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Shaul E, Kennedy KV, Spergel ZC, Daneshdoost S, Mahon M, Thanawala S, Spergel JM, Wilkins B, Ryan MJ, Muir AB. Endoscopic and histologic utility of transnasal endoscopy in pediatric eosinophilic esophagitis. J Pediatr Gastroenterol Nutr 2024; 78:1155-1160. [PMID: 38482943 DOI: 10.1002/jpn3.12170] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/12/2024] [Accepted: 02/03/2024] [Indexed: 05/03/2024]
Abstract
Unsedated transnasal endoscopy (TNE) is an alternative method of examining the esophageal mucosa in pediatric patients with eosinophilic esophagitis (EoE), reducing cost, time, and risk associated with frequent surveillance esophagogastroduodenoscopies (EGD). Adequacy of transnasal esophageal biopsies for the evaluation of eosinophilic esophagitis histologic scoring system (EoEHSS) has not yet been evaluated. We compared procedure times, endoscopic findings, and EoEHSS scoring for EoE patients undergoing TNE versus standard EGD. Sixty-six TNE patients and 132 EGD controls matched for age (mean age 14.0 years) and disease status (29.3% active) were included. Compared to patients undergoing standard EGD, patients undergoing TNE spent 1.94 h less in the GI suite (p < 0.0001), with comparable occurrence rates of all visual endoscopic findings and most EoEHSS components. TNE serves as a useful tool for long-term disease surveillance, and consideration should be given to its use in clinical trials for EoE.
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Affiliation(s)
- Eliana Shaul
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Division of Pediatric Gastroenterology, Department of Pediatrics, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Kanak V Kennedy
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Zachary C Spergel
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Shanaz Daneshdoost
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Mark Mahon
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Shivani Thanawala
- Department of Medicine, Perelman School of Medicine, Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan M Spergel
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Benjamin Wilkins
- Department of Pathology, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Matthew J Ryan
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amanda B Muir
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Udelson JE, Barker CM, Wilkins G, Wilkins B, Gooley R, Lockwood S, Potter BJ, Meduri CU, Fail PS, Solet DJ, Feldt K, Kriegel JM, Shaburishvili T. No-Implant Interatrial Shunt for HFpEF: 6-Month Outcomes From Multicenter Pilot Feasibility Studies. JACC Heart Fail 2023; 11:1121-1130. [PMID: 37115132 DOI: 10.1016/j.jchf.2023.01.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 01/24/2023] [Accepted: 03/24/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Most approaches to the creation of an interatrial shunt require placement of a permanent implant to maintain patency. OBJECTIVES The goal of this study was to investigate the safety and efficacy of a no-implant interatrial shunt for patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with mildly reduced ejection fraction (HFmrEF). METHODS This was a multicenter, uncontrolled study of patients with HFpEF/HFmrEF and NYHA functional class ≥II, ejection fraction >40%, and pulmonary capillary wedge pressure (PCWP) during supine exercise ≥25 mm Hg with PCWP-to-right atrial gradient ≥5 mm Hg. Follow-up was through 6 months with imaging to assess shunt durability. RESULTS A total of 28 patients were enrolled: mean age was 68 ± 9 years, and 68% were female. Baseline resting and peak exercise PCWP were 19 ± 7 mm Hg and 40 ± 11 mm Hg, respectively. All procedures displayed technical success with confirmation of left-to-right flow (shunt diameter 7.1 ± 0.9 mm). At 1 month, peak exercise PCWP decreased 5.4 ± 9.6 mm Hg (P = 0.011) with no change in right atrial pressure. There were no serious device or procedure-related adverse events through 6 months. Mean 6-minute walk distance increased 101 ± 71 meters (P < 0.001); Kansas City Cardiomyopathy Questionnaire Overall Summary Score increased 26 ± 19 points (P < 0.001); N-terminal pro-B-type natriuretic peptide decreased 372 ± 857 pg/mL (P = 0.018); and shunt patency was confirmed with unchanged diameter. CONCLUSIONS In these feasibility studies of a no-implant interatrial shunt, HFpEF/HFmrEF shunts exhibited stability with favorable safety and early efficacy signals. The results show promise toward this new approach for treating patients with HFpEF/HFmrEF and an appropriate hemodynamic profile. (Evaluation of the Safety and Feasibility of a Percutaneously Created Interatrial Shunt to Alleviate Heart Failure Symptoms in Patients With Chronic Heart Failure and Preserved or Mid-Range Left Ventricular Ejection Fraction [ALLEVIATE-HF-1]; NCT04583527; Evaluation of the Safety and Effectiveness of a Percutaneously Created Interatrial Shunt to Alleviate Heart Failure Symptoms in Patients With Chronic Heart Failure and Preserved or Mid-Range Left Ventricular Ejection Fraction [ALLEVIATE-HF-2]; NCT04838353).
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Affiliation(s)
- James E Udelson
- Division of Cardiology and the CardioVascular Center, Tufts Medical Center, Boston, Massachusetts, USA.
| | - Colin M Barker
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | | | | | | | - Brian J Potter
- Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | | | - Peter S Fail
- Cardiovascular Institute of the South, Houma, Louisiana, USA
| | - Darrell J Solet
- Cardiovascular Institute of the South, Houma, Louisiana, USA
| | - Kari Feldt
- Karolinska University Hospital, Stockholm, Sweden
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Barker C, Wilkins G, Wilkins B, Gooley R, Lockwood S, Fail P, Meduri C, Feldt K, Solet D, Kriegel J, Shaburishvili T. CRT-600.04 Multi-Center Clinical Outcomes of a No-Implant Interatrial Shunt for Heart Failure With Preserved and Reduced Ejection Fraction: Update From the Early Feasibility ALLEVIATE-HF Program. JACC Cardiovasc Interv 2023. [DOI: 10.1016/j.jcin.2023.01.244] [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: 02/22/2023]
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4
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Hannink E, Mansoubi M, Cronin N, Wilkins B, Najafi AA, Waller B, Dawes H. Validity and feasibility of remote measurement systems for functional movement and posture assessments in people with axial spondylarthritis. Healthc Technol Lett 2022; 9:110-118. [PMID: 36514477 PMCID: PMC9731560 DOI: 10.1049/htl2.12038] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION This study aimed to estimate the criterion validity of functional movement and posture measurement using remote technology systems in people with and without Axial spondylarthritis (axSpA). METHODS Validity and agreement of the remote-technology measurement of functional movement and posture were tested cross-sectionally and compared to a standard clinical measurement by a physiotherapist. The feasibility of remote implementation was tested in a home environment. There were two cohorts of participants: people with axSpA and people without longstanding back pain. In addition, a cost-consequence analysis was performed. RESULTS Sixty-two participants (31 with axSPA, 53% female, age = 45(SD14), BMI = 26.6(SD4.6) completed the study. In the axSpA group, cervical rotation, lumbar flexion, lumbar side flexion, shoulder flexion, hip abduction, tragus-to-wall and thoracic kyphosis showed a significant moderate to strong correlation; in the non-back pain group, the same measures showed significant correlation ranging from weak to strong. CONCLUSIONS Although not valid for clinical use in its current form, the remote technologies demonstrated moderate to strong correlation and agreement in most functional and postural tests measured in people with AxSA. Testing the CV-aided system in a home environment suggests it is a safe and feasible method. Yet, validity testing in this environment still needs to be performed.
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Affiliation(s)
- Erin Hannink
- Centre for Movement, Occupational and Rehabilitation Science (MOReS)Oxford Brookes UniversityOxfordUK,Oxford University Hospitals NHS Foundation TrustOxfordUK
| | - Maedeh Mansoubi
- Intersect@Exeter, Medical SchoolUniversity of ExeterExeterUK,Biomedical Research CenterMedical SchoolFaculty of Health and Life sciencesUniversity of ExeterExeterEX1 2LUUnited Kingdom
| | - Neil Cronin
- Neuromuscular Research CentreFaculty of Sport and Health SciencesUniversity of JyvaskylaJyvaskylaFinland,School of Sport and ExerciseUniversity of GloucestershireGloucestershireUK
| | | | - Ali A. Najafi
- Centre for Movement, Occupational and Rehabilitation Science (MOReS)Oxford Brookes UniversityOxfordUK
| | - Benjamin Waller
- Good Boost Wellbeing LimitedLondonUK,Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH)Sports Science DepartmentSchool of Science and EngineeringReykjavik UniversityReykjavikIceland
| | - Helen Dawes
- Centre for Movement, Occupational and Rehabilitation Science (MOReS)Oxford Brookes UniversityOxfordUK,Oxford University Hospitals NHS Foundation TrustOxfordUK,Intersect@Exeter, Medical SchoolUniversity of ExeterExeterUK,Biomedical Research CenterMedical SchoolFaculty of Health and Life sciencesUniversity of ExeterExeterEX1 2LUUnited Kingdom
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Natale A, Wilkins G, Wilkins B, Gooley R, Lockwood S, Barker C, Fail P, Meduri C, Feldt K, Solet D, Kriegel J, Shaburishvili T. PO-658-05 CLINICAL UPDATE FOR NO-IMPLANT INTERATRIAL SHUNT FOR HEART FAILURE WITH PRESERVED EJECTION FRACTION. Heart Rhythm 2022. [DOI: 10.1016/j.hrthm.2022.03.302] [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: 11/04/2022]
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6
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Kondo A, Ma S, Lee MYY, Ortiz V, Traum D, Schug J, Wilkins B, Terry NA, Lee H, Kaestner KH. Highly Multiplexed Image Analysis of Intestinal Tissue Sections in Patients With Inflammatory Bowel Disease. Gastroenterology 2021; 161:1940-1952. [PMID: 34529988 PMCID: PMC8606000 DOI: 10.1053/j.gastro.2021.08.055] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/23/2021] [Accepted: 08/27/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND & AIMS Significant progress has been made since the first report of inflammatory bowel disease (IBD) in 1859, after decades of research that have contributed to the understanding of the genetic and environmental factors involved in IBD pathogenesis. Today, a range of treatments is available for directed therapy, mostly targeting the overactive immune response. However, the mechanisms by which the immune system contributes to disease pathogenesis and progression are not fully understood. One challenge hindering IBD research is the heterogeneous nature of the disease and the lack of understanding of how immune cells interact with one another in the gut mucosa. Introduction of a technology that enables expansive characterization of the inflammatory environment of human IBD tissues may address this gap in knowledge. METHODS We used the imaging mass cytometry platform to perform highly multiplex image analysis of IBD and healthy deidentified intestine sections (6 Crohn's disease compared to 6 control ileum; 6 ulcerative colitis compared to 6 control colon). The acquired images were graded for inflammation severity by analysis of adjacent H&E tissue sections. We assigned more than 300,000 cells to unique cell types and performed analyses of tissue integrity, epithelial activity, and immune cell composition. RESULTS The intestinal epithelia of patients with IBD exhibited increased proliferation rates and expression of HLA-DR compared to control tissues, and both features were positively correlated with the severity of inflammation. The neighborhood analysis determined enrichment of regulatory T cell interactions with CD68+ macrophages, CD4+ T cells, and plasma cells in both forms of IBD, whereas activated lysozyme C+ macrophages were preferred regulatory T cell neighbors in Crohn's disease but not ulcerative colitis. CONCLUSIONS Altogether, our study shows the power of imaging mass cytometry and its ability to both quantify immune cell types and characterize their spatial interactions within the inflammatory environment by a single analysis platform.
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Affiliation(s)
- Ayano Kondo
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Siyuan Ma
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michelle Y. Y. Lee
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Vivian Ortiz
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Department of Gastroenterology and Hepatology, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia PA
| | - Daniel Traum
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jonathan Schug
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin Wilkins
- Department of Pathology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Hongzhe Lee
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Klaus H. Kaestner
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Nakagawa H, Kasagi Y, Karakasheva TA, Hara T, Aaron B, Shimonosono M, Kijima T, Giroux V, Bailey D, Wilkins B, Abrams JA, Falk GW, Aceves SS, Spergel JM, Hamilton KE, Whelan KA, Muir AB. Modeling Epithelial Homeostasis and Reactive Epithelial Changes in Human and Murine Three-Dimensional Esophageal Organoids. ACTA ACUST UNITED AC 2021; 52:e106. [PMID: 32105412 DOI: 10.1002/cpsc.106] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 01/10/2023]
Abstract
The homeostatic proliferation-differentiation gradient in the esophageal epithelium is perturbed under inflammatory disease conditions such as gastroesophageal reflux disease and eosinophilic esophagitis. Herein we describe the protocols for rapid generation (<14 days) and characterization of single-cell-derived, three-dimensional (3D) esophageal organoids from human subjects and mice with normal esophageal mucosa or inflammatory disease conditions. While 3D organoids recapitulate normal epithelial renewal, proliferation, and differentiation, non-cell autonomous reactive epithelial changes under inflammatory conditions are evaluated in the absence of the inflammatory milieu. Reactive epithelial changes are reconstituted upon exposure to exogenous recombinant cytokines. These changes are modulated pharmacologically or genetically ex vivo. Molecular, structural, and functional changes are characterized by morphology, flow cytometry, biochemistry, and gene expression analyses. Esophageal 3D organoids can be translated for the development of personalized medicine in assessment of individual cytokine sensitivity and molecularly targeted therapeutics in esophagitis patients © 2020 by John Wiley & Sons, Inc. Basic Protocol 1: Generation of esophageal organoids from biopsy or murine esophageal epithelial sheets Basic Protocol 2: Propagation and cryopreservation of esophageal organoids Basic Protocol 3: Harvesting of esophageal organoids for RNA isolation, immunohistochemistry, and evaluation of 3D architecture Basic Protocol 4: Modeling of reactive epithelium in esophageal organoids.
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Affiliation(s)
- Hiroshi Nakagawa
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York.,Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| | - Yuta Kasagi
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Epithelial Biology Center, Department of Pediatrics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tatiana A Karakasheva
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Epithelial Biology Center, Department of Pediatrics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Takeo Hara
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Epithelial Biology Center, Department of Pediatrics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Bailey Aaron
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Epithelial Biology Center, Department of Pediatrics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Masataka Shimonosono
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York.,Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| | - Takashi Kijima
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York.,Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, New York
| | - Veronique Giroux
- Department of Anatomy and Cell Biology, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - Dominique Bailey
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York.,Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Benjamin Wilkins
- Department of Pathology and Laboratory Medicine, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Julian A Abrams
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York
| | - Gary W Falk
- Division of Gastroenterology, Department of Medicine, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Seema S Aceves
- Division of Allergy & Immunology, Rady Children's Hospital-San Diego, San Diego, California
| | - Jonathan M Spergel
- Epithelial Biology Center, Department of Pediatrics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kathryn E Hamilton
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Epithelial Biology Center, Department of Pediatrics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly A Whelan
- Department of Pathology & Laboratory Medicine, Fels Institute for Cancer Research & Molecular Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Amanda B Muir
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Epithelial Biology Center, Department of Pediatrics, Perlman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Fukutomi M, Wilkins B, Søndergaard L. The role of device closure of patent foramen ovale in patients with cryptogenic stroke. J Intern Med 2020; 288:400-409. [PMID: 32812297 DOI: 10.1111/joim.13143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 01/16/2023]
Abstract
One of the most frequent causes of cardiac embolism in cryptogenic stroke is a paradoxical embolus, which originate from systemic venous source though an unidentified patent foramen ovale (PFO). PFO is a common finding in the general population with a prevalence of 25% to 30%. Transcatheter PFO device closure is known to be feasible and safety treatment for such patients. In recent years, several randomized controlled trials (RCTs) have been conducted to address the superiority of PFO closure over medical therapy alone in the prevention of stroke recurrence in patients with PFO. In contrast to findings from early 3 RCTs, recent 4 RCTs could successfully show the benefits of PFO device closure compared with medical therapy, with less peri- and postprocedural complication. Based on these data, PFO device closure is recommended to carefully select cryptogenic stroke patients aged from 18 to 65 years, with a high probability of a causal role of the PFO in stroke events. However, it is still uncertain whether PFO closure is superior to oral anticoagulants therapy in these patients. Therefore, further prospective randomized trials are needed to address the efficacy of PFO device closure to oral anticoagulants therapy.
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Affiliation(s)
- M Fukutomi
- From the Heart Center, Rigshospitalet, Copenhagen, Denmark
| | - B Wilkins
- From the Heart Center, Rigshospitalet, Copenhagen, Denmark
| | - L Søndergaard
- From the Heart Center, Rigshospitalet, Copenhagen, Denmark
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Whelan KA, Godwin BC, Wilkins B, Elci OU, Benitez A, DeMarshall M, Sharma M, Gross J, Klein-Szanto AJ, Liacouras CA, Dellon ES, Spergel JM, Falk GW, Muir AB, Nakagawa H. Persistent Basal Cell Hyperplasia Is Associated With Clinical and Endoscopic Findings in Patients With Histologically Inactive Eosinophilic Esophagitis. Clin Gastroenterol Hepatol 2020; 18:1475-1482.e1. [PMID: 31499251 PMCID: PMC7058491 DOI: 10.1016/j.cgh.2019.08.055] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/24/2019] [Accepted: 08/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Although eosinophil count is the standard used to monitor disease activity in patients with eosinophilic esophagitis (EoE), there are often disparities between patient-reported symptoms and eosinophil counts. We examined the prevalence of epithelial alterations, namely basal cell hyperplasia (BCH) and spongiosis, among patients with inactive EoE (eosinophil counts below 15 following therapy) and aimed to determine whether maintenance of these changes in epithelial morphology are associated with persistent clinical findings. METHODS Esophageal biopsies of 243 patients (mean age, 16.9 years) undergoing routine endoscopy at the University of Pennsylvania were evaluated for epithelial BCH and spongiosis. Univariable analysis was used to calculate the association between epithelial changes and symptoms as well as endoscopic findings and peak eosinophil count. We validated our findings using data from a cohort of patients at the University of North Carolina. RESULTS The discovery and validation cohorts each included patients with inactive EoE, based on histologic factors, but ongoing BCH and spongiosis. Ongoing BCH, but not spongiosis, in patients with inactive EoE was associated with symptoms (odds ratio, 2.14; 95% CI, 1.03-4.42; P = .041) and endoscopic findings (odds ratio, 7.10; 95% CI, 3.12-16.18; P < .001). CONCLUSIONS In patients with EoE, the presence of BCH might indicate ongoing disease activity, independent of eosinophil count. This might account for the persistent symptoms in patients who are considered to be in remission based on histologic factors.
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Affiliation(s)
- Kelly A. Whelan
- Department of Pathology & Laboratory Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140,Fels Institute for Cancer Research & Molecular Biology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140
| | - Bridget C. Godwin
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Benjamin Wilkins
- Division of Pathology and Laboratory Medicine, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Okan U. Elci
- Westat-Biostatistics and Data Management Core, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Alain Benitez
- Division of Allergy and Immunology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Maureen DeMarshall
- Gastroenterology Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Medha Sharma
- Gastroenterology Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Jonathan Gross
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Andres J. Klein-Szanto
- Histopathology Facility and Cancer Biology Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA
| | - Chris A. Liacouras
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Evan S. Dellon
- Division of Gastroenterology and Hepatology, University of North Carolina School of Medicine, Chapel Hill, NC 27514, USA
| | - Jonathan M. Spergel
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Division of Allergy and Immunology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Gary W. Falk
- Gastroenterology Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Amanda B. Muir
- Division of Gastroenterology, Hepatology, and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Hiroshi Nakagawa
- Gastroenterology Division, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; University of Pennsylvania Abramson Cancer Center, Philadelphia, Pennsylvania.
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10
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Godwin B, Wilkins B, Muir AB. EoE disease monitoring: Where we are and where we are going. Ann Allergy Asthma Immunol 2019; 124:240-247. [PMID: 31830586 DOI: 10.1016/j.anai.2019.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To review literature on various methods of monitoring and characterizing eosinophilic esophagitis (EoE) with respect to their validity as well as risk to the patient. DATA SOURCES A literature search was performed using PubMed with keyword combinations of EoE and monitoring as well as various techniques used for monitoring, including but not limited to, symptoms, endoscopy, histology, fluoroscopy, FLIP, noninvasive monitoring, and biomarkers. STUDY SELECTIONS Case-control studies, observational studies, peer-reviewed reviews and guidelines, and systematic reviews were selected, reviewed, and summarized here. RESULTS A wealth of research regarding monitoring of EoE is currently being undertaken and published. Our review highlights those that have been validated and are currently being used, as well as some that show promise for future monitoring and disease characterization. CONCLUSION Eosinophilic esophagitis is a chronic condition that at this time requires upper endoscopy as the gold standard of diagnosis and monitoring. There is a great need in the field for less invasive monitoring tools and better ways to characterize disease to allow for personalization of therapies.
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Affiliation(s)
- Bridget Godwin
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perlman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Benjamin Wilkins
- Department of Pathology and Laboratory Medicine, Perlman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Amanda B Muir
- Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Pediatrics, Perlman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
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Spergel JM, Elci O, Muir A, Liacouras CA, Wilkins B, Burke DD, Ott Lewis M, Brown-Whitehorn TF, Cianferoni A. Double-Blind, Placebo-Controlled Randomized Trial of Epicutaneous Immunotherapy in Children of Milk-Induced Eosinophilic Esophagitis. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.974] [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: 10/27/2022]
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12
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Wilkins B, Simmonds M, Matsis P, Scott B, Gaskin D, Harding S, Larsen P. Effect of Reduced Frame-Rate Protocol on Radiation Dose During Cardiac Catheterisation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.1021] [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: 11/16/2022]
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13
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O’Connor M, Harding S, Kirby A, Wilkins B, Larsen P. Current Anticoagulant and Antiplatelet Prescribing Practice in Acute Coronary Syndromes With Concurrent Atrial Fibrillation Across Australia And New Zealand. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.914] [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: 11/28/2022]
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14
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Holley A, Wilkins B, Fairley S, Ranchord A, Larsen P, Harding S. Prior Myocardial Infarction an Independent Predictor of Adverse Cardiovascular Events. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.110] [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: 10/19/2022]
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15
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Harding S, Holley A, Fairley S, Wilkins B, Simmonds M, Larsen P. Contemporary Antiplatelet Therapy in Acute Coronary Syndromes: Are There Differences in Outcomes and Complications Between Clopidogrel and Ticagrelor? Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.576] [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]
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16
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Zhao X, Lorent K, Wilkins B, Marchione DM, Gillespie K, Waisbourd-Zinman O, So J, Koo KA, Shin D, Porter JR, Wells RG, Blair I, Pack M. Glutathione antioxidant pathway activity and reserve determine toxicity and specificity of the biliary toxin biliatresone in zebrafish. Hepatology 2016; 64:894-907. [PMID: 27102575 PMCID: PMC5251204 DOI: 10.1002/hep.28603] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 03/15/2016] [Accepted: 04/12/2016] [Indexed: 12/13/2022]
Abstract
UNLABELLED Biliatresone is an electrophilic isoflavone isolated from Dysphania species plants that has been causatively linked to naturally occurring outbreaks of a biliary atresia (BA)-like disease in livestock. Biliatresone has selective toxicity for extrahepatic cholangiocytes (EHCs) in zebrafish larvae. To better understand its mechanism of toxicity, we performed transcriptional profiling of liver cells isolated from zebrafish larvae at the earliest stage of biliatresone-mediated biliary injury, with subsequent comparison of biliary and hepatocyte gene expression profiles. Transcripts encoded by genes involved in redox stress response, particularly those involved in glutathione (GSH) metabolism, were among the most prominently up-regulated in both cholangiocytes and hepatocytes of biliatresone-treated larvae. Consistent with these findings, hepatic GSH was depleted at the onset of biliary injury, and in situ mapping of the hepatic GSH redox potential using a redox-sensitive green fluorescent protein biosensor showed that it was significantly more oxidized in EHCs both before and after treatment with biliatresone. Pharmacological and genetic manipulation of GSH redox homeostasis confirmed the importance of GSH in modulating biliatresone-induced injury given that GSH depletion sensitized both EHCs and the otherwise resistant intrahepatic cholangiocytes to the toxin, whereas replenishing GSH level by N-acetylcysteine administration or activation of nuclear factor erythroid 2-like 2 (Nrf2), a transcriptional regulator of GSH synthesis, inhibited EHC injury. CONCLUSION These findings strongly support redox stress as a critical contributing factor in biliatresone-induced cholangiocyte injury, and suggest that variations in intrinsic stress responses underlie the susceptibility profile. Insufficient antioxidant capacity of EHCs may be critical to early pathogenesis of human BA. (Hepatology 2016;64:894-907).
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Affiliation(s)
- Xiao Zhao
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kristin Lorent
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Benjamin Wilkins
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Dylan M. Marchione
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kevin Gillespie
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Orith Waisbourd-Zinman
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Juhoon So
- Department of Developmental Biology, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Kyung Ah Koo
- Department of Biological Sciences, University of the Sciences, Philadelphia, PA 19104, USA
| | - Donghun Shin
- Department of Developmental Biology, McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - John R. Porter
- Department of Biological Sciences, University of the Sciences, Philadelphia, PA 19104, USA
| | - Rebecca G. Wells
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ian Blair
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Michael Pack
- Division of Gastroenterology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA., Cell and Developmental Biology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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17
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Wilkins B, Aitken A. Fontan Follow-up: A Review of Central New Zealand Congenital Care. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.727] [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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18
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Wilkins B, Gudex F, Sasse A. Measures of frailty in elderly patients considered for cardiac surgery and comparison of 30-day outcomes in both medical and surgical treatment groups. Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.04.117] [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: 10/23/2022]
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19
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Wilkins B, Hullikunte S, Simmonds M, Harding S, Larsen P. What is the cause of the guideline prescribing gap post myocardial infarction? Heart Lung Circ 2015. [DOI: 10.1016/j.hlc.2015.06.663] [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: 10/23/2022]
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20
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21
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Neat MJ, Foot NJ, Hicks A, Breen R, Wilkins B, McLean E, Santis G. ALKrearrangements in EBUS-derived transbronchial needle aspiration cytology in lung cancer. Cytopathology 2013; 24:356-64. [DOI: 10.1111/cyt.12060] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2013] [Indexed: 01/30/2023]
Affiliation(s)
- M. J. Neat
- Cytogenetics Unit; GSTS Pathology; Guy's & St Thomas' NHS Foundation Trust; London UK
| | - N. J. Foot
- Cytogenetics Unit; GSTS Pathology; Guy's & St Thomas' NHS Foundation Trust; London UK
| | - A. Hicks
- Division of Asthma, Allergy & Lung Biology; King's College London; Guy's Hospital; London UK
| | - R. Breen
- Department of Respiratory Medicine; Guy's & St Thomas' NHS Foundation Trust; London UK
| | - B. Wilkins
- Department of Cellular Pathology; Guy's & St Thomas' NHS Foundation Trust; London UK
| | - E. McLean
- Department of Cellular Pathology; Guy's & St Thomas' NHS Foundation Trust; London UK
| | - G. Santis
- Division of Asthma, Allergy & Lung Biology; King's College London; Guy's Hospital; London UK
- Department of Respiratory Medicine; Guy's & St Thomas' NHS Foundation Trust; London UK
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22
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Abstract
A 38-year-old primiparous woman presented with pre-eclampsia at 36 weeks gestation with an abnormal full blood count and leukoerythroblastic blood film. JAK2 V617F was negative and splenomegaly was noted on abdominal ultrasound. Delivery was at 37 weeks gestation by emergency caesarean section due to abnormal cardiotocography. Bone marrow aspirate and trephine confirmed a diagnosis of myelofibrosis. The case highlights a rare presentation of primary myelofibrosis in pregnancy, the difficulties in management, and the UK Obstetric Surveillance System who are collecting epidemiological data on uncommon disorders in pregnancy.
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Affiliation(s)
- S Okoli
- Department of Haematology, Guy's & St Thomas' Hospital, London SE1 7EH, UK
| | - B Wilkins
- Department of Histopathology, Guy's & St Thomas' Hospital, London SE1 7EH, UK
| | - S Robinson
- Department of Haematology, Guy's & St Thomas' Hospital, London SE1 7EH, UK
| | - C Harrison
- Department of Haematology, Guy's & St Thomas' Hospital, London SE1 7EH, UK
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23
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Kendrick T, Wall M, Wilkins B. Paediatric retrievals to New South Wales (NSW) tertiary centres—How sick are they? Aust Crit Care 2011. [DOI: 10.1016/j.aucc.2010.12.060] [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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24
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Hutchinson CV, Burthem J, Bisland M, Carey P, Crotty G, Devalia V, Janda B, Gordon W, Harrison CN, Murray J, Shlebak A, Thomas A, Wilkins B, McMullin MF. British Society for Haematology, slide session, annual scientific meeting, Glasgow, 2008. Int J Lab Hematol 2009; 32:174-83. [PMID: 19364371 DOI: 10.1111/j.1751-553x.2009.01153.x] [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: 11/30/2022]
Abstract
A morphology session is held each year at the Annual Scientific Meeting of the British Society of Haematology. Prior to the meeting this year, eight morphology cases were made available to BSH members as glass slides and also digitally as 'virtual slides'. A panel of invited commentators who had no prior knowledge of the diagnosis discussed the eight cases. An initial limited history and blood count are given with representative images from the case material; this is followed by the discussants' comments and suggested diagnosis. The actual clinical diagnosis is then given with other relevant information.
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Affiliation(s)
- C V Hutchinson
- Division of Cancer Studies, Stopford Building, University of Manchester, Manchester, UK
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25
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Abstract
BACKGROUND Adult elite competitive rock climbers are small in stature with low body mass and very low body fat percentage. These characteristics have generated concern that young climbers may attempt body mass reduction to extreme levels with adverse consequences for health and performance. No published anthropometry data for young competitive climbers exist. OBJECTIVE To describe the general anthropometric characteristics of junior US competitive rock climbers. METHODS Ninety subjects (mean (SD) age 13.5 (3.0) years) volunteered to participate. All competed at the Junior Competition Climbers Association US National Championship. Anthropometric variables, including height, mass, body mass index (BMI), arm span, biiliocristal and biacromial breadths, skinfold thickness at nine anatomical sites, forearm and hand volumes, and handgrip strength, were measured. Selected variables were expressed as ratio values and as normative age and sex matched centile scores where appropriate. A control group (n=45) of non-climbing children and youths who participated in a variety of sports activities, including basketball, cross country running, cross country skiing, soccer, and swimming, underwent the same testing procedures in the Exercise Science Laboratory of Northern Michigan University. RESULTS Mean (SD) self reported climbing ability was 11.80 (1.20), or about 5.11 d on the Yosemite decimal system scale. The mean (SD) experience level was 3.2 (1.9) years, and subjects competed in 10 (5) organised competitions over a 12 month period. Despite similarity in age, there were significant differences (p<0.01) between climbers and control subjects for height, mass, centile scores for height and mass, ratio of arm span to height ("ape index"), biiliocristal/biacromial ratio, sum of seven and sum of nine skinfolds, estimated body fat percentage, and handgrip/mass ratio. Despite significantly lower skinfold sums and estimated body fat percentage, no differences were found between climbers and controls for absolute BMI or BMI expressed as a centile score. CONCLUSIONS Young competitive climbers have similar general anthropometric characteristics to elite adult climbers. These include relatively small stature, low body mass, low sums of skinfolds, and high handgrip to mass ratio. Relative to age matched athletic non-climbers, climbers appear to be more linear in body type with narrow shoulders relative to hips. Differences in body composition exist between climbers and non-climbing athletes despite similar BMI values.
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Affiliation(s)
- P B Watts
- Northern Michigan University, Marquette, MI 49855, USA.
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26
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Pellatt J, Sweetenham J, Pickering RM, Brown L, Wilkins B. A single-centre study of treatment outcomes and survival in 120 patients with peripheral T-cell non-Hodgkin's lymphoma. Ann Hematol 2002; 81:267-72. [PMID: 12029536 DOI: 10.1007/s00277-002-0450-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [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: 06/21/2001] [Accepted: 02/28/2002] [Indexed: 11/29/2022]
Abstract
We conducted a retrospective study of treatment outcomes and survival in 120 consecutive, unselected patients with peripheral T-cell non-Hodgkin's lymphoma, presenting at a single centre over a 20-year period. Cases met the criteria of the Revised European-American Lymphoma (REAL) Classification and patients with peripheral T-cell lymphoma of the following subtypes were included: anaplastic large T-cell lymphoma (ALCL), angioimmunoblastic T-cell lymphoma (AILD), peripheral T-cell lymphoma unspecified (PTCLu), and intestinal T-cell lymphoma (ITCL). The study population consisted of 120 patients with a presenting diagnosis of peripheral T-cell lymphoma. Cases that had been previously confirmed as T-cell lymphoma at formal pathology review were identified from the lymphoma database of this institution. Staging investigations, treatment type and outcomes were taken from patient records. For each subtype, clinical characteristics, response to initial treatment, duration of response and any subsequent relapse were recorded. Overall, relapse, and progression-free survival figures were calculated. The ALCL group had the best response rate to first line treatment 19 of 22 (86 percent) while the AILD group had the lowest response 12 of 29 (41 percent). Relapse rates were PTCLu 13 of 35 (37 percent), ITCL 10 of 34 (29 percent), ALCL 6 of 22 (27 percent) and AILD 7 of 29 (24 percent). In terms of median overall survival, a significantly superior survival was demonstrated for the ALCL group (7.05 years) compared to the remaining three groups. The ALCL group had the lowest risk of death while the ITCL group had the highest risk (hazard ratio: 2.82). Five-year survival rates were estimated to be ALCL 60 percent, PTCLu 40 percent, AILD 30 percent and ITCL 25 percent. This single-centre study demonstrated different outcomes for each group with significant differences in overall survival rates. These findings support the clinical utility of the REAL lymphoma classification in respect to the PTCL subgroups included in this study.
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Affiliation(s)
- J Pellatt
- Department of CRC Medical Oncology, University of Southampton and Southampton University NHS Trust and CRC Wessex Medical Oncology Unit, Royal South Hants Hospital, Brinton's Terrace, UK.
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27
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Affiliation(s)
- N J McDonald
- Department of Paediatric Intensive Care, New Children's Hospital, Westmead, New South Wales, Australia
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28
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Austen B, McCarthy H, Wilkins B, Smith A, Duncombe A. Fatal disseminated fusarium infection in acute lymphoblastic leukaemia in complete remission. J Clin Pathol 2001; 54:488-90. [PMID: 11376027 PMCID: PMC1731440 DOI: 10.1136/jcp.54.6.488] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [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: 11/04/2022]
Abstract
Fusarium species are increasingly recognised as serious pathogens in the immunocompromised. The outcome in the context of persistent severe neutropenia has been almost universally fatal. However, there have been several case reports of successful treatment if neutrophil recovery can be achieved. This report presents the case of a fatality that occurred despite neutrophil recovery. A 67 year old man developed disseminated fusariosis during the neutropenic phase of induction chemotherapy for acute lymphoblastic leukaemia. Fusarium dimerum was isolated from blood cultures. This species is highly unusual and very few case reports exist in the literature. An initial response to amphotericin treatment coincided with neutrophil recovery but a subsequent relapse occurred, despite adequate neutrophil counts, which proved fatal. It is postulated that reseeding of the blood from an occult site, namely the right vitreum in this case, led to this secondary relapse despite achieving complete leukaemic remission.
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Affiliation(s)
- B Austen
- Department of Haematology, Southampton General Hospital, Tremona Road, Southampton S016 6YD, UK.
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29
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Wickham CL, Sarsfield P, Joyner MV, Jones DB, Ellard S, Wilkins B. Formic acid decalcification of bone marrow trephines degrades DNA: alternative use of EDTA allows the amplification and sequencing of relatively long PCR products. Mol Pathol 2000; 53:336. [PMID: 11193054 PMCID: PMC1186990 DOI: 10.1136/mp.53.6.336] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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30
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Abstract
We report a new variant of the BCL1 syngeneic mouse B-cell lymphoma model, which we have called pi-BCL1. pi-BCL1 can be established as a syngeneic tumor in BALB/c mice. Tumors can be removed, prepared and easily grown in liquid culture and subsequently transferred back successfully as syngeneic tumors. As a syngeneic tumor pi-BCL1 behave more like a lymphoma with solid tumor masses, than a chronic lymphocytic leukaemia of the original BCL1 model. The immunophenotype and the growth characteristics of the pi-BCL1 and BCL1 tumors appear very similar. Cytologically, pi-BCL1 appears to be a transformation from a small lymphocytic lymphoma to a more diffuse large cell centroblast-like higher-grade lymphoma. We are not aware of any previous reports of such transformation events in a syngeneic animal model of B cell lymphoma. We believe pi-BCL1 provides a useful new tool for the study of B cell lymphoma in vitro and in vivo and enables reduced numbers of tumor passage in mice.
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Affiliation(s)
- T Illidge
- Cancer Sciences Division, School of Medicine, Southampton University, Southampton, United Kingdom.
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31
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Affiliation(s)
- N Varma
- Department of Haematology and Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India [corrected]
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32
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Watts PB, Daggett M, Gallagher P, Wilkins B. Metabolic response during sport rock climbing and the effects of active versus passive recovery. Int J Sports Med 2000; 21:185-90. [PMID: 10834350 DOI: 10.1055/s-2000-302] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.3] [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: 10/16/2022]
Abstract
The objectives of this study were to 1) continuously assess oxygen uptake during and after difficult sport rock climbing and 2) to evaluate the effects of active versus passive recovery on post-climbing blood lactate and hand grip strength. Fifteen expert rock climbers attempted to climb (i.e., red point lead) a 20 m difficult route (5.12 b, YDS scale) set on an indoor climbing wall. Subjects were assigned to either active recovery (AR; n = 8), consisting of recumbent cycling at 25 Watts, or passive recovery (PR; n = 7). Expired air was analyzed during climbing and through a 10-minute recovery period by a lightweight battery-powered open circuit system. Oxygen uptake (VO2) and heart rate (HR) were measured continuously and averaged over 20-second intervals. These data were expressed as averages over the entire climb (VO2avg and HRavg) and as peak values. An estimated resting VO2 of 250 ml x min(-1) was subtracted from the interval VO2 values to provide net VO2 data which were subsequently converted to absolute VO2 values in liters for climbing (C - VO2net) and recovery (R - VO2net). Total net VO2 was calculated as the sum of C - VO2net plus R - VO2net. Blood samples were obtained via fingerprick at pre-climb and at 1-, 10-, 20-, and 30-minutes post-climb and analyzed for whole blood lactate. Handgrip strength was measured via dynamometry at pre-climb and at 1-, 10-, 20-, and 30-minutes post-climb. Mean climbing time was 2.57 +/- 0.41 min. During climbing, VO2avg and HRavg means were 1660 +/- 340 ml x min(-1) and 148 +/- 16 b x min(-1) respectively with mean peaks of 2147 +/- 413 ml x min(-1) and 162 +/- 17 b x min(-1). Relative VO2avg was 24.7 +/- 4.3 ml x kg(-1) x min(-1) with a mean peak value of 31.9 +/- 5.3 ml x kg(-1) x min(-1). Mean values for C - VO2net and R - VO2net were 4.009 +/- 0.929 L and 2.809 +/- 0.518 L respectively for the PR group with mean total net VO2 at 6.818 +/- 1.291 L. For the AR group mean values for C - VO2net and R - VO2net were 4.216 +/- 1.174 L and 7.691 +/- 3.154 L respectively with a mean total net VO2 of 11.906 +/- 4.172 L. There was no difference between the groups for C - VO2net, however R - VO2net and total net VO2 were significantly different (p < 0.05) between PR and AR. Blood lactate increased significantly with climbing in both AR and PR groups. Lactate remained elevated in the PR group until 30 minutes post-climb, but had returned to pre-climb level by 20 minutes in the AR group. Handgrip strength was significantly decreased at 1-minute post-climb for the AR group, but was not significantly changed for the PR group. Although climbers may be able to attain a plateau in VO2, the observed accumulation of lactate in the blood combined with the elevated recovery VO2 indicate a higher overall energy demand than indicated via the recorded VO2 during climbing. Low intensity active recovery appears to significantly reduce accumulated blood lactate within 20 minutes following difficult climbing, however further research is required to establish whether this strategy is advantageous for subsequent climbing performance.
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Affiliation(s)
- P B Watts
- HPER Department, Northern Michigan University, Marquette 49855, USA.
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Trim N, Morgan S, Evans M, Issa R, Fine D, Afford S, Wilkins B, Iredale J. Hepatic stellate cells express the low affinity nerve growth factor receptor p75 and undergo apoptosis in response to nerve growth factor stimulation. Am J Pathol 2000; 156:1235-43. [PMID: 10751349 PMCID: PMC1876895 DOI: 10.1016/s0002-9440(10)64994-2] [Citation(s) in RCA: 148] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We have examined the expression of p75, a member of the TNF receptor superfamily in hepatic stellate cells (HSC) and pancreatic stellate cells (PSC). Activated HSC and PSC were demonstrated by Western blot analysis to express p75. p75 was immunolocalized to cells with a myofibroblast-like morphology in the fibrotic bands of six fibrotic and cirrhotic liver biopsies and three biopsies of fibrotic human pancreas. Immunostaining of parallel sections indicated that these cells were alpha-smooth muscle actin-positive, identifying them as activated HSC and PSC, respectively. HSC apoptosis in tissue culture in the presence of serum was quantified after addition of 0.1 to 100 ng/ml of nerve growth factor (NGF) a ligand for p75, by in situ counting of apoptotic bodies after addition of acridine orange. HSC demonstrated a significant increase in apoptosis in response to 100 ng/ml NGF (0.05 > P by Wilcoxon's rank; n = 7) after 24 hours. NGF 100 ng/ml had no effect on HSC proliferation, but reduced total HSC DNA by 19% relative to control after 24 hours (n = 3). These data demonstrate that activated HSC express p75 and respond to NGF stimulation by undergoing apoptosis. We therefore report p75 as a novel marker of activated HSC and suggest that signaling via ligand binding to p75 may provide a mechanism for selective apoptosis of HSC.
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Affiliation(s)
- N Trim
- Divisions of Cell and Molecular Medicine and Cancer Sciences, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
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34
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Watts PB, Coleman B, Clure C, Daggett M, Gallagher P, Sustrich P, Wilkins B. Metabolic and cardiovascular responses during work on a high ropes course. J Sports Med Phys Fitness 1999; 39:37-41. [PMID: 10230167] [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: 02/12/2023]
Abstract
BACKGROUND High ropes course facilities are employed in adventure programs to promote self-esteem, stress management, and problem-solving skill development. Although the combination of fear, anxiety, and potentially high levels of physical exertion during such activity could yield situations of cardiac risk for certain individuals, no previous research has described the physiological nature of high ropes course work. The purpose of this study was to observe the metabolic and cardiovascular responses to a typical high ropes course experience. METHODS Seventeen subjects gave informed consent to complete a 5-element sequence on an indoor high ropes course. The elements included step-swings (SS), swinging tires (ST), a 4-inch balance beam (B1), a vertical cargo net (CN), and a second beam (B2). These elements were positioned in series at a height of 20 feet above the floor. Expired air was analyzed continuously using a portable open circuit metabolic analyzer and heart rate (HR) was recorded at 5-second intervals via telemetry. Pre- and postcourse blood samples were obtained via finger-prick and analyzed for lactate (BL). Systolic (SBP) and diastolic (DBP) blood pressures were taken at an orientation session prior to each subject's test date and at pre-, mid-, and post course points during each test session. RESULTS The mean ropes course work time was 11.2 +/- 2.9 min. Mean averaged/peak oxygen uptake (VO2), ventilation (VE), HR, and energy expenditure (EE) were 13.9 +/- 2.3/21.6 +/- 3.7 ml.kg-1.min-1, 36.4 +/- 8.1/49.6 +/- 10.3 l.min-1, 142 +/- 16/167 +/- 15 b.min-1, and 5.1 +/- 0.9/7.7 +/- 1.0 kcal.min-1 respectively. In descending order, mean EE was 6.2 +/- 1.1, 6.2 +/- 0.8, 5.4 +/- 1.0, 4.5 +/- 0.5, and 4.2 +/- 0.5 kcal +/- min-1 for the B2, ST, CN, B1, and SS elements respectively. Blood lactate increased (p < 0.05) from a pre course value of 1.9 +/- 0.6 mmol.l-1 to 5.0 +/- 1.1 mmol.l-1 post course. SBP values at pre- (136.7 +/- 16.0), mid-(169.8 +/- 19.7), and postcourse (154.1 +/- 19.2) were higher (p < 0.05) than the orientation SBP of 126.2 +/- 14.7 mmHg. Mid- and post course SBP means were significantly higher than the precourse mean. A significant difference was found for DBP between the midcourse (86.3 +/- 8.9) vs the orientation mean (79.1 +/- 6.8) only. CONCLUSIONS Based upon the results of this study, average high ropes course work can be classified as aerobically moderate to heavy, at just over 4 METs with peak periods over 7 METs. Transient elevation in DBP may occur during elements with a high level of upper body work. High ropes course work does not present an unusually high physiological stress for healthy, physically fit individuals.
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Affiliation(s)
- P B Watts
- Exercise Science Laboratory, Northern Michigan University, Marquette, USA
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35
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Smith P, Carroll C, Wilkins B, Johnson P, Gabhainn SN, Smith LP. The effect of wind speed and direction on the distribution of sewage-associated bacteria. Lett Appl Microbiol 1999; 28:184-8. [PMID: 10196765 DOI: 10.1046/j.1365-2672.1999.00507.x] [Citation(s) in RCA: 13] [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] [Indexed: 11/20/2022]
Abstract
A study of the relationship between wind and the distribution of sewage-associated bacteria was undertaken at a location where the sewage was discharged into the sea adjacent to the mouth of a river. The numbers of presumptive Escherichia coli were determined in 149 sea-water samples taken from three locations at distances of 1.9, 2.4 and 4.3 km from the outfall. On each sampling occasion, data on the wind speed and direction in the 3 h prior to collection of the samples were also collected. Analysis of these data demonstrated a significant role for wind speed and direction. With respect to wind direction, the numbers of presumptive E. coli present in a sample were significantly higher when the sample site lay downwind of the outfall. Wind speed was shown to have an influence on the numbers of presumptive E. coli only when the sample site was downwind of the outfall. In an analysis of 61 samples, an inverse correlation (r2 = 0.73) between salinity and log presumptive E. coli numbers was demonstrated. These data demonstrate that wind speed and direction at the time of sampling significantly influence the numbers of presumptive E. coli detected in any sea-water sample. It is argued that failure to pay sufficient attention to these parameters in the design of monitoring programmes may result in the generation of data that could provide a seriously distorted picture of the microbiological status of a water body.
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Affiliation(s)
- P Smith
- Department of Microbiology, National University of Ireland, Galway, Ireland, UK
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36
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Waring WP, Wilkins B, Louk V. Switching gears. Rehab Manag 1998; 11:40-5. [PMID: 11066853] [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: 02/18/2023]
Affiliation(s)
- W P Waring
- St Francis Health Care Centre, Green Springs, Ohio, USA
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O'Donnell PG, Jackson SA, Tung KT, Hassan B, Wilkins B, Mead GM. Radiological appearances of lymphomas arising from mucosa-associated lymphoid tissue (MALT) in the lung. Clin Radiol 1998; 53:258-63. [PMID: 9585040 DOI: 10.1016/s0009-9260(98)80123-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We review the radiological findings in 13 patients with histologically proven (n = 10) or clinically diagnosed (n = 3) lymphomas arising in mucosa-associated lymphoid tissue (MALT) of the lung. These rare B-cell lymphomas typically follow an indolent course, and many cases are still being incorrectly described in current radiological literature under the term pseudolymphoma. The patients frequently give a history of autoimmune disease involving the affected organ, and involvement of another mucosal site as part of a disseminated MALT lymphoma, is common. The radiographic patterns of pulmonary parenchymal involvement in lung MALT lymphomas have been reviewed, and correlation made with their clinical behaviour.
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Affiliation(s)
- P G O'Donnell
- Department of Radiology, Royal South Hants Hospital, Southampton, UK
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38
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Mayer GG, Wilkins B. The expanded role of the office manager in the managed care medical group. Health Care Innov 1997; 7:10-2, 16-7. [PMID: 10167696] [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: 02/11/2023]
Affiliation(s)
- G G Mayer
- Friendly Hills HealthCare Foundation, Whittier, CA, USA
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Affiliation(s)
- B Wilkins
- Paediatric Intensive Care Unit, Royal Alexandra Hospital for Children, NSW, Australia
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Abstract
Hemorrhagic shock and encephalopathy syndrome (HSES) is a sudden-onset symptom complex occurring in previously healthy infants and children. It was first described in 1983 in the United Kingdom in 10 infants. Subsequently, > 140 cases have been reported worldwide, although no cases have been previously reported in the forensic literature. Typically the child presents with fever, shock, encephalopathy with coma and seizures, evidence of hemorrhage, and diarrhea. Laboratory investigation reveals falling hemoglobin and platelet counts, renal impairment, evidence of disseminated intravascular coagulation, metabolic acidosis, and raised serum transaminases. Microbiological cultures are uniformly negative. The condition has a high mortality and morbidity. The etiology is unknown and may be multifactorial. However, hyperpyrexia appears to play a central role in pathogenesis. The diagnosis of HSES in the deceased child is one of exclusion and requires a careful antemortem history as well as a thorough autopsy with toxicological and microbiological investigations. A case of HSES is reported and the literature reviewed.
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Affiliation(s)
- D Little
- Department of Forensic Medicine, Westmead Hospital, New South Wales, Australia
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Wilkins B. Cerebral oedema after MDMA ("ecstasy") and unrestricted water intake. Hyponatraemia must be treated with low water input. BMJ 1996; 313:689-90; author reply 690. [PMID: 8811776 PMCID: PMC2351978 DOI: 10.1136/bmj.313.7058.689b] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
A cDNA encoding the rabbit 55 kDa ZP protein was expressed using a baculovirus expression system and was evaluated for its ability to elicit antibodies which may interfere with sperm-ZP interaction. The expressed glycosylated protein, BV55, was purified by wheat germ agglutinin lectin affinity chromatography. Antisera made in guinea pigs immunized with BV55 (GP-alpha-BV55) is specific for the 55 kDa rabbit ZP protein. Indirect immunofluorescence studies indicate that GP-alpha-BV55 localizes to a filamentous meshwork on the surface of the ZP of isolated rabbit eggs. Immunohistochemical analysis of rabbit ovaries demonstrated that this antigen is localized within the ZP of primary and more advanced stage ovarian follicles but is not detected in primordial follicles. In addition, the 55 kDa antigen was detected in the granulosa cells of secondary stage follicles but not in the oocyte. GP-alpha-BV55 effectively blocked the binding of rabbit sperm to rabbit eggs in vitro. However, Fab fragments generated from GP-alpha-BV55 failed to block sperm binding, suggesting that the inhibitory effect of GP-alpha-BV55 was due to stearic hindrance rather than specific blocking of a sperm receptor site. Although the Fab fragment did not inhibit sperm binding, additional studies demonstrated that biotinylated BV55 protein bound to rabbit sperm in the acrosomal region in a manner consistent with ligand activity in the sperm-ZP interaction, and that BV55 bound to rabbit sperm in a dose-dependent manner. These studies therefore demonstrate that antibodies against recombinant ZP proteins recognize the native intact ZP and inhibit sperm-ZP interaction. They also provide evidence that the rabbit 55 kDa ZP protein, which is the homolog of the pig ZP3 alpha sperm receptor protein, has sperm receptor activity.
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Affiliation(s)
- S V Prasad
- Department of Cell Biology, Baylor College of Medicine, Houston, Texas 77030, USA
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Burgner D, Choong R, Wilkins B. Misleading Haemophilus influenzae type B antigenuria following immunization. J Paediatr Child Health 1996; 32:77. [PMID: 8652226] [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: 02/01/2023]
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Humphreys SE, Wilkins B. KINEMATIC ANALYSIS OF THE LUGE START PADDLING PHASE. Med Sci Sports Exerc 1995. [DOI: 10.1249/00005768-199505001-01279] [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: 11/21/2022]
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Clure C, Watts PB, Gallagher P, Hill R, Humphreys S, Wilkins B. ACCURACY OF THE TEEM 100 METABOLIC ANALYZER DURING MAXIMUM OXYGEN UPTAKE TESTING OF NORDIC SKIERS. Med Sci Sports Exerc 1995. [DOI: 10.1249/00005768-199505001-00485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Morland BJ, Barley J, Boehm D, Flavell SU, Ghaleb N, Kohler JA, Okayama K, Wilkins B, Flavell DJ. Effectiveness of HB2 (anti-CD7)--saporin immunotoxin in an in vivo model of human T-cell leukaemia developed in severe combined immunodeficient mice. Br J Cancer 1994; 69:279-85. [PMID: 7507691 PMCID: PMC1968696 DOI: 10.1038/bjc.1994.52] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
The transplantation of the human T-cell acute lymphoblastic leukaemia (T-ALL) cell line HSB-2 into severe combined immunodeficient (SCID) mice was found to produce a disseminated pattern of leukaemia similar to that seen in man. The intravenous injection of 10(7) HSB-2 cells was associated with a universally fatal leukaemia. Histopathological examination of animals revealed the spread of leukaemia initially from bone marrow to involve all major organs including the meninges. An immunotoxin (HB2-Sap) was constructed by conjugating the anti-CD7 MAb HB2 to the ribosome-inactivating protein saporin. An in vitro protein synthesis inhibition assay revealed specific delivery of HB2-Sap immunotoxin (IT) to CD7+ HSB-2 target cells with an IC50 of 4.5 pM. When SCID mice were injected with 10(6) HSB-2 cells and then treated 8 days later with a single intravenous dose of 10 micrograms of immunotoxin there was a significant therapeutic effect evidenced by the numbers of animals surviving in the therapy group compared with untreated controls (chi 2 = 5.348, P = 0.021). These results demonstrate the useful application of human leukaemia xenografts in SCID mice and the potential therapeutic effect of an anti-CD7 immunotoxin in human T-ALL.
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MESH Headings
- Animals
- Antibodies, Monoclonal
- Antigens, CD/immunology
- Antigens, CD7
- Antigens, Differentiation, T-Lymphocyte/immunology
- Humans
- Immunotoxins/therapeutic use
- In Vitro Techniques
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Leukemia-Lymphoma, Adult T-Cell/therapy
- Mice
- Mice, SCID
- N-Glycosyl Hydrolases
- Neoplasm Transplantation
- Plant Proteins/therapeutic use
- Ribosome Inactivating Proteins, Type 1
- Saporins
- Tumor Cells, Cultured
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Affiliation(s)
- B J Morland
- Simon Flavell Leukaemia Research Laboratory, Southampton General Hospital, UK
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Dunbar BS, Avery S, Lee V, Prasad S, Schwahn D, Schwoebel E, Skinner S, Wilkins B. The mammalian zona pellucida: its biochemistry, immunochemistry, molecular biology, and developmental expression. Reprod Fertil Dev 1994; 6:331-47. [PMID: 7831484 DOI: 10.1071/rd9940331] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.8] [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: 01/27/2023] Open
Abstract
Many studies of the molecular and biochemical aspects of mammalian fertilization have focused on the interaction of the spermatozoa with the zona pellucida (ZP). The zona pellucida, a unique extracellular matrix surrounding the mammalian oocyte, is formed during ovarian follicular development. Following ovulation of the mature ovum, the spermatozoa must bind to and penetrate this matrix before the fertilization process is completed and the male and female genetic information combine. Although numerous models for this interaction have been proposed, the complete process has yet to be elucidated. The precise mechanisms by which these interactions occur also vary markedly among different mammalian species, making it more difficult to establish a unified model. To a great extent, the study of the molecules involved in these interactions have been limited because small numbers of female gametes are available for these studies. The recent development of techniques to isolate large numbers of zonae pellucidae as well as advances in immunological and molecular biology techniques have permitted the detailed characterization of ZP proteins. Although there is a paucity of information on the post-translational modification and extracellular processing of these molecules which result in matrix formation, a number of properties have been elucidated allowing better correlation between the structure and function of different ZP proteins among species. This review reflects these studies in relation to protein nomenclature and the molecular complexity of ZP antigens.
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Affiliation(s)
- B S Dunbar
- Department of Cell Biology, Baylor College of Medicine, Houston, TX 77030
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DeBruyn L, Hymbaugh K, Simpson D, Wilkins B, Nelson S. When communities are in crisis: planning for response to suicides and suicide attempts among American Indian tribes. Am Indian Alsk Native Ment Health Res Monogr Ser 1994; 4:223-32; discussion 232-4. [PMID: 8205217 DOI: 10.5820/aian.mono04.1994.223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Wilkins B. Assessment of cell proliferation in clinical practice. P.A. Hall, D. A. Levison and N. A. Wright (Eds). Springer-Verlag, Heidelberg, 1992. No. of pages: 210. Price: DM 148.00. ISBN: 3 540 19700 1. J Pathol 1992. [DOI: 10.1002/path.1711680320] [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: 11/08/2022]
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Lanka E, Wilkins B. Sex, promiscuity, and the bacterial cell. Bacterial Conjugation Systems sponsored by the European Molecular Biology Organization, Schloss Ringberg, Germany, June 30-July 4, 1991. New Biol 1991; 3:1035-9. [PMID: 1777477] [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: 12/28/2022]
Affiliation(s)
- E Lanka
- Max-Planck-Institut für Molekulare Genetik, Abteilung Schuster, Berlin, Germany
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