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Beattie H, Subramanian T, Scudamore E, Middleton T, MacDonald C, Lindley R, Murthi G. Assessment of long-term quality of life, bowel and voiding function outcomes in patients with anorectal malformation at a single UK centre. Pediatr Surg Int 2024; 40:95. [PMID: 38565744 DOI: 10.1007/s00383-024-05684-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/22/2024] [Indexed: 04/04/2024]
Abstract
AIMS Assess long-term quality of life (QoL), bowel and voiding function in anorectal malformation (ARM) paediatric patients. METHOD Retrospective review of ARM patients between 2007 and 2020 was performed. QoL (all patients), bowel and voiding function (> 5 yo) were assessed using the paediatric quality of life inventory (PedsQL), paediatric incontinence and constipation score (PICS) and dysfunctional voiding scoring system (DVSS), respectively. RESULTS There were 122 patients (49% female, 85 > 5 yo) with ARM. Two had died, four refused, twenty-two were non-contactable, leaving ninety-four patients (65 > 5 yo) included. Mean age was 89 months (19-183), and follow-up was 86 months (13-183). Patients had significantly poorer scores for QoL, bowel and voiding function compared to published healthy controls. 57% had poor bowel function, 32% had poor voiding function and 38% required 'ancillary aids' to facilitate function. Patients using 'ancillary aids' for voiding function had a significantly lower QoL (parent: 62 vs 77; p = 0.01, patient: 66 vs 79; p = 0.05). Bowel continence was worse in those with high vs low ARM (13 vs 20, p = 0.004) and timely vs delayed diagnosis (17 vs 24, p = 0.04). CONCLUSION Patients with ARM have significantly worse QoL, bowel and voiding function than normal healthy controls. There is a need for long-term monitoring of function and further support for these children. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Harriet Beattie
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
- The Medical School, University of Sheffield, Sheffield, S10 2RX, UK
| | - Thejasvi Subramanian
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Elizabeth Scudamore
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Thomas Middleton
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Caroline MacDonald
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Richard Lindley
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK
| | - Govind Murthi
- Paediatric Surgical Unit, Sheffield Children's NHS Foundation Trust, Sheffield, S10 2TH, UK.
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Corbett HJ, Clothier J, Driver C, Farrugia MK, Garriboli M, Gopal M, Kulkarni M, Marshall D, MacDonald C, Radford A, Rhodes H, Williams A, McCarthy L. A consensus process to identify research priorities in paediatric urology in the United Kingdom. J Pediatr Urol 2024; 20:240.e1-240.e8. [PMID: 37957075 DOI: 10.1016/j.jpurol.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023]
Abstract
INTRODUCTION Paediatric urologists manage a spectrum of conditions, much of the evidence for relevant treatment pathways is of low quality. For many conditions treatment varies according to location and surgeon; children with the same condition might have surgery in one unit but watchful waiting in another. Underlying this variation are differences in opinion, and insufficient high-level evidence with few prospective randomized studies. Such studies may be challenging to design, fund and recruit into, and are more likely to succeed if there is a collaborative approach. Research prioritization is a tool to identify the research of most value. Delphi methodology is an interpretive technique aiming to gain the consensus view of interested parties. The British Association of Paediatric Urologists (BAPU) set out to ascertain consensus on what paediatric urologists, working in the UK, consider to be areas of priority for research. This paper describes the process used, and the resulting list of research questions. METHODS A scoping survey of paediatric urologists in the UK was undertaken to identify an initial set of research questions. These were refined by the BAPU research committee (BAPU RC), then prioritized using a modified Delphi process. During Stage 1a multiple new research questions were submitted leading to Stage 1b, an interim process. All UK paediatric urologists were invited to take part in Stage 2 of the prioritization process. RESULTS Sixty-five questions were submitted to the scoping survey by 24 paediatric urologists. The BAPU RC refined these to 60 questions, which were submitted to Stage 1a of the modified Delphi process. Sixty-seven people completed Stage 1a, at the same time submitting 224 additional research questions. The BAPU RC revised the entire question set, ensuring the key subject of the original question was not altered and novel questions were retained. The BAPU RC undertook interim scoring of the resultant 79 questions, the top scoring 25 questions plus 5 lower scoring 'wild card' questions (to ensure the breadth of the specialty was represented) were put forward to Stage 2. A total of 65 people completed Stage 2, including a lay representative. A list of 30 priority research questions was generated; the top 10 includes management of neuropathic bladder, posterior urethral valves, antibiotic prophylaxis, DSD & CAH, continence, male external genitalia, VUR and transition care (Table). CONCLUSION This process has provided BAPU, paediatric urologists in the UK, and funders with areas of research considered a priority in the specialty.
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Affiliation(s)
- Harriet J Corbett
- Department of Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, L12 2AP, UK.
| | - Joanna Clothier
- Paediatric Nephrology, Evelina London Children's Hospital, UK
| | - Chris Driver
- Department of Paediatric Surgery, Royal Aberdeen Children's Hospital, Westburn Road, Aberdeen, AB252ZN, UK
| | - Marie-Klaire Farrugia
- Department of Paediatric Urology, Chelsea & Westminster and Imperial College Hospitals, London SW10 9NH, UK
| | | | - Milan Gopal
- Department of Paediatric Surgery and Urology, Great North Children's Hospital, Newcastle Upon Tyne, UK
| | - Milind Kulkarni
- Paediatric Urology, Norfolk and Norwich University Hospital NHS Trust, UK
| | - David Marshall
- Royal Belfast Hospital for Sick Children, 180 Falls Road, BELFAST, BT12 6BE, UK
| | | | - Anna Radford
- Department of Paediatric Surgery, Hull Royal Infirmary, Hull University Teaching Hospitals NHS Trust, UK
| | - Hannah Rhodes
- Department Paediatric Surgery and Urology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham B4 6NH, UK
| | - Alun Williams
- Department of Paediatric Urology, Nottingham University Hospitals NHS Trust, UK
| | - Liam McCarthy
- Department Paediatric Surgery and Urology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham B4 6NH, UK
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Nguyen E, Bennett R, MacDonald C, Wang A, Liu W. High Resolution Imaging with Focused kV X-Rays for Small Animal Radio-Neuromodulation. Int J Radiat Oncol Biol Phys 2023; 117:e690-e691. [PMID: 37786029 DOI: 10.1016/j.ijrobp.2023.06.2163] [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) High precision radiotherapy for small animal radio-neuromodulation requires conformal treatment to very small targets down to 2.5 mm. A focused kV technique based on novel usage of polycapillary x-ray lenses can focus x-ray beams to <0.2 mm in diameter, which is ideal for such uses. Such application also requires high resolution CT images for treatment planning and setup, which was hard to achieve using conventional x-ray tube. In this work, we demonstrate the feasibility of using a virtual focal spot generated with an x-ray lens to perform high-resolution CBCT acquisition. MATERIALS/METHODS The experiment with x-ray lens was set up on an x-ray tabletop system to generate a virtual focal spot. A pinhole image was acquired for the virtual focal spot and compared with the one acquired with the conventional focal spot without the lens. The planar imaging resolution with and without the lens were evaluated using a line pair resolution phantom. The spatial resolution of the two settings were estimated by reconstructing a 0.15-mm wire phantom and comparing its full width half maximum (FWHM). A CBCT scan of a rodent head was also acquired to further demonstrate the improved resolution using the x-ray lens. RESULTS Compared to conventional imaging acquisition with a measured x-ray focal spot of 0.395 mm FWHM, the virtual focal spot size was measured at 0.175 mm. The reduction in focal spot size with lens leads to an almost doubled planar imaging resolution and a 26% enhancement in 3D spatial resolution. A realistic CBCT acquisition of a rodent head mimicked the imaging acquisition step for radio-neuromodulation and further showed the improved visualization for fine structures. CONCLUSION This work demonstrated that the focused kV x-ray technique was capable of generating small focal spot size of <0.2 mm. The proposed method provides an adaptive imaging platform to acquire x-ray and CBCT images for treatment planning and setup with improved spatial resolution compared to conventional CBCT image acquisition.
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Affiliation(s)
- E Nguyen
- Department of Radiation Oncology, Stanford University, Stanford, CA
| | - R Bennett
- Department of Radiology, Stanford University, Stanford, CA
| | - C MacDonald
- Department of Physics, SUNY - Albany, Albany, NY
| | - A Wang
- Department of Radiology, Stanford University, Stanford, CA
| | - W Liu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
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Middleton T, Zarifa I, Jancauskaite M, Subramanian T, MacDonald C. Letter to the Editor in response to: Routine evaluation of vesicle-ureteric reflux in children with ano-rectal malformation does not reduce the rate of urinary tract infection. J Pediatr Surg 2022; 57:326. [PMID: 34389156 DOI: 10.1016/j.jpedsurg.2021.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Thomas Middleton
- Sheffield Children's Hospital, Paediatric Surgical Department, PSU Department, Steveonson Wing, Western Bank, Sheffield, S10 2TH, UK.
| | - Iyad Zarifa
- Sheffield Children's Hospital, Paediatric Surgical Department, Sheffield, UK
| | - Milda Jancauskaite
- Sheffield Children's Hospital, Paediatric Surgical Department, Sheffield, UK
| | | | - Caroline MacDonald
- Sheffield Children's Hospital, Paediatric Surgical Department, Sheffield, UK
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Prodinger C, Yerlett N, MacDonald C, Subhanitthaya C, Laimer M, Goh L, Du Toit G, Mellerio JE, Petrof G, Martinez AE. Characteristics of children with Netherton syndrome: a review of 21 patients. J Eur Acad Dermatol Venereol 2021; 35:e466-e469. [PMID: 33725371 DOI: 10.1111/jdv.17226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/01/2021] [Accepted: 03/10/2021] [Indexed: 11/28/2022]
Affiliation(s)
- C Prodinger
- Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - N Yerlett
- Dietetics Department, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - C MacDonald
- Department of Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - C Subhanitthaya
- Department of Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - M Laimer
- Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - L Goh
- Paediatric Allergy Clinic, University College London Hospital NHS Foundation Trust, London, UK
| | - G Du Toit
- Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas's NHS Foundation Trust, London, UK
| | - J E Mellerio
- St. John's Institute of Dermatology, King's College London, Guy's Hospital NHS Foundation Trust, London, UK
| | - G Petrof
- Department of Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - A E Martinez
- Department of Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
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MacDonald C, Burton M, Carachi R, O'Toole S. Why adolescents delay with presentation to hospital with acute testicular pain: A qualitative study. J Pediatr Surg 2021; 56:614-619. [PMID: 32828543 DOI: 10.1016/j.jpedsurg.2020.06.041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/21/2020] [Accepted: 06/26/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND/PURPOSE Adolescents have poor outcomes following testicular torsion directly attributable to delay from onset of symptoms to presentation to hospital. The aim of this study was to investigate the barriers to urgent presentation in young men. METHODS Semistructured interviews were undertaken with young men (11-19 years), using a topic guide exploring issues surrounding testicular pain and health. Thematic analysis was undertaken using a framework approach. RESULTS Twenty-seven adolescents were recruited, data saturation was reached at sixteen participants, and median age was 13.5 years (range 11-18). The process by which an adolescent gets to hospital with testicular pain is slow. They must recognize the problem and alert their parents, who then use a 'watch and wait' policy to assess need for medical review, often leaving it 'a day' or overnight. Adolescent males do not engage with healthcare services independently of their parents. Additional factors preventing early presentation include: absence of knowledge about testicular pathology from adolescents and their parents; concern from the young people about raising a false alarm and family concerns about burdening healthcare services. CONCLUSIONS Recommendations include designing a testicular health education campaign for young men and educating parents regarding the medical conditions where a 'watch and wait' policy may be harmful to their child. LEVEL OF EVIDENCE VI.
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Affiliation(s)
- Caroline MacDonald
- School of MVLS, University of Glasgow, University Avenue, Glasgow G12 8QQ, Scotland; Royal Hospital for Children, 1345 Govan Rd, Glasgow G51 4TF, Scotland.
| | - Maria Burton
- Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, S1 1WB, UK
| | - Robert Carachi
- School of MVLS, University of Glasgow, University Avenue, Glasgow G12 8QQ, Scotland
| | - Stuart O'Toole
- School of MVLS, University of Glasgow, University Avenue, Glasgow G12 8QQ, Scotland; Royal Hospital for Children, 1345 Govan Rd, Glasgow G51 4TF, Scotland
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Raeside MC, Byron J, Cameron F, MacDonald C, Rochfort S, Partington DL, Kearney GA, Behrendt R. Effect of grazing different forage systems prior to and during mating on the liveweight, condition score, conception and reproductive rate of maternal-composite ewe lambs. Anim Prod Sci 2021. [DOI: 10.1071/an19183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Context
Economic modelling identified that mating of ewe lambs for lambing at 1 year of age has the potential to increase the profitability of sheep-production systems in south-western Victoria. In order to optimise reproductive rates, ewe lambs should weigh at least 35–40 kg, have a condition score (CS) of 3.0 at mating, and be gaining weight (100–150 g/day) during mating. However, typical perennial ryegrass (Lolium perenne L.) pastures in south-west Victoria do not support the attainment of these targets without additional supplementation.
Aim
Our research aimed to determine how grazing summer-active pastures or brassica (Brassica napus L.) forages affects the liveweight, CS, conception and reproductive rate of ewe lambs when offered before and during mating compared with a system using perennial ryegrass plus supplement.
Methods
A field experiment was conducted at Hamilton, Victoria, Australia, in 2014 and 2016 testing seven forage treatments replicated four times in a complete block design. The treatments were: canola (B. napus, two treatments of different cultivars), forage brassica, lucerne (Medicago sativa L.), chicory (Cichorium intybus L.), plantain (Plantago lanceolata L.) and perennial ryegrass.
Key results
Ewe lambs grazing canola or forage brassica had higher (P < 0.05) liveweight gains during the pre-mating and mating periods than those grazing the perennial ryegrass treatment (148 vs 75 g/day in 2014, s.e.m. 17; 139 vs 54 g/day in 2016, s.e.m. 17). In 2014, spring-sown dual-purpose canola, lucerne and chicory resulted in higher (P < 0.05) reproductive rates (144–151%) than the perennial ryegrass treatment (103%); forage brassica and plantain gave intermediate results (128% and 129%).
Conclusion
Brassica forages (including spring-sown canola), lucerne and chicory can support the attainment of key liveweight and CS targets for successful mating of ewe lambs in autumn.
Implications
Spring-sown canola is therefore a viable alternative forage for use by livestock producers in southern Australia and presents an opportunity to incorporate an alternative income stream in mixed-farming systems.
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Raeside MC, Byron J, Cameron F, MacDonald C, Partington DL, Kearney GA, Behrendt R. Effect of defoliation on spring-sown winter-type canola (Brassica napus) grain yield, quality and morphology. Anim Prod Sci 2021. [DOI: 10.1071/an20123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Context
In Australia’s high-rainfall zone (>550 mm/year), winter-type canola (Brassica napus L.) can be sown in spring and grazed as a forage crop during its vegetative phase, producing a canola grain crop in late spring of the second year. The timing, length and intensity of grazing or defoliation that can be imposed on canola before a grain yield penalty occurs remains largely unknown.
Aim
Our research aimed to determine the impact of grazing spring sown canola during summer and autumn on the subsequent canola grain yield.
Methods
A paddock-scale field experiment was conducted over 2 years, 2013–14 and 2015–2016, at Hamilton, Victoria, Australia, with two winter-type canola treatments and three grazing–defoliation sub-treatments replicated four times in a replicated block design. The canola cultivars used were Hyola971CL and Taurus in 2013–14 and Hyola971CL and Brazzil in 2015–16. The three grazing–defoliation sub-treatments were: NG, no grazing; VG, grazing with sheep for a 10-week period during the vegetative phase over summer–autumn; RG, grazing with sheep as per the VG sub-treatment and then in the reproductive phase, either cutting the canola for silage in August (2013–14) or grazing with sheep between 28 July and 17 August 2016 (2015–16).
Key results
The VG sub-treatment resulted in no grain-yield penalty (P > 0.05) relative to NG in either year. In 2014, canola grain yields from VG for Hyola971CL and Taurus were 2.32 and 2.13 t/ha, compared with NG grain yields of 2.66 and 2.19 t/ha. In 2016, grain yields from VG for Hyola971CL and Brazzil were 2.14 and 1.74 t/ha, compared with NG grain yields of 1.87 and 1.90 t/ha. The RG sub-treatment reduced (P < 0.05) canola grain yield by ~65% in 2014 and 80% in 2016 compared with NG and VG.
Conclusions
Spring-sown winter-type canola can be grazed during summer and autumn in southern Australia with no grain-yield penalty relative to ungrazed canola. However, further grazing or defoliation in winter once bud elongation commences can result in large grain-yield penalties.
Implications
Spring-sown winter-type canola is a viable forage option for filling the summer–autumn feed gap in southern Australia while also providing a dual-purpose income in mixed-farming systems.
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Raeside MC, Byron J, Cameron F, MacDonald C, Partington DL, Kearney GA, Behrendt R. Spring-sown winter-type canola (Brassica napus) as summer–autumn forage for sheep production in southern Australia. Anim Prod Sci 2021. [DOI: 10.1071/an19182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Context
Filling the summer–autumn feed gap is a key priority for sheep producers in southern Australia’s high-rainfall zone.
Aim
Our research aimed to determine whether spring-sown winter-type canola (Brassica napus L.) could increase herbage mass and nutritive characteristics during summer and autumn relative to other forage options in southern Australia’s HRZ.
Methods
A field experiment was conducted at Hamilton, Victoria, Australia, in 2014 and 2016 testing seven forage treatments replicated four times in the complete block design. The treatments were: canola (two treatments of different cultivars), forage brassica (B. napus), lucerne (Medicago sativa L.), chicory (Cichorium intybus L.), plantain (Plantago lanceolata L.) and perennial ryegrass (Lolium perenne L.).
Key results
Herbage mass and nutritive characteristics of the canola varieties did not differ (P > 0.05) from forage brassica. Herbage mass in March 2014 was 3.35–3.64 t dry matter (DM)/ha for brassicas; 1.05–1.37 t DM/ha for perennial ryegrass, plantain and chicory; and 2.94 t DM/ha for lucerne (P < 0.001, l.s.d. = 1.20). In March 2016, herbage mass was 1.86–2.05 t DM/ha for brassicas and 2.14–2.49 for the other forage treatments (P < 0.05; l.s.d. = 0.47). Brassicas had higher (P < 0.05) metabolisable energy (ME) concentrations and lower (P < 0.05) neutral detergent fibre (NDF) concentrations on most sampling dates than chicory, plantain, lucerne and perennial ryegrass. The crude protein (CP) concentration of the brassica treatments was not different (P > 0.05) from that of the other forage treatments. Concentrations of ME, CP and NDF were very similar between years for the brassicas, with March ME, CP and NDF concentrations of 12.0–13.2 MJ/kg DM, 14.0–20.1% DM and 16.7–23.6% DM.
Conclusion
Canola provided increased or equivalent levels of herbage mass and nutritive characteristics compared with other forage options in south-western Victoria on most, but not all, sampling dates. However, the annual spring-sowing requirement is a challenge under variable spring-rainfall conditions and may limit productivity if there is poor establishment.
Implications
Spring-sown canola is a viable alternative forage for livestock producers and offers a potential second income stream in high-rainfall-zone livestock farming systems.
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Yan H, Schneider B, Graves E, Sun W, Xing L, MacDonald C, Liu W. Focused kV X-rays for Preclinical Studies of Radiation-based Neuromodulation. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2081] [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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Marshall NC, Baxi M, MacDonald C, Sikora C, Tyrrell GJ. New decade, new response: Altering the public health response to toxigenic cutaneous diphtheria. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.833] [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: 11/12/2022] Open
Abstract
Abstract
Background
Classical diphtheria is a potentially fatal respiratory disease mediated by the diphtheria toxin of Corynebacterium diphtheriae. Due to high vaccination rates against this toxin in Canada, the national incidence of respiratory diphtheria is near zero, and the toxin plays no recognized role in cutaneous diphtheria. Therefore, in this study, we assessed the diagnostic and public health benefits of diphtheria toxin testing and cutaneous diphtheria investigations in a highly vaccinated population.
Methods
Over the last 10 years, we retrospectively determined: the number of C. diphtheriae isolates identified in the province of Alberta, Canada; the disease state of each individual tested (disease vs asymptomatic carrier); the source (cutaneous vs respiratory); and the number of toxin tests performed.
Results
In 10 years, zero cases of respiratory diphtheria and three cases of toxigenic cutaneous diphtheria were identified. Despite zero cases of respiratory disease, diphtheria toxin testing significantly increased (p = 0.0001), with 86% of toxin tests performed on cutaneous isolates. Subsequent public health investigations of each case of toxigenic cutaneous diphtheria mandated the collection of 315 total specimens from 92 individuals, revealing low rates of C. diphtheriae colonization among contacts and no further cases.
Conclusions
This study challenges the value of reflexive diphtheria toxin testing in uncomplicated cutaneous diphtheria among highly vaccinated populations. Cutaneous diphtheria investigations demanded disproportionate public health and laboratory resources and demonstrated a discrepancy between toxin pathophysiology and disease. Therefore, we recommend stewarding diphtheria toxin tests for toxin-mediated disease forms and ensuring adequate vaccination. This approach would spare public health and laboratory resources by customizing responses around the role of the diphtheria toxin in each form of disease.
Key messages
Investigations for cutaneous diphtheria increased demand for toxin testing in Alberta, Canada, though the toxin plays no role in this form of disease. In populations with high vaccination rates against diphtheria toxoid, cutaneous diphtheria cases do not require additional laboratory testing for the presence of the diphtheria toxin.
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Affiliation(s)
- N C Marshall
- Division of Diagnostic & Applied Medicine, University of Alberta, Edmonton, Canada
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Canada
- Alberta Precision Laboratories – Public Health, Edmonton, Canada
| | - M Baxi
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - C MacDonald
- Division of Diagnostic & Applied Medicine, University of Alberta, Edmonton, Canada
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Canada
- Alberta Precision Laboratories – Public Health, Edmonton, Canada
| | - C Sikora
- Alberta Health Services, Edmonton, Canada
| | - G J Tyrrell
- Division of Diagnostic & Applied Medicine, University of Alberta, Edmonton, Canada
- Department of Laboratory Medicine & Pathology, University of Alberta, Edmonton, Canada
- Alberta Precision Laboratories – Public Health, Edmonton, Canada
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Hawksworth GM, Bach PH, Nagelkerke JF, Dekant W, Diezi JE, Harpur E, Lock EA, MacDonald C, Morin JP, Pfaller W, Rutten FA, Ryan MP, Toutain HJ, Trevisan A. Nephrotoxicity Testing In Vitro. Altern Lab Anim 2020. [DOI: 10.1177/026119299502300525] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gabrielle M. Hawksworth
- Department of Medicine & Therapeutics and Department of Biomedical Sciences, Polwarth Building, University of Aberdeen, Aberdeen AB9 2ZD, UK
| | - Peter H. Bach
- Faculty of Science, University of East London, Romford Road, London E15 4LZ, UK
| | - J. Fred Nagelkerke
- LADCR, Division of Toxicology, Center for Bio-Pharmaceutical Sciences, Leiden University, 2300 RA Leiden, The Netherlands
| | - Wolfgang Dekant
- Universitat Wurzburg, Versbacherstrasse 9, 97074 Wurzburg, Germany
| | - Jacques E. Diezi
- Institut de Pharmacologic et de Toxicologic de l'Universite, rue de Bugnon 27, 1005 Lausanne, Switzerland
| | - Ernest Harpur
- Sanofi-Winthrop Research Centre, Willowburn Avenue, Alnwick, Northumberland NE66 2JH, UK
| | - Edward A. Lock
- ZENECA Central Toxicology Laboratory, Alderley Park, Macclesfield, Cheshire SK10 4TJ, UK
| | - Caroline MacDonald
- Department of Biological Sciences, University of Paisley, High Street, Paisley PA1 2BE, UK
| | - Jean-Paul Morin
- INSERM U295 Uer Medicine Pharmacie, Université de Rouen, 76803 Saint Etienne Rouvray, France
| | - Walter Pfaller
- Institut für Physiologie und Balneologie, Universität Innsbruck, Fritz-Preglstrasse 3, 6010 Innsbruck, Austria
| | - Fons A.J.J.L. Rutten
- TNO Nutrition and Food Research Institute, Division of Toxicology, 3700 AJ Zeist, The Netherlands
| | - Michael P. Ryan
- Department of Pharmacology, University College Dublin, Fosters Avenue, Blackrock, Dublin, Ireland
| | - Hervé J. Toutain
- Rhone-Poulenc Rorer, Centre de Recherche de Vitry, 13 Quai Jules Guisde, 94405 Vitry Cedex, France
| | - Andrea Trevisan
- Instituto di Medicina del Lavoro, Universita di Padova, Via Facciolati 71, 35127 Padova, Italy
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Robilliard LD, MacDonald C, Angel CE, Finlay GJ, Joseph W, Graham ES. P12.02 Glioblastoma Multiforme immunological blockades and the implications of glioma cancer stem cells. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.213] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Glioblastoma Multiforme (GBM) is classified as a WHO grade IV astrocytoma that continues to circumvent classical and novel chemo-, radio- and immuno-therapies. The recent FDA approvals for the use of targeted immunotherapies against inhibitory checkpoint ligands (for melanoma; ipilimumab and nivolumab) have brought the use of monoclonal antibody therapies to the forefront of GBM research. However, poor immunological responses, exemplified by down-regulation of anti-tumour T-cell activity, and up-regulation of immunosuppressive cells and secreted factors within the tumour micro-environment, have limited the effectiveness of immunotherapy in GBM to date. Therefore, understanding how GBM modulates an extensive repertoire of immune checkpoint ligands and the functional consequence on immune evasion is necessary to develop more targeted immuno-therapeutics.
MATERIAL AND METHODS
Patient derived glioblastoma cell lines were cultured using established serum-based or glioma cancer stem cell (gCSC) conditions. The phenotypes of resultant GBM cells and gCSC’s were characterised using flow cytometry and immunocytochemistry, to assess expression of neural lineage and stem cell-associated markers. Thereafter, cells were screened for the expression of an extensive range of inhibitory checkpoint ligands by flow cytometry. Finally, the secretion of immune modulating factors by GBM cells and gCSC’s were evaluated by using XL cytokine proteome arrays. Cytokines that appeared to be differentially expressed were subsequently measured using Cytometric Bead Arrays.
RESULTS
Adherent gCSC’s and gCSC derived glioma-spheres express nestin, CD44, A2B5 and vimentin, consistent with a stem cell phenotype. Furthermore, the gCSC’s exhibited reduced expression of the neural lineage markers NeuN and OSP. Flow cytometry analyses revealed that glioblastoma cells expressed all 11 checkpoint ligands investigated. Interestingly, gCSC’s showed higher levels of PD-L1, B7-H3, CD155 and HVEM expression than GBM cells.
CONCLUSION
Glioblastoma Multiforme is highly immuno-suppressive, which is reinforced by this study. Glioblastoma cells express all the inhibitory checkpoint ligands investigated and glioma cancer stem cell cultures up-regulate expression levels further. This implies that GBM cells are heavily equipped to inhibit infiltrating T-cells, exemplifying the need to find suitable therapeutics that target multiple immuno-suppressive mechanisms simultaneously.
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Affiliation(s)
| | - C MacDonald
- University of Auckland, Auckland, New Zealand
| | - C E Angel
- University of Auckland, Auckland, New Zealand
| | - G J Finlay
- University of Auckland, Auckland, New Zealand
| | - W Joseph
- University of Auckland, Auckland, New Zealand
| | - E S Graham
- University of Auckland, Auckland, New Zealand
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Liu W, Yan H, MacDonald C, Roberts K, Chen Z, Nath R. Focused kV X-ray Radiotherapy for Ocular Diseases. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.345] [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]
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Gopal M, Peycelon M, Caldamone A, Chrzan R, El-Ghoneimi A, Olsen H, Leclair MD, Stillebroer A, MacDonald C, Tonnhofer U, Strasser C, Adam A, Spinoit AF, Haid B. Management of ureteropelvic junction obstruction in children-a roundtable discussion. J Pediatr Urol 2019; 15:322-329. [PMID: 31227314 DOI: 10.1016/j.jpurol.2019.05.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 05/08/2019] [Indexed: 12/13/2022]
Abstract
The investigation, management and follow-up of paediatric ureteropelvic junction obstruction is not standardized. The Young Pediatric Urology Committee of the European Society of Pediatric Urology interviewed five experts in the field on various aspects of management and compared this with published literature.
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Affiliation(s)
- M Gopal
- Department of Paediatric Surgery, Great North Children's Hospital, Newcastle Upon Tyne, UK.
| | - M Peycelon
- Robert-Debré University Hospital (Assistance-Publique Hôpitaux de Paris), Department of Pediatric Surgery and Urology, Reference Center for Rare Diseases (CRMR), Malformations Rares des Voies Urinaires (MARVU), Université Paris Diderot, Sorbonne Paris CitéParis, France; Riley Hospital for Children, Indiana University and Purdue University in Indiana, Indianapolis, IN, USA
| | - A Caldamone
- Division of Pediatric Urology, Hasbro Children's Hospital, Warren Alpert School of Medicine at Brown University, Providence Rhode Island, USA
| | - R Chrzan
- Department of Paediatric Urology, Jagiellonian University Medical College, Krakow, Poland
| | - A El-Ghoneimi
- Robert-Debré University Hospital (Assistance-Publique Hôpitaux de Paris), Department of Pediatric Surgery and Urology, Reference Center for Rare Diseases (CRMR), Malformations Rares des Voies Urinaires (MARVU), Université Paris Diderot, Sorbonne Paris CitéParis, France
| | - H Olsen
- Department of Urology, Aarhus University Hospital, Arhus, Denmark
| | - M-D Leclair
- Department of Paediatric Surgery, Children University Hospital, NANTES, France
| | - A Stillebroer
- Department of Urology, University Medical Centre Groningen, Groningen, the Netherlands
| | - C MacDonald
- Department of Paediatric Surgery, Royal Hospital for Children, Glasgow, UK
| | - U Tonnhofer
- Department of Pediatric Surgery, Medical University Vienna, Austria
| | - C Strasser
- Department of Pediatric Urology, Hospital of the Sisters of Charity, Linz, Austria
| | - A Adam
- The Division of Urology, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - A-F Spinoit
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - B Haid
- Department of Pediatric Urology, Hospital of the Sisters of Charity, Linz, Austria
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MacDonald C, Small R, Flett M, Cascio S, O'Toole S. Predictors of complications following retroperitoneoscopic total and partial nephrectomy. J Pediatr Surg 2019; 54:331-334. [PMID: 30502005 DOI: 10.1016/j.jpedsurg.2018.10.097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 10/21/2018] [Accepted: 10/30/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Recent reports in the literature suggest an increased risk of complications with retroperitoneal as opposed to transperitoneal approach to partial nephrectomy (PN) and total nephrectomy (TN). We are a large unit performing predominantly retroperitoneoscopic PN and TN. We aim to review our outcomes and perform analysis to elucidate the predictors of complications following the retroperitoneal approach for extirpative kidney surgery. METHODS We performed a single center retrospective review of children undergoing MIMS TN and PN between 2005 and 2015. Variables were tested for association with outcomes using Chi2 and Spearman's Rho correlation. RESULTS We performed 173 MIMS nephrectomies, 119 total and 54 partial. Median age and weight were 5 years (6 months to 18 years) and 24.9 kg (7.7 to 85 kg) and operative time 147 min. There were 4 conversions and 17 postoperative complications. 19.6% children required further surgery, including 8 completion stumpectomies. Retroperitoneal approach did not have increased risk compared to transperitoneal for need of further surgery. Partial nephrectomy was not associated with higher rate of intraoperative complication or LOS. Predictors of intraoperative complication were vessel closure technique. Associations with need for further surgery were: ESRF, contralateral disease, bladder dysfunction, presence of PD catheter, and need for concomitant procedure. CONCLUSION Our conversion rate (1.9%) and need for further surgery (13.1%) following the retroperitoneal approach to the kidney are favorable to the literature. Need for reoperation is often associated with the underlying diagnosis and the natural sequelae of the disease process. LEVEL OF EVIDENCE IV.
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Affiliation(s)
| | - Robert Small
- The Royal Hospital for Children, Glasgow, Scotland
| | - Martyn Flett
- The Royal Hospital for Children, Glasgow, Scotland
| | | | - Stuart O'Toole
- The Royal Hospital for Children, Glasgow, Scotland. Stuart.O'
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MacDonald C, Kronfli R, Carachi R, O'Toole S. A systematic review and meta-analysis revealing realistic outcomes following paediatric torsion of testes. J Pediatr Urol 2018; 14:503-509. [PMID: 30404723 DOI: 10.1016/j.jpurol.2018.09.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 04/16/2018] [Accepted: 09/25/2018] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Reported testicular loss rates following paediatric testicular torsion often reflect the surgical decision-making process, rather than long-term survival of the testes. OBJECTIVES We aim to perform systematic analysis and meta-analysis to investigate testicular salvage rates and to assess predictors of long-term viability. STUDY DESIGN Systematic review according to PRISMA guidelines was performed to investigate immediate and long-term (>12 months) testicular loss rates following torsion in the paediatric population. Literature search and study inclusion were performed by two investigators. A study quality score was derived and attributed to each study. Predictors of testicular loss were described. Proportions meta-analysis was performed with random effects modelling, and testing for heterogeneity. RESULTS Twelve studies were includedm, 6 reporting early orchidectomy rates, and 6 reporting long-term outcomes. Study quality was generally low. DISCUSSION The mean early testicular loss rate was 39%, whereas meta-analysis revealed late loss to approach 50%. Predictors of outcomes include prehospital symptom duration, location of presentation, transfer to a tertiary centre, social affluence and use of ultrasound prior to diagnosis or transfer. CONCLUSIONS This study has shown a considerable late testicular loss rate, which must be relayed to families even after testicular salvage. Delay in time to presentation is consistently found to predict poor outcomes.
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Affiliation(s)
- C MacDonald
- Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, United Kingdom.
| | - R Kronfli
- Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, United Kingdom
| | - R Carachi
- Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, United Kingdom
| | - S O'Toole
- Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, United Kingdom
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MacDonald C, Ross R, Houston JG. Shear wave velocity measurements of the brachial artery in a population with end-stage renal disease. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aad8a3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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MacDonald C, Stillebroer A, Tonnhofer U, Melling C, Romero R, Radford A, Gopal M, Peycelon M. Correspondence: Training opportunities in renal replacement access. J Pediatr Urol 2018; 14:87-88. [PMID: 29229432 DOI: 10.1016/j.jpurol.2017.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 10/31/2017] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Uschi Tonnhofer
- Interdisciplinary Center of Pediatric Urology, Medical University of Vienna, Vienna, Austria
| | | | - Rosa Romero
- Médico Especialista en Cirugía Pediátrica Jefe de Sección de Urología Infantil, UK
| | | | - Milan Gopal
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Matthieu Peycelon
- Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, Assistance-Publique Hôpitaux de Paris, Paris, France
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Bell GM, Anderson AE, Diboll J, Reece R, Eltherington O, Harry RA, Fouweather T, MacDonald C, Chadwick T, McColl E, Dunn J, Dickinson AM, Hilkens CMU, Isaacs JD. Autologous tolerogenic dendritic cells for rheumatoid and inflammatory arthritis. Ann Rheum Dis 2016; 76:227-234. [PMID: 27117700 PMCID: PMC5264217 DOI: 10.1136/annrheumdis-2015-208456] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 02/29/2016] [Accepted: 03/24/2016] [Indexed: 11/28/2022]
Abstract
Objectives To assess the safety of intra-articular (IA) autologous tolerogenic dendritic cells (tolDC) in patients with inflammatory arthritis and an inflamed knee; to assess the feasibility and acceptability of the approach and to assess potential effects on local and systemic disease activities. Methods An unblinded, randomised, controlled, dose escalation Phase I trial. TolDC were differentiated from CD14+ monocytes and loaded with autologous synovial fluid as a source of autoantigens. Cohorts of three participants received 1×106, 3×106 or 10×106 tolDC arthroscopically following saline irrigation of an inflamed (target) knee. Control participants received saline irrigation only. Primary outcome was flare of disease in the target knee within 5 days of treatment. Feasibility was assessed by successful tolDC manufacture and acceptability via patient questionnaire. Potential effects on disease activity were assessed by arthroscopic synovitis score, disease activity score (DAS)28 and Health Assessment Questionnaire (HAQ). Immunomodulatory effects were sought in peripheral blood. Results There were no target knee flares within 5 days of treatment. At day 14, arthroscopic synovitis was present in all participants except for one who received 10×106 tolDC; a further participant in this cohort declined day 14 arthroscopy because symptoms had remitted; both remained stable throughout 91 days of observation. There were no trends in DAS28 or HAQ score or consistent immunomodulatory effects in peripheral blood. 9 of 10 manufactured products met quality control release criteria; acceptability of the protocol by participants was high. Conclusion IA tolDC therapy appears safe, feasible and acceptable. Knee symptoms stabilised in two patients who received 10×106 tolDC but no systemic clinical or immunomodulatory effects were detectable. Trial registration number NCT01352858.
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Affiliation(s)
- G M Bell
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - A E Anderson
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - J Diboll
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - R Reece
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - O Eltherington
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - R A Harry
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - T Fouweather
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - C MacDonald
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - T Chadwick
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - E McColl
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Clinical Trials Unit, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - J Dunn
- Haematological Sciences, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - A M Dickinson
- Haematological Sciences, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - C M U Hilkens
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - John D Isaacs
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
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Liu W, MacDonald C, Abbas H, Nath R, Chen Z. Nanoparticle Enhanced Focused Kv X-ray Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.348] [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: 10/22/2022]
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MacDonald C, Charles CRJ, Cornett RJ, Zhao XL, Kieser WE, Litherland AE. Detection of (135) Cs by accelerator mass spectrometry. Rapid Commun Mass Spectrom 2015; 29:115-118. [PMID: 25462371 DOI: 10.1002/rcm.7083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/21/2014] [Accepted: 10/22/2014] [Indexed: 06/04/2023]
Abstract
RATIONALE The ability to measure both (135) Cs and (137) Cs can provide an estimate of the age and source of Cs isotopes in an environmental sample. Accelerator mass spectrometry (AMS) consistently reports lower abundance sensitivities than other techniques and, with the addition of an on-line reaction cell, simpler isobaric suppression. Therefore, an AMS methodology was developed to measure Cs isotopes using CsF2- as the initial anion. METHODS The ion beam is passed through the Isobar Separator for Anions (ISA) where it is captured by radiofrequency quadrupoles in a gas cell before injection into the tandem accelerator. In the ISA, the beam reacts with O2 gas, selectively removing the BaF2- and leaving the Cs analyte to be reaccelerated and sent through the remainder of the AMS system. RESULTS The BaF2- signal was attenuated by a factor of 10(5) in the ISA while 25% of the original CsF2- current was transmitted into the accelerator. (135) Cs was measured without any interference from (133) Cs to an abundance sensitivity of 1.3 × 10(-10) . The abundances of four stable Ba isotopes (masses 133, 134, 135 and 137) were measured and no isotope-dependent bias was detected using the ISA in vacuum. CONCLUSIONS The results demonstrate the feasibility of measuring long-lived Cs isotopes without Ba interference by AMS with on-line isobar separation and the ability to use shorter lived Cs isotopes for yield tracing.
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Affiliation(s)
- C MacDonald
- Department of Physics, University of Ottawa, 150 Louis Pasteur, Ottawa, ON, K1N 6N5, Canada
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Abbas H, Satti J, MacDonald C. SU-E-T-17: Comparison of MCNP5 Calculations in the Buildup Region with Plane Parallel Ionization Chamber Measurements for 6 and 18 MV Photon Beams. Med Phys 2012; 39:3706. [DOI: 10.1118/1.4735071] [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: 11/07/2022] Open
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Abbas H, Mahato D, Satti J, MacDonald C. MO-A-213AB-01: Potential for Focused Low Energy X-Ray Beam for Therapy. Med Phys 2012; 39:3859. [DOI: 10.1118/1.4735753] [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: 11/07/2022] Open
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Chatterjee S, Rees C, Dwarakanath AD, Barton R, MacDonald C, Greenaway J, Gregory W, Reddy A, Nylander DL. Endoscopic retrograde cholangio-pancreatography practice in district general hospitals in North East England: a Northern Regional Endoscopy Group (NREG) study. J R Coll Physicians Edinb 2011; 41:109-13. [PMID: 21677912 DOI: 10.4997/jrcpe.2011.221] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
AIM Endoscopic retrograde cholangio-pancreatography (ERCP) is an important tool for the management of pancreato-biliary disease. The aim of this study was to compare the current practice of ERCP in North East England against the key 2004 National Confidential Enquiry Report into Patient Outcome and Death (NCEPOD) recommendations and the standards set by the Joint Advisory Group on Gastrointestinal Endoscopy (JAG). METHODS This was a prospective multicentre study involving all hospitals in North East England, coordinated through the Northern Regional Endoscopy Group (NREG). RESULTS Fourteen endoscopy units submitted data for 481 ERCPs. Mean dose of midazolam was 3.24 mg (standard deviation 1.35; range 1-8 mg). Coagulation profile results were available on 469 patients (97%). Radiological investigations were documented in 96% of the procedures (463 of 481) prior to ERCP. The most common indication for ERCP was related to choledocholithiasis and its complications. All procedures were performed with a therapeutic intent. A total of 84% of all patients were either American Society of Anesthesiologists grade I or II. The selective biliary cannulation rate was 87.3%. The total completion rate of all procedures was 80.2% (381 of 475) and completion of therapy was 89.5% (425 of 475). The 30-day mortality rate was 2% (ten patients) and procedure-related complications occurred in 5% of patients. There were no deaths directly as a result of ERCP; all deaths were related to underlying medical conditions. CONCLUSIONS The practice of ERCP in North East England adheres to the key recommendations of the NCEPOD and the standards set by JAG. The rates of complications compare favourably with those reported internationally.
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Affiliation(s)
- S Chatterjee
- Department of Gastroenterology, Sunderland Royal Hospital, Kayll Road, Sunderland, Tyne and Wear, UK.
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Skinner R, Conlon L, Gibbons D, MacDonald C. PW01-194 - Cannabis use and non-clinical dimensions of psychosis in university students presenting to primary care. Eur Psychiatry 2010. [DOI: 10.1016/s0924-9338(10)71601-1] [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: 12/01/2022] Open
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Kinn S, MacDonald C, Hinks S, Nandwani R, Ilett R, Shields N, Carr S, Bigrigg A. Client and staff views on facilities and services, before and after the convergence of sexual, reproductive and women's services. EUR J CONTRACEP REPR 2009. [DOI: 10.1080/ejc.8.2.65.74] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
OBJECTIVE To determine whether patients with gastro-oesophageal reflux disease (GERD) can be grouped according to the physical and psychological impact of their disease. METHODS In this multinational study, 7713 primary care physicians (PCPs) and gastrointestinal (GI) specialists took part in a structured online survey to determine how they perceive the clinical and psychological needs of their GERD patients, based on their three most recent consultations. Patients were grouped according to one of the five clusters that were subjectively developed based on preceding qualitative research. RESULTS Findings are reported for 1157 respondents (875 PCPs, 282 GI specialists), who reviewed 3471 patient records. Two of the five original clusters were collapsed because of overlapping characteristics, giving rise to three patient clusters. Patients with 'long-term, disrupting GERD' (39%) had symptoms considered to have not only high physical but also psychological impact. Patients with 'recurrent, distressing GERD' (14%) experienced both physical and psychological impact and were worried about the recurrent, restrictive nature of their disease or the possibility of having a more serious underlying condition. Patients with 'inconveniencing GERD' (48%) had less frequent symptoms with overall lower impact. Overall, there was a trend for GI specialists to more likely see patients at higher clinical need than PCPs. CONCLUSIONS Patients with GERD can generally be classified according to the physical and psychological impact of their disease. Recognition that such patients have different needs may facilitate improved management of GERD by allowing treatment to be tailored according to the patient's need.
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Affiliation(s)
- A King
- CLEAR, Richmond, Surrey, UK.
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MacDonald C, Mann S, Moriarty H. SCREENING FOR CARDIOVASCULAR RISK IS BEING TAKEN UP RAPIDLY AND ENTHUSIASTICALLY BY PATIENTS IN NEW ZEALAND PRIMARY CARE SETTINGS. Heart Lung Circ 2008. [DOI: 10.1016/j.hlc.2008.03.046] [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: 11/30/2022]
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Zhou W, MacDonald C. WE-E-L100J-04: Coherent Scatter Imaging for Mammography. Med Phys 2007. [DOI: 10.1118/1.2761579] [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: 11/07/2022] Open
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McGhan SL, MacDonald C, James DE, Naidu P, Wong E, Sharpe H, Hessel PA, Befus AD. Factors associated with poor asthma control in children aged five to 13 years. Can Respir J 2006; 13:23-9. [PMID: 16470250 PMCID: PMC2539007 DOI: 10.1155/2006/149863] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Most children with asthma should be able to achieve acceptable control. However, are there differences between those with acceptable and poor control, and if so, how can health care approaches be modified accordingly? OBJECTIVE To examine the characteristics of elementary school children aged five to 13 years with acceptable and poor levels of asthma control. METHODS The present cross-sectional study of children with asthma used five indicators of control, as outlined by the Canadian Asthma Consensus Report, to categorize acceptable and poor asthma control. RESULTS Of 153 children, 115 (75%) were rated as having poorly controlled asthma. Of those with poor control, 65 (64%) children were currently using inhaled corticosteroids, and 65% of those reported using inhaled corticosteroids daily versus as needed. Fifty-one per cent of the children with poorly controlled asthma had exposure to tobacco smoke, whereas 79% of the children with asthma under acceptable control were from households with no smokers (P=0.002). The poor control group also had significantly worse parental perceptions of the psychosocial impact of asthma on their child. No significant difference was found in the percentage of those who had written action plans in the poor control group (28%) compared with the acceptable control group (26%), and similar percentages in each group stated that they used the plans. CONCLUSIONS Despite the high use of inhaled corticosteroids, the majority of children had poorly controlled asthma. The poor control group had more exposure to tobacco smoke and a worse psychosocial impact due to asthma. Few children had past asthma education and action plans, suggesting that there is a need to improve access to and tools for education.
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Affiliation(s)
- S L McGhan
- Alberta Asthma Centre, Edmonton, Canada.
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Posadas EM, Simpkins F, Liotta LA, MacDonald C, Kohn EC. Proteomic analysis for the early detection and rational treatment of cancer--realistic hope? Ann Oncol 2005; 16:16-22. [PMID: 15598930 DOI: 10.1093/annonc/mdi004] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Proteomics is an emerging field in medical science focused on the library of proteins specific to a given biosystem, the proteome, and understanding relationships therein. This field incorporates technologies that can be applied to serum and tissue in order to extract important biological information to aid clinicians and scientists in understanding the dynamic biology of their system of interest, such as a patient with cancer. These tools include laser capture microdissection, tissue lysate arrays and mass spectrometry approaches. These new technologies are more potent coupled with advanced bioinformatics analysis. They are used to characterize the content of, and changes in, the proteome induced by physiological changes, benign and pathologic. The application of these tools has assisted in the discovery of new biomarkers and may lead to new diagnostic tests and improvements in therapeutics. These tools additionally can provide a molecular characterization of cancers, which may allow for individualized molecular therapy. Understanding the basic concepts and tools used will illustrate how best to apply these technologies for patient benefit for the early detection of cancer and improved patient care.
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Affiliation(s)
- E M Posadas
- Laboratory of Pathology, National Cancer Institute and NCI/FDA Clinical Proteomics Program, Bethesda, MD, USA.
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Chidwick P, Connolly E, Frolic A, Hardingham L, MacDonald C, Murphy P, Rodney P, Webster GC. Commentary on the Olivieri symposium. J Med Ethics 2004; 30:231. [PMID: 15082825 PMCID: PMC1733836 DOI: 10.1136/jme.2004.007815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- P Chidwick
- William Osler Health Centre, Brampton Memorial Hospital Campus, Brampton, Ontario and University of Toronto Joint Centre for Bioethics/Trillium Health Centre, Toronto, Ontario, Canada
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Abstract
OBJECTIVE To assess patient and/or illness characteristics associated with aspects of quality of life (QOL) in first-episode psychosis (FEP). METHOD Patient characteristics, symptom ratings and Wisconsin QOL scale (client version) were assessed. Data were analysed with correlation coefficients and a hierarchical regression analysis. RESULTS Patients presented with varying levels of QOL on different domains. The level of 'general satisfaction' was related to age of onset and social premorbid adjustment; 'weighted index of QOL' to social premorbid adjustment and inversely to educational premorbid adjustment; 'social relations' inversely to duration of untreated psychosis (DUP), length of prodrome and negative symptoms; 'psychological well-being' inversely to depression and educational premorbid adjustment; 'activities of daily living' to social premorbid adjustment and inversely to negative symptoms; and 'outlook on symptoms' to level of depression. CONCLUSION Domains of self-rated QOL in FEP patients are differentially associated with malleable and non-malleable aspects of patient and illness characteristics.
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Affiliation(s)
- A K Malla
- McGill University, Montreal, Quebec, Canada.
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35
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Abstract
After the discovery and clinical use of insulin for treatment of diabetes it became clear that some of the biological effect of insulin was dependent on the circumstances under which it was given. Relevant for this review is the notion that physical activity, in addition to its own direct metabolic effects also markedly affects the ability of insulin to stimulate a range of metabolic processes. More specifically, during and for a prolonged period after, exercise elicits effects on processes such as insulin-induced muscle glucose uptake and glucose metabolism which influence systemic glucose homeostasis. These phenomena are probably responsible for the improvement in glucose homeostasis and metabolic control that typically occurs with exercise in people with insulin resistance and probably contributes to the reduced risk for development of type 2 diabetes in individuals who engage in regular exercise. Here we focus on the influence of a single bout of exercise on the action of insulin on processes such as glucose uptake and glucose storage in skeletal muscle.
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Affiliation(s)
- J F P Wojtaszewski
- Copenhagen Muscle research Centre, Institute of Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark
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Kinn S, MacDonald C, Hinks S, Nandwani R, Ilett R, Shields N, Carr S, Bigrigg A. Client and staff views on facilities and services, before and after the convergence of sexual, reproductive and women's services. EUR J CONTRACEP REPR 2003; 8:65-74. [PMID: 12831603] [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: 03/03/2023]
Abstract
OBJECTIVE To evaluate client and staff views on existing facilities and services, before and after the convergence of sexual, reproductive and women's services. METHODS Evaluation involved questionnaire survey of clients and staff, one-to-one interviews with staff and review of routinely collected clinical activity data. RESULTS The integration of the three services led to a reduction in stigma associated with attending sexual health services. Despite some staff concerns, the number of men attending the services did not decrease. There was increased satisfaction with the new service, especially the quality of facilities. There were increased numbers of referrals between clinical services in the Sandyford Initiative. CONCLUSIONS Sexual, reproductive and women's services can be integrated to provide improved facilities for clients.
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Affiliation(s)
- S Kinn
- Nursing Research Initiative for Scotland, Glasgow Caledonian University, Glasgow, UK
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Affiliation(s)
- C MacDonald
- Department of Bioethics, Dalhousie University, 5849 University Avenue, Room 105, Halifax, NS, Canada, B3H 4H7.
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MacDonald C, Brookfield JFY. Intraspecific molecular variation in the seaweed fly Coelopa frigida consistent with behavioural distinctness of British and Swedish populations. Mol Ecol 2002; 11:1637-46. [PMID: 12207715 DOI: 10.1046/j.1365-294x.2002.01559.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The major aim of this study was to compare the intraspecific variation and genetic structure of the behaviourally distinct British and Swedish populations of the seaweed fly Coelopa frigida. C. frigida has been the subject of intense study into the basis of female choice. The behaviour of British females is consistent with a 'good genes' model, whereas that of the Swedish flies suggests a Fisher process, in which the difference between the former and the latter is defined by female choice increasing offspring viability in 'good genes' models. Through a study of variability in the mitochondrial cytochrome oxidase II gene from more than 600 flies, we show that there is clear differentiation at the molecular level between the two countries' populations, with an FST of > 75% and no shared haplotypes. Tajima's test reveals an excess of rare variants relative to expectation, which, if not the result of selective sweep, indicates either a population expansion or purifying selection against weakly deleterious variants. Within the two populations, substantial subpopulation differentiation is observed in the UK, where there is also evidence of isolation by distance. Swedish populations exhibit lower variability, and no evidence of isolation by distance, with the latter result possibly being related to the continuous distribution of suitable habitat. The pattern of intraspecific variation is explainable by a combination of contemporary and also historical factors. British and Swedish populations may have been descended from at least two separate founding populations during the recolonization of these areas following Pleistocene glaciations.
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Affiliation(s)
- C MacDonald
- Institute of Genetics, University of Nottingham, Queens Medical Centre, Nottingham NG7 2UH, UK.
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Abstract
Knowledge of the target cells is fundamental to maximise efficiency in attempts at immortalisation of specific cell types. It is also important to optimise the primary cell culture system to promote the survival of the target cell population. Other important factors that may influence the success in obtaining immortalised cells include the toxicity and efficiency of the immortalisation procedure. These can be assessed experimentally and if necessary appropriate techniques can be employed to purify the target cells. When cell lines have been established it is vital to assess them at an early stage for desired scientific and practical features as well as determining their stability and life-span. Furthermore, early characterisation of cell line authenticity (e.g. genetic characters, species of origin) and quality control testing will avoid wasted time and resources should contamination with micro-organisms or another cell line occur. Establishing a programme of immortalisation is a serious undertaking that should only be considered when there are no candidate continuous cell lines available. However, new approaches to modify the biology of cells to give extended life-span, whilst retaining the characteristics of differentiated cells in vivo, will hopefully provide valuable new substrates for in vitro toxicology.
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Affiliation(s)
- C MacDonald
- Department of Bioethics, Dalhousie University, 5849 University Ave., Halifax, NS, B3H 4H7, Canada
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Lin CC, Lu YP, Lou YR, Ho CT, Newmark HH, MacDonald C, Singletary KW, Huang MT. Inhibition by dietary dibenzoylmethane of mammary gland proliferation, formation of DMBA-DNA adducts in mammary glands, and mammary tumorigenesis in Sencar mice. Cancer Lett 2001; 168:125-32. [PMID: 11403916 DOI: 10.1016/s0304-3835(01)00506-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [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: 11/23/2022]
Abstract
Dibenzoylmethane (DBM) is a minor constituent of licorice and a beta-diketone analogue of curcumin. Feeding 1% DBM in the diet to Sencar mice during both the initiation and the post-initiation periods strongly inhibited 7,12-dimethylbenz[a]anthracene (DMBA)-induced mammary tumor multiplicity and mammary tumor incidence by 97%. In further in vivo studies to elucidate the possible mechanisms of the inhibitory action of DBM, feeding the 1% DBM in the AIN-76A diet to immature Sencar mice for 4-5 weeks decreased the uterine wet weight by 43%, inhibited the proliferation rate of mammary gland epithelial cells by 53%, uterine epithelium by 23%, and uterine stroma by 77%, when mice were killed during the first estrus phase of estrous cycle. In addition, feeding 1% DBM in the diet to Sencar mice at 2 weeks before, during and 1 week after DMBA treatment (intubation of 1 mg DMBA per mouse once a week for 5 weeks) inhibited formation of total DMBA-DNA adducts in mammary glands by 72% using a post-32P-labeling assay. Thus, feeding 1% DBM diet to Sencar mice inhibited formation of DMBA-DNA adducts in mammary glands and lowered the proliferation rate of the mammary gland in vivo. These results may explain the strong inhibitory actions of dietary DBM on mammary carcinogenesis in mice.
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MESH Headings
- 9,10-Dimethyl-1,2-benzanthracene/analogs & derivatives
- 9,10-Dimethyl-1,2-benzanthracene/antagonists & inhibitors
- 9,10-Dimethyl-1,2-benzanthracene/metabolism
- 9,10-Dimethyl-1,2-benzanthracene/toxicity
- Animals
- Anticarcinogenic Agents/pharmacology
- Benzoates/pharmacology
- Carcinogens/antagonists & inhibitors
- Carcinogens/metabolism
- Carcinogens/toxicity
- Cell Division/drug effects
- Chalcones
- DNA Adducts/biosynthesis
- Diet
- Female
- Mammary Glands, Animal/cytology
- Mammary Glands, Animal/drug effects
- Mammary Glands, Animal/metabolism
- Mammary Neoplasms, Experimental/chemically induced
- Mammary Neoplasms, Experimental/prevention & control
- Mice
- Mice, Inbred SENCAR
- Organ Size/drug effects
- Uterus/anatomy & histology
- Uterus/cytology
- Uterus/drug effects
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Affiliation(s)
- C C Lin
- Laboratory for Cancer Research, College of Pharmacy, Rutgers, The State University of New Jersey, 164 Frelinghuysen Road, Piscataway, NJ 08854-8020, USA
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42
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Young WB, MacDonald C, Flowers MA. Validity of double- and single-leg vertical jumps as tests of leg extensor muscle function. J Strength Cond Res 2001; 15:6-11. [PMID: 11708708] [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: 02/22/2023]
Abstract
The purpose of this research was to determine if 5 weeks of resistance training for the shoulder and hip flexor muscles produces improvements in vertical jumping (VJ) performance. Twenty-eight men were assessed on tests of shoulder power, leg extensor muscle function, and VJ performance using jumps performed from a standing position, a 3-stride run-up, and double- and single-leg takeoffs. A shoulder and hip flexor training group (n = 14) improved significantly more than a nontraining control group (n = 12) in shoulder power and 2 VJ performance tests, but not in the tests of leg extensor muscle function. It was concluded that the arm swing and free-leg drive significantly influence VJ performance and, therefore, VJ tests are not valid for assessment of leg extensor muscle function.
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Affiliation(s)
- W B Young
- School of Human Movement and Sport Sciences, University of Ballarat, Victoria, Australia
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MacDonald C, Mikhailian H, Yoo SJ, Freedom RM, Adatia I. Angiographic findings of persistent primitive hepatic venous plexus with underdevelopment of the infrahepatic inferior vena cava in pediatric patients. AJR Am J Roentgenol 2000; 175:1397-401. [PMID: 11044051 DOI: 10.2214/ajr.175.5.1751397] [Citation(s) in RCA: 16] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We describe the angiographic diagnosis and significance of persistence of the primitive hepatic venous plexus with underdevelopment of the infrahepatic inferior vena cava. CONCLUSION We recommend that inferior venacavography be performed in routine assessment before surgery of patients with azygos or hemiazygos continuation of the inferior vena cava, in whom redirection of systemic venous blood to the pulmonary artery is contemplated.
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Affiliation(s)
- C MacDonald
- Department of Diagnostic Imaging, Hospital for Sick Children and University of Toronto, 555 University Ave., Toronto M5G 1X8, Canada
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44
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Singletary K, MacDonald C. Inhibition of benzo[a]pyrene- and 1,6-dinitropyrene-DNA adduct formation in human mammary epithelial cells bydibenzoylmethane and sulforaphane. Cancer Lett 2000; 155:47-54. [PMID: 10814878 DOI: 10.1016/s0304-3835(00)00412-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.0] [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: 11/21/2022]
Abstract
Numerous phytochemicals have been examined for their capacity to act as cancer chemopreventive agents. Dibenzoylmethane, a minor constituent of licorice and a compound structurally-related to curcumin, recently was identified as an effective inhibitor of chemically-induced rat mammary DNA-adduct formation and tumorigenesis (Carcinogenesis 19(1998)1039-1043). The present studies were conducted to examine the capacity of dibenzoylmethane to inhibit the formation of DNA adducts following exposure to benzo[a]pyrene (BP) and 1,6-dinitropyrene (1,6-DNP), and to stimulate the expression of glutathione-S-transferase (GST) and NAD(P)H-quinone reductase (QR) proteins in the human mammary epithelial cell line MCF-10F. In addition, the efficacy of dibenzoylmethane as an enzyme inducer and adduct inhibitor was compared with that of sulforaphane, a potent inducer of phase II detoxification enzymes and inhibitor of chemically-induced rat mammary tumorigenesis. Dibenzoylmethane at concentrations from 0.1 M to 2.0 microM inhibited BP-DNA adduct formation by 63 to 81%. Likewise, sulforaphane inhibited BP-DNA adduct formation by 68 to 80% over the same concentration range. DNA adduct formation following exposure to 1,6-DNP was significantly inhibited by 46 to 61% due to dibenzoylmethane treatment (0.1 to 2.0 microM) and 30 to 56% due to sulforaphane treatment at the same concentrations. The expression of QR and GSTP1-1 proteins were increased by 3 to 4-fold and 3 to 5-fold, respectively, for MCF-10F cells treated with sulforaphane (0.5-2.0 microM). Dibenzoylmethane treatment at the same concentrations did not induce GSTP1-1 expression and significantly stimulated QR expression only at the 2.0 microM concentration. These data indicate that human mammary epithelial MCF-10F cells can convert BP and 1,6-DNP to DNA-binding forms, and that DNA adduct formation can be inhibited by the phytochemicals dibenzoylmethane and sulforaphane. The inhibition of BP-DNA and 1, 6-DNP adduct formation by sulforaphane was associated with increases in QR and GST protein expression. The mechanisms underlying the capacity of dibenzoylmethane to inhibit BP-DNA and 1,6-DNP-DNA adduct formation could not be explained by changes in QR or GST expression and remain to be determined. Together these data suggest that dibenzoylmethane and sulforaphane warrant continued evaluation as breast cancer chemopreventive agents.
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Affiliation(s)
- K Singletary
- Department of Food Science and Human Nutrition, University of Illinois, 905 South Goodwin Avenue, Urbana 61801, USA.
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45
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Abstract
Considerable literature concerning cardiac tumors in infancy and childhood has accumulated summarizing the prevalence, histologic types, clinical presentation and outcome, and changing imaging algorithms [1, 7, 10, 14, 20, 24, 33, 37, 43, 48, 57, 58, 60-62, 67, 69, 70, 90, 105, 106, 110, 124, 139, 140, 142, 143, 149]. In this review, we focus on selected aspects of cardiac tumors in the neonate, infant, and child, with an emphasis on imaging modalities [6, 13, 15, 18, 21-23, 60, 71, 77, 80, 92, 98, 99, 103, 107, 112, 114, 119, 146]. Various types of primary cardiac tumors in childhood are discussed in this article.
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Affiliation(s)
- R M Freedom
- Department of Pediatrics, University of Toronto Faculty of Medicine and Division of Cardiology, the Hospital for Sick Children, 555 University Avenue, Room 1503C, Toronto, Ontario M5G 1X8, Canada
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Affiliation(s)
- M L Greer
- Division of Cardiologyand Departments of Diagnostic Imaging and Critical Care Medicine, Toronto Hospital for Sick Children and University of Toronto, Canada
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47
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Affiliation(s)
- N P Kenny
- Department of Bioethics, Dalhousie University, Halifax, NS, Canada
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48
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Grant MH, Anderson K, McKay G, Wills M, Henderson C, MacDonald C. Manipulation of the phenotype of immortalised rat hepatocytes by different culture configurations and by dimethyl sulphoxide. Hum Exp Toxicol 2000; 19:309-17. [PMID: 10918525 DOI: 10.1191/096032700678815936] [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: 12/22/2022]
Abstract
The liver-specific phenotype of immortalised rat hepatocytes is not irretrievably lost as they age in culture but can be manipulated by modifying the culture environment. Testosterone metabolism was used to investigate the profile of cytochrome P450 isoenzymes present in two immortalised cell lines, P9 and LQC, and in primary cultures of rat hepatocytes, cultured on collagen films, gels and double gel cultures (sandwich configuration). The extent of testosterone metabolism, and the range of metabolites produced, was increased in immortalised cells by the presence of collagen as a substratum film or gel but survival was poorer and the range of metabolites was reduced in sandwich culture. In contrast, testosterone metabolism was retained in primary hepatocytes in sandwich cultures at a higher level than in collagen film or gel cultures. Expression of alpha class glutathione-S-transferases (GSTs) increased and that of GSTP1 decreased (changes which indicate a recovery of normal liver GST phenotype) when the medium of immortalised cell cultures was supplemented with dimethyl sulphoxide (DMSO). DMSO also improved ethoxyresorufin O-deethylation (EROD) and testosterone metabolism in immortalised cells. It also markedly inhibited proliferation, DNA, RNA and protein synthesis. Maximal testosterone metabolism was observed in immortalised cells cultured on collagen gels in the presence of 1% (v/v) DMSO. Development of a protocol for treating immortalised liver cells cultured on collagen gels with DMSO to switch between proliferation and differentiation may provide a convenient system expressing the xenobiotic metabolising enzymes required for in vitro toxicity testing.
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Affiliation(s)
- M H Grant
- Bioengineering Unit, Strathclyde University, Wolfson Centre, 106 Rottenrow, Glasgow G4 0NW, UK
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Fitzgerald U, Hettle S, MacDonald C, McLean JS. Umbilical cord endothelial cells expressing large T antigen: comparison with primary cultures and effect of cell age. In Vitro Cell Dev Biol Anim 2000; 36:222-7. [PMID: 10852346 DOI: 10.1290/1071-2690(2000)036<0222:ucecel>2.0.co;2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A number of human endothelial cell lines from umbilical cord cells (HUVECs) have been generated by transfection with SV40 large T and small t antigen sequences. Comparison of these lines with primary cultures of HUVECs has been carried out by monitoring the expression of a number of endothelial cell markers with specific regard to cell age. The secreted levels of the protein plasminogen activator inhibitor (PAI) was found to be significantly reduced in SV40-transfected cells when compared to untransfected controls. Tissue plasminogen activator (tPA) and urokinase (uPA) levels were unchanged. As cells entered crisis, there was a rapid and significant increase in the levels of tPA, uPA, and PAl and this was observed for all clones screened. The endothelial cell marker von Willebrand Factor (vWF) was found intracellularly and was also secreted into the medium. The levels were not altered between transfected and untransfected cells. Angiotensin converting enzyme (ACE) activity was maintained in cell lines at levels found in nonimmortalized HUVECs. Both isoforms (alpha and beta) of IL-1 (interleukin-1) increased as cells approached crisis, and the presence of these cytokines may be responsible for the increased levels of tPA, PAI, and uPA. With one exception, the ability of the transfected cells to produce prostacyclin (PGI2) was lost by all clones.
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Affiliation(s)
- U Fitzgerald
- Departmernt of Biological Sciences. University of Paisley, Scotland
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Abstract
OBJECTIVES We sought to investigate the clinical impact of balloon angioplasty for native coarctation of the aorta (CoA) and determine predictors of outcome. BACKGROUND Balloon dilation of native CoA remains controversial and more information on its long-term impact is required. METHODS Hemodynamic, angiographic and follow-up data on 69 children who underwent balloon angioplasty of native CoA between 1988 and 1996 were reviewed. Stretch, recoil and gain of CoA circumference and area were calculated and related to outcomes. RESULTS Initial systolic gradients (mean +/- SD, 31+/-12 mm Hg) fell by -74+/-27% (p < 0.001), with an increase in mean CoA diameters of 128+/-128% in the left anterior oblique and 124+/-87% in the lateral views (p < 0.001). Two deaths occurred, one at the time of the procedure and one 23 months later, both as a result of an associated cardiomyopathy. Seven patients had residual gradients of >20 mm Hg. One patient developed an aneurysm, stable in follow-up, and four patients had mild dilation at the site of the angioplasty. Freedom from reintervention was 90% at one year and 87% at five years with follow-up ranging to 8.5 years. Factors significantly associated with decreased time to reintervention included: a higher gradient before dilation, a smaller percentage change in gradient after dilation, a small transverse arch and a greater stretch and gain, but not recoil. CONCLUSION Balloon dilation is a safe and efficient treatment of native CoA in children. Greater stretch and gain are factors significantly associated with reintervention, possibly related to altered elastic properties and vessel scarring.
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Affiliation(s)
- C Ovaert
- Department of Pediatrics, University of Toronto School of Medicine, Canada.
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