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Vaphiades MS, Grondines B, Kline LB, Riser E, Spencer D. Skin in the game. Surv Ophthalmol 2023; 68:308-311. [PMID: 34813855 DOI: 10.1016/j.survophthal.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/01/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022]
Abstract
A 23-year-old man with a history of migraine and focal seizures, developed painless visual loss in the left eye associated with optic disk edema. There was no recent history of cat exposure except for a cat that lives outside. Initial laboratory studies were negative. magnetic resonance imaging brain and orbits without and with fat suppression and intravenous contrast was normal. The patient admitted to routinely skinning, processing and consuming deer while not wearing gloves, and he also frequently had cuts on his hands while doing so. The serum Toxoplasma gondii IgG antibody returned at >400 (0-7.1 IU/mL) with the IgM at 10.4 (0-7.9 AU/mL).
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Affiliation(s)
- Michael S Vaphiades
- Departments of Ophthalmology and Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
| | - Brendan Grondines
- Departments of Ophthalmology and Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lanning B Kline
- Departments of Ophthalmology and Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Emily Riser
- Departments of Ophthalmology and Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Doran Spencer
- Shiley Eye Institute, University of California, San Diego, California, USA
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2
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Abstract
A 43-year-old woman presented with decreased vision in the right eye associated with painful eye movements 10 days after receiving her first dose of Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine (Pfizer Inc, New York, NY). Two days later she developed painful loss of vision in the left eye. Clinical presentation and magnetic resonance imaging findings were consistent with bilateral optic perineuritis transitioning to optic neuritis. Extensive evaluation including aquaporin-4 immunoglobin G (IgG), myelin oligodendrocyte glycoprotein IgG, and lumbar puncture was unrevealing. Visual acuity at nadir was counting fingers in both eyes, but after receiving intravenous steroids and plasma exchange vision eventually improved to 20/20 in each eye, although she was left with inferior visual field defects and bilateral optic disc pallor. This case highlights the diagnostic challenge in the evaluation of atypical optic neuritis with a review of post-COVID-19 vaccination-associated optic neuritis.
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Affiliation(s)
- M Tariq Bhatti
- Department of Ophthalmology, The Permanente Medical Group, Roseville, CA.
| | - Aubrey L Gilbert
- Department of Ophthalmology, The Permanent Medical Group, Vallejo, CA
| | - George Watson
- Department of Neurology, The Permanente Medical Group, Roseville, CA
| | - Mark Waheed
- Department of Ophthalmology, The Permanent Medical Group, Vallejo, CA
| | - Doran Spencer
- Shiley Eye Institute, University of California, San Diego, La Jolla, CA
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3
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Ray M, Lee Y, Faris N, Fehnel C, Akinbobola O, Meadows-Taylor M, Spencer D, Sales E, Okun S, Giampapa C, Anga A, Pacheco A, Smeltzer M, Osarogiagbon R. MA17.05 Intrapulmonary Lymph Node (LN) Retrieval With a Novel Gross Dissection Method: A Prospective, Population-Based Cohort Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.203] [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: 10/20/2022]
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4
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Englert H, Richards BL, Angelides S, Kumar V, Spencer D, Howe G, Manolios N. 99mTc-labelled glucosamine in the assessment of systemic sclerosis inflammatory lung disease: a novel inexpensive investigative tool with predictive value. Ann Nucl Med 2021; 35:1157-1166. [PMID: 34319547 DOI: 10.1007/s12149-021-01653-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the role of 99mTc-labelled glucosamine [99mTc-ECDG] as a clinical biomarker for the early detection of interstitial lung disease (ILD) in systemic sclerosis (SSc). METHODS In this prospective pilot study, glucosamine scanning (GS) was performed in 15 SSc patients, with and without ILD. Collected data included patient disease characteristics, autoantibody profile, GS results, high-resolution computerised tomography [HRCT], pulmonary function tests [PFT], and transthoracic echocardiogram [TTE]. Glucosamine results were correlated with patient clinical profile, HRCT, and PFT's findings. RESULTS Lung uptake of 99mTc-ECDG was high in 4 patients, moderate in 3, mild in 5, and normal in 3 with SSc, respectively. Of the patients with high and moderate uptake there was a 100% correlation between 99mTc-ECDG uptake and HRCT showing ILD. Of the 5 patients with mild 99mTc-ECDG uptake, 4 patients had aspiration pneumonia, and 1 had early ILD using HRCT. Of the 3 patients with normal 99mTc-ECDG, 2 had normal HRCTs; the third had severe pulmonary arterial hypertension with minimal HRCT changes of ILD. High and moderate 99mTc-ECDG lung uptake predicted abnormal PFT's in 100% of cases. In 3 patients, there was less extensive disease depicted on the 99mTc-ECDG scans than on the HRCT. These patients demonstrated a more favourable outcome than would have been expected from the HRCT scans alone. Mild 99mTc-ECDG lung uptake correlated with abnormal PFT's in 60% of cases. The pattern of 99mTc-ECDG uptake was excellent (100%) at distinguishing metabolically active ILD from aspiration pneumonia. Diffuse uptake was noted in the former and patchy uptake in the latter disease entity. CONCLUSION Increased 99mTc-ECDG uptake in scleroderma lung correlated positively with both structural and functional changes. 99mTc-ECDG is a useful adjunct helping elucidate inflammation secondary to aspiration pneumonia and/or other causes of abnormal PFT's.
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Affiliation(s)
- H Englert
- Staff Specialist Blacktown Hospital, Sydney, Australia.,Visiting Medical Officer Westmead Hospital, Sydney, NSW, Australia
| | - B L Richards
- Staff Specialist Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - S Angelides
- Nuclear Medicine Dept, Westmead Hospital, Westmead, Sydney, Australia. .,Faculty Medical Health, University of Sydney, Sydney, NSW, Australia.
| | - V Kumar
- Nuclear Medicine Dept, Westmead Hospital, Westmead, Sydney, Australia.,Faculty Medical Health, University of Sydney, Sydney, NSW, Australia
| | - D Spencer
- Visiting Medical Officer Westmead Hospital, Sydney, NSW, Australia.,Faculty Medical Health, University of Sydney, Sydney, NSW, Australia
| | - G Howe
- Rheumatology Department, Westmead Hospital, Sydney, Australia
| | - N Manolios
- Nuclear Medicine Dept, Westmead Hospital, Westmead, Sydney, Australia.,Rheumatology Department, Westmead Hospital, Sydney, Australia
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Smeltzer M, Lee YS, Faris N, Fehnel C, Houston-Harris C, Meadows-Taylor M, Ray M, Mahul A, Fullenwider J, Okun S, Spencer D, Sales E, Osarogiagbon R. OFP01.04 Improving Quality of Pathology Reports for Resected Non-Small Cell Lung Cancer (NSCLC) in the Mid-South US. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2020.10.036] [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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Barnett BP, Wahlin K, Krawczyk M, Spencer D, Welsbie D, Afshari N, Chao D. Potential of Ocular Transmission of SARS-CoV-2: A Review. Vision (Basel) 2020; 4:vision4030040. [PMID: 32883010 PMCID: PMC7559808 DOI: 10.3390/vision4030040] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE OF REVIEW to provide a prospective on the current mechanisms by which SARS-CoV-2 enters cells and replicates, and its implications for ocular transmission. The literature was analyzed to understand ocular transmission as well as molecular mechanisms by which SARS-CoV-2 enters cells and replicates. Analysis of gene expression profiles from available datasets, published immunohistochemistry, as well as current literature was reviewed, to assess the likelihood that ocular inoculation of SARS-CoV-2 results in systemic infection. RECENT FINDINGS The ocular surface and retina have the necessary proteins, Transmembrane Serine Protease 2 (TMPRSS2), CD147, Angiotensin-Converting Enzyme 2 (ACE2) and Cathepsin L (CTSL) necessary to be infected with SARS-CoV-2. In addition to direct ocular infection, virus carried by tears through the nasolacrimal duct to nasal epithelium represent a means of ocular inoculation. SUMMARY There is evidence that SARS-CoV-2 may either directly infect cells on the ocular surface, or virus can be carried by tears through the nasolacrimal duct to infect the nasal or gastrointestinal epithelium.
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Affiliation(s)
- Brad P. Barnett
- NVISION Eye Centers—South Sacramento, 7501 Hospital Dr. Suite 105, Sacramento, CA 95823, USA
- Correspondence: ; Tel.: +91-6423-4040; Fax: +91-6689-2100
| | - Karl Wahlin
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093, USA; (K.W.); (M.K.); (D.S.); (D.W.); (N.A.); (D.C.)
| | - Michal Krawczyk
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093, USA; (K.W.); (M.K.); (D.S.); (D.W.); (N.A.); (D.C.)
| | - Doran Spencer
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093, USA; (K.W.); (M.K.); (D.S.); (D.W.); (N.A.); (D.C.)
| | - Derek Welsbie
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093, USA; (K.W.); (M.K.); (D.S.); (D.W.); (N.A.); (D.C.)
| | - Natalie Afshari
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093, USA; (K.W.); (M.K.); (D.S.); (D.W.); (N.A.); (D.C.)
| | - Daniel Chao
- Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093, USA; (K.W.); (M.K.); (D.S.); (D.W.); (N.A.); (D.C.)
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Datte P, Baker J, Bliss D, Butler N, Celliers P, Cohen S, Crosley M, Edwards J, Erskine D, Fratanduono D, Frieders G, Galbraith J, Hess M, Johnson D, Jones M, LeChien K, Lusk J, Myers C, McCarville T, McDonald R, Natoni G, Olson M, Raman K, Robertson G, Shelton R, Shores J, Speas S, Spencer D, de Dios EV, Wong N. The design of a line velocity interferometer for any reflector for inertial confinement experiments on the Z-machine. Rev Sci Instrum 2020; 91:043508. [PMID: 32357683 DOI: 10.1063/1.5141093] [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] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/26/2020] [Indexed: 06/11/2023]
Abstract
A line VISAR (Velocity Interferometer System for Any Reflector) has been designed and commissioned at the Sandia National Laboratory's Z-machine. The instrument consists of an F/2 collection system, beam transport, and an interferometer table that contains two Mach-Zehnder type interferometers and an eight channel Gated Optical Imaging (GOI) system. The VISAR probe laser operates at the 532 nm wavelength, and the GOI bandpass is 540-600 nm. The output of each interferometer is passed to an optical streak camera with four selectable sweep speeds. The system is designed with three interchangeable optics modules to select a full field of view of 1 mm, 2 mm, or 4 mm. The optical beam transport system connects the target image plane to the interferometers and the gated optical imagers. The target is integrated into a sacrificial final optics assembly that is integral to the transport beamline.
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Affiliation(s)
- P Datte
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - J Baker
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - D Bliss
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - N Butler
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - P Celliers
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - S Cohen
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - M Crosley
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - J Edwards
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - D Erskine
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - D Fratanduono
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - G Frieders
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - J Galbraith
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - M Hess
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - D Johnson
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - M Jones
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - K LeChien
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - J Lusk
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - C Myers
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - T McCarville
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - R McDonald
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - G Natoni
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - M Olson
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - K Raman
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - G Robertson
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - R Shelton
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - J Shores
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - S Speas
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - D Spencer
- Sandia National Laboratory, P.O. Box 5800, Albuquerque, New Mexico 87185, USA
| | - E Vergel de Dios
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
| | - N Wong
- Lawrence Livermore National Laboratory, P.O. Box 808, Livermore, California 94551, USA
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Spencer D, Shepherd C. A045 An Exercise Based Cardiac Rehabilitation Programme is Associated with Significant Improvement in Psychological Health. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.05.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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9
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Shmueli O, Levy J, Patal R, Shelef I, Chowers I, Spencer D. Acquired unilateral visual deterioration: More to ischemia than meets the eye. Surv Ophthalmol 2019; 65:740-743. [PMID: 31887306 DOI: 10.1016/j.survophthal.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 12/20/2019] [Indexed: 11/26/2022]
Abstract
A 56-year-old woman presented with visual loss in the right eye with best-corrected visual acuity of 20/40. Funduscopic examination revealed neovascularization of the disk with peripapillary preretinal hemorrhages and leakage on fluorescein angiography. Cerebral arteriography demonstrated stenosis of the major cerebral vessels with classic collaterals configuring as "puff of smoke." A diagnosis of moyamoya-related ocular ischemic syndrome manifesting with optic disk neovascularization was made.
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Affiliation(s)
- Or Shmueli
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
| | - Jaime Levy
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Rani Patal
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ilan Shelef
- Radiological Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Itay Chowers
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Doran Spencer
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, California, USA
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Funk LM, Herron R, Spencer D, Dansereau L, Wrathall M. More than "petty squabbles" - Developing a contextual understanding of conflict and aggression among older women in low-income assisted living. J Aging Stud 2018; 48:1-8. [PMID: 30832925 DOI: 10.1016/j.jaging.2018.11.001] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/30/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
Abstract
Dominant approaches to relational aggression among older adults tend to conceptualize the problem as a behavioral or interpersonal issue, and can inadvertently infantilize the phenomenon as 'bullying.' In this article we use a narrative approach and the conceptual lens of precarity to develop an in-depth, theoretically informed analysis of relational aggression between older women in low-income assisted living. The analysis of the narratives of tenants (and a manager) indicated that past life experiences and intersecting threats to power and identity shaped and could intensify tenants' interpretations of and reactions to others' actions and comments. Conflicts over a) unequal distributions of caring labor, b) control of social activities, and c) access to appreciation are complex and rational responses to precarious contextual conditions. Findings contribute empirically to the body of research on relational aggression among older adults, expanding this field through connecting it to critical gerontological conceptualizations of precarity. Preventing relational aggression requires increased public investment in formal social supports for older adults, challenging dominant discourses that privilege independence, and recognizing how the legacies of past disadvantage and contextual precarity (as opposed to mental illness or dementia) shape social interactions with and responses to others.
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Affiliation(s)
- L M Funk
- Department of Sociology and Criminology, University of Manitoba, Canada.
| | - R Herron
- Department of Geography, Brandon University, Brandon, Manitoba R7A 6A9, Canada.
| | - D Spencer
- Department of Law and Legal Studies, Carleton University, Ottawa, Ontario K1S 5B6, Canada.
| | - L Dansereau
- Department of Community Health Sciences, University of Manitoba, R3E 0W3, Canada.
| | - M Wrathall
- Department of Sociology and Anthropology, University of Guelph, Winnipeg, Manitoba N1G 2W1, Canada.
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Honrado C, Ciuffreda L, Spencer D, Ranford-Cartwright L, Morgan H. Dielectric characterization of Plasmodium falciparum-infected red blood cells using microfluidic impedance cytometry. J R Soc Interface 2018; 15:rsif.2018.0416. [PMID: 30333248 PMCID: PMC6228484 DOI: 10.1098/rsif.2018.0416] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/05/2018] [Indexed: 02/07/2023] Open
Abstract
Although malaria is the world's most life-threatening parasitic disease, there is no clear understanding of how certain biophysical properties of infected cells change during the malaria infection cycle. In this article, we use microfluidic impedance cytometry to measure the dielectric properties of Plasmodium falciparum-infected red blood cells (i-RBCs) at specific time points during the infection cycle. Individual parasites were identified within i-RBCs using green fluorescent protein (GFP) emission. The dielectric properties of cell sub-populations were determined using the multi-shell model. Analysis showed that the membrane capacitance and cytoplasmic conductivity of i-RBCs increased along the infection time course, due to membrane alterations caused by parasite infection. The volume ratio occupied by the parasite was estimated to vary from less than 10% at earlier stages, to approximately 90% at later stages. This knowledge could be used to develop new label-free cell sorting techniques for sample pre-enrichment, improving diagnosis.
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Affiliation(s)
- C Honrado
- Faculty of Physical Sciences and Engineering, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - L Ciuffreda
- Institute of Infection, Immunity and Inflammation, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - D Spencer
- Faculty of Physical Sciences and Engineering, Institute for Life Sciences, University of Southampton, Southampton, UK
| | - L Ranford-Cartwright
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - H Morgan
- Faculty of Physical Sciences and Engineering, Institute for Life Sciences, University of Southampton, Southampton, UK
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McGrath JS, Honrado C, Spencer D, Horton B, Bridle HL, Morgan H. Analysis of Parasitic Protozoa at the Single-cell Level using Microfluidic Impedance Cytometry. Sci Rep 2017; 7:2601. [PMID: 28572634 PMCID: PMC5454013 DOI: 10.1038/s41598-017-02715-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 04/18/2017] [Indexed: 11/24/2022] Open
Abstract
At present, there are few technologies which enable the detection, identification and viability analysis of protozoan pathogens including Cryptosporidium and/or Giardia at the single (oo)cyst level. We report the use of Microfluidic Impedance Cytometry (MIC) to characterise the AC electrical (impedance) properties of single parasites and demonstrate rapid discrimination based on viability and species. Specifically, MIC was used to identify live and inactive C. parvum oocysts with over 90% certainty, whilst also detecting damaged and/or excysted oocysts. Furthermore, discrimination of Cryptosporidium parvum, Cryptosporidium muris and Giardia lamblia, with over 92% certainty was achieved. Enumeration and identification of (oo)cysts can be achieved in a few minutes, which offers a reduction in identification time and labour demands when compared to existing detection methods.
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Affiliation(s)
- J S McGrath
- Institute of Biological Chemistry, Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom
| | - C Honrado
- Faculty of Physical Sciences and Engineering and Institute for Life Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - D Spencer
- Faculty of Physical Sciences and Engineering and Institute for Life Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom
| | - B Horton
- Moredun Scientific, Pentlands Science Park, Bush Loan, Penicuik, Midlothian, EH26 0PZ, United Kingdom
| | - H L Bridle
- Institute of Biological Chemistry, Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom
| | - H Morgan
- Faculty of Physical Sciences and Engineering and Institute for Life Sciences, University of Southampton, Southampton, SO17 1BJ, United Kingdom.
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Jamieson L, Evans D, Brennan AT, Moyo F, Spencer D, Mahomed K, Maskew M, Long L, Rosen S, Fox MP. Changes in elevated cholesterol in the era of tenofovir in South Africa: risk factors, clinical management and outcomes. HIV Med 2017; 18:595-603. [PMID: 28332270 DOI: 10.1111/hiv.12495] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Antiretroviral therapy (ART) has been associated with unfavourable lipid profile changes and increased risk of cardiovascular disease (CVD). With a growing population on ART in South Africa, there has been concern about the increase in noncommunicable diseases such as CVD. We determined risk factors associated with increased total cholesterol (TC) in a large cohort on ART and describe the clinical management thereof. METHODS We conducted an observational cohort study of ART-naïve adults initiating standard first-line ART in a large urban clinic in Johannesburg, South Africa. TC was measured annually for most patients. A proportional hazards regression model was used to determine risk factors associated with incident high TC (≥ 6 mmol/L). RESULTS Significant risk factors included initial regimen non-tenofovir vs. tenofovir [hazard ratio (HR) 1.54; 95% confidence interval (CI) 1.14-2.08], age ≥40 vs. <30 years (HR 3.22; 95% CI 2.07-4.99), body mass index (BMI) ≥ 30 kg/m2 (HR 1.65; 95% CI 1.18-2.31) and BMI 25-29.9 kg/m2 (HR 1.70; 95% CI 1.30-2.23) vs. 18-24.9 kg/m2 , and baseline CD4 count < 50 cells/μL (HR 1.55; 95% CI 1.10-2.20) and 50-99 cells/μL (HR 1.40; 95% CI 1.00-1.97) vs. > 200 cells/μL. Two-thirds of patients with high TC were given cholesterol-lowering drugs, after repeat TC measurements about 12 months apart, while 31.8% were likely to have received dietary counselling only. CONCLUSIONS Older age, higher BMI, lower CD4 count and a non-tenofovir regimen were risk factors for incident elevated TC. Current guidelines do not indicate regular cholesterol testing at ART clinic visits, which are the main exposure to regular clinical monitoring for most HIV-positive individuals. If regular cholesterol monitoring is conducted, improvements can be made to identify and treat patients sooner.
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Affiliation(s)
- L Jamieson
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - D Evans
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - A T Brennan
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - F Moyo
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - D Spencer
- Right to Care, Johannesburg, South Africa
| | - K Mahomed
- Right to Care, Johannesburg, South Africa
| | - M Maskew
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - L Long
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - S Rosen
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - M P Fox
- Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Department of Global Health, Boston University School of Public Health, Boston, MA, USA
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Johnston S, Patel C, Wilson K, Spencer D, Rosenblatt L. THU0632 Retrospective Analysis of The Association between anti-cyclic Citrullinated Peptide Positivity and Healthcare Costs among Patients with Rheumatoid Arthritis Initiating Conventional Disease-Modifying Antirheumatic Drugs. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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15
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Rushworth D, Alpert A, Santana-Carrero R, Olivares S, Spencer D, Cooper LJN. Antithymidylate resistance enables transgene selection and cell survival for T cells in the presence of 5-fluorouracil and antifolates. Gene Ther 2015; 23:119-28. [PMID: 26273805 DOI: 10.1038/gt.2015.88] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/11/2015] [Accepted: 08/05/2015] [Indexed: 12/31/2022]
Abstract
Antithymidylates (AThy) constitute a class of drugs used in the treatment of cancers such as lung, colon, breast and pancreas. These drugs inhibit DNA synthesis by targeting the enzymes dihydrofolate reductase (DHFR) and/or thymidylate synthase (TYMS). AThys effectively inhibit cancer cells, and also inhibit T cells, preventing anticancer immunity, which might otherwise develop from AThy-induced cancer destruction. We establish that T cells expressing mutant DHFR--DHFR L22F, F31S (DHFR(FS))--and/or mutant TYMS--TYMS T51S, G52S (TYMS(SS))-effectively survive in toxic concentrations of AThys methotrexate, pemetrexed and 5-fluorouracil. Furthermore, we show that DHFR(FS) permitted rapid selection of an inducible suicide transgene in T cells. These findings demonstrate that AThy resistances prevent AThy cytotoxicity to T cells while permitting selection of important transgenes. This technological development could enhance in vitro and in vivo survival and selection of T-cell therapeutics being designed for a broad range of cancers.
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Affiliation(s)
- D Rushworth
- Division of Pediatrics, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Unit 907, Houston, TX, USA.,The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
| | - A Alpert
- The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
| | - R Santana-Carrero
- The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA.,University of Puerto Rico School of Medicine, San Juan, Puerto Rico, United States Minor Outlying Islands
| | - S Olivares
- Division of Pediatrics, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Unit 907, Houston, TX, USA
| | - D Spencer
- Bellicum Pharmaceuticals, Houston, TX, USA
| | - L J N Cooper
- Division of Pediatrics, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Unit 907, Houston, TX, USA.,The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA
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16
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Srivastava R, Khan AA, Spencer D, Vahed H, Lopes PP, Thai NTU, Wang C, Pham TT, Huang J, Scarfone VM, Nesburn AB, Wechsler SL, BenMohamed L. HLA-A02:01-restricted epitopes identified from the herpes simplex virus tegument protein VP11/12 preferentially recall polyfunctional effector memory CD8+ T cells from seropositive asymptomatic individuals and protect humanized HLA-A*02:01 transgenic mice against ocular herpes. J Immunol 2015; 194:2232-48. [PMID: 25617474 DOI: 10.4049/jimmunol.1402606] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The HSV type 1 tegument virion phosphoprotein (VP) 11/12 (VP11/12) is a major Ag targeted by CD8(+) T cells from HSV-seropositive individuals. However, whether and which VP11/12 epitope-specific CD8(+) T cells play a role in the "natural" protection seen in seropositive healthy asymptomatic (ASYMP) individuals (who have never had clinical herpes disease) remain to be determined. In this study, we used multiple prediction computer-assisted algorithms to identify 10 potential HLA-A*02:01-restricted CD8(+) T cell epitopes from the 718-aa sequence of VP11/12. Three of 10 epitopes exhibited high-to-moderate binding affinity to HLA-A*02:01 molecules. In 10 sequentially studied HLA-A*02:01-positive and HSV-1-seropositive ASYMP individuals, the most frequent, robust, and polyfunctional effector CD8(+) T cell responses, as assessed by a combination of tetramer frequency, granzyme B, granzyme K, perforin, CD107(a/b) cytotoxic degranulation, IFN-γ, and multiplex cytokines assays, were predominantly directed against three epitopes: VP11/1266-74, VP11/12220-228, and VP11/12702-710. Interestingly, ASYMP individuals had a significantly higher proportion of CD45RA(low)CCR7(low)CD44(high)CD62L(low)CD27(low)CD28(low)CD8(+) effector memory CD8(+) T cells (TEMs) specific to the three epitopes, compared with symptomatic individuals (with a history of numerous episodes of recurrent ocular herpetic disease). Moreover, immunization of HLA-A*02:01 transgenic mice with the three ASYMP CD8(+) TEM cell epitopes induced robust and polyfunctional epitope-specific CD8(+) TEM cells that were associated with a strong protective immunity against ocular herpes infection and disease. Our findings outline phenotypic and functional features of protective HSV-specific CD8(+) T cells that should guide the development of an effective T cell-based herpes vaccine.
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Affiliation(s)
- Ruchi Srivastava
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Arif A Khan
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Doran Spencer
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Hawa Vahed
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Patricia P Lopes
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Nhi Thi Uyen Thai
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Christine Wang
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Thanh T Pham
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Jiawei Huang
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Vanessa M Scarfone
- Stem Cell Research Center, University of California Irvine, Irvine, CA 92697
| | - Anthony B Nesburn
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697
| | - Steven L Wechsler
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697; Virology Research, Gavin Herbert Eye Institute and Department of Ophthalmology, University of California Irvine, School of Medicine, Irvine, CA 92697; Department of Microbiology and Molecular Genetics, University of California Irvine, School of Medicine, Irvine, CA 92697; Center for Virus Research, University of California Irvine, Irvine, CA 92697
| | - Lbachir BenMohamed
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, University of California Irvine, School of Medicine, Irvine, CA 92697; Department of Molecular Biology and Biochemistry, University of California Irvine, School of Medicine, Irvine, CA 92697; and Institute for Immunology, University of California Irvine, School of Medicine, Irvine, CA 92697
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Taggar A, Lau H, Lim G, Nordal R, Khan R, Breitman K, Hudson A, Spencer D, Voroney J. Outcomes From First 3 Years of Frameless Stereotactic Radiosurgery in Treating Brain Metastases. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1068] [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: 10/24/2022]
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18
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Spencer D. Long-term risk of stroke in children treated with growth hormone for short stature: Looking at the big picture. Neurology 2014; 83:e103-4. [DOI: 10.1212/wnl.0000000000000808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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19
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Jones MC, Ampleford DJ, Cuneo ME, Hohlfelder R, Jennings CA, Johnson DW, Jones B, Lopez MR, MacArthur J, Mills JA, Preston T, Rochau GA, Savage M, Spencer D, Sinars DB, Porter JL. X-ray power and yield measurements at the refurbished Z machine. Rev Sci Instrum 2014; 85:083501. [PMID: 25173263 DOI: 10.1063/1.4891316] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Advancements have been made in the diagnostic techniques to measure accurately the total radiated x-ray yield and power from z-pinch implosion experiments at the Z machine with high accuracy. The Z machine is capable of outputting 2 MJ and 330 TW of x-ray yield and power, and accurately measuring these quantities is imperative. We will describe work over the past several years which include the development of new diagnostics, improvements to existing diagnostics, and implementation of automated data analysis routines. A set of experiments on the Z machine were conducted in which the load and machine configuration were held constant. During this shot series, it was observed that the total z-pinch x-ray emission power determined from the two common techniques for inferring the x-ray power, a Kimfol filtered x-ray diode diagnostic and the total power and energy diagnostic, gave 449 TW and 323 TW, respectively. Our analysis shows the latter to be the more accurate interpretation. More broadly, the comparison demonstrates the necessity to consider spectral response and field of view when inferring x-ray powers from z-pinch sources.
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Affiliation(s)
- M C Jones
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - D J Ampleford
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - M E Cuneo
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - R Hohlfelder
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - C A Jennings
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - D W Johnson
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - B Jones
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - M R Lopez
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - J MacArthur
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - J A Mills
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - T Preston
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - G A Rochau
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - M Savage
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - D Spencer
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - D B Sinars
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
| | - J L Porter
- Sandia National Laboratories, Albuquerque, New Mexico 87185, USA
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20
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Samandary S, Kridane-Miledi H, Sandoval JS, Choudhury Z, Langa-Vives F, Spencer D, Chentoufi AA, Lemonnier FA, BenMohamed L. Associations of HLA-A, HLA-B and HLA-C alleles frequency with prevalence of herpes simplex virus infections and diseases across global populations: implication for the development of an universal CD8+ T-cell epitope-based vaccine. Hum Immunol 2014; 75:715-29. [PMID: 24798939 DOI: 10.1016/j.humimm.2014.04.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Revised: 04/15/2014] [Accepted: 04/15/2014] [Indexed: 02/01/2023]
Abstract
A significant portion of the world's population is infected with herpes simplex virus type 1 and/or type 2 (HSV-1 and/or HSV-2), that cause a wide range of diseases including genital herpes, oro-facial herpes, and the potentially blinding ocular herpes. While the global prevalence and distribution of HSV-1 and HSV-2 infections cannot be exactly established, the general trends indicate that: (i) HSV-1 infections are much more prevalent globally than HSV-2; (ii) over a half billion people worldwide are infected with HSV-2; (iii) the sub-Saharan African populations account for a disproportionate burden of genital herpes infections and diseases; (iv) the dramatic differences in the prevalence of herpes infections between regions of the world appear to be associated with differences in the frequencies of human leukocyte antigen (HLA) alleles. The present report: (i) analyzes the prevalence of HSV-1 and HSV-2 infections across various regions of the world; (ii) analyzes potential associations of common HLA-A, HLA-B and HLA-C alleles with the prevalence of HSV-1 and HSV-2 infections in the Caucasoid, Oriental, Hispanic and Black major populations; and (iii) discusses how our recently developed HLA-A, HLA-B, and HLA-C transgenic/H-2 class I null mice will help validate HLA/herpes prevalence associations. Overall, high prevalence of herpes infection and disease appears to be associated with high frequency of HLA-A(∗)24, HLA-B(∗)27, HLA-B(∗)53 and HLA-B(∗)58 alleles. In contrast, low prevalence of herpes infection and disease appears to be associated with high frequency of HLA-B(∗)44 allele. The finding will aid in developing a T-cell epitope-based universal herpes vaccine and immunotherapy.
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Affiliation(s)
- Sarah Samandary
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, CA 92697, USA
| | - Hédia Kridane-Miledi
- UNITE INSERM 1016, Institut Cochin, Hôpital Saint-Vincent-de-Paul, 82, Avenue Denfert-Rochereau, 75674 Paris Cedex 14, France
| | - Jacqueline S Sandoval
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, CA 92697, USA
| | - Zareen Choudhury
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, CA 92697, USA
| | - Francina Langa-Vives
- Plate-Forme Technologique, Centre d'Ingénierie Génétique Murine, Département de Biologie du Développement, Institut Pasteur, 75015 Paris, France
| | - Doran Spencer
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, CA 92697, USA
| | - Aziz A Chentoufi
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, CA 92697, USA
| | - François A Lemonnier
- UNITE INSERM 1016, Institut Cochin, Hôpital Saint-Vincent-de-Paul, 82, Avenue Denfert-Rochereau, 75674 Paris Cedex 14, France
| | - Lbachir BenMohamed
- Laboratory of Cellular and Molecular Immunology, Gavin Herbert Eye Institute, School of Medicine, University of California Irvine, Irvine, CA 92697, USA; Department of Molecular Biology & Biochemistry, University of California Irvine, Irvine, CA 92697, USA; Institute for Immunology, University of California Irvine, Irvine, CA 92697, USA.
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Abstract
Gross ascites is a rare presentation of lupus. Ascites in lupus may be due to lupus peritonitis or secondary to one of the complications including nephrotic syndrome. The ascites due to lupus peritonitis has been described as exudative with a serum-ascites albumin gradient (SAAG) below 11 g/L, unless associated with nephrotic syndrome. We report an unusual case of lupus ascites in a 23-year-old woman who presented with acute painless gross ascites with no constitutional, skin or musculoskeletal symptoms of a lupus flare. The ascites was a transudate with SAAG above 11 g/L with no associated nephrotic syndrome. She was treated with corticosteroids, mycophenolate mofetil and diuretics with a good response and no recurrence of her ascites.
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Affiliation(s)
- T Erfani
- Department of Rheumatology, Westmead Hospital, New South Wales, Australia
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22
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Manolios N, Burneikis A, Spencer D, Howe G. Failure of anti-TNF therapy to reactivate previously septic prosthetic joints. Case Reports 2013; 2013:bcr-2013-009827. [DOI: 10.1136/bcr-2013-009827] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Tong D, Manolios N, Howe G, Spencer D. New onset sarcoid-like granulomatosis developing during anti-TNF therapy: an under-recognised complication. Intern Med J 2012; 42:89-94. [PMID: 22389903 DOI: 10.1111/j.1445-5994.2011.02612.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Tumour necrosis factor-alpha (TNF-a) antagonists have advanced the treatment of inflammatory arthropathies, and are even considered for use in refractory sarcoidosis with some success. Paradoxically, cases of new onset sarcoidosis-like diseases are increasingly reported in patients receiving TNF-a antagonists. Here, we report three cases of sarcoid-like granulomatosis that developed during treatment with TNF-a antagonists. Review of the Biologics clinic data base at Westmead, Sydney, Australia identified three patients whom, during anti-TNF therapy, developed non-caseating granulomas consistent with sarcoidosis. These three cases are described with review of the literature from 2000 to 2009 using PubMed. One hundred and sixty-nine patients within our data base were reviewed for the period 2003–2009. Sarcoidosis-like granulomas developed in three patients within a period of 3 to 36 months of treatment with etanercept and/or adalimumab. All cases demonstrated non-infective, non-caseating granulomas on renal or lymph node biopsy. Improvement was seen in two cases upon cessation of TNF-a antagonist and steroid therapy. Interestingly, clinical deterioration was noted upon re-challenge with the same TNF-a antagonist in one patient. To date, a total of 37 cases of sarcoid-like granuloma development after anti-TNF therapy have been reported in the literature. Development of sarcoidosis-like granulomatosis in patients treated with TNF-a antagonists is a phenomenon previously under-recognised. All three anti-TNF agents have been observed to cause this phenomenon, suggesting a ‘class effect’ rather than being drug specific.
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Affiliation(s)
- D Tong
- Department of Rheumatology, Westmead Hospital, Sydney, New South Wales, Australia.
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24
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Stanley J, Dunscombe P, Spencer D. SU-E-T-548: Retrospective Evaluation of Stereotactic Radiosurgery Plans at the Tom Baker Cancer Centre. Med Phys 2011. [DOI: 10.1118/1.3612510] [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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25
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Osarogiagbon RU, Ramirez RA, Wang C, Miller LE, Ul-Haq M, Farooq A, Allen JW, Spencer D, Berry A, Weir AB, Cole H, O'Brien T. Survival analysis of patients with/without lymph node examination after lung cancer resection. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.7054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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26
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Teitelbaum A, Spencer D, Bollu VK, Chastek B, Coombs J, Kulakodlu M, Morlock R. Monitoring response and treatment outcome in patients with chronic phase chronic myeloid leukemia (CML) treated with imatinib. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e16612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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27
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Kirk A, Spencer D, Radwan A. P23 Effect of omalizumab on oral corticosteroid requirements of young children with severe asthma; results of a UK survey. Thorax 2010. [DOI: 10.1136/thx.2010.150961.23] [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: 11/03/2022]
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28
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Spencer D. Changing treatments for bacterial meningitis. Neurology 2010; 75:e71-2. [DOI: 10.1212/wnl.0b013e3181fd57a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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29
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Zhang Z, Zhong W, Hinrichs D, Wu X, Weinberg A, Hall M, Spencer D, Wegmann K, Rosenbaum JT. Activation of OX40 augments Th17 cytokine expression and antigen-specific uveitis. Am J Pathol 2010; 177:2912-20. [PMID: 20952591 DOI: 10.2353/ajpath.2010.100353] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Uveitis is a major and common cause of visual disability. Recent studies have shown that Th17 cells are implicated in the pathogenesis of this serious intraocular disorder. Activated T cells express an inducible costimulatory molecule called OX40, and OX40 in turn promotes the activation and proliferation of these lymphocytes. Nevertheless, it is unclear whether OX40 plays a vital role in enhancing the effector function of Th17 cells as well as the severity of uveitis. In this study, we demonstrated an increase of OX40 transcription in ovalbumin-induced uveitis, whereas anti-OX40L antibody substantially inhibited the antigen-specific ocular inflammation. Next, results from flow cytometry showed that activated Th17 cells expressed OX40, and OX40-activating antibody significantly augmented the production of Th17 cytokines in vitro. To validate the impact of OX40 in vivo, we stimulated ovalbumin-specific T cells with the OX40-activating antibody. Compared to donor cells without OX40 activation, adoptive transfer of OX40-stimulated lymphocytes elicited more severe ocular inflammation. Furthermore, an interleukin-17-neutralizing antibody attenuated OX40-mediated uveitis. In conclusion, our findings suggest that activation of OX40 augments Th17 cell function and thereby contributes to ocular inflammation. This study thus enhances our knowledge of costimulatory molecule-mediated immunopathological mechanisms of uveitis and suggests a future therapeutic strategy to treat uveitis by the targeting of OX40.
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Affiliation(s)
- Zili Zhang
- Departments of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA.
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Anderson A, Caraher M, Johnston S, Heslop K, O'Brien C, Spencer D, Bourke S. Transition to adulthood with cystic fibrosis: current characteristics and challenges. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60252-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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Spencer D, Perez-Torrealba JR, Kaura S, Henk HJ. A retrospective database analysis of treatment patterns and outcomes for multiple myeloma (MM) patients with malignant bone lesions (BM). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e18506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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32
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Kimura K, Spencer D, Bilardi R, Swift L, Box A, Brownlee R, Cutts S, Phillips D. Barminomycin, a Model for the Development of New Anthracyclines. Anticancer Agents Med Chem 2010; 10:70-7. [DOI: 10.2174/1871520611009010070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2009] [Accepted: 09/25/2009] [Indexed: 11/22/2022]
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33
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Smyth AR, Barbato A, Beydon N, Bisgaard H, de Boeck K, Brand P, Bush A, Fauroux B, de Jongste J, Korppi M, O'Callaghan C, Pijnenburg M, Ratjen F, Southern K, Spencer D, Thomson A, Vyas H, Warris A, Merkus PJ. Respiratory medicines for children: current evidence, unlicensed use and research priorities. Eur Respir J 2009; 35:247-65. [PMID: 19840958 DOI: 10.1183/09031936.00139508] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This European Respiratory Society task force has reviewed the evidence for paediatric medicines in respiratory disease occurring in adults and children. We describe off-licence use, research priorities and ongoing studies. Off-licence and off-label prescribing in children is widespread and potentially harmful. Research areas in asthma include novel formulations and regimens, and individualised prescribing. In cystic fibrosis, future studies will focus on screened infants and robust outcome measures are needed. Other areas include new enzyme and antibiotic formulations and the basic defect. Research into pneumonia should include evaluation of new antibacterials and regimens, rapid diagnostic tests and, in pleural infection, antibiotic penetration, fibrinolytics and surveillance. In uncommon conditions, such as primary ciliary dyskinesia, congenital pulmonary abnormalities or neuromuscular disorders, drugs indicated for other conditions (e.g. dornase alfa) are commonly used and trials are needed. In neuromuscular disorders, the beta-agonists may enhance muscle strength and are in need of evaluation. Studies of antibiotic prophylaxis, immunoglobulin and antifungal drugs are needed in immune deficiency. We hope that this summary of the evidence for respiratory medicines in children, highlighting gaps and research priorities, will be useful for the pharmaceutical industry, the paediatric committee of the European Medicines Agency, academic investigators and the lay public.
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Affiliation(s)
- A R Smyth
- University of Nottingham Division of Child Health, Queens Medical Centre, Nottingham, NG7 2UH, UK.
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Zhang Z, Zhong W, Hall MJ, Kurre P, Spencer D, Skinner A, O'Neill S, Xia Z, Rosenbaum JT. CXCR4 but not CXCR7 is mainly implicated in ocular leukocyte trafficking during ovalbumin-induced acute uveitis. Exp Eye Res 2009; 89:522-31. [PMID: 19524567 DOI: 10.1016/j.exer.2009.05.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2009] [Revised: 05/04/2009] [Accepted: 05/20/2009] [Indexed: 01/13/2023]
Abstract
Uveitis is an inflammatory ocular disease characterized by the infiltration of T lymphocytes and other leukocytes into the eye. The recruitment of these inflammatory cells from systemic vasculature to ocular tissue is a well-coordinated multistep process including rolling, firm adhesion and transmigration. CXCL12 (SDF-1alpha) is an endothelial cell-derived cytokine interacting with CXCR4 and CXCR7, two chemokine receptors mainly expressed in T cells, neutrophils and monocytes. Recent studies have shown that CXCR4, CXCR7 and their ligand, CXCL12, are important for the regulation of leukocyte mobilization and trafficking. However, it is unclear whether these two chemokine receptors are implicated in the pathogenesis of uveitis. In this study, we used DO11.10 mice, whose CD4+ T cells are genetically engineered to react with ovalbumin (OVA), to investigate the role of CXCR4 and CXCR7 in an animal model of uveitis. Intravital microscopy revealed that intravitreal OVA challenge of DO11.10 mice caused the infiltration of both T cells and neutrophils. The invasion of these inflammatory cells coincided with the detection of transcriptional up-regulation of CXCR4 and CXCR7 in the eye. In addition, both real-time-PCR and immunohistochemistry revealed an enhanced expression of endothelial CXCL12. Furthermore, intraperitoneal injection of AMD3100 (a specific CXCR4 antagonist) significantly attenuated OVA-induced uveitis and CXCL12-mediated transwell migration. In contrast, intraperitoneal administration of CXCR7 neutralizing antibody did not significantly alter ocular infiltration of inflammatory cells caused by OVA challenge. Our data suggest that CXCR4 but not CXCR7 plays a critical role in antigen-induced ocular inflammation by facilitating leukocyte infiltration. This study not only enhances our knowledge of the immunopathological mechanism of uveitis but also provides a novel rationale to target CXCR4 as an anti-inflammatory strategy to treat uveitis.
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Affiliation(s)
- Zili Zhang
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
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Farooq A, Osarogiagbon RU, Allen JW, O'Brien TF, Spencer D, Berry A. Accuracy and comprehensiveness of pathology reportage after lung cancer resection. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.6523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6523 Background: Decisions about prognosis, adjuvant chemo/radiation therapy and clinical trial eligibility require careful examination of the surgical resection specimen. In January 2004, the College of American Pathologists (CAP) and the American College of Surgeons Committee on Cancer mandated reportage of specific items after resection of lung cancer. The extent of compliance is unknown. Methods: We examined final pathology reports for all lung cancer resections in the Memphis Metropolitan Area from January 2004 to December 2007. End-points were the percentage of reports with each CAP item and the 6 most vital determinants of post-operative management and accuracy of TNM staging. Chi-square test was used for year to year comparisons. Results: Table 1 shows frequency of reportage of CAP items. Of those with reported pT stage, it was accurate in 242 of 263 (92.02%) identified as T1; 193 of 208 (92.79%) T2; 21 of 24 (87.5%) T3; 11 of 11 (100%) T4. The most common T-staging error, understaging of satellite nodules (T4), occurred in 12 of 21 (57%) mis-staged as T1, 11 of 15 (73%) T2, 3 of 3 (100%) T3. Overall, 62.6% of reports accurately identified pT-stage. Of those with reported pN-stage, 351 of 352 (99.7%) accurately identified N0; 69 of 81 (85.2%) accurately identified N1, 12 of 81 (14.81%) N1 designations were actually N2; 27 of 27 (100%) N2 designations were accurate; 31 of 34 (91.2%) identified as Nx (no lymph nodes in the specimen) were accurate, 3 (8.8%) were truly N0. Overall, 64.08% of reports accurately identified pN-stage. 4 of 503 identified as pMx (0.8%) had pM1. There was no change in proportion of incomplete and/or inaccurate pathology reports over the 4 years of analysis. Conclusions: Pathology evaluation of lung cancer resection specimens is frequently incomplete or inaccurate, potentially impairing clinical decision-making. Satellite nodules are often understaged. Simple corrective interventions such as enforcement of mandatory institutional utilization of the CAP checklist and AJCC staging manual need to be investigated. [Table: see text] [Table: see text]
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Affiliation(s)
- A. Farooq
- University of Tennessee, Memphis, TN; University of Tennessee Cancer Institute, Memphis, TN; Duckworth Pathology Group, Memphis, TN; Trumbull Labs, Memphis, TN; Saint Francis Hospital, Memphis, TN
| | - R. U. Osarogiagbon
- University of Tennessee, Memphis, TN; University of Tennessee Cancer Institute, Memphis, TN; Duckworth Pathology Group, Memphis, TN; Trumbull Labs, Memphis, TN; Saint Francis Hospital, Memphis, TN
| | - J. W. Allen
- University of Tennessee, Memphis, TN; University of Tennessee Cancer Institute, Memphis, TN; Duckworth Pathology Group, Memphis, TN; Trumbull Labs, Memphis, TN; Saint Francis Hospital, Memphis, TN
| | - T. F. O'Brien
- University of Tennessee, Memphis, TN; University of Tennessee Cancer Institute, Memphis, TN; Duckworth Pathology Group, Memphis, TN; Trumbull Labs, Memphis, TN; Saint Francis Hospital, Memphis, TN
| | - D. Spencer
- University of Tennessee, Memphis, TN; University of Tennessee Cancer Institute, Memphis, TN; Duckworth Pathology Group, Memphis, TN; Trumbull Labs, Memphis, TN; Saint Francis Hospital, Memphis, TN
| | - A. Berry
- University of Tennessee, Memphis, TN; University of Tennessee Cancer Institute, Memphis, TN; Duckworth Pathology Group, Memphis, TN; Trumbull Labs, Memphis, TN; Saint Francis Hospital, Memphis, TN
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Zhang Z, Zhong W, Spencer D, Chen H, Lu H, Kawaguchi T, Rosenbaum JT. Interleukin-17 causes neutrophil mediated inflammation in ovalbumin-induced uveitis in DO11.10 mice. Cytokine 2009; 46:79-91. [PMID: 19254849 DOI: 10.1016/j.cyto.2008.12.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 11/05/2008] [Accepted: 12/29/2008] [Indexed: 10/21/2022]
Abstract
T cell-mediated uveitis is strongly associated with many systemic inflammatory disorders. Th17 cells are a novel T cell subset characterized by production of interleukin (IL)-17. In this study, we used DO11.10 mice to investigate the role of IL-17 in the pathogenesis of uveitis. CD4(+) T cells in DO11.10 mice are genetically engineered to react with ovalbumin (OVA). IL-17 expression was determined by real-time PCR and ELISPOT. Uveitis was induced by intravitreal injection of OVA, and ocular inflammation was evaluated by intravital microscopy. OVA challenge significantly induced IL-17 production by DO11.10 splenocytes in vitro. Next, we examined whether OVA challenge could elicit local inflammation and induce IL-17 in vivo. OVA elicited marked neutrophil-predominant inflammatory cell infiltration in the eyes. This leukocyte influx was mediated by CD4(+) lymphocytes as evidenced by significant inhibition of the ocular inflammation by CD4+ depleting antibody. Compared to control mice, OVA treatment induced IL-17 expression. Moreover, anti-IL-17 antibody markedly reduced OVA-mediated ocular inflammation. Finally, the neutralization of IL-17 attenuated ocular expression of CXCL2 and CXCL5, two cytokines which are chemotactic for neutrophils. Our study suggests that IL-17 is implicated in the pathogenesis of this T cell-mediated model of uveitis in part through neutrophil chemotaxis as a downstream effect of IL-17.
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Affiliation(s)
- Zili Zhang
- Department of Pediatrics, Oregon Health & Science University, Portland, OR 97239, USA.
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Arvidson R, Adams D, Bonfiglio G, Christensen P, Cull S, Golombek M, Guinn J, Guinness E, Heet T, Kirk R, Knudson A, Malin M, Mellon M, McEwen A, Mushkin A, Parker T, Seelos F, Seelos K, Smith P, Spencer D, Stein T, Tamppari L. Mars Exploration Program 2007 Phoenix landing site selection and characteristics. ACTA ACUST UNITED AC 2008. [DOI: 10.1029/2007je003021] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [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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Sewell A, Sharpe C, Bloomer J, Spencer D. Newborn screening in the northern region difficulties and dilemmas. J Cyst Fibros 2008. [DOI: 10.1016/s1569-1993(08)60376-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nygren I, Spencer D. SU-GG-T-441: A New Method of Measuring the Accuracy of Stereotactic Cones and MLC with Gantry and Collimator Rotation. Med Phys 2008. [DOI: 10.1118/1.2962189] [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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Clark JE, Hammal D, Hampton F, Spencer D, Parker L. Epidemiology of community-acquired pneumonia in children seen in hospital. Epidemiol Infect 2007; 135:262-9. [PMID: 17291362 PMCID: PMC2870565 DOI: 10.1017/s0950268806006741] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2006] [Indexed: 11/06/2022] Open
Abstract
There is little UK data on hospital admission rates for childhood pneumonia, lobar pneumonia, severity or risk factors. From 13 hospitals serving the catchment population, demographic and clinical details were prospectively collected between 2001 and 2002 for children aged 0-15 years, seen by a paediatrician with community-acquired pneumonia (CAP) and consistent chest X-ray changes. From 750 children assessed in hospital, incidence of CAP was 14.4 (95% CI 13.4-15.4)/10,000 children per year and 33.8 (95% CI 31.1-36.7) for <5-year-olds; with an incidence for admission to hospital of 12.2 (95% CI 11.3-13.2) and 28.7 (95% CI 26.2-31.4) respectively. Where ascertainment was confirmed, incidence of CAP assessed in hospital was 16.1 (95% CI 14.9-17.3) and 41.0 (95% CI 37.7-44.5) in the 0-4 years age group, whilst incidence for hospital admission was 13.5 (95% CI 12.4-14.6) and 32 (95% CI 29.1-35.1) respectively. In the <5 years age group incidence of lobar pneumonia was 5.6 (95% CI 4.5-6.8)/10,000 per year and severe disease 19.4 (95% CI 17.4-21.7)/10,000 per year. Risk of severe CAP was significantly increased for those aged <5 years (OR 1.50, 95% CI 1.07-2.11) and with prematurity, OR 4.02 (95% CI 1.16-13.85). It also varied significantly by county of residence. This is a unique insight into the burden of hospital assessments and admissions caused by childhood pneumonia in the United Kingdom and will help inform future preventative strategies.
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Affiliation(s)
- J E Clark
- Department of Paediatric Infectious Disease, Newcastle General Hospital, Newcastle, UK.
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Niendorf T, Spencer D, Ruhl K, Kuehl HP, Kouwenhoven M, Guenther RW. Highly accelerated, millimeter in-plane resolution myocardial perfusion imaging using a 32-channel 3.0 T MR system. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-972145] [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: 10/21/2022]
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Abstract
Most doctors can identify key papers that have influenced their approach to the management of a particular clinical problem, although sometimes the gestation period of this effect can be very prolonged. In this short review I discuss the effects of a seminal paper by Sheila Mackenzie from the early 1990s on my current approach to the diagnosis and management of chronic cough in children.
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Affiliation(s)
- D Spencer
- Department of Respiratory Paediatrics, Regional Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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Smith W, Spencer D. Po-Thur Eve General-13: Commissioning a gated kV imaging system. Med Phys 2006. [DOI: 10.1118/1.2244640] [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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Spencer D, White RG, Wildman SG. Distribution of chlorophyll-bearing organelles in the shoot apex of a range of dicotyledonous plants. Protoplasma 2005; 225:185-90. [PMID: 15997337 DOI: 10.1007/s00709-005-0082-x] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2004] [Accepted: 10/20/2004] [Indexed: 05/03/2023]
Abstract
Confocal laser scanning microscopy was used to study the distribution of the smallest detectable autofluorescing, chlorophyll-bearing structures in fresh, 40 microm thick longitudinal sections of the shoot apex of four dicotyledonous plants (Arabidopsis thaliana, Nicotiana glauca, Lupinus alba, and Spinacia oleracea). In all species, the smallest chlorophyll-bearing particles were found in the outermost cell layers (L1 and L2) of the shoot apex. Their distribution between these layers differed in each species. The smallest such particles were about 0.5-1.0 microm in maximum dimension, approximating the size of a single granum in the developing leaf. Their size and abundance increased with increasing cell age and distance from the peak of the apex. Immediately beneath the L1 and L2 layers was a zone largely devoid of these particles. Below this nonfluorescing zone, in the region where the derivatives of the meristematic zone differentiate into cells of the central pith region, the size and abundance of the chlorophyll-bearing particles increased progressively with increasing distance from the nonfluorescing zone. The presence of these small autofluorescing particles in the L1 and L2 cell layers of the shoot apex places the development of photosystem II fluorescence at an earlier stage of leaf development than previously observed. The use of confocal laser scanning microscopy to study unfixed sections provides another useful metabolic marker for mapping patterns of differentiation and development in the cells of the shoot apex.
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Affiliation(s)
- D Spencer
- CSIRO Plant Industry, Canberra, A.C.T., Australia
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Igna C, Spencer D, Kay I, Chan A, Kiss Z, Frayne R. Sci-YIS Fri - 08: Regional change in brain perfusion after fractionated stereotactic radiotherapy (FSRT) at 4 months and 3 years follow-up. Med Phys 2005. [DOI: 10.1118/1.2031030] [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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48
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Spencer D, Igna C, Kay I, Chan A, Kiss Z, Frayne R. SU-EE-A4-01: Regional Change in Brain Perfusion, in Irradiated Normal Tissue: Correlation Study Between Perfusion MRI and Spatial Distribution of Radiation Dose Delivered. Med Phys 2005. [DOI: 10.1118/1.1997465] [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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Balfour-Lynn IM, Abrahamson E, Cohen G, Hartley J, King S, Parikh D, Spencer D, Thomson AH, Urquhart D. BTS guidelines for the management of pleural infection in children. Thorax 2005; 60 Suppl 1:i1-21. [PMID: 15681514 PMCID: PMC1766040 DOI: 10.1136/thx.2004.030676] [Citation(s) in RCA: 232] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- I M Balfour-Lynn
- Consultant in Paediatric Respiratory Medicine, Royal Brompton Hospital, Syndey St, SW3 6NP London, UK.
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Ignacio RC, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha PA. Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc 2003; 18:334-7. [PMID: 14691696 DOI: 10.1007/s00464-003-8927-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.9] [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: 07/28/2003] [Accepted: 09/15/2003] [Indexed: 12/23/2022]
Abstract
BACKGROUND The comparison of laparoscopic to open appendectomy has been reviewed in many retrospective and prospective studies. Some report shorter hospital stays, less postoperative pain, and earlier return to work while others fail to demonstrate such differences. We performed a prospective, randomized double-blinded trial to evaluate this ongoing debate. METHODS Fifty-two consecutive men presenting with signs and symptoms suggestive of acute appendicitis were randomized to undergo either laparoscopic appendectomy or open appendectomy. Length of operative times, hospital stay, lost work days, visual analog pain scores, and operative costs were compared. RESULTS Length of stay averaged 21.5 h for the laparoscopic group and was not statistically different when compared to the open group. Perceived postoperative pain on postoperative days 1 and 7 were not statistically different between the two groups. Mean time to return to work was 11 days, and there was no statistical difference between groups. Operative costs were >600 dollars greater for the laparoscopic approach. CONCLUSIONS In this prospective randomized double-blinded trial, laparoscopic appendectomy appears to confer no significant advantage over open appendectomy for postoperative pain or lost work days. It does carry an increase in operating room costs and, contrary to other reports, hospital stay is not shortened. Further studies are needed to determine if specific populations, such as the obese or women, may benefit from a minimally invasive approach to appendicitis.
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Affiliation(s)
- R C Ignacio
- Department of General Surgery, Naval Medical Center-Portsmouth, Charette Health Care Center, 27 Effingham Street, Portsmouth, VA 23708-2197, USA
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