after pregnancy. We also believe that because of the chaotic nature of these women some review of an "at risk" register for the children should be carried out.
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Affiliation(s)
- E Keenan
- Drug Treatment Centre Board, Dublin
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Coleman K, Baak JP, Dorman A, Mullaney J, Curran B, Tiernan D, Farrell M, Fenton M, Leader M. Deoxyribonucleic acid ploidy studies in choroidal melanomas. Am J Ophthalmol 1993; 115:376-83. [PMID: 8442500 DOI: 10.1016/s0002-9394(14)73592-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
In several tumors of different organ sites, the amount of DNA in a cell (ploidy) is associated with malignancy. We performed DNA quantitation in 21 choroidal melanomas and compared flow cytometry with image analysis in 11 of these melanomas. We modified our preparation technique to overcome problems with pigment and control cell populations in the image analysis group. Fifteen tumors were diploid and two tumors were tetraploid. Four tumors were unprocessable by flow cytometry, but two of these tumors were diploid by image analysis. Image analysis also detected tetraploidy in two tumors that were diploid by flow cytometry. During image analysis, cells were classified according to the Callendar classification and histograms were plotted for each cell type. All spindle A cells were diploid and most tetraploid peaks were formed by epithelioid cells. The use of image analysis on small samples of choroidal melanomas may be of value both in confirmation of diagnosis and prognosis of these lesions, and perhaps therapeutically, for example, in the monitoring of radiation treatment.
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Affiliation(s)
- K Coleman
- Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
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McGibney CA, Byrne PJ, Lawlor P, Denham B, Hennessy TPJ, Greally P, Hampton FJ, MacFadyen UM, Simpson H, Gururangan S, McMahon C, Guiney EJ, Fitzgerald RJ, O’Donnell B, Breathnach F, Thomas G, Lambert I, Gill D, Ledwith MV, Conlon P, Cronin C, O’Halpin D, Donoghue V, Webb DW, Osborne JP, Naughten E, Darling G, Saul I, Prakash N, McDonald M, Cosgrove J, Costigan C, Naughten ER, King M, Rowland P, Bressan J, Lillis DF, Loftus BG, Fitzgerald J, Jackson J, Fleming P, Deb L, Temperley IJ, Daly NJ, McShane D, Jackson JF, O’Nuallain EM, Reen DJ, Monaghan H, Dorman A, Ball R, Curran B, Leader M, O’Meara A, Flood T, Sweed Y, Puri P, Twomey M, Duncan J, Kiernan M, Kearney PJ, Abushaban L, Denham B, Duff D, Donnelly MJ, Maguire AJ, Dennis AR, Donnelly M, Aziz MA, Gormally SM, Matthews TG, Fitzsimons R, Ahmed Z, Hensey O, Deshpande D, George A, Rao JS, Gaffney E, Gorman W, Kierce B, Quinn F, Drumm B, Naughton A, McMenamin JB, Stack J, Coveney E, Ninan G, Praedeep Dumar VK, Watson B, O’Neill M. Irish paediatric association. Ir J Med Sci 1992. [DOI: 10.1007/bf02942160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gururangan S, Dorman A, Ball R, Curran B, Leader M, Breatnach F, O'Meara A. DNA quantitation of Wilms' tumour (nephroblastoma) using flow cytometry and image analysis. J Clin Pathol 1992; 45:498-501. [PMID: 1320635 PMCID: PMC495223 DOI: 10.1136/jcp.45.6.498] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AIMS To compare flow cytometry (FCM) with image analysis (IA) in the DNA quantitation of Wilms' tumour (WT) and to correlate data so obtained with recognised clinical and pathological prognostic parameters. METHODS Thirty six patients with histologically proved WT diagnosed between 1980-89 were investigated. Fifteen patients had stage I disease, 10 stage II, six stage III, two stage IV and three stage V. Suspension of nuclei obtained by pepsin digestion of paraffin wax embedded tumour tissue was analysed using a FAC-Scan flow cytometer, and a CAS-100 image analyser. RESULTS Tumours were concordant in most instances, however, IA identified aneuploidy in two tumour samples which were diploid by FCM. Aneuploidy was detected in 5/33 tumours with favourable histology and 3/3 with unfavourable histology. Three of 28 patients with Stage I, II and V disease and 5/8 patients with stage III and IV had aneuploid tumours. All patients with unfavourable histology died of disease. In the group with favourable histology, 4/5 patients with aneuploid tumours developed recurrent disease compared with 1/27 diploid tumours (p less than 0.0001). CONCLUSIONS Ploidy may be a useful additional prognostic indicator in Wilms' tumour with favourable histology. Larger scale studies are needed to confirm the relation of ploidy to survival in early stage WT.
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Affiliation(s)
- S Gururangan
- Children's Research Centre, Our Lady's Hospital for Sick Children, Dublin, Ireland
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Abstract
Mixed types of carcinoma of the prostate are rare. The majority of those described (22 cases) are examples of mixed adenocarcinoma and transitional cell carcinoma. Much more unusual is the mixed adenosquamous carcinoma, of which only three cases have been described. This report presents an additional case of the rare adenosquamous carcinoma of the prostate. It discusses the clinicopathologic features and the possible histogenesis of this tumor and suggests a role for stilbestrol in its development.
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Affiliation(s)
- D M Devaney
- Department of Histopathology, Beaumont Hospital, Dublin, Ireland
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Dorman A, Graham D, Curran B, Henry K, Leader M. Ploidy of smooth muscle tumours: retrospective image analysis study of formalin fixed, paraffin wax embedded tissue. J Clin Pathol 1990; 43:465-8. [PMID: 2199531 PMCID: PMC502498 DOI: 10.1136/jcp.43.6.465] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The feasibility of using an image analyser, the CAS 100, to assess the ploidy of smooth muscle tumours on formalin fixed paraffin wax embedded tissue was assessed. Various different methods of assessment were compared. A paraffin wax block of 15 leiomyomata and 13 leiomyosarcomata yielded serial sections of 3 microns, 5 microns, and 7 microns and a cytospin preparation (from a 50 micron section). Sections and cytospin preparations were stained with Feulgen and quantified using the CAS 100. The suitability of lymphocytes, previously suggested to be unsuitable as control cells in tissue sections due to the compact nature of their DNA, was assessed in sections and cytospin preparations and compared with endothelial cells, the standard alternative, on the same slide. Despite having a mean nuclear area of only 18.5 microns 2 in sections lymphocytes had a similar diploid peak--that is, 4.1 pg--to endothelial cells (mean nuclear area 39 microns 2). A comparison of 3 microns, 5 microns, and 7 microns sections showed 5 microns to be the optimal thickness. Cytospin preparations yielded histograms of superior quality than those from tissue sections. All 15 leiomyomata had a 5C exceeding rate of less than 0.3%. Ten of 11 histologically malignant tumours had a 5C exceeding rate of more than 5% (mean 14%) in sections and cytospins. Two leiomyosarcomata that had arisen in the lower gastrointestinal tract had a mitotic rate of less than or equal to 1/10 per high power fields and yielded histograms similar to those of the leiomyomata. It is concluded that formalin fixed, paraffin wax embedded tissue can be used for DNA quantification by image analysis; that tissue sections yield poorer results than cytospin preparations; that lymphocytes are reliable control cells in cytospin preparations; and that a population of cell greater than 5C is seen in 90% of leiomyosarcomata.
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Affiliation(s)
- A Dorman
- Department of Pathology, Royal College of Surgeons in Ireland, St Stephen's Green, Dublin 2
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Abstract
Rat's tongues were injured by cold and the reactive processes were observed by light and electron microscopy. Injured animals and untreated controls were injected with aurothiomalate and the cells in tongue muscles which contained gold were observed after increasing injection-sacrifice time intervals. In the very rapid regeneration, gold-containing macrophage-like cells fused with each other and with well preserved parts of myofibers. The selectivity of gold localization suggested, at least morphologically, a macrophage to myoblast development. The possible factors affecting the rate of muscle regeneration have been discussed with special reference to the nature of the injurious stimulus and the type of cellular response.
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