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Heuberger CE, Janney A, Ilott N, Bertocchi A, Pott S, Gu Y, Pohin M, Friedrich M, Mann EH, Pearson C, Powrie FM, Pott J, Thornton E, Maloy KJ. MHC class II antigen presentation by intestinal epithelial cells fine-tunes bacteria-reactive CD4 T cell responses. Mucosal Immunol 2023:S1933-0219(23)00032-6. [PMID: 37209960 DOI: 10.1016/j.mucimm.2023.05.001] [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: 01/23/2023] [Revised: 04/18/2023] [Accepted: 05/01/2023] [Indexed: 05/22/2023]
Abstract
Although intestinal epithelial cells (IECs) can express major histocompatibility complex class II (MHC II), especially during intestinal inflammation, it remains unclear if antigen presentation by IECs favours pro- or anti-inflammatory CD4+ T cell responses. Using selective gene ablation of MHC II in IECs and IEC organoid cultures, we assessed the impact of MHC II expression by IECs on CD4+ T cell responses and disease outcomes in response to enteric bacterial pathogens. We found that intestinal bacterial infections elicit inflammatory cues that greatly increase expression of MHC II processing and presentation molecules in colonic IECs. Whilst IEC MHC II expression had little impact on disease severity following Citrobacter rodentium or Helicobacter hepaticus infection, using a colonic IEC organoid-CD4+ T cell co-culture system, we demonstrate that IECs can activate antigen-specific CD4+ T cells in an MHC II-dependent manner, modulating both regulatory and effector Th cell subsets. Furthermore, we assessed adoptively transferred H. hepaticus-specific CD4+ T cells during intestinal inflammation in vivo and report that IEC MHC II expression dampens pro-inflammatory effector Th cells. Our findings indicate that IECs can function as non-conventional antigen presenting cells and that IEC MHC II expression fine-tunes local effector CD4+ T cell responses during intestinal inflammation.
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Affiliation(s)
- C E Heuberger
- Sir William Dunn School of Pathology, University of Oxford, United Kingdom; Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - A Janney
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - N Ilott
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - A Bertocchi
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - S Pott
- Department of Human Genetics, University of Chicago, United States
| | - Y Gu
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - M Pohin
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - M Friedrich
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom; Translational Gastroenterology Unit, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - E H Mann
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - C Pearson
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - F M Powrie
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - J Pott
- Sir William Dunn School of Pathology, University of Oxford, United Kingdom; Kennedy Institute of Rheumatology, University of Oxford, United Kingdom
| | - E Thornton
- Kennedy Institute of Rheumatology, University of Oxford, United Kingdom; current address: MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, United Kingdom
| | - K J Maloy
- School of Infection and Immunity, University of Glasgow, Glasgow, Great Britain.
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O’Shea A, Foran AT, Murray TE, Thornton E, Dunne R, Lee MJ, Morrin MM. Quality of same-day CT colonography following incomplete optical colonoscopy. Eur Radiol 2020; 30:6508-6516. [DOI: 10.1007/s00330-020-06979-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 04/17/2020] [Accepted: 05/25/2020] [Indexed: 01/25/2023]
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O'Shea A, Murray T, Morrin MM, Lee MJ, Thornton E. Incidence of clinically significant perforation at low dose non-contrast CT and its value prior to same day CT colonography following incomplete colonoscopy. Abdom Radiol (NY) 2020; 45:1044-1048. [PMID: 31123769 DOI: 10.1007/s00261-019-02062-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE Routine low dose non-contrast CT of the abdomen and pelvis has been suggested prior to same day completion CT colonography (CTC) to assess for occult perforation at preceding incomplete colonoscopy, before further gaseous insufflation at CTC. The aim of our study is to examine the incidence of clinically significant perforation at low dose CT. We also examine the benefits of low dose pre-scan in assessing adequacy of bowel preparation and identifying any other relevant contraindications to CT colonography. MATERIALS AND METHODS We conducted a retrospective review of all low dose non-contrast CTs performed following failed colonoscopies over a 4-year period (n = 392). We also assessed the adequacy of bowel preparation on a scale of 1-5, in order of increasingly adequate preparation. Incidentally noted bowel pathology and contraindications to CT colonography were also recorded. RESULTS No perforation was identified either prospectively or in the course of our retrospective review. However, 15 patients (3.8%) were found to have potential contraindications to CT colonography, including: acute diverticulitis, acute colitis, and poor bowel preparation. Overall, the bowel preparation was felt to be adequate (≥ 3) in 86% percent of patients. Two patients (0.5%) identified prospectively had their CT colonography postponed due to poor bowel preparation.
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Affiliation(s)
- Aileen O'Shea
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
| | - Timothy Murray
- Vancouver General Hospital, 899 W 12th Avenue, Vancouver, V5Z 1M9, Canada
| | | | | | - Eavan Thornton
- Bon Secours Hospital, Glasnevin Hill, Botanic, D09 YN97, Dublin 9, Ireland
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O'Neill DC, Murray TE, Thornton E, Burke J, Dunne R, Lee MJ, Morrin MM. Imaging features of Benign Perianal lesions. J Med Imaging Radiat Oncol 2019; 63:617-623. [PMID: 31368659 DOI: 10.1111/1754-9485.12934] [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: 03/24/2019] [Accepted: 07/03/2019] [Indexed: 01/16/2023]
Abstract
Magnetic resonance imaging provides detailed visualisation, identification and extent assessment of many anal disorders. While many studies are performed in the evaluation of malignant processes such as anorectal carcinoma, the primary focus of this pictorial review is benign lesions, which involve the anal canal and perianal spaces. This pictorial review will illustrate the MRI appearances of a variety of benign conditions, which predominantly affect the anal canal, including abscess, fistulae, lipomas, developmental cysts and inflammatory conditions. MRI aids in the identification and characterisation of these abnormalities, of coexisting complications and differentiation from other perineal abnormalities. This pictorial review highlights the spectrum of non-malignant processes involving the perianal region.
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Affiliation(s)
| | | | - Eavan Thornton
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - John Burke
- Department of Surgery, Beaumont Hospital, Dublin, Ireland
| | - Ruth Dunne
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
| | - Michael J Lee
- Department of Radiology, Beaumont Hospital, Dublin, Ireland
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Battle CE, Lynch C, Thorpe C, Biggs S, Grobbelaar K, Morgan A, Roberts S, Thornton E, Hobrok M, Pugh R. Incidence and risk factors for alopecia in survivors of critical illness: A multi-centre observational study. J Crit Care 2018; 50:31-35. [PMID: 30471558 DOI: 10.1016/j.jcrc.2018.11.015] [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: 08/22/2018] [Revised: 10/03/2018] [Accepted: 11/14/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the incidence, nature and risk factors for patient-reported alopecia in survivors of critical illness. MATERIALS AND METHODS A multi-centre, mixed methods observational study in the intensive care units (ICU) of ten hospitals in Wales. All patients with an ICU stay of 5 days or more, able to give consent were included. Demographic variables and risk factors were collected. A pre-designed survey was completed at three months post-ICU discharge. Statistical analysis included numbers and percentages (categorical variables) and medians and interquartile ranges (continuous variables). Comparisons between patients with and without alopecia were made using Fisher's Exact test (categorical variables) and Mann Whitney U test (continuous variables). Multivariate logistic regression analysis was used to determine the risk factors for alopecia. RESULTS The survey was completed by 123 patients with alopecia reported in 44 (36%) patients. The only risk factor for alopecia on analysis was sepsis / septic shock (p < .001; OR: 5.1, 95%CI: 2.1-12.4). CONCLUSIONS Limited research exists examining the incidence, nature and risk factors for patient-reported alopecia in adult survivors of critical illness. The results of this study highlight the need to discuss the potential for alopecia with survivors of critical illness, who had sepsis / septic shock.
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Affiliation(s)
- C E Battle
- Ed Major Critical Care Unit, Morriston Hospital, Swansea, SA6 6NL Wales, UK.
| | - C Lynch
- Intensive Care Unit, Royal Glamorgan Hospital, Llantrisant, UK.
| | - C Thorpe
- Department of Anaesthetics and Intensive Care Medicine, Ysbyty Gwynedd, Bangor, UK.
| | - S Biggs
- Physiotherapy Dept, Royal Gwent Hospital, Newport, UK.
| | - K Grobbelaar
- Physiotherapy Dept, Nevill Hall Hospital, Abergavenny, UK.
| | - A Morgan
- Physiotherapy Dept, Glangwili General Hospital, Carmarthen, UK.
| | - S Roberts
- Physiotherapy Dept, Princess of Wales Hospital, Bridgend, UK.
| | - E Thornton
- Physiotherapy Dept, University Hospital Wales, Cardiff, UK.
| | - M Hobrok
- Intensive Care Unit, Bronglais General Hospital, Aberystwyth, UK.
| | - R Pugh
- Department of Anaesthetics, Glan Clwyd Hospital, Bodelwyddan, Denbighshire, UK..
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Thornton E, Howard SA, Jagannathan J, Krajewski KM, Shinagare AB, O'Regan K, Cleary JM, Ramaiya NH. Imaging features of bowel toxicities in the setting of molecular targeted therapies in cancer patients. Br J Radiol 2012; 85:1420-6. [PMID: 22674709 DOI: 10.1259/bjr/19815818] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Molecular targeted therapies are becoming ubiquitous in cancer treatment. These drugs may cause gastrointestinal toxicities including perforation, pneumatosis, enteritis, colitis and fistula formation. Knowledge of these complications and their management enables early radiological identification and appropriate intervention, reducing patient morbidity and mortality.
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Affiliation(s)
- E Thornton
- Department of Imaging, Dana-Farber Cancer Institute, Boston, MA, USA
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Thornton E, Krajewski KM, O'Regan KN, Giardino AA, Jagannathan JP, Ramaiya N. Imaging features of primary and secondary malignant tumours of the sacrum. Br J Radiol 2011; 85:279-86. [PMID: 22167504 DOI: 10.1259/bjr/25247602] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Malignant tumours of the sacrum may be primary or secondary. While sacral metastases are frequently encountered, a diagnostic dilemma can present when there is a single sacral bone tumour with no history or evidence of malignancy elsewhere in the body. Familiarity with the imaging features and clinical presentations of primary malignant bone tumours is helpful in narrowing the differential. This pictorial review will illustrate with both common and uncommon malignant sacral tumours CT, MRI and positron emission tomography/CT, highlighting the specific features of each.
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Affiliation(s)
- E Thornton
- Department of Imaging, Dana Farber Cancer Institute, Boston, MA 02115, USA.
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Chakrabarti B, Ando H, Thornton E, Ford V, Young CA, Angus RM. P156 Does analysis of patient-ventilator interaction offer benefits in addition to overnight pulse oximetry in patients with motor neurone disease being followed on non-invasive ventilation? Thorax 2010. [DOI: 10.1136/thx.2010.151043.7] [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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Thornton E, Brook OR, Mendiratta-Lala M, Hallett DT, Kruskal JB. Application of failure mode and effect analysis in a radiology department. Radiographics 2010; 31:281-93. [PMID: 20980666 DOI: 10.1148/rg.311105018] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
With increasing deployment, complexity, and sophistication of equipment and related processes within the clinical imaging environment, system failures are more likely to occur. These failures may have varying effects on the patient, ranging from no harm to devastating harm. Failure mode and effect analysis (FMEA) is a tool that permits the proactive identification of possible failures in complex processes and provides a basis for continuous improvement. This overview of the basic principles and methodology of FMEA provides an explanation of how FMEA can be applied to clinical operations in a radiology department to reduce, predict, or prevent errors. The six sequential steps in the FMEA process are explained, and clinical magnetic resonance imaging services are used as an example for which FMEA is particularly applicable. A modified version of traditional FMEA called Healthcare Failure Mode and Effect Analysis, which was introduced by the U.S. Department of Veterans Affairs National Center for Patient Safety, is briefly reviewed. In conclusion, FMEA is an effective and reliable method to proactively examine complex processes in the radiology department. FMEA can be used to highlight the high-risk subprocesses and allows these to be targeted to minimize the future occurrence of failures, thus improving patient safety and streamlining the efficiency of the radiology department.
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Affiliation(s)
- Eavan Thornton
- Department of Radiology, Beth Israel Deaconess Medical Center, 1 Deaconess Rd, Boston, MA 02215, USA.
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Brook OR, O’Connell AM, Thornton E, Eisenberg RL, Mendiratta-Lala M, Kruskal JB. Quality Initiatives: Anatomy and Pathophysiology of Errors Occurring in Clinical Radiology Practice. Radiographics 2010; 30:1401-10. [DOI: 10.1148/rg.305105013] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Mendiratta-Lala M, Brook OR, Midkiff BD, Brennan DD, Thornton E, Faintuch S, Sheiman RG, Goldberg SN. Quality initiatives: strategies for anticipating and reducing complications and treatment failures in hepatic radiofrequency ablation. Radiographics 2010; 30:1107-22. [PMID: 20442337 DOI: 10.1148/rg.304095202] [Citation(s) in RCA: 20] [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] [Indexed: 12/15/2022]
Abstract
Radiofrequency (RF) ablation is one of several local treatment strategies that can be used for the destruction of a variety of primary and secondary liver tumors. As experience with RF ablation grows, it becomes increasingly evident that successful ablation requires meticulous technique. In addition, knowledge of potential complications is critical for both the interventionalist and the radiologist, whose postablation interpretation can facilitate identification of complications and treatment failures. Hepatic RF ablation offers significant advantages in that it is less invasive than surgery and carries a low risk of major complications. Successful prevention of complications and treatment failures begins at initial consultation and continues with preablation evaluation of specific patient factors such as coagulation profiles, use of medications, and risk factors for infection. Other predisposing factors include background liver cirrhosis, prior hepatectomy, and portal hypertension. During ablation, careful attention must be given to tumor size, number, and location. For large or multiple ablations, separate ablation sessions can help reduce the prevalence of postablation syndrome, and clustered electrodes and multiple overlapping treatment zones may be used to reduce the risk of treatment failure. It is critical to reevaluate tumors during ablation to determine the best approach and to compensate for changes in size and relative location due to patient positioning. With use of these strategies, hepatic RF ablation can be performed with greater safety, better patient tolerance, and a reduced risk of complications and treatment failures.
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Affiliation(s)
- Mishal Mendiratta-Lala
- Department of Radiology, Beth Israel Deaconess Medical Center, One Deaconess Rd, W/ML 302, Boston, MA 02215, USA.
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Grimsley L, Horner W, White L, Mitchell H, Kennedy S, El-Dahr J, Cohn R, Sterling Y, Mvula M, Stephens K, Lichtveld M, Thornton E, Chulada P, Martin W. Trend Analysis Of New Orleans Outdoor Mold Spore Counts: A Comparison Of Heal Preliminary Data And Post-katrina Mold Concentrations. J Allergy Clin Immunol 2010. [DOI: 10.1016/j.jaci.2009.12.949] [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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Loftus L, Davies A, Thornton E, Turnbull C. P1.210 Negative reactions to receiving spousal care in older Parkinson's disease patients: the role of depression. Parkinsonism Relat Disord 2009. [DOI: 10.1016/s1353-8020(09)70332-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Foster A, Given M, Thornton E, Geoghegan T, Keeling F, McGrath F, Lee MJ. Removal of T-Fasteners 2 Days After Gastrostomy is Feasible. Cardiovasc Intervent Radiol 2008; 32:317-9. [PMID: 19082660 DOI: 10.1007/s00270-008-9473-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Revised: 10/24/2008] [Accepted: 10/30/2008] [Indexed: 01/25/2023]
Affiliation(s)
- A Foster
- Department of Academic Radiology, Beaumont Hospital, Dublin 9, Ireland
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McOrist S, Thornton E, Peake A, Walker R, Robson S, Finlaison D, Kirkland P, Reece R, Ross A, Walker K, Hyatt A, Morrissy C. An infectious myocarditis syndrome affecting late-term and neonatal piglets. Aust Vet J 2008; 82:509-11. [PMID: 15359968 DOI: 10.1111/j.1751-0813.2004.tb11172.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S McOrist
- QAF Meat Industries, Corowa, New South Wales 2646
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Thornton E. Strategies for implementation of an asthma counseling intervention: From research to the “real world”. J Allergy Clin Immunol 2005. [DOI: 10.1016/j.jaci.2004.12.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sarpong S, Quartey R, Greeley S, Thornton E, Brown R, Reece E, Kwagyan J, Ford E, Malveaux F. Asthma counseling: A strategy for reducing asthma symptoms. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80358-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Thornton E. Viscosity and Thermal Conductivity of Binary Gas Mixtures: Xenon-Krypton, Xenon-Argon, Xenon-Neon and Xenon-Helium. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0370-1328/76/1/313] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Thornton E, Harris RR. Use of an infrared scanning thermometer for calorimetric measurement of a pulsed high current electron beam. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0022-3735/6/11/032] [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] [Indexed: 11/11/2022]
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Dougan CF, Connell CO, Thornton E, Young CA. Development of a patient-specific dyspnoea questionnaire in motor neurone disease (MND): the MND dyspnoea rating scale (MDRS). J Neurol Sci 2000; 180:86-93. [PMID: 11090871 DOI: 10.1016/s0022-510x(00)00415-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Motor neurone disease (MND) is a progressive, unremitting and fatal disease. Respiratory dysfunction is common and a significant cause of morbidity. The relationship between subjective dyspnoea and objective measures of lung function have been unexplored in MND. Increasing interest in the specific treatment of respiratory symptoms in MND has highlighted the need for simple, reliable and valid measures to quantify the degree of dyspnoea in this condition. Several generic questionnaires have been developed to rate subjective breathlessness but are inappropriate for use in MND patients as they often assess dyspnoea by exercise-limitation. As yet, there are no published disease-specific measures to assess dyspnoea in MND. In order to accurately and reproducibly measure the subjective experience of dyspnoea in this patient group, we have developed and validated a novel patient-specific dyspnoea questionnaire, the MND dyspnoea rating scale (MDRS). It comprises three domains covering dyspnoea, emotion and mastery and is valid for use in MND patients at all stages of disease progression. In our cohort of 40 unselected patients with MND we have shown that the patients subjective experience of dyspnoea is closely related to emotion and psychological control over the disease. Dyspnoea is not related to objective measures of lung function such as vital capacity, irrespective of limb or bulbar presentation. In conclusion, vital capacity, although useful prognostically, is only one aspect of respiratory function in MND. The MDRS is a reliable and valid tool to rate subjective dyspnoea in MND.
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Affiliation(s)
- C F Dougan
- Walton Centre for Neurology and Neurosurgery, Lower Lane, Fazakerley, Liverpool L9 7LJ, UK
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Nicolaides A, Thornton E. The process of writing a scientific paper. INT ANGIOL 2000; 19:184-90. [PMID: 10905804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- A Nicolaides
- Irvine Laboratory for Cardiovascular Investigation and Research, St. Mary's Hospital, London, UK
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Abstract
A scale based on underlying core beliefs generated by the experience of epilepsy was developed. The scale, with measures of coping, adaptability, and knowledge, was used to examine the commonly-reported differences in emotional adjustment between patients (EP) and a non-epileptic population (NEP). The EP had significantly lower perceived self efficacy and was more depressed and anxious than the NEP controls. The NEP showed greater knowledge of medical aspects of epilepsy than the EP. Positive correlations between scale values and measures of mastery, self esteem, affect balance, felt stigma and impact of epilepsy were found. Factor analysis produced a three factor solution of emotion, knowledge and anxiety which explained 61.6% of the variance in scores. Results are discussed in terms of Bandura's theory of self efficacy as the motivating and sustaining force in the ability to change behaviour. Core beliefs are central to both the development and maintenance of anxiety and depression in epilepsy patients and need to be addressed in any attempts at remedial intervention.
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Affiliation(s)
- S Tedman
- Department of Psychology, University of Liverpool, UK
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Scudamore CL, Pennington AM, Thornton E, McMillan L, Newlands GF, Miller HR. Basal secretion and anaphylactic release of rat mast cell protease-II (RMCP-II) from ex vivo perfused rat jejunum: translocation of RMCP-II into the gut lumen and its relation to mucosal histology. Gut 1995; 37:235-41. [PMID: 7557574 PMCID: PMC1382724 DOI: 10.1136/gut.37.2.235] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The kinetics of the release of rat mast cell protease-II (RMCP-II) from mucosal mast cells in the jejunum of Nippostrongylus brasiliensis primed (immune) rats was investigated using ex vivo perfusion of a segment of jejunum through the cranial mesenteric artery. The aim of the study was to assess the role of the protease in anaphylaxis and in particular to ascertain whether it is responsible for the histological changes, which include widespread epithelial shedding, seen in the mucosa in in vivo models of anaphylaxis. Perfusion of the jejunal vasculature with a Krebs-Ringer buffer showed that there was basal secretion of RMCP-II by jejunal mast cells in all rats studied. The baseline concentration of RMCP-II was significantly greater (p < 0.05) in immune rats (> 7 ng/ml) previously exposed to nippostrongylus infection than in control, naive animals (< 2 ng/ml). Challenge of immune rats with 100 or 400 worm equivalents of whole worm antigen resulted in an immediate (within 40 seconds) and significant (p < 0.02) increase in the concentration of RMCP-II (to > 3 micrograms/ml) in the vascular perfusate, which was not seen in naive rats or immune rats challenged with an irrelevant antigen. Greater amounts of RMCP-II were also recovered from the jejunal lumen of immune rats compared with naive rats after challenge of both groups with worm antigen. Despite the release of microgram quantities of RMCP-II into the gut lumen and vascular perfusate, however, there were no significant changes seen in the mucosal histology. These results suggest that RMCP-II alone is not responsible fore the loss of gut epithelium seen during anaphylaxis in the rat.
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Affiliation(s)
- C L Scudamore
- Department of Veterinary Clinical Studies, Veterinary Field Station, Easter Bush, Roslin, Midlothian
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Wallace WA, Roberts SN, Caldwell H, Thornton E, Greening AP, Lamb D, Howie SE. Circulating antibodies to lung protein(s) in patients with cryptogenic fibrosing alveolitis. Thorax 1994; 49:218-24. [PMID: 8202877 PMCID: PMC1021149 DOI: 10.1136/thx.49.3.218] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND It has been hypothesised that cryptogenic fibrosing alveolitis has an immunological pathogenesis mediated by T lymphocytes. It is, however, recognised that patients may show dysregulation of the humoral immune system and that the presence of large numbers of B lymphocytes in open lung biopsies may be associated with a poor prognosis. Evidence of a role for the humoral immune system in the pathogenesis of cryptogenic fibrosing alveolitis has been suggested, but attempts to demonstrate circulating immunoglobulin to antigen within the lung have been inconclusive. METHODS Plasma samples from 22 patients with cryptogenic fibrosing alveolitis, 22 patients with sarcoidosis, and 17 healthy controls were screened by SDS-PAGE and Western blotting for the presence of autoantibodies to lung proteins derived from cryptogenic fibrosing alveolitis, sarcoid and control lung tissue, as well as four normal non-pulmonary tissues. Possible site(s) of target protein(s) within the lung tissue were identified by immunohistochemical examination using IgG purified from the plasma of six patients and two controls. RESULTS Eighteen of the plasma samples from patients with cryptogenic fibrosing alveolitis had reactive IgG to lung protein(s) in the 70-90 kDa molecular weight range compared with five of 18 plasma samples from patients with sarcoidosis and one of 17 controls. Plasma from patients with cryptogenic fibrosing alveolitis recognised antigen(s) of the same molecular weight in control and sarcoid lung tissue, but not non-pulmonary tissues, with a similar frequency. Immunohistochemical staining of cryptogenic fibrosing alveolitis biopsy material using IgG purified from plasma samples from patients with cryptogenic fibrosing alveolitis, but not control samples, revealed fine linear positivity in the lung parenchyma in a pattern suggestive of reaction with alveolar lining cells. The pattern was cytoplasmic/membranous and not nuclear. CONCLUSIONS Patients with cryptogenic fibrosing alveolitis have a high frequency of plasma IgG autoantibodies to protein(s) within lung tissue associated with alveolar lining cells. This is believed to be the site where immunological injury occurs in cryptogenic fibrosing alveolitis, but the significance of these antibodies to the aetiology and pathogenesis is as yet unclear.
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Affiliation(s)
- W A Wallace
- Department of Pathology, Edinburgh University Medical School, UK
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Howie SE, Aldridge RD, McVittie E, Thornton E, Ramage E, Hunter JA. A non-radiolabelledin situhybridization method for the detection of epidermal cytokine mRNA. Exp Dermatol 1992; 1:230-5. [PMID: 1365324 DOI: 10.1111/j.1600-0625.1992.tb00081.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We describe a non-radiolabelled method for the in situ detection of epidermal cytokine mRNA in paraffin sections of skin biopsies from sites of nickel contact sensitivity. The method uses fluorescein isothiocyanate-labelled oligonucleotide exon probe cocktails.
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Affiliation(s)
- S E Howie
- Department of Dermatology, University of Edinburgh, Scotland
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Abstract
Previous research has indicated that training in the martial arts leads to a reduction in levels of hostility. However, such research has only compared hostility within martial arts groups. The present research compares two martial arts groups and two other sporting groups on levels of assaultive, verbal and indirect hostility. Moderated multiple regression analyses revealed a significant interaction between length of training in the respondent's stated sport and whether that sport was a martial art in predicting assaultive and verbal hostility. The form of the interaction suggests that participation in the martial arts is associated, over time, with decreased feelings of assaultive and verbal hostility.
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Affiliation(s)
- K Daniels
- School of Management, Cranfield Institute of Technology, Bedfordshire, UK
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di Giovine FS, Malawista SE, Thornton E, Duff GW. Urate crystals stimulate production of tumor necrosis factor alpha from human blood monocytes and synovial cells. Cytokine mRNA and protein kinetics, and cellular distribution. J Clin Invest 1991; 87:1375-81. [PMID: 2010550 PMCID: PMC295177 DOI: 10.1172/jci115142] [Citation(s) in RCA: 178] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Crystals of monosodium urate (MSU) provide a dose-dependent stimulus for the production by human blood monocytes of tumor necrosis factor (TNF), a cytokine with proinflammatory properties; TNF activity was inhibited selectively by monoclonal antibody to TNF alpha. Biologically active cell-associated TNF activity peaked at 3 h and was exceeded at 6 h by extracellular activity, which peaked at 12-18 h. Comparable kinetics were observed with immunoreactive TNF alpha. TNF alpha mRNA accumulation in monocytes stimulated with MSU crystals appeared as a single peak at 2-4 h, kinetics compatible with rapid production of a short half-life transcript. In contrast, crystals of calcium pyrophosphate or of hydroxyapatite did not stimulate significant production of TNF or of message. Fresh tophaceous material from a patient with gout contained significant levels of TNF alpha and cells cultured from the tophus produced TNF alpha in vitro. In rheumatoid synovial cells, spontaneous release of TNF alpha was increased by in vitro exposure to MSU crystals. Taken together with earlier work, these results support an expanded view of gouty inflammation in which the crystal-stimulated production of cytokines provides a crucial link between crystal deposition and many of the clinical and pathological facts of both acute and chronic gouty arthritis.
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Affiliation(s)
- F S di Giovine
- University Department of Medicine, Northern General Hospital, Edinburgh, United Kingdom
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Abstract
Tiaprofenic acid is a non-steroidal anti-inflammatory drug which also has hypouriceamic effect. Studies involving 10 healthy volunteers were designed to investigate the mode of this effect. We postulate that the site of action of tiaprofenic acid is at the cell membrane, the mechanism being an interference with the transport of uric acid from intra- to extra-cellular fluid thus limiting its passage into the plasma. The same mechanism acting on renal tubular cells impedes reabsorption thereby increasing uric acid clearance.
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Affiliation(s)
- V Lyfar
- Department of Biochemistry, Royal Sussex County Hospital, Brighton, UK
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Thornton E, Vollenweider M, Hirschel B. [Acquired immunodeficiency syndrome and opportunistic infections in a female]. Schweiz Med Wochenschr 1983; 113:28-30. [PMID: 6600850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Case report on a 49-year-old woman who contracted acute hepatitis B during a trip to Haiti in 1977. The hepatitis healed and the patient was in good health until July 1982 when she died of pneumocystis carinii pneumonia despite early treatment. This case resembles the acquired immune deficiency syndrome recently described in the United States among homosexuals and Haitians.
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Glencross D, Thornton E. Position sense following joint injury. J Sports Med Phys Fitness 1981; 21:23-7. [PMID: 7278217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Saihan EM, Burton JL, Meyrick G, Speller DC, Thornton E, Chestney V. The effect of a topical antibiotic preparation in acne vulgaris--a controlled clinical and laboratory study. Br J Clin Pract 1981; 35:106-9. [PMID: 6455138] [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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