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Wanhainen K, Berkseth M, Sando N, Golden L, Techam A, Wieworka J, Bergerud KB, Argenta P, O'Shea A, Rivard C, Ghebre R, Teoh D, Reynolds MA, Terezakis SA, Yuan J, Sloan L. Effect of External Beam Radiation Therapy (EBRT) and Brachytherapy (BT) on Circulating MDSC Populations in Patients Treated Definitively for Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e554. [PMID: 37785703 DOI: 10.1016/j.ijrobp.2023.06.1864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The immunosuppressive function of myeloid derived suppressor cells (MDSCs) has been implicated in the regulation of immune responses against cancer. MDSCs have been associated with progression and poor response to therapy in various types of cancer, including cervical cancer. Radiation treatment (RT) alters immune cell populations within the tumor and is thought to augment antitumor responses. However, whether RT also recruits immunosuppressive MDSC populations is not well understood. Here, we investigate how circulating MDSC populations change in response to RT and if changes in MDSC frequency or subsets is predictive of RT responses in cervical cancer patients. MATERIALS/METHODS Newly diagnosed, treatment-naïve pts with locally advanced carcinoma of the cervix will be enrolled from July 2022 to July 2023. EBRT to the pelvis was delivered at a dose of 45 Gy in 25 fractions with a simultaneous integrated boost of 52-55 Gy to involved regional lymph nodes and parametria and concurrent weekly cisplatin. Gross tumor was boosted via interstitial or tandem ring BT (22.5-27.5 Gy) after completion of EBRT. Serial blood samples were collected prior to initiating therapy (T0), post-EBRT and pre-BT (T1), and one-month post-BT (T2). Treatment response was determined based on pre-treatment MRI compared to MRI post-EBRT. Peripheral blood mononuclear cells (PBMCs) were isolated from whole blood using density gradient centrifugation and stained for analysis via flow cytometry. MDSC populations were identified by Live/Dead-CD11b+CD33+HLA-DR- staining. MDSC subsets were further subdivided into granulocytic (G-, CD15+CD14-), monocytic (M-, CD15-CD14+), or early-MDSCs (e-, CD15-CD14-). RESULTS Blood samples were collected at indicated time points for four patients (FIGO stage IIA-IIB). Three had partial responses to chemoradiotherapy (CRT), while one had a complete response. All three patients with partial response had an increase in total frequency of circulating MDSCs in response to EBRT/BT (mean %fx MDSC 16.6 at T0 to 35.9 at T2), and an increase in total MDSCs in two of these patients occurred with EBRT alone. Interestingly, the patient that had a complete response had fewer MDSCs at T2 relative to T0 (35.8% at T0 to 27% at T2). Proportion of MDSC subsets varied considerably among the patients, and all had altered distribution of subsets in response to RT. G-MDSCs expanded the most to RT while M-MDSCs and e-MDSCs were less affected (mean fold change from T0 to T2 G-MDSC 4.75, M-MDSC 1.27, e-MDSC 0.942). CONCLUSION In this cohort of patients, an increase in MDSC frequency occurred after RT and altered subset distribution. Only the patient with a complete response had fewer total MDSCs following completion of CRT, suggesting further studies are needed to determine if circulating MDSCs could be a biomarker for treatment response to RT in cervical cancer.
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Affiliation(s)
- K Wanhainen
- University of Minnesota Medical School, Minneapolis, MN
| | - M Berkseth
- University of Minnesota, Minneapolis, MN
| | - N Sando
- University of Minnesota, Minneapolis, MN
| | - L Golden
- University of Minnesota, Minneapolis, MN
| | - A Techam
- M Health Fairview, Minneapolis, MN
| | | | | | - P Argenta
- University of Minnesota Medical School, Minneapolis, MN
| | - A O'Shea
- University of Minnesota Medical School, Minneapolis, MN
| | - C Rivard
- University of Minnesota Medical School, Minneapolis, MN
| | - R Ghebre
- University of Minnesota Medical School, Minneapolis, MN
| | - D Teoh
- University of Minnesota Medical School, Minneapolis, MN
| | - M A Reynolds
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
| | | | - J Yuan
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
| | - L Sloan
- Department of Radiation Oncology, University of Minnesota Medical School, Minneapolis, MN
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O'Shea A, Kilcoyne A, McDermott E, O'Grady M, McDermott S. Can radiomic feature analysis differentiate adrenal metastases from lipid-poor adenomas on single-phase contrast-enhanced CT abdomen? Clin Radiol 2022; 77:e711-e718. [DOI: 10.1016/j.crad.2022.06.015] [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] [Received: 01/04/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022]
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McDermott E, Kilcoyne A, O'Shea A, Cahalane AM, McDermott S. The role of percutaneous CT-guided biopsy of an adrenal lesion in patients with known or suspected lung cancer. Abdom Radiol (NY) 2021; 46:1171-1178. [PMID: 32945923 DOI: 10.1007/s00261-020-02743-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/24/2020] [Revised: 08/26/2020] [Accepted: 09/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine the sensitivity, specificity, and complication rate of percutaneous adrenal biopsy in patients with known or suspected lung cancer. METHODS This study was approved by the Institutional Review Board at our institution as a retrospective analysis; therefore, the need for informed consent was waived. All percutaneous adrenal biopsies performed between April 1993 and May 2019 were reviewed. 357 of 582 biopsies were performed on 343 patients with known or suspected lung cancer (M:F 164:179; mean age 66 years). The biopsy results were classified into malignant, benign, or non-diagnostic. The final diagnosis was established by pathology (biopsy and/or surgical resection) or imaging follow-up on CT for at least 12 months following the biopsy. Patients with less than 12 months follow-up were excluded (n = 44). Complications were recorded. RESULTS The final diagnosis was metastatic lung cancer in 235 cases (77.8%), metastasis from an extrapulmonary primary in 2 cases (0.7%), pheochromocytoma in 2 cases (0.7%), and benign lesions in 63 cases (20.9%). Percutaneous adrenal gland biopsy had a sensitivity of 97% and specificity of 100% for lung cancer metastases. The non-diagnostic rate was 0.6%. Larger lesions were more likely to be malignant (p = 0.0000) and to be correctly classified as a lung metastasis (p = 0.025). The incidence of minor complications was 1.1%. There were no major complications. CONCLUSION Over 20% of adrenal lesions in patients with known or suspected lung cancer were not related to lung cancer. Percutaneous adrenal gland biopsy is a safe procedure, with high sensitivity and specificity for lung cancer metastases.
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Affiliation(s)
- E McDermott
- Tallaght University Hospital, Tallaght, Dublin, Ireland
| | - A Kilcoyne
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA.
| | - A O'Shea
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - A M Cahalane
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - S McDermott
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
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Shakur A, Hames K, O'Shea A, Harisinghani MG. Prostatitis: imaging appearances and diagnostic considerations. Clin Radiol 2021; 76:416-426. [PMID: 33632522 DOI: 10.1016/j.crad.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/14/2021] [Indexed: 02/07/2023]
Abstract
Acute and chronic inflammation of the prostate gland can be attributed to several underlying aetiologies, including but not limited to, bacterial prostatitis, granulomatous prostatitis, and Immunoglobulin G4-related prostatitis. In this review, we provide an overview of the general imaging appearances of the different types of prostatitis, their distinguishing features and characteristic appearances at cross-sectional imaging. Common imaging pitfalls are presented and illustrated with examples.
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Affiliation(s)
- A Shakur
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
| | - K Hames
- Department of Radiology, Hamilton General Hospital, 237 Barton Street E, Hamilton, Ontario, L8L 2X2, Canada
| | - A O'Shea
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - M G Harisinghani
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
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Fogg KC, Miller AE, Li Y, Flanigan W, Walker A, O'Shea A, Kendziorski C, Kreeger PK. Ovarian cancer cells direct monocyte differentiation through a non-canonical pathway. BMC Cancer 2020; 20:1008. [PMID: 33069212 PMCID: PMC7568422 DOI: 10.1186/s12885-020-07513-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/25/2020] [Accepted: 10/08/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Alternatively-activated macrophages (AAMs), an anti-inflammatory macrophage subpopulation, have been implicated in the progression of high grade serous ovarian carcinoma (HGSOC). Increased levels of AAMs are correlated with poor HGSOC survival rates, and AAMs increase the attachment and spread of HGSOC cells in vitro. However, the mechanism by which monocytes in the HGSOC tumor microenvironment are differentiated and polarized to AAMs remains unknown. METHODS Using an in vitro co-culture device, we cultured naïve, primary human monocytes with a panel of five HGSOC cell lines over the course of 7 days. An empirical Bayesian statistical method, EBSeq, was used to couple RNA-seq with observed monocyte-derived cell phenotype to explore which HGSOC-derived soluble factors supported differentiation to CD68+ macrophages and subsequent polarization towards CD163+ AAMs. Pathways of interest were interrogated using small molecule inhibitors, neutralizing antibodies, and CRISPR knockout cell lines. RESULTS HGSOC cell lines displayed a wide range of abilities to generate AAMs from naïve monocytes. Much of this variation appeared to result from differential ability to generate CD68+ macrophages, as most CD68+ cells were also CD163+. Differences in tumor cell potential to generate macrophages was not due to a MCSF-dependent mechanism, nor variance in established pro-AAM factors. TGFα was implicated as a potential signaling molecule produced by tumor cells that could induce macrophage differentiation, which was validated using a CRISPR knockout of TGFA in the OVCAR5 cell line. CONCLUSIONS HGSOC production of TGFα drives monocytes to differentiate into macrophages, representing a central arm of the mechanism by which AAMs are generated in the tumor microenvironment.
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Affiliation(s)
- Kaitlin C Fogg
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1111 Highland Ave, WIMR 4553, Madison, WI, 53705, USA
| | - Andrew E Miller
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1111 Highland Ave, WIMR 4553, Madison, WI, 53705, USA
| | - Ying Li
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Will Flanigan
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1111 Highland Ave, WIMR 4553, Madison, WI, 53705, USA
| | - Alyssa Walker
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1111 Highland Ave, WIMR 4553, Madison, WI, 53705, USA
| | - Andrea O'Shea
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Christina Kendziorski
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Pamela K Kreeger
- Department of Biomedical Engineering, University of Wisconsin-Madison, 1111 Highland Ave, WIMR 4553, Madison, WI, 53705, USA.
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
- University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
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O'Shea A, Tam AL, Kilcoyne A, Flaherty KT, Lee SI. Image-guided biopsy in the age of personalised medicine: strategies for success and safety. Clin Radiol 2020; 76:154.e1-154.e9. [PMID: 32896425 DOI: 10.1016/j.crad.2020.08.010] [Citation(s) in RCA: 6] [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] [Received: 06/03/2020] [Accepted: 08/04/2020] [Indexed: 12/28/2022]
Abstract
Oncology has progressed into an era of personalised medicine, whereby the therapeutic regimen is tailored to the molecular profile of the patient's cancer. Determining personalised therapeutic options is achieved by using tumour genomics and proteomics to identify the specific molecular targets against which candidate drugs can interact. Several dozen targeted drugs, many for multiple cancer types are already widely in clinical use. Molecular profiling of tumours is contingent on high-quality biopsy specimens and the most common method of tissue sampling is image-guided biopsy. Thus, for radiologists performing these biopsies, the paradigm has now shifted away from obtaining specimens simply for histopathological diagnosis to acquiring larger amounts of viable tumour cells for DNA, RNA, or protein analysis. These developments have highlighted the central role now played by radiologists in the delivery of personalised cancer care. This review describes the principles of molecular profiling assays and biopsy techniques for optimising yield, and describes a scoring system to assist in patient selection for percutaneous biopsy.
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Affiliation(s)
- A O'Shea
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, 02114, USA.
| | - A L Tam
- Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - A Kilcoyne
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - K T Flaherty
- Department of Medicine, Division of Oncology, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - S I Lee
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, 02114, USA
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O'Shea A, Batten A, Hu E, Augustine M, Kaboli P. Association between Secure Messaging and Primary Care Face‐to‐Face Visits and Phone Visits. Health Serv Res 2020. [DOI: 10.1111/1475-6773.13382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- A. O'Shea
- Iowa City VA Healthcare System Iowa City IA United States
- University of Iowa Carver College of Medicine Iowa City IA United States
| | - A. Batten
- Department of Veterans Affairs Seattle WA United States
| | - E. Hu
- Department of Veterans Affairs Seattle WA United States
| | - M. Augustine
- VA Puget Sound Health Care System Seattle WA United States
| | - P. Kaboli
- Iowa City VA Medical Center and University of Iowa Iowa City IA United States
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Atre I, Eurboonyanun K, O'Shea A, Lahoud R, Shih A, Kalva S, Harisinghani M, Hedgire S. Predictors Of Transmural Intestinal Necrosis In Patients Presenting With Acute Mesenteric Ischemia On Computed Tomography. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.141] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fogg KC, Renner CM, Christian H, Walker A, Marty-Santos L, Khan A, Olson WR, Parent C, O'Shea A, Wellik DM, Weisman PS, Kreeger PK. Ovarian Cells Have Increased Proliferation in Response to Heparin-Binding Epidermal Growth Factor as Collagen Density Increases. Tissue Eng Part A 2020; 26:747-758. [PMID: 32598229 DOI: 10.1089/ten.tea.2020.0001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/16/2022] Open
Abstract
It is well known that during ovarian cancer progression, the omentum transforms from a thin lacy organ to a thick tougher tissue. However, the mechanisms regulating this transformation and the implications of the altered microenvironment on ovarian cancer progression remain unclear. To address these questions, the global and local concentrations of collagen I were determined for normal and metastatic human omentum. Collagen I was increased 5.3-fold in omenta from ovarian cancer patients and localized to areas of activated fibroblasts rather than regions with a high density of cancer cells. Transforming growth factor beta 1 (TGFβ1) was detected in ascites from ovarian cancer patients (4 ng/mL), suggesting a potential role for TGFβ1 in the observed increase in collagen. Treatment with TGFβ1 induced fibroblast activation, proliferation, and collagen deposition in mouse omental explants and an in vitro model with human omental fibroblasts. Finally, the impact of increased collagen I on ovarian cancer cells was determined by examining proliferation on collagen I gels formulated to mimic normal and cancerous omenta. While collagen density alone had no impact on proliferation, a synergistic effect was observed with collagen density and heparin-binding epidermal growth factor treatment. These results suggest that TGFβ1 induces collagen deposition from the resident fibroblasts in the omentum and that this altered microenvironment impacts cancer cell response to growth factors found in ascites. Impact statement Using quantitative analysis of patient samples, in vitro models of the metastatic ovarian cancer microenvironment were designed with pathologically relevant collagen densities and growth factor concentrations. Studies in these models support a mechanism where transforming growth factor β1 in the ascites fluid induces omental fibroblast proliferation, activation, and deposition of collagen I, which then impacts tumor cell proliferation in response to additional ascites growth factors such as heparin-binding epidermal growth factor. This approach can be used to dissect mechanisms involved in microenvironmental modeling in multiple disease applications.
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Affiliation(s)
- Kaitlin C Fogg
- Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Carine M Renner
- Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Hannah Christian
- Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Alyssa Walker
- Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Leilani Marty-Santos
- Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Aisha Khan
- Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Will R Olson
- Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Carl Parent
- Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA
| | - Andrea O'Shea
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Deneen M Wellik
- Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,University of Wisconsin Carbone Cancer Center, and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Paul S Weisman
- University of Wisconsin Carbone Cancer Center, and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Pamela K Kreeger
- Department of Biomedical Engineering, University of Wisconsin - Madison, Madison, Wisconsin, USA.,Department of Cell and Regenerative Biology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.,University of Wisconsin Carbone Cancer Center, and University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Adams NC, Griffin E, Motyer R, Farrell T, Carmody E, O'Shea A, Murphy B, O'Hare A, Looby S, Power S, Brennan P, Doyle KM, Thornton J. Review of external referrals to a regional stroke centre: it is not just about thrombectomy. Clin Radiol 2019; 74:950-955. [PMID: 31521325 DOI: 10.1016/j.crad.2019.07.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 07/26/2019] [Indexed: 02/02/2023]
Abstract
AIMS To determine the experience of a regional stroke referral centre of external referrals for endovascular thrombectomy (EVT) in patients with symptoms of acute ischaemic stroke (AIS) and large vessel occlusion (LVO). MATERIALS AND METHODS Data were collected prospectively over two 4-month periods (2017-2018) on consecutive external referrals for EVT. Baseline demographics, imaging findings, and key time parameters were recorded. Reasons for not transferring patients and for not performing EVT were recorded. Key time intervals were calculated and compared between the transferred and non-transferred group with and without intracranial occlusion and between the transferred patients who underwent thrombectomy and those who did not. RESULTS Two hundred and sixty-two patients were referred. Sixty-one percent (n=159) were accepted and transferred for treatment. Of those transferred, 86% (n=136) had EVT. Fourteen percent (n=23) were unsuitable for EVT on arrival due to no vessel occlusion (48% n=11), poor Alberta Stroke Program Early CT Score (ASPECTS)/established infarct (30%, n=7) haemorrhage (9%, n=2), and clinical recovery (13% n=3). One hundred and three patients (39%) were ineligible for EVT following phone discussion due to absence of intracranial occlusion (59%, n=61), low ASPECTS (22%, n=23), distal occlusion (4%, n=4), low/improving National Institutes of Health Stroke Scale (NIHSS; 10.7%, n=11), and poor modified Rankin Scale (mRS) at baseline (3%, n=3). Patients with LVO but not transferred had longer onset to hospital arrival time compared with those transferred 151.5 versus 91 minutes (p<0.005), with a trend also toward a longer door to CT/CTA 40 minutes versus 30 minutes (p=0.142). CONCLUSION These data provide valuable insights into the service provision of a comprehensive stroke network. The present rates of EVT and futile transfers are modest compared to published data. Access to neuroradiology and specialised stroke assessment is crucial to optimise time to treatment.
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Affiliation(s)
- N C Adams
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland.
| | - E Griffin
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - R Motyer
- Department of Radiology, Tallaght Hospital, Tallaght, Dublin 24, Ireland
| | - T Farrell
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - E Carmody
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - A O'Shea
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - B Murphy
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - A O'Hare
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - S Looby
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - S Power
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - P Brennan
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - K M Doyle
- Department of Physiology, School of Medicine, National University of Ireland, Galway, Ireland
| | - J Thornton
- Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland; Honorary Clinical Associate Professor, Royal College of Surgeons, 123 St Stephens Green, Dublin, Ireland
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Connor JP, O'Shea A, McCool K, Sampene E, Barroilhet LM. Peri-operative allogeneic blood transfusion is associated with poor overall survival in advanced epithelial ovarian Cancer; potential impact of patient blood management on Cancer outcomes. Gynecol Oncol 2018; 151:294-298. [PMID: 30201233 DOI: 10.1016/j.ygyno.2018.08.040] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Transfusion related immune modulation associated with red blood cell (RBC) transfusion is thought to result in decreased cancer survival. Results in epithelial ovarian cancer (EOC) have been mixed however most suggest worse oncologic outcomes in patients who were transfused at the time of debulking surgery. The impact of restrictive transfusion strategies on this patient population is currently not known. METHODS We conducted a retrospective study of women with EOC. The study population was divided into two groups based on whether they were transfused RBCs during the peri-operative period or not. Clinical characteristics and prognosticators were compared between groups. Overall survival was compared between groups based on transfusion status and other known prognostic factors. Cox proportional hazard modeling was used to examine the association between the prognostic factors and the study endpoint. RESULTS Sixty-six percent of women were transfused. Transfusion was associated with CA125, the use of neoadjuvant chemotherapy (NACT), surgical blood loss, and anemia. The mean pre-transfusion Hgb was 7.8 + 0.6 g/dL and 94% had a hemoglobin level greater than the transfusion threshold of 7 g/dL. RBC transfusion, suboptimal debulking, anemia, and NACT were associated with decreased survival. Only RBC transfusion and suboptimal debulking status remained significant in a multivariate model. CONCLUSIONS Peri-operative RBC transfusion compromises survival in ovarian cancer supporting the need to minimize the use of transfusion at the time of debulking surgery. Adherence to evidence-based transfusion guidelines offers an opportunity to reduce transfusion rates in this population with a resulting positive influence on survival.
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Affiliation(s)
- Joseph P Connor
- University of Wisconsin, Department of Pathology and Laboratory Medicine, Section of Transfusion Medicine, Madison, WI, United States of America.
| | - Andrea O'Shea
- University of Wisconsin, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Madison, WI, United States of America
| | - Kevin McCool
- University of Wisconsin, Department of Obstetrics and Gynecology, Madison, WI, United States of America
| | - Emmanuel Sampene
- University of Wisconsin, Department of Biostatistics and Medical Informatics, Madison, WI, United States of America
| | - Lisa M Barroilhet
- University of Wisconsin, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Madison, WI, United States of America
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Ryan G, Thoma M, Stern J, Mengeling M, O'Shea A, Syrop C, Stewart K, Torner J, Van Voorhis B. Reproductive health risk due to sexual and combat-related trauma in US veterans. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.025] [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: 10/18/2022]
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13
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Mills J, Chamberlain-Salaun J, Harrison H, Yates K, O'Shea A. Retaining early career registered nurses: a case study. BMC Nurs 2016; 15:57. [PMID: 27766042 PMCID: PMC5057224 DOI: 10.1186/s12912-016-0177-z] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 09/21/2016] [Indexed: 11/16/2022] Open
Abstract
Background A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses’ (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs. Methods A single case study design focused on early career registered nurses (ECRNs) working in a hospital and health service in northern Australia. The research team adopted Djukic et al’s definition of ECRNs as “RNs who have practiced for less than 5 years”. Data was collected via three individual interviews and two focus groups. Thirty-five ECRNs participated in the study. Results Qualitative analysis of data generated during interviews and focus groups, identified the key themes of receiving career advice and choice or no choice. Analysis of study data in the context of the broader literature resulted in the researchers identifying six areas of focus for ECRN retention: 1) well-planned, supported and structured transition periods; 2) consideration of rotation through different areas with a six month minimum for skills development; 3) empowering decision making; 4) placement opportunities and choice in decisions of where to work; 5) career advice and support that considers ECRNs’ personalities and skills; and 6) encouragement to reflect on career choices. Conclusions Reducing turnover and improving retention relies on understanding the factors that influence nurses’ decisions to leave or remain within an organisation and the profession. Ensuring nurses in the current workforce remain engaged and productive, rather than leave the profession, is reliant on addressing factors that cause attrition and implementing strategies that strengthen retention rates and workforce sustainability.
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Affiliation(s)
- Jane Mills
- Centre for Nursing and Midwifery Research, College of Healthcare Services, James Cook University, PO Box 6811, Cairns, Queensland 4870 Australia
| | | | - Helena Harrison
- Centre for Nursing and Midwifery Research, College of Healthcare Services, James Cook University, PO Box 6811, Cairns, Queensland 4870 Australia
| | - Karen Yates
- Centre for Nursing and Midwifery Research, College of Healthcare Services, James Cook University, PO Box 6811, Cairns, Queensland 4870 Australia
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Sevel L, Letzen J, Boissoneault J, O'Shea A, Robinson M, Staud R. (337) MRI based classification of chronic fatigue, fibromyalgia patients and healthy controls using machine learning algorithms: a comparison study. The Journal of Pain 2016. [DOI: 10.1016/j.jpain.2016.01.244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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15
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O'Shea A, Stephan J, Mott S, Goodheart M. The importance of pelvic ultrasounds performed at a tertiary care center in the diagnosis and management of women with a pelvic mass. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.07.078] [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: 11/25/2022]
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16
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Hardy J, O'Shea A, Gilbert C, Norris R. Is levomepromazine stable over time? Palliat Med 2011; 25:284-5. [PMID: 21248181 DOI: 10.1177/0269216310387963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Levomepromazine (methotrimeprazine) is an anti-psychotic used at low dose for the control of nausea and vomiting. When levomepromazine hydrochloride as Nozinan® is diluted with 0.9% sodium chloride at concentrations ranging from 0.13 to 6.25 mg/ml, and stored in polypropylene syringes, the drug is stable for at least 14 days.
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Affiliation(s)
- J Hardy
- Department of Palliative and Supportive Care, Mater Health Services, Australia.
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Corcoran TB, Engel A, Sakamoto H, O'Shea A, O'Callaghan-Enright S, Shorten GD. The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function. Br J Anaesth 2006; 97:825-31. [PMID: 17032661 DOI: 10.1093/bja/ael270] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [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: 11/12/2022] Open
Abstract
BACKGROUND Coronary artery bypass grafting (CABG) with cardiopulmonary bypass elicits a potent reperfusion injury and inflammatory response, more intense in patients with impaired myocardial function. Propofol has antioxidant properties which may attenuate such a response. METHODS In total, 27 patients with impaired left ventricular function undergoing CABG were randomly allocated to receive either target-controlled infusion propofol (P) or saline (S) immediately before aortic cross-clamp release until 4 h after reperfusion. Troponin-I, Urinary 8-epi PGF-2alpha isoprostane, coronary sinus and systemic malondialdehyde concentrations, Interleukin-6 (IL-6), -8 and -10 concentrations and leucocytes function studies (neutrophil respiratory burst, phagocytosis, CD-11b and CD-18 expression) were measured. RESULTS Propofol decreased MDA coronary sinus concentration at 1, 3 and 5 min after reperfusion (P<0.01); 60 min after reperfusion a significant difference between the two groups in systemic MDA concentrations was also seen. IL-6 concentration increases were significantly greater in Group S than Group P, 4 h after reperfusion [1118 (1333) pg ml(-1) vs 228 (105) pg ml(-1), P<0.01]. Serum IL-8 concentrations did not increase significantly in either group. Compared with baseline values IL-10 concentrations decreased after reperfusion but the values were higher in the propofol group than in the control group [22 (16) vs 11 (4) pg ml(-1), P<0.05]. No difference in leucocyte function or urinary isoprostane concentrations was demonstrated. CONCLUSION Propofol attenuates free-radical-mediated lipid peroxidation and systemic inflammation in patients with impaired myocardial function undergoing CABG.
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Affiliation(s)
- T B Corcoran
- Department of Anaesthesia and Intensive Care Medicine, Cork University/Mercy Hospitals and University College Cork, Cork City, Ireland.
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Corcoran TB, O'Shea A, Engel A, Shorten GD. The influence of propofol on P-selectin expression and nitric oxide production in re-oxygenated human umbilical vein endothelial cells. Acta Anaesthesiol Scand 2006; 50:348-54. [PMID: 16480469 DOI: 10.1111/j.1399-6576.2006.00955.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [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: 11/30/2022]
Abstract
BACKGROUND Reperfusion injury is characterized by free radical production and endothelial inflammation. Neutrophils mediate much of the end-organ injury that occurs, requiring P-selectin-mediated neutrophil-endothelial adhesion, and this is associated with decreased endothelial nitric oxide production. Propofol has antioxidant properties in vitro which might abrogate this inflammation. METHODS Cultured human umbilical vein endothelial cells were exposed to 20 h of hypoxia and then returned to normoxic conditions. Cells were treated with saline, Diprivan 5 microg/l or propofol 5 microg/l for 4 h after re-oxygenation and were then examined for P-selectin expression and supernatant nitric oxide concentrations for 24 h. P-selectin was determined by flow cytometry, and culture supernatant nitric oxide was measured as nitrite. RESULTS In saline-treated cells, a biphasic increase in P-selectin expression was demonstrated at 30 min (P = 0.01) and 4 h (P = 0.023) after re-oxygenation. Propofol and Diprivan prevented these increases in P-selectin expression (P < 0.05). Four hours after re-oxygenation, propofol decreased endothelial nitric oxide production (P = 0.035). CONCLUSION This is the first study to demonstrate an effect of propofol upon endothelial P-selectin expression. Such an effect may be important in situations of reperfusion injury such as cardiac transplantation and coronary artery bypass surgery. We conclude that propofol attenuates re-oxygenation-induced endothelial inflammation in vitro.
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Affiliation(s)
- T B Corcoran
- Department of Anaesthesia, Cork University Hospital, Cork City, Republic of Ireland.
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Bratos K, Roszak A, Cikowska-Wozniak E, O'Shea A. HDR VERSUS LDR BRACHYTHERAPY IN THE ADJUVANT TREATMENT OF ENDOMETRIAL CANCER. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00269] [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: 11/04/2022] Open
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Roszak A, Cikowska-Wozniak E, Bratos K, O'Shea A. RADIOCHEMOTHERAPY - THE NEW WAY OF ADVANCED CERVICAL CANCER TREATMENT. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00342] [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: 11/04/2022] Open
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O'Shea A, Mróz Bąk G, Kubaszewska M, Nowakowska E, Skowronek J, Adamska K. 78. Screening for prostate cancer in Greatpoland Cancer Center. Rep Pract Oncol Radiother 2001. [DOI: 10.1016/s1507-1367(01)70448-8] [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: 11/15/2022] Open
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Mróz-Bąk G, O'Shea A, Jezierska D, Kubaszewska M. 70. Meningiomas treated in Greatpoland Cancer Center between 1990–1997. Rep Pract Oncol Radiother 2001. [DOI: 10.1016/s1507-1367(01)70440-3] [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: 11/26/2022] Open
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Nowakowska E, Milecki P, Sibilska E, Kubicka M, Bąk G, Skowronek J, O'Shea A, Adamska K. 79. The effectivness of pain treatment with Strontium 89 in patient with osseous metastases. Rep Pract Oncol Radiother 2001. [DOI: 10.1016/s1507-1367(01)70449-x] [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: 10/18/2022] Open
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Abstract
Recent research has begun to provide support for the assumptions that memories are stored as a composite and are accessed in parallel (Tehan & Humphreys, 1998). New predictions derived from these assumptions and from the Chappell and Humphreys (1994) implementation of these assumptions were tested. In three experiments, subjects studied relatively short lists of words. Some of the lists contained two similar targets (thief and theft) or two dissimilar targets (thief and steal) associated with the same cue (robbery). As predicted, target similarity affected performance in cued recall but not free association. Contrary to predictions, two spaced presentations of a target did not improve performance in free association. Two additional experiments confirmed and extended this finding. Several alternative explanations for the target similarity effect, which incorporate assumptions about separate representations and sequential search, are rejected. The importance of the finding that, in at least one implicit memory paradigm, repetition does not improve performance is also discussed.
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Affiliation(s)
- M S Humphreys
- Department of Psychology, University of Queensland, Brisbane, Australia.
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Abstract
Three neonatal alpacas were treated for MCP flexural deformities. Two crias responded well to conservative therapy using splints made from fibreglass cast material. One cria with severe deformity failed to respond to conservative treatment but recovered satisfactorily after transection of the suspensory ligament in both legs. It seems that mild cases of flexural deformity of the MCP joint in alpaca crias respond well to conservative therapy but that surgical correction may be required in more severe cases. Sequential transection of the structures limiting extension of the MCP joint may result in fewer complications than previously reported techniques.
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Affiliation(s)
- T Cashman
- University Veterinary Centre, Department of Veterinary Clinical Sciences, Camden, New South Wales
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Skowronek J, Adamska K, Nowakowska E, Jaraszyk D, Kubaszewska M, O'Shea A. 71 Zasady leczenia napromienianiem chorych na czerniaka złośliwego na przykładzie chorych leczonych w Wielkopolskim Centrum Onkologii. Rep Pract Oncol Radiother 1999. [DOI: 10.1016/s1507-1367(99)70070-2] [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: 10/18/2022] Open
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O'Shea A. Spiritual care network model. Catholic Health Initiatives creates regional structure. Health Prog 1998; 79:38-9, 50. [PMID: 10180020] [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] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Affiliation(s)
- A O'Shea
- Catholic Health Initiatives-Eastern Region, Aston, PA, USA
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Skowronek J, Jaroszyk D, Nowakowska E, O'Shea A, Bąk G, Kubaszewska M. 21P Drugi nowotwór sutka u chorych leczonych w przeszłości raka sutka. Rep Pract Oncol Radiother 1998. [DOI: 10.1016/s1507-1367(98)70230-5] [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: 10/18/2022] Open
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Skowronek J, Matecka-Nowak M, Nowakowska E, O'Shea A, Kubaszewska M. The role of radiotherapy in the treatment of malignant melanoma. Rep Pract Oncol Radiother 1998. [DOI: 10.1016/s1507-1367(98)70158-0] [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: 11/26/2022] Open
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Skowronek J, Adamska K, Jaroszyk D, Nowakowska E, O'Shea A, Kubaszewska M. 11 Wyniki leczenia lokalnie zaawansowanego raka sutka w materiale Wielkopolskiego Centrum Onkologii. Rep Pract Oncol Radiother 1998. [DOI: 10.1016/s1507-1367(98)70185-3] [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: 10/18/2022] Open
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Vakharia DD, Dias JA, Thakur AN, Andersen TT, O'Shea A. Mapping of an assembled epitope of human follicle-stimulating hormone-beta utilizing monoclonal antibodies, synthetic peptides, and hormone-receptor inhibition. Endocrinology 1990; 127:658-66. [PMID: 1695567 DOI: 10.1210/endo-127-2-658] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Monoclonal antibodies (mabs) to human (h) FSH were utilized to probe epitopes of the beta-subunit of hFSH (hFSH beta). These mabs had an average approximate affinity constant (Ka) of 10(8) M-1 for hFSH beta and 10(7) M-1 for heterodimeric hFSH. Hormone specificity of mabs for hFSH beta was demonstrated by a lack of cross-reactivity with hCG alpha, FSH alpha, or LH alpha. Epitope specificity of each mab was initially assessed by determining whether solid phase mab could bind to [125I]hFSH already bound to mabs in liquid phase. In addition, it was determined whether [125I]mab could bind to hFSH already bound to solid-phase mabs. Both epitope cross-matching protocols indicated that all mabs bound to the same epitopes on hFSH beta. Next, synthetic peptides corresponding to the sequence of hFSH beta were used in an enzyme-linked immunosorbent assay to map this epitope. All mabs bound to peptides 7-19, 1-20, 33-53 and 66-85 but did not bind or bound weakly to peptides 81-100, 95-103, and 103-110. Titration experiments were performed using different concentrations of peptide (0.3-41 nmol) and one mab 3G3 (500 ng-25 ng) in the enzyme-linked immunosorbent assay. The product of the lowest mass of both peptide and antibody which gave a positive result was used to rank the peptides for their binding with mab 3G3. Peptides were ranked in the following descending order of potency: 33-53, 49-67, 66-85 much greater than 16-36, 1-20, 95-103, 52-65, 81-100, and 103-110. Ability of the mabs to inhibit binding of [125I]hFSH to bovine testis membrane receptor (Rec) was also studied. When [125I]hFSH was preincubated with increments of each mab for 2 h at 25 C before adding Rec with further incubation for 16 h, all mabs inhibited [125I]hFSH binding to Rec. The data suggest that most of the hFSH beta molecule has a conformation enabling all antibody recognizable regions to be in close proximity to each other. The present study provides evidence for an assembled epitope comprising in part, amino acids 33-53, which has been previously shown to be involved in receptor binding. Peptide sequences 49-67 and 66-85 are neighboring sequences in this assembled epitope which contains the determinants for receptor binding.
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Affiliation(s)
- D D Vakharia
- Wadsworth Center for Laboratories and Research, New York State Department of Health, Albany 12201-0509
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Abstract
A study was carried out to assess the effectiveness of ranitidine in the short-term treatment of reflux oesophagitis. In a double-blind randomized trial of 37 outpatients with symptomatic, endoscopically proven, moderate or severe reflux oesophagitis, 18 patients received ranitidine (150 mg twice a day) and 19 patients received identical-looking placebo tablets for a period of six weeks. Clinical, laboratory, and endoscopic assessments were made initially, and at the end of six weeks. Two patients withdrew during the trial. Endoscopic evidence of improvement was found in 15 of 17 ranitidine-treated and in five of 18 placebo-treated patients. This difference was significant (P less than 0.01). Antacid consumption was significantly lower in the ranitidine-treated group (P less than 0.01). Improvement in histological findings, and the relief of retrosternal pain, regurgitation, dysphagia, and epigastric pain did not achieve levels of statistical significance. No adverse clinical or laboratory changes occurred in patients in either group. It is concluded that, as judged by endoscopic evidence, ranitidine is an effective drug for the short-term treatment of reflux oesophagitis.
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Papadaki L, Beilby JO, Chowaniec J, Coulson WF, Darby AJ, Newman J, O'Shea A, Wykes JR. Hormone replacement therapy in the menopause: a suitable animal model. J Endocrinol 1979; 83:67-77. [PMID: 521730 DOI: 10.1677/joe.0.0830067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Female CBA mice, aged 11 months, were treated cyclically with oral ethynyl oestradiol or oestrone sulphate for 3 months. The ovaries of all animals appeared to be atrophied. Target tissues throughout the genital tract showed a response to both oestrogens. Electron microscopy of both the endometrium and the urothelium demonstrated morphological changes characteristic of increased cellular metabolic activity in the treated mice. Endometrial hyperplasia developed in both treatment groups but more pronounced epithelial changes occurred with oestrone sulphate. This hyperplasia was accompanied by a doubling in the number of uterine cytoplasmic oestrogen receptors. A 50% fall in serum levels of luteinizing hormone in the treated mice revealed that the hypothalamic-pituitary system was still intact. Both oestrogens improved skeletal balance by changes in cortical-endosteal bone remodelling. The results suggest that the CBA strain of mouse is a suitable model for the study of the human climacteric and its response to hormone replacement therapy.
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Jequier AM, O'Shea A, Jacobs HS. Functional and post-oral contraceptive amenorrhoea: response to luteinizing hormone releasing hormone (LH-RH). Br J Obstet Gynaecol 1975; 82:333-6. [PMID: 1092321 DOI: 10.1111/j.1471-0528.1975.tb00644.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Basal levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) in serum and their response to the luteinizing hormone releasing hormone (LH-RH) were measured in a group of patients with functional amenorrhoea. The results in this group were compared to those obtained in a second group of patients with secondary amenorrhoea which had followed cessation of a combined oral contraceptive. No difference either in the basal levels or in the response to LH-RH could be found. These data indicate that there is no detectable difference in pituitary gonadotrophin status between the two groups and that the two types of amenorrhoea have ghe same aetiological background.
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Bramble FJ, Houghton LE, O'Shea A, Jacobs HS. Proceedings: Endocrine evaluation of treated cryptorchidism: results of a 10 year follow-up. J Endocrinol 1975; 64:56P-57P. [PMID: 237057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Jequier AM, Jacobs HS, Kurtz AJ, O'Shea A, Rubeiro B, Nabarro JD. Proceedings: Gonadotrophin secretion in endocrine disorders: response to luteinizing hormone-follicle-stimulating hormone releasing hormone. J Endocrinol 1974; 61:LXI. [PMID: 4599393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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