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Kilic Y, Graham A, Tait NP, Spalding D, Vlavianos P, Jiao LR, Alsafi A. Percutaneous biliary stone clearance: is there still a need? A 10-year single-centre experience. Clin Radiol 2021; 77:130-135. [PMID: 34893340 DOI: 10.1016/j.crad.2021.10.015] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/21/2021] [Indexed: 11/18/2022]
Abstract
AIM To evaluate the safety and efficacy of percutaneous biliary stone clearance in a single hepatopancreaticobiliary (HPB) centre. MATERIALS AND METHODS All patients who underwent percutaneous biliary stone clearance between 2010 and 2020 at a HPB centre were identified from the radiology information system. Their demographic data, presentation, previous surgery, number/size of biliary calculi, success and complications were collected from patient records. Unpaired student's t-test was used to compare numerical variables and the Chi-square test was used to compare categorical data. RESULTS Sixty-eight patients aged between 58.5-91.1 years underwent the procedure, and 42.6% (29/68) had the procedure due to surgically altered anatomy precluding endoscopic retrograde cholangiopancreatography (ERCP). The most common presentation was cholangitis (62%). The success rate of percutaneous stone clearance was 92.7%. The average number of calculi was two (range 1-412). Of the patients included, 4.4% developed pancreatitis, 4.4% developed cholangitis, and 1.5% had hepatic artery branch pseudoaneurysm successfully treated with transarterial embolisation. There was no significant difference in success or complication rates between the different access sites (right lobe, left lobe, roux-loop, T-tube, p=0.7767). CONCLUSION Percutaneous biliary stone clearance is safe and effective and will continue to play an important role where ERCP fails or is impossible due surgically altered anatomy.
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Affiliation(s)
- Y Kilic
- Imaging Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - A Graham
- Imaging Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - N P Tait
- Imaging Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - D Spalding
- Department of Surgery and Cancer, Imperial College, Hammersmith Hospital Campus, London, UK
| | - P Vlavianos
- Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK
| | - L R Jiao
- Department of Surgery and Cancer, Imperial College, Hammersmith Hospital Campus, London, UK
| | - A Alsafi
- Imaging Department, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
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Markar SR, Brodie B, Chin ST, Romano A, Spalding D, Hanna GB. Profile of exhaled-breath volatile organic compounds to diagnose pancreatic cancer. Br J Surg 2018; 105:1493-1500. [DOI: 10.1002/bjs.10909] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 04/01/2018] [Accepted: 05/11/2018] [Indexed: 12/23/2022]
Abstract
Abstract
Background
Pancreatic cancer has a very poor prognosis as most patients are diagnosed at an advanced stage when curative treatments are not possible. Breath volatile organic compounds (VOCs) have shown potential as novel biomarkers to detect cancer. The aim of the study was to quantify differences in exhaled breath VOCs of patients with pancreatic cancers compared with cohorts without cancer.
Methods
Patients were recruited to an initial development cohort and a second validation cohort. The cancer group included patients with localized and metastatic cancers, whereas the control group included patients with benign pancreatic disease or normal pancreas. The reference test for comparison was radiological imaging using abdominal CT, ultrasound imaging or endoscopic ultrasonography, confirmed by histopathological examination as appropriate. Breath was collected from the development cohort with steel bags, and from the validation cohort using the ReCIVA™ system. Analysis was performed using gas chromatography–mass spectrometry.
Results
A total of 68 patients were recruited to the development cohort (25 with cancer, 43 no cancer) and 64 to the validation cohort (32 with cancer, 32 no cancer). Of 66 VOCs identified, 12 were significantly different between groups in the development cohort on univariable analysis. Receiver operating characteristic (ROC) curve analysis using significant volatile compounds and the validation cohort produced an area under the curve of 0·736 (sensitivity 81 per cent, specificity 58 per cent) for differentiating cancer from no cancer, and 0·744 (sensitivity 70 per cent, specificity 74 per cent) for differentiating adenocarcinoma from no cancer.
Conclusion
Breath VOCs may distinguish patients with pancreatic cancer from those without cancer.
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Affiliation(s)
- S R Markar
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - B Brodie
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - S-T Chin
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - A Romano
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - D Spalding
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - G B Hanna
- Department of Surgery and Cancer, Imperial College London, London, UK
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Miller HC, Drymousis P, Flora R, Goldin R, Spalding D, Frilling A. Role of Ki-67 proliferation index in the assessment of patients with neuroendocrine neoplasias regarding the stage of disease. World J Surg 2014; 38:1353-61. [PMID: 24493070 DOI: 10.1007/s00268-014-2451-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Neuroendocrine neoplasias (NEN) of the gastroenteropancreatic (GEP) system frequently present with metastatic deposits. The proliferation marker Ki-67 is used for diagnosis and to assess the prognosis of disease. The aim of our study was to evaluate the usefulness of Ki-67 % in the assessment of NEN patients with regard to their disease stage in clinical practice. Additionally, a comparative analysis of Ki-67 levels among different sites of disease was performed. METHODS This retrospective study included patients with GEP NEN referred to our center from 2010 to 2012. The NEN diagnosis was confirmed by standard histopathology. Ki-67 immunohistochemistry was done on paraffin-embedded sections using an automated Leica immunohistochemistry machine. NEN grading was carried out according to European Neuroendocrine Tumor Society recommendations (low grade [G1] to intermediate grade [G2], well to moderately differentiated neuroendocrine neoplasms; high-grade [G3], moderately to poorly differentiated neuroendocrine neoplasms). Results of tumor staging and grading were correlated. In a subgroup of cases, comparative analysis of Ki-67 levels in different sites of disease was carried out. RESULTS One hundred sixty-one GEP NEN patients were included in the study. Metastatic disease was seen in 46.1 % (53/115) of G1 tumors, 77.8 % (28/36) of G2 tumors, and 100 % of (10/10) G3 tumors (p = 0.0002). When stratified according to primary tumor site, metastatic disease was documented in 42.9 % (36/84) of patients with pancreatic NEN and in 91.9 % (34/37) of those with small intestinal primary. Stage IV metastatic disease was present in 27.8 % (32/115) and 72.2 % (26/36) of the G1 and G2 tumors, respectively, and in 90 % (9/10) of the G3 tumors. Assessment of the Ki-67 index for a subset of cases at metastatic sites as well as the primary tumor site showed discrepancies in 35.3 % cases. In 7/9 (77.8 %) patients with liver metastases, Ki-67 % was higher in the liver lesions than in the primary tumor. CONCLUSIONS Patients with GEP NEN exhibiting a high Ki-67 proliferation index present with metastatic disease in the vast majority of cases. Depending upon the primary tumor site, metastases are to be expected also in tumors with low Ki-67 %, although they are considered less aggressive. Different disease sites may express heterogeneous Ki-67 levels.
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Affiliation(s)
- H C Miller
- Department of Surgery and Cancer, Imperial College London, Hammersmith Campus, Du Cane Road, London, W12 0HS, UK
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4
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Reebye V, Sætrom P, Mintz P, Huang K, Swiderski P, Peng L, Liu C, Liu X, Jensen S, Zacharoulis D, Kostomitsopoulos N, Kasahara N, Nicholls J, Jiao L, Pai M, Mizandari M, Chikovani T, Emara M, Haoudi A, Tomalia D, Rossi J, Habib N, Spalding D. Novel RNA oligonucleotide improves liver function and inhibits liver carcinogenesis in vivo. Hepatology 2014; 59:216-27. [PMID: 23929703 PMCID: PMC4655108 DOI: 10.1002/hep.26669] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [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: 03/06/2013] [Accepted: 07/31/2013] [Indexed: 12/11/2022]
Abstract
UNLABELLED Hepatocellular carcinoma (HCC) occurs predominantly in patients with liver cirrhosis. Here we show an innovative RNA-based targeted approach to enhance endogenous albumin production while reducing liver tumor burden. We designed short-activating RNAs (saRNA) to enhance expression of C/EBPα (CCAAT/enhancer-binding protein-α), a transcriptional regulator and activator of albumin gene expression. Increased levels of both C/EBPα and albumin mRNA in addition to a 3-fold increase in albumin secretion and 50% decrease in cell proliferation was observed in C/EBPα-saRNA transfected HepG2 cells. Intravenous injection of C/EBPα-saRNA in a cirrhotic rat model with multifocal liver tumors increased circulating serum albumin by over 30%, showing evidence of improved liver function. Tumor burden decreased by 80% (P = 0.003) with a 40% reduction in a marker of preneoplastic transformation. Since C/EBPα has known antiproliferative activities by way of retinoblastoma, p21, and cyclins, we used messenger RNA (mRNA) expression liver cancer-specific microarray in C/EBPα-saRNA-transfected HepG2 cells to confirm down-regulation of genes strongly enriched for negative regulation of apoptosis, angiogenesis, and metastasis. Up-regulated genes were enriched for tumor suppressors and positive regulators of cell differentiation. A quantitative polymerase chain reaction (PCR) and western blot analysis of C/EBPα-saRNA-transfected cells suggested that in addition to the known antiproliferative targets of C/EBPα, we also observed suppression of interleukin (IL)6R, c-Myc, and reduced STAT3 phosphorylation. CONCLUSION A novel injectable saRNA-oligonucleotide that enhances C/EBPα expression successfully reduces tumor burden and simultaneously improves liver function in a clinically relevant liver cirrhosis/HCC model.
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MESH Headings
- Albumins/metabolism
- Animals
- CCAAT-Enhancer-Binding Protein-alpha/metabolism
- Carcinoma, Hepatocellular/complications
- Carcinoma, Hepatocellular/drug therapy
- Carcinoma, Hepatocellular/pathology
- Drug Evaluation, Preclinical
- Gene Expression Regulation
- Genetic Therapy
- Hep G2 Cells
- Humans
- Injections, Intravenous
- Liver/pathology
- Liver Cirrhosis/complications
- Liver Function Tests
- Liver Neoplasms, Experimental/complications
- Liver Neoplasms, Experimental/drug therapy
- Liver Neoplasms, Experimental/pathology
- Male
- Oligonucleotide Array Sequence Analysis
- Proto-Oncogene Proteins c-myc/metabolism
- RNA/therapeutic use
- Rats
- Rats, Wistar
- Receptors, Interleukin-6/metabolism
- STAT3 Transcription Factor/metabolism
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Affiliation(s)
- V. Reebye
- Department of Surgery and Cancer; Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - P. Sætrom
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway
- Department of Computer and Information Science, Norwegian University of Science and Technology, NO-7489 Trondheim, Norway
| | - P.J. Mintz
- Department of Surgery and Cancer; Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - K.W. Huang
- Department of Surgery & Hepatitis Research Center. National Taiwan University Hospital, Taipei City, 10002, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University. Taipei City, 10002, Taiwan
| | - P. Swiderski
- Department of Molecular Medicine, Beckman Research Institute of the City of Hope, CA 91010. USA
| | - L. Peng
- Centre Interdisciplinaire de Nanoscience de Marseille, 13288 Marseille, France
| | - C. Liu
- Centre Interdisciplinaire de Nanoscience de Marseille, 13288 Marseille, France
| | - X.X. Liu
- Centre Interdisciplinaire de Nanoscience de Marseille, 13288 Marseille, France
| | - S. Jensen
- Department of Surgery and Cancer; Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - D. Zacharoulis
- Department of Surgery, University Hospital of Larissa Mezourlo, Larisa, Greece
| | - N. Kostomitsopoulos
- Centre for Experimental Surgery, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - N. Kasahara
- Department of Medicine, UCLA School of Medicine, Los Angeles, CA 90095-7019, USA
| | - J.P. Nicholls
- Department of Surgery and Cancer; Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - L.R. Jiao
- Department of Surgery and Cancer; Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - M. Pai
- Department of Surgery and Cancer; Faculty of Medicine, Imperial College London, London, W12 0NN, UK
| | - M. Mizandari
- Department of Radiology. Tbilisi 1 Hospital University Clinic. High Technology Medical Center. Tbilisi, Georgia
| | - T. Chikovani
- Department of Microbiology and Immunology. Faculty of Medicine. Tbilisi State Medical University. Tbilisi, Georgia
| | - M.M. Emara
- Qatar Biomedical Research Institute, Education City, P.O BOX 5825, Doha, Qatar
| | - A. Haoudi
- Qatar Biomedical Research Institute, Education City, P.O BOX 5825, Doha, Qatar
| | - D.A. Tomalia
- Department of Chemistry, University of Pennsylvania, Philadelphia, PA, USA
| | - J.J. Rossi
- Division of Molecular Biology, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - N.A. Habib
- Department of Surgery and Cancer; Faculty of Medicine, Imperial College London, London, W12 0NN, UK
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Hunter D, Shrestha AK, Pai M, Spalding D. Determining complete clinical response of radiologically disappearing colorectal liver metastases after chemotherapy and how they should be managed. Ann R Coll Surg Engl 2013. [DOI: 10.1308/rcsann.2013.95.6.e20] [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: 11/22/2022] Open
Abstract
The 2013 Alpine Liver and Pancreatic Surgery meeting was held in Madonna di Campiglio, Italy. The meeting was organised by the Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland. The following abstracts were selected for presentation at the meeting.
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Affiliation(s)
- D Hunter
- Imperial College Healthcare NHS Trust, UK
| | | | - M Pai
- Imperial College Healthcare NHS Trust, UK
| | - D Spalding
- Imperial College Healthcare NHS Trust, UK
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6
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Dina R, Tran-Dang MA, Mauri F, Gudi M, Cohen P, Ahmad R, Batav L, Vlavianos P, Spalding D. Pancreatobiliary cytology in the multidisciplinary setting. Cytopathology 2013; 24:150-8. [DOI: 10.1111/cyt.12077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2013] [Indexed: 01/30/2023]
Affiliation(s)
- R. Dina
- Department of Cellular Pathology; Imperial College NHS Trust; London; UK
| | - M.-A. Tran-Dang
- Department of Cellular Pathology; Imperial College NHS Trust; London; UK
| | - F. Mauri
- Department of Cellular Pathology; Imperial College NHS Trust; London; UK
| | - M. Gudi
- Department of Cellular Pathology; Imperial College NHS Trust; London; UK
| | - P. Cohen
- Department of Cellular Pathology; Imperial College NHS Trust; London; UK
| | - R. Ahmad
- Department of Cellular Pathology; Imperial College NHS Trust; London; UK
| | - L. Batav
- Department of Cellular Pathology; Imperial College NHS Trust; London; UK
| | - P. Vlavianos
- Diagnostic Endoscopy Unit; Imperial College NHS Trust; London; UK
| | - D. Spalding
- Department of Surgery; Imperial College NHS Trust; London; UK
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Abstract
BACKGROUND Somatostatinomas are rare neuroendocrine tumours with an annual incidence of 1 in 40 million. They arise in the pancreas or periampullary duodenum. Most are clinically non-secretory and do not cause the somatostatinoma syndrome. Many are metastatic at presentation and their management is typically multimodal. CASE HISTORIES Four cases of somatostatinoma are described. Two patients with periampullary disease presented with biliary obstruction, one with frank jaundice and one with incidental bile duct obstruction on investigation of hepatitis B. Each patient had type 1 neurofibromatosis and resection of the somatostatinoma by means of a pylorus-preserving proximal pancreaticoduodenectomy has resulted in long-term survival. Another two patients with metastatic pancreatic somatostatinomas presented with abdominal pain. Contrasting management illustrates current treatment strategies that are dependent in part on the distribution of the disease. DISCUSSION The pathophysiology, presentation, clinical associations and role of diagnostic imaging are discussed for periampullary and pancreatic neuroendocrine tumours. Operative treatment has an important role in both the curative and palliative settings in conjunction with appropriate medical treatments and these are described. Management options depend on the extent of the disease and the cases are used to illustrate the rationale of such strategies.
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Abstract
Acute cholecystitis is treated by antibiotics and cholecystectomy. When the gallbladder neck is obstructed in the presence of infection, preventing pus from draining via the cystic duct, an empyema of the gallbladder develops. Under these circumstances, treatment may be either cholecystectomy or, in the presence of significant comorbidity, by drainage via percutaneous cholecystostomy, followed at a later date by cholecystectomy. We present the case of a patient who presented acutely with an attack of cholecystitis and refused to undergo a cholecystectomy owing to previous respiratory arrest following general anaesthesia. She settled with intravenous antibiotic treatment and was discharged. However, she presented shortly afterwards with a further attack of cholecystitis that was refractory to intravenous antibiotics and so was treated initially with percutaneous drainage. This was subsequently replaced with interno-external drainage of the gallbladder (transpapillary cholecystoduodenal stent) with the use of a J-J ureteric stent, which was then fully internalised. She remained well following this procedure and was discharged home. The long-term patency of the stent is not known and we hope that no further intervention will be required, but if necessary the stent could be exchanged endoscopically, by a percutaneous route, or via a combined approach.
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Affiliation(s)
- P Gatenby
- Departments of Hepatopancreaticobiliary Surgery, Imperial College of Science and Technology, London W12 0HS, UK.
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Affiliation(s)
- M. Holdsworth
- Leicestershire Nutrition and Dietetic Service, Fosse Health NHS Trust, Humberstone, Leicester, UK
| | - D. Spalding
- Leicestershire Nutrition and Dietetic Service, Fosse Health NHS Trust, Humberstone, Leicester, UK
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Abstract
BACKGROUND Surgical resection remains the gold standard in dealing with liver tumours. Blood loss, biliary leak and postoperative liver function are still the main concerns of surgeons operating on the liver, even though different techniques have been developed to allow safer liver resection. A novel concept for liver resection is described using a radiofrequency energy (RF) assisted technique. METHOD A patient with a large colorectal liver metastasis located in segments VI, VII, VIII underwent a right hepatectomy using this technique. At laparotomy the tumour was staged with intraoperative ultrasonography, and a 'cooled tipped' radiofrequency probe was used to achieve a 'zone of desiccation' in the liver parenchyma 2 cm away from the edge of the tumour. Liver parenchyma was subsequently divided with a surgical scalpel. RESULTS The resection time was 80 min with a blood loss of 30 ml. The patient was discharged on the ninth postoperative day without complications. DISCUSSION Liver resection assisted by RF energy is feasible and safe. This technique could offer a new method for 'transfusion-free' resection without the need for sutures, ties, staples, tissue glue or admission to the intensive care unit.
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Affiliation(s)
- G Navarra
- Department of Surgical Oncology and Technology, Faculty of Medicine, Imperial College of Science. Technology & Medicine, Hammersmith Hospital CampusLondon WI2 ONNUK
| | - D Spalding
- Department of Surgical Oncology and Technology, Faculty of Medicine, Imperial College of Science. Technology & Medicine, Hammersmith Hospital CampusLondon WI2 ONNUK
| | - D Zacharoulis
- Department of Surgical Oncology and Technology, Faculty of Medicine, Imperial College of Science. Technology & Medicine, Hammersmith Hospital CampusLondon WI2 ONNUK
| | - JP Nicholls
- Department of Surgical Oncology and Technology, Faculty of Medicine, Imperial College of Science. Technology & Medicine, Hammersmith Hospital CampusLondon WI2 ONNUK
| | - S Kirby
- Department of Anaesthetics and Operating Theatres, Hammersmith HospitalLondonUK
| | - I Costa
- Department of Anaesthetics and Operating Theatres, Hammersmith HospitalLondonUK
| | - NA Habib
- Department of Surgical Oncology and Technology, Faculty of Medicine, Imperial College of Science. Technology & Medicine, Hammersmith Hospital CampusLondon WI2 ONNUK
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Cockerill S, Stubberfield C, Stables J, Carter M, Guntrip S, Smith K, McKeown S, Shaw R, Topley P, Thomsen L, Affleck K, Jowett A, Hayes D, Willson M, Woollard P, Spalding D. Indazolylamino quinazolines and pyridopyrimidines as inhibitors of the EGFr and c-erbB-2. Bioorg Med Chem Lett 2001; 11:1401-5. [PMID: 11378364 DOI: 10.1016/s0960-894x(01)00219-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [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: 10/17/2022]
Abstract
Described herein is the design and synthesis of indazolylaminopyridopyrimidines and quinazolines as inhibitors of the class 1 tyrosine kinase receptor family. Data is presented for N(4)-(1-benzyl-1H-indazol-5-yl)-N(6),N(6)-dimethylpyrido[3,4-d]pyrimidine-4,6-diamine 3B. This compound inhibited EGFr and c-erbB-2 enzymes selectively over other kinases. It inhibited the proliferation of a range of tumour cell lines in vitro and the growth of BT474 xenografts in SCID mice.
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Affiliation(s)
- S Cockerill
- Enzyme Chemistry 1, Oncology Unit, Enzyme Pharmacology, Research Biomet. Glaxo Wellcome Medicines Research Centre, Gunnels Wood Road, Hertfordshire SG1 2NY, Stevenage, UK.
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13
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Abstract
Modelling of the shoulder mechanism is dependent upon reliable data on the morphometry and points of attachment of the relevant muscles. In this paper, the authors present coordinate data which have been derived from the radiography of dissected cadavers. All of the coordinates have been normalised with respect to reference dimensions of the relevant segments (humerus, scapula, clavicle and trunk). Similarly the measurements of physiological cross-section area (PCSA) have been normalised with respect to that of deltoid. The measurements of PCSA have been shown to agree largely with the work of Veeger et al. [J. Biomechanics 24, 615-629 (1991)] and Karlsson and Peterson [J. Biomechanics 25, 189-199 (1992)]. While the majority of the descriptions of morphometry concur with accepted texts there are some notable disagreements, particularly concerning trapezius.
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Affiliation(s)
- G R Johnson
- Centre for Rehabilitation and Engineering Studies (CREST), University of Newcastle upon Tyne, U.K
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14
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Burden ML, Samanta A, Spalding D, Burden AC. A comparison of the glycaemic and insulinaemic effects of an Asian and a European meal. ACTA ACUST UNITED AC 1994. [DOI: 10.1002/pdi.1960110508] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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15
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Gerdin E, Spalding D, Lindberg B, Rane A. Glucuronidation of morphine and some drug oxidation reactions in liver microsomes from pregnant and non-pregnant rhesus monkeys. Pharmacol Toxicol 1991; 69:78-80. [PMID: 1946197 DOI: 10.1111/j.1600-0773.1991.tb00415.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- E Gerdin
- Department of Obstetrics and Gynaecology, University Hospital, Uppsala, Sweden
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Mortimer O, Persson K, Ladona MG, Spalding D, Zanger UM, Meyer UA, Rane A. Polymorphic formation of morphine from codeine in poor and extensive metabolizers of dextromethorphan: relationship to the presence of immunoidentified cytochrome P-450IID1. Clin Pharmacol Ther 1990; 47:27-35. [PMID: 2295216 DOI: 10.1038/clpt.1990.4] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.0] [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: 12/31/2022]
Abstract
We studied the oxidation capacity in liver biopsies of a series of extensive metabolizers (n = 10) and poor metabolizers (n = 2) as identified by in vivo phenotyping with dextromethorphan. Codeine and dextromethorphan were used as probe drugs in vitro. The data were compared with the contents of cytochrome P-450IID1 as quantitated by Western immunoblotting by use of a specific monoclonal antibody (MAb 114/2). The O-demethylation of codeine was highly correlated with the O-demethylation of dextromethorphan (r = 0.90). The N-demethylation of codeine was catalyzed at a considerably higher rate than the O-demethylation. The N-demethylation to O-demethylation ratio of codeine was 46 in the poor metabolizer and, on average, 6.2 (range, 2.6 to 11) in the extensive metabolizers, respectively. The band intensity in Western blots correlated with the rate of O-demethylation of codeine (r = 0.95) and of dextromethorphan (r = 0.88) in the extensive metabolizers. The comeasurement of the O-demethylation and N-demethylation of codeine may provide a tool with which to phenotype individuals in vitro with respect to the polymorphism of the cytochrome P-450IID1.
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Affiliation(s)
- O Mortimer
- Division of Clinical Pharmacology, Akademiska Hospital, University of Uppsala, Sweden
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Persson K, Lindström B, Spalding D, Wahlström A, Rane A. Determination of codeine and its metabolites in human blood plasma and in microsomal incubates by high-performance liquid chromatography with ultraviolet detection. J Chromatogr 1989; 491:473-80. [PMID: 2808632 DOI: 10.1016/s0378-4347(00)82868-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- K Persson
- Division of Clinical Pharmacology, University Hospital, Uppsala, Sweden
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Evans V, Spalding D. Nutrition education for children aged 7-11 years--a practical approach. Hum Nutr Appl Nutr 1984; 38:223-4. [PMID: 6480408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Abstract
In previous papers (Pilowsky, Levine and Boulton, 1969; Pilowsky and Boulton, 1970; Pilowsky and McGrath, 1970) we have described the development of a depression questionnaire and its use in the classification and identification of depressed patients. In order to increase the flexibility of the questionnaire as a research tool we have derived a depression scale from the items in it and have investigated its validity as a measure of the depth of depression. The purpose of this paper is to describe the development of the depression scale and report the results of validation studies.
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Richard P, von Brentano P, Weiman H, Wharton W, Weitkamp WG, McDonald WW, Spalding D. Low-Lying Levels ofPb208withg92,i112, orj152Neutron-Particle Configurations. ACTA ACUST UNITED AC 1969. [DOI: 10.1103/physrev.183.1007] [Citation(s) in RCA: 46] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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