1
|
Madela F, Anderson F, Nhlonzi GB, Thomson SR. HIV associated malignancies presenting as acute pancreatitis: a case series. S AFR J SURG 2023; 61:45-47. [PMID: 38450696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
BACKGROUND Acute pancreatitis (AP) may be the presenting symptom in a small percentage of patients harbouring pancreatic or extra pancreatic tumours. This case series aims to describe the pathological spectrum of tumours detected in two AP cohorts from a high HIV-endemic region. METHODS Prospectively collected databases of patients admitted with AP over two periods 2001 to 2010 and 2013 to 2015, were retrospectively evaluated to detect those with pancreatic and extra-pancreatic tumours. The diagnosis of AP was by standard criteria. HIV infection and CD4 counts were routinely tested for in the latter period and only tested on clinical grounds in the initial period. CT scan was performed when there was diagnostic doubt, predicted severe disease, and failure to improve clinically after one week. Demographic, clinical, investigative, and pathology details were collected and presented. RESULTS HIV-positive patients admitted with AP were 106 (17%) of 628 in the first period and 90 (38%) of 238 of the second period. No tumours were diagnosed in the HIV-negative patients. Seven of the HIV-positive patients had tumours diagnosed at endoscopy, CT scan, and endoscopic retrograde cholangiography. Of the seven HIV-positive patients with tumours, two patients had a CD4 count above 200. There were four patients with lymphoma involving the pancreatic head, three having associated cholestasis, and three patients with Kaposi's Sarcoma. One Kaposi's sarcoma patient died three months after presentation. One patient with lymphoma died on day 14 and another two months after initial presentation, and the remaining four patients were referred to oncology. CONCLUSION Despite their rarity (< 4%), when HIV-positive patients with low CD4 count and cholestasis present with AP,tumours should be suspected and evaluated by cross sectional imaging and endoscopic ultrasound.
Collapse
Affiliation(s)
- F Madela
- Department of Surgery, Surgical Gastroenterology, University of KwaZulu-Natal, South Africa
| | - F Anderson
- Department of Surgery, Surgical Gastroenterology, University of KwaZulu-Natal, South Africa
| | - G B Nhlonzi
- Department of Anatomical pathology, University of KwaZulu-Natal, South Africa
| | - S R Thomson
- Division of Gastroenterology, Department of Medicine, University of Cape Town, South Africa
| |
Collapse
|
2
|
Madela F, Anderson F, Nhlonzi GB, Thomson SR. HIV associated malignancies presenting as acute pancreatitis: a case series. S AFR J SURG 2023; 61:234-236. [PMID: 37877269 DOI: 10.36303/sajs.3511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
BACKGROUND Acute pancreatitis (AP) may be the presenting symptom in a small percentage of patients harbouring pancreatic or extra pancreatic tumours. This case series aims to describe the pathological spectrum of tumours detected in two AP cohorts from a high HIV-endemic region. METHODS Prospectively collected databases of patients admitted with AP over two periods 2001 to 2010 and 2013 to 2015, were retrospectively evaluated to detect those with pancreatic and extra-pancreatic tumours. The diagnosis of AP was by standard criteria. HIV infection and CD4 counts were routinely tested for in the latter period and only tested on clinical grounds in the initial period. CT scan was performed when there was diagnostic doubt, predicted severe disease, and failure to improve clinically after one week. Demographic, clinical, investigative, and pathology details were collected and presented. RESULTS HIV-positive patients admitted with AP were 106 (17%) of 628 in the first period and 90 (38%) of 238 of the second period. No tumours were diagnosed in the HIV-negative patients. Seven of the HIV-positive patients had tumours diagnosed at endoscopy, CT scan, and endoscopic retrograde cholangiography. Of the seven HIV-positive patients with tumours, two patients had a CD4 count above 200. There were four patients with lymphoma involving the pancreatic head, three having associated cholestasis, and three patients with Kaposi's Sarcoma. One Kaposi's sarcoma patient died three months after presentation. One patient with lymphoma died on day 14 and another two months after initial presentation, and the remaining four patients were referred to oncology. CONCLUSION Despite their rarity (< 4%), when HIV-positive patients with low CD4 count and cholestasis present with AP, tumours should be suspected and evaluated by cross sectional imaging and endoscopic ultrasound.
Collapse
Affiliation(s)
- F Madela
- Department of Surgery, Surgical Gastroenterology, University of KwaZulu-Natal, South Africa
| | - F Anderson
- Department of Surgery, Surgical Gastroenterology, University of KwaZulu-Natal, South Africa
| | - G B Nhlonzi
- Department of Anatomical pathology, University of KwaZulu-Natal, South Africa
| | - S R Thomson
- Division of Gastroenterology, Department of Medicine, University of Cape Town, South Africa
| |
Collapse
|
3
|
Makofane TN, Clarke DL, Anderson F, Ferndale L. The utility of the bedside index of severity in acute pancreatitis at prognosticating adverse outcomes. S AFR J SURG 2023; 61:100-103. [PMID: 37381808 DOI: 10.36303/sajs.3857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Identification of at-risk patients with acute pancreatitis (AP) early on in the course of hospital admission remains a challenge. Early identification of these patients can facilitate early referral to tertiary hospitals with skilled multidisciplinary teams (MDTs) and high-dependency health care facilities. This study retrospectively reviewed the ability of the bedside index of severity in acute pancreatitis (BISAP) score and other biochemical markers to predict organ failure and mortality in acute pancreatitis. METHODS All patients presenting to Grey's Hospital with AP between 2012 and 2020 were included in the study. The BISAP score and other biomarkers were evaluated at presentation in predicting organ failure (≥ 48 hours duration) and mortality. RESULTS A total of 235 patients were included in the study. A total of 144 (61%) were male and 91 (39%) were female. Alcohol (81%) and gallstones (69%) were the commonest aetiological factors amongst males and females respectively. A total of 42 (29%) males and 10 (11%) females developed organ failure during their hospital stay. The mortality rate was 11.8% for males, 6.59% for females, with an overall mortality of 9.8%. A BISAP score of 2 had a sensitivity of 87.98% and specificity of 59.62% at predicting organ failure (positive predictive value [PPV] = 88.46%, negative predictive value [NPV] = 58.49%, 95% confidence interval [CI], p = 0.001). A BISAP score of 3 and above had a sensitivity of 98.11% and specificity of 69.57% at predicting mortality (PPV = 96.74%, NPV = 80%, 95% CI, p = 0.001). A multivariate analysis of biomarkers bicarbonate, base excess, lactate, urea and creatinine either failed to reach statistical significance or had specificity that is too low to prognosticate organ failure and mortality. CONCLUSION The BISAP score has limitations at predicting organ failure, but it is a reliable tool for predicting mortality in AP. Due to its simplicity of use, it should be used in resource-constrained settings to triage at-risk patients in smaller hospitals, for early referral to tertiary hospitals.
Collapse
Affiliation(s)
- T N Makofane
- Department of Surgery, University of KwaZulu-Natal, South Africa
| | - D L Clarke
- Department of Surgery, University of KwaZulu-Natal, South Africa
| | - F Anderson
- Clinical Unit Surgical Gastroenterology, Inkosi Albert Luthuli Central Hospital, South Africa
| | - L Ferndale
- Clinical Unit Surgical Gastroenterology, Grey's Hospital, University of KwaZulu-Natal, South Africa
| |
Collapse
|
4
|
Sithole MSA, Madela FG, Buthelezi-Zulu TN, Lusu T, Mody K, Nyakale NE, Pillay V, Hadebe BP, Anderson F. Spectrum and surgical outcomes of gastrointestinal stromal tumours. S AFR J SURG 2022; 60:248-253. [PMID: 36477053 DOI: 10.17159/2078-5151/sajs3721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Surgery and imatinib are the mainstays of the management of gastrointestinal stromal tumours (GIST). This study aimed to analyse the outcomes in the management of GIST utilising surgery and imatinib. METHODS Progression-free survival (PFS) and overall survival (OS) were analysed in relation to imatinib therapy, location of tumour, resection margins, type and extent of surgery. Imatinib was administered in the neoadjuvant (maximum 12 months) and adjuvant setting (minimum 36 months) and until disease progression or drug intolerance. Disease response was assessed with the Choi criteria. Survival analysis included calculation of PFS, OS and Kaplan-Meier curves. RESULTS Sixty-two patients were reviewed and 56 had surgical resection. The median age (range) was 58.5 (8-95) years. The median PFS and OS (IQR) was 24.0 (0-52.0) and 41.0 (15.0-74.0) months, respectively. Thirty-nine (70%) patients were treated with imatinib, with 21 of these in a neoadjuvant setting. In the patients undergoing surgery, surgical margins were R0, R1 and R2 in 41 (75%), eight (15%) and six (11%) respectively. There was an insignificant difference in the overall survival in these three groups. For those having liver metastasectomy and multivisceral resection, the PFS and OS were 32.5 (17.5-60.3) and 28.5 (5.75-49.8) (p = 0.008), and 96.0 (58.5-116) and 80 (50.5-92.3) months (p = 0.033), respectively. CONCLUSION Whilst the numbers were small, certain trends were observed. Surgery in combination with imatinib offers survival benefit in patients undergoing R0, R1, R2, liver metastases and multivisceral resections.
Collapse
Affiliation(s)
- M S A Sithole
- Department of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa
| | - F G Madela
- Department of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa and GI Oncology Multidisciplinary Team, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa
| | - T N Buthelezi-Zulu
- GI Oncology Multidisciplinary Team, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa
| | - T Lusu
- GI Oncology Multidisciplinary Team, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa
| | - K Mody
- GI Oncology Multidisciplinary Team, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa
| | - N E Nyakale
- GI Oncology Multidisciplinary Team, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa and Department of Nuclear Medicine, Sefako Makgatho Health Sciences University and Dr George Mukhari Academic Hospital, South Africa
| | - V Pillay
- GI Oncology Multidisciplinary Team, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa
| | - B P Hadebe
- GI Oncology Multidisciplinary Team, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa
| | - F Anderson
- Department of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa and GI Oncology Multidisciplinary Team, Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, South Africa
| |
Collapse
|
5
|
Servais L, Benguerba K, De Vivo D, Kirschner J, Muntoni F, Proud C, Tizzano E, Saito K, Raju D, LaMarca N, Sun R, Anderson F, Faulkner E, Finkel R. P.105 Safety and effectiveness of onasemnogene abeparvovec (OA) alone or with other disease-modifying therapies (DMTs): Findings from RESTORE. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.190] [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: 11/06/2022]
|
6
|
Serrero MC, Girault V, Weigang S, Greco TM, Ramos-Nascimento A, Anderson F, Piras A, Hickford Martinez A, Hertzog J, Binz A, Pohlmann A, Prank U, Rehwinkel J, Bauerfeind R, Cristea IM, Pichlmair A, Kochs G, Sodeik B. The interferon-inducible GTPase MxB promotes capsid disassembly and genome release of herpesviruses. eLife 2022; 11:e76804. [PMID: 35475759 PMCID: PMC9150894 DOI: 10.7554/elife.76804] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/22/2022] [Indexed: 11/18/2022] Open
Abstract
Host proteins sense viral products and induce defence mechanisms, particularly in immune cells. Using cell-free assays and quantitative mass spectrometry, we determined the interactome of capsid-host protein complexes of herpes simplex virus and identified the large dynamin-like GTPase myxovirus resistance protein B (MxB) as an interferon-inducible protein interacting with capsids. Electron microscopy analyses showed that cytosols containing MxB had the remarkable capability to disassemble the icosahedral capsids of herpes simplex viruses and varicella zoster virus into flat sheets of connected triangular faces. In contrast, capsids remained intact in cytosols with MxB mutants unable to hydrolyse GTP or to dimerize. Our data suggest that MxB senses herpesviral capsids, mediates their disassembly, and thereby restricts the efficiency of nuclear targeting of incoming capsids and/or the assembly of progeny capsids. The resulting premature release of viral genomes from capsids may enhance the activation of DNA sensors, and thereby amplify the innate immune responses.
Collapse
Affiliation(s)
- Manutea C Serrero
- Institute of Virology, Hannover Medical SchoolHannoverGermany
- RESIST - Cluster of Excellence, Hannover Medical SchoolHannoverGermany
| | | | - Sebastian Weigang
- Institute of Virology, Freiburg University Medical Center, University of FreiburgFreiburgGermany
| | - Todd M Greco
- Department of Molecular Biology, Princeton UniversityPrincetonUnited States
| | | | - Fenja Anderson
- Institute of Virology, Hannover Medical SchoolHannoverGermany
| | - Antonio Piras
- Institute of Virology, Technical University MunichMunichGermany
| | | | - Jonny Hertzog
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of OxfordOxfordUnited Kingdom
| | - Anne Binz
- Institute of Virology, Hannover Medical SchoolHannoverGermany
- RESIST - Cluster of Excellence, Hannover Medical SchoolHannoverGermany
- German Center for Infection Research (DZIF), Hannover-Braunschweig Partner SiteHannoverGermany
| | - Anja Pohlmann
- Institute of Virology, Hannover Medical SchoolHannoverGermany
- RESIST - Cluster of Excellence, Hannover Medical SchoolHannoverGermany
- German Center for Infection Research (DZIF), Hannover-Braunschweig Partner SiteHannoverGermany
| | - Ute Prank
- Institute of Virology, Hannover Medical SchoolHannoverGermany
| | - Jan Rehwinkel
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, Radcliffe Department of Medicine, University of OxfordOxfordUnited Kingdom
| | - Rudolf Bauerfeind
- Research Core Unit Laser Microscopy, Hannover Medical SchoolHannoverGermany
| | - Ileana M Cristea
- Department of Molecular Biology, Princeton UniversityPrincetonUnited States
| | - Andreas Pichlmair
- Institute of Virology, Technical University MunichMunichGermany
- German Center for Infection Research (DZIF), Munich Partner siteMunichGermany
| | - Georg Kochs
- Institute of Virology, Freiburg University Medical Center, University of FreiburgFreiburgGermany
| | - Beate Sodeik
- Institute of Virology, Hannover Medical SchoolHannoverGermany
- RESIST - Cluster of Excellence, Hannover Medical SchoolHannoverGermany
- German Center for Infection Research (DZIF), Hannover-Braunschweig Partner SiteHannoverGermany
| |
Collapse
|
7
|
Payne CE, Anderson F, Pannier L, Pethick DW, Gardner GE. Bone mineral concentration predicted by dual energy X-ray absorptiometry and its relationship with lamb eating quality. Meat Sci 2021; 186:108725. [PMID: 35078013 DOI: 10.1016/j.meatsci.2021.108725] [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: 04/14/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
Lumbar bone mineral concentration, as predicted by dual energy x-ray absorptiometry (DEXA), may reflect changes in lamb maturity and eating quality. New season (n = 60) and old season (n = 60) lambs were slaughtered and DEXA scanned at a commercial abattoir across 2 kill groups. The second lumbar vertebra was isolated from the spine for determination of calcium, phosphorus, and magnesium concentration (mg/g). The loin and rack cuts were collected for consumer sensory grilling and roasting analyses. Mineral concentration was significantly higher in old season lambs within kill group 1 (P < 0.05). DEXA was a positive predictor of phosphorus and calcium concentration, but only when DEXA lean % (P < 0.05) was included in the model. Calcium and phosphorus were significant positive predictors of overall liking scores (P < 0.05), but only for the rack roast. These effects became insignificant when DEXA lean % was included. These results suggest that DEXA values likely reflect changes in both DEXA lean % and bone minerals, and that DEXA lean % was the driver of eating quality, rather than maturity.
Collapse
Affiliation(s)
- C E Payne
- Australian Cooperative Research Centre for Sheep Industry Innovation, Australia; Murdoch University, College of Science, Health, Engineering and Education, Western Australia 6150, Australia; Department of Primary Industries and Regional Development, Western Australia 6151, Australia.
| | - F Anderson
- Murdoch University, College of Science, Health, Engineering and Education, Western Australia 6150, Australia
| | - L Pannier
- Murdoch University, College of Science, Health, Engineering and Education, Western Australia 6150, Australia
| | - D W Pethick
- Australian Cooperative Research Centre for Sheep Industry Innovation, Australia; Murdoch University, College of Science, Health, Engineering and Education, Western Australia 6150, Australia
| | - G E Gardner
- Australian Cooperative Research Centre for Sheep Industry Innovation, Australia; Murdoch University, College of Science, Health, Engineering and Education, Western Australia 6150, Australia
| |
Collapse
|
8
|
Anderson F, Payne C, Pannier L, Pethick D, Gardner G. The potential for dual energy X-ray absorptiometry to predict lamb eating quality. Meat Sci 2021; 181:108434. [DOI: 10.1016/j.meatsci.2021.108434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/25/2022]
|
9
|
Servais L, De Vivo D, Kirschner J, Mercuri E, Muntoni F, Tizzano E, Roy S, Saito K, Menier M, LaMarca N, Anderson F, Dabbous O, Finkel R. SMA - TREATMENT. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.314] [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]
|
10
|
Servais L, Day J, De Vivo D, Mercuri E, Muntoni F, Shieh P, Tizzano E, Desguerre I, Saito K, Menier M, LaMarca N, Anderson F, Dabbous O, Finkel R. SMA - TREATMENT. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.316] [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]
|
11
|
Walkom SF, Gardner GE, Anderson F, Williams A, Brown DJ. Capturing lean distribution in lamb carcases is of more value to the processor than the breeder. Meat Sci 2021; 181:108524. [PMID: 33896686 DOI: 10.1016/j.meatsci.2021.108524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/20/2020] [Revised: 04/13/2021] [Accepted: 04/13/2021] [Indexed: 10/21/2022]
Abstract
With an increased implementation of chain speed measures of lean weight in lamb processing plants there is the potential for increased feedback of measures for carcase composition to the breeder. The following studies used computed tomography scans of 3167 Merino and Merino cross lamb carcases to determine the importance of capturing variation in carcase, fore, saddle and hind section lean to the processor and the breeder. Sectional measures of lean weight will provide processors with improved precision around the decision making associated with carcase processing and endpoint usage. Genetic correlations between lean (adjusted for carcase weight) within carcase sections ranged from 0.47 to 0.63. Whilst the correlations are moderate, current differences in the value of lean across the carcase does not make it viable for sheep breeders to target disproportional gains in lean across carcase sections. Instead, sheep breeders should continue to target overall carcase lean as part of their breeding objective.
Collapse
Affiliation(s)
- S F Walkom
- Animal Genetics and Breeding Unit (AGBU is a joint venture of the NSW Department of Primary Industries and University of New England), University of New England, Armidale 2350, NSW, Australia; Advanced Livestock Measurement Technologies project, Meat & Livestock Australia, 40 Mount Street, 2060 North Sydney, Australia.
| | - G E Gardner
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA 6150, Australia; Advanced Livestock Measurement Technologies project, Meat & Livestock Australia, 40 Mount Street, 2060 North Sydney, Australia
| | - F Anderson
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA 6150, Australia; Advanced Livestock Measurement Technologies project, Meat & Livestock Australia, 40 Mount Street, 2060 North Sydney, Australia
| | - A Williams
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA 6150, Australia; Advanced Livestock Measurement Technologies project, Meat & Livestock Australia, 40 Mount Street, 2060 North Sydney, Australia
| | - D J Brown
- Animal Genetics and Breeding Unit (AGBU is a joint venture of the NSW Department of Primary Industries and University of New England), University of New England, Armidale 2350, NSW, Australia; Advanced Livestock Measurement Technologies project, Meat & Livestock Australia, 40 Mount Street, 2060 North Sydney, Australia
| |
Collapse
|
12
|
Olotu B, Anderson F. Knowledge and attitude of patients undergoing lower extremity amputation at RK Khan Hospital, Chatsworth. S AFR J SURG 2019; 57:42. [PMID: 31773933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Amputation is one of the oldest and most commonly performed surgical procedures. OBJECTIVE To review the knowledge and attitude of patients undergoing lower extremity amputations and describe the associated causative factors. METHODOLOGY A questionnaire-based prospective study assessing patients either preoperatively or immediately postoperatively regarding their knowledge and attitudes toward lower extremity amputation was conducted between November 2016 and April 2017. Extracted data was captured into an Excel spreadsheet and imported into SPSS for statistical analysis. RESULTS Sixty-three amputations were performed with males accounting for 56% of the study population. The majority were in the age group of 61-70 years (33%). The commonest indication for amputation was complication of diabetes mellitus or diabetes foot sepsis (65%). Below-knee amputation (BKA) was the most frequently performed procedure and accounted for 56% of all amputations. Seventy per cent of the participants had formal education and 60% knew that their condition could lead to an amputation, but only approximately 10% visited the foot clinic before their major amputation despite the service being available at RK Khan Hospital. Smoking was the commonest habit associated with amputation. CONCLUSION There is a gradual temporal increase in the frequency of resected papillary cancer over a 16 year period while follicular has remained static. These changes may be attributable to better salt iodination.
Collapse
Affiliation(s)
- B Olotu
- Department of General Surgery, Nelson R. Mandela Medical School, University of KwaZulu-Natal, South Africa
| | - F Anderson
- Department of Hepato-Biliary Surgery, Inkosi Albert Luthuli Central Hospital, South Africa
| |
Collapse
|
13
|
Servais L, Day J, De Vivo D, Kirschner J, Mercuri E, Muntoni F, Shieh P, Tizzano E, Droege M, Dabbous O, Khan F, Anderson F, Finkel R. REGISTRIES. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.550] [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]
|
14
|
|
15
|
Taheri S, James S, Roy V, Decaëns T, Williams B, Anderson F, Rougerie R, Chang CH, Brown G, Cunha L, Stanton D, Da Silva E, Chen JH, Lemmon A, Moriarty Lemmon E, Bartz M, Baretta D, Barois I, Lapied E, Coulis M, Dupont L. Complex taxonomy of the ‘brush tail’ peregrine earthworm Pontoscolex corethrurus. Mol Phylogenet Evol 2018; 124:60-70. [DOI: 10.1016/j.ympev.2018.02.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/20/2018] [Accepted: 02/20/2018] [Indexed: 01/19/2023]
|
16
|
Osseman Q, Gallucci L, Au S, Cazenave C, Berdance E, Blondot ML, Cassany A, Bégu D, Ragues J, Aknin C, Sominskaya I, Dishlers A, Rabe B, Anderson F, Panté N, Kann M. The chaperone dynein LL1 mediates cytoplasmic transport of empty and mature hepatitis B virus capsids. J Hepatol 2018; 68:441-448. [PMID: 29113909 DOI: 10.1016/j.jhep.2017.10.032] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/26/2017] [Accepted: 10/27/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND & AIMS Hepatitis B virus (HBV) has a DNA genome but replicates within the nucleus by reverse transcription of an RNA pregenome, which is converted to DNA in cytoplasmic capsids. Capsids in this compartment are correlated with inflammation and epitopes of the capsid protein core (Cp) are a major target for T cell-mediated immune responses. We investigated the mechanism of cytoplasmic capsid transport, which is important for infection but also for cytosolic capsid removal. METHODS We used virion-derived capsids containing mature rcDNA (matC) and empty capsids (empC). RNA-containing capsids (rnaC) were used as a control. The investigations comprised pull-down assays for identification of cellular interaction partners, immune fluorescence microscopy for their colocalization and electron microscopy after microinjection to determine their biological significance. RESULTS matC and empC underwent active transport through the cytoplasm towards the nucleus, while rnaC was poorly transported. We identified the dynein light chain LL1 as a functional interaction partner linking capsids to the dynein motor complex and showed that there is no compensatory transport pathway. Using capsid and dynein LL1 mutants we characterized the required domains on the capsid and LL1. CONCLUSIONS This is the first investigation on the detailed molecular mechanism of how matC pass the cytoplasm upon infection and how empC can be actively removed from the cytoplasm into the nucleus. Considering that hepatocytes with cytoplasmic capsids are better recognized by the T cells, we hypothesize that targeting capsid DynLL1-interaction will not only block HBV infection but also stimulate elimination of infected cells. LAY SUMMARY In this study, we identified the molecular details of HBV translocation through the cytoplasm. Our evidence offers a new drug target which could not only inhibit infection but also stimulate immune clearance of HBV infected cells.
Collapse
Affiliation(s)
- Quentin Osseman
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Lara Gallucci
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Shelly Au
- Department of Zoology, University of British Columbia Vancouver, B.C. V6T 1Z4, Canada
| | - Christian Cazenave
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Elodie Berdance
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Marie-Lise Blondot
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Aurélia Cassany
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Dominique Bégu
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Jessica Ragues
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Cindy Aknin
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | | | - Andris Dishlers
- Latvian Biomedical Research and Study Center, 1067 Riga, Latvia
| | - Birgit Rabe
- Institute of Medical Virology, University of Giessen, 35392 Giessen, Germany
| | - Fenja Anderson
- Institute of Medical Virology, University of Giessen, 35392 Giessen, Germany; Institute of Virology, Hannover Medical School, 30625 Hannover, Germany
| | - Nelly Panté
- Department of Zoology, University of British Columbia Vancouver, B.C. V6T 1Z4, Canada
| | - Michael Kann
- Univ. de Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR 5234, 33076 Bordeaux, France; CNRS, Microbiologie Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France; Institute of Medical Virology, University of Giessen, 35392 Giessen, Germany; CHU de Bordeaux, 33000 Bordeaux, France.
| |
Collapse
|
17
|
Döhner K, Ramos-Nascimento A, Bialy D, Anderson F, Hickford-Martinez A, Rother F, Koithan T, Rudolph K, Buch A, Prank U, Binz A, Hügel S, Lebbink RJ, Hoeben RC, Hartmann E, Bader M, Bauerfeind R, Sodeik B. Importin α1 is required for nuclear import of herpes simplex virus proteins and capsid assembly in fibroblasts and neurons. PLoS Pathog 2018; 14:e1006823. [PMID: 29304174 PMCID: PMC5773220 DOI: 10.1371/journal.ppat.1006823] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 01/18/2018] [Accepted: 12/16/2017] [Indexed: 01/28/2023] Open
Abstract
Herpesviruses are large DNA viruses which depend on many nuclear functions, and therefore on host transport factors to ensure specific nuclear import of viral and host components. While some import cargoes bind directly to certain transport factors, most recruit importin β1 via importin α. We identified importin α1 in a small targeted siRNA screen to be important for herpes simplex virus (HSV-1) gene expression. Production of infectious virions was delayed in the absence of importin α1, but not in cells lacking importin α3 or importin α4. While nuclear targeting of the incoming capsids, of the HSV-1 transcription activator VP16, and of the viral genomes were not affected, the nuclear import of the HSV-1 proteins ICP4 and ICP0, required for efficient viral transcription, and of ICP8 and pUL42, necessary for DNA replication, were reduced. Furthermore, quantitative electron microscopy showed that fibroblasts lacking importin α1 contained overall fewer nuclear capsids, but an increased proportion of mature nuclear capsids indicating that capsid formation and capsid egress into the cytoplasm were impaired. In neurons, importin α1 was also not required for nuclear targeting of incoming capsids, but for nuclear import of ICP4 and for the formation of nuclear capsid assembly compartments. Our data suggest that importin α1 is specifically required for the nuclear localization of several important HSV1 proteins, capsid assembly, and capsid egress into the cytoplasm, and may become rate limiting in situ upon infection at low multiplicity or in terminally differentiated cells such as neurons. Nuclear pore complexes are highly selective gateways that penetrate the nuclear envelope for bidirectional trafficking between the cytoplasm and the nucleoplasm. Viral and host cargoes have to engage specific transport factors to achieve active nuclear import and export. Like many human and animal DNA viruses, herpesviruses are critically dependent on many functions of the host cell nucleus. Alphaherpesviruses such as herpes simplex virus (HSV) cause many diseases upon productive infection in epithelial cells, fibroblasts and neurons. Here, we asked which nuclear transport factors of the host cells help HSV-1 to translocate viral components into the nucleus for viral gene expression, nuclear capsid assembly, capsid egress into the cytoplasm, and production of infectious virions. Our data show that HSV-1 requires the nuclear import factor importin α1 for efficient replication and virus assembly in fibroblasts and in mature neurons. To our knowledge this is the first time that a specific importin α isoform is shown to be required for herpesvirus infection. Our study fosters our understanding on how the different but highly homologous importin α isoforms could fulfill specific functions in vivo which are only understood for a very limited number of host and viral cargos.
Collapse
Affiliation(s)
- Katinka Döhner
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | | | - Dagmara Bialy
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Fenja Anderson
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | | | - Franziska Rother
- Max-Delbrück Center for Molecular Medicine, Berlin-Buch, Germany
- Institute for Biology, University of Lübeck, Lübeck, Germany
| | - Thalea Koithan
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Kathrin Rudolph
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Anna Buch
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Ute Prank
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Anne Binz
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | - Stefanie Hügel
- Max-Delbrück Center for Molecular Medicine, Berlin-Buch, Germany
- Institute for Biology, University of Lübeck, Lübeck, Germany
| | - Robert Jan Lebbink
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Rob C. Hoeben
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Enno Hartmann
- Institute for Biology, University of Lübeck, Lübeck, Germany
| | - Michael Bader
- Max-Delbrück Center for Molecular Medicine, Berlin-Buch, Germany
- Institute for Biology, University of Lübeck, Lübeck, Germany
| | - Rudolf Bauerfeind
- Research Core Unit Laser Microscopy, Hannover Medical School, Hannover, Germany
| | - Beate Sodeik
- Institute of Virology, Hannover Medical School, Hannover, Germany
- * E-mail:
| |
Collapse
|
18
|
Mbatha SZ, Anderson F. Outcomes in laparoscopic cholecystectomy in a resource constrained environment. S AFR J SURG 2016; 54:8-12. [PMID: 28240461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Laparoscopic cholecystectomy (LC) is a common surgical procedure performed for symptomatic gallstones. There is a trend towards early cholecystectomy for patients with acute cholecystitis who present timeously. Local inflammation has been identified as a risk factor for bile duct injuries. This study sought to assess the outcomes of LC in patients managed within a resource constrained environment where late presentation is common. METHOD We performed a retrospective analysis of laparoscopic cholecystectomy performed from January 2010 to June 2011. The mode of presentation, co-morbidities, timing of cholecystectomy and complications were analysed. RESULTS One hundred and sixty seven patients were evaluated. The median age was 43 years with range (17-78) years and 93% were female and 7% male. There were 44%, 23%, 20% and 13% who presented with biliary colic, acute pancreatitis, acute cholecystitis and obstructive jaundice respectively. Nine (5.4%) patients required conversion to an open cholecystectomy. Complications occurred in 16.2% and bile duct injuries and bile leaks in 1.2% and 1.8% respectively. One patient died. CONCLUSION Most patients had a delayed laparoscopic cholecystectomy. There was no difference in outcomes for the different presentations and the complications are similar to other reports.
Collapse
Affiliation(s)
- S Z Mbatha
- Consultant, Addington Hospital. Department Of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal
| | - F Anderson
- Head of Department - Specialised Surgery, Inkosi Albert Luthuli Hospital. Department of Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal
| |
Collapse
|
19
|
Anderson F, Williams A, Pannier L, Pethick D, Gardner G. Sire carcass breeding values affect body composition in lambs — 1. Effects on lean weight and its distribution within the carcass as measured by computed tomography. Meat Sci 2015; 108:145-54. [DOI: 10.1016/j.meatsci.2015.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 05/23/2015] [Accepted: 06/03/2015] [Indexed: 11/27/2022]
|
20
|
Anyebe EA, Sanchez AM, Hindmarsh S, Chen X, Shao J, Rajpalke MK, Veal TD, Robinson BJ, Kolosov O, Anderson F, Sundaram R, Wang ZM, Falko V, Zhuang Q. Realization of Vertically Aligned, Ultrahigh Aspect Ratio InAsSb Nanowires on Graphite. Nano Lett 2015; 15:4348-4355. [PMID: 26086785 DOI: 10.1021/acs.nanolett.5b00411] [Citation(s) in RCA: 9] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The monolithic integration of InAs(1-x)Sb(x) semiconductor nanowires on graphitic substrates holds enormous promise for cost-effective, high-performance, and flexible devices in optoelectronics and high-speed electronics. However, the growth of InAs(1-x)Sb(x) nanowires with high aspect ratio essential for device applications is extremely challenging due to Sb-induced suppression of axial growth and enhancement in radial growth. We report the realization of high quality, vertically aligned, nontapered and ultrahigh aspect ratio InAs(1-x)Sb(x) nanowires with Sb composition (xSb(%)) up to ∼12% grown by indium-droplet assisted molecular beam epitaxy on graphite substrate. Low temperature photoluminescence measurements show that the InAs(1-x)Sb(x) nanowires exhibit bright band-to-band related emission with a distinct redshift as a function of Sb composition providing further confirmation of successful Sb incorporation in as-grown nanowires. This study reveals that the graphite substrate is a more favorable platform for InAs(1-x)Sb(x) nanowires that could lead to hybrid heterostructures possessing potential device applications in optoelectronics.
Collapse
Affiliation(s)
- E A Anyebe
- †Physics Department, Lancaster University, Lancaster LA1 4YB, U.K
| | - A M Sanchez
- ‡Department of Physics, Warwick University, Coventry CV4 7AL, U.K
| | - S Hindmarsh
- ‡Department of Physics, Warwick University, Coventry CV4 7AL, U.K
| | - X Chen
- §National Laboratory for Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, 200083 Shanghai, People's Republic of China
| | - J Shao
- §National Laboratory for Infrared Physics, Shanghai Institute of Technical Physics, Chinese Academy of Sciences, 200083 Shanghai, People's Republic of China
| | - M K Rajpalke
- ∥Stephenson Institute for Renewable Energy and Department of Physics, University of Liverpool, Liverpool L69 7ZF, U.K
| | - T D Veal
- ∥Stephenson Institute for Renewable Energy and Department of Physics, University of Liverpool, Liverpool L69 7ZF, U.K
| | - B J Robinson
- †Physics Department, Lancaster University, Lancaster LA1 4YB, U.K
| | - O Kolosov
- †Physics Department, Lancaster University, Lancaster LA1 4YB, U.K
| | - F Anderson
- ⊥Oxford Instruments, Tubney Woods, Abingdon OX13 5QX, U.K
| | - R Sundaram
- ⊥Oxford Instruments, Tubney Woods, Abingdon OX13 5QX, U.K
| | - Z M Wang
- #Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu 610054, People's Republic of China
| | - V Falko
- †Physics Department, Lancaster University, Lancaster LA1 4YB, U.K
| | - Q Zhuang
- †Physics Department, Lancaster University, Lancaster LA1 4YB, U.K
| |
Collapse
|
21
|
Silverman S, Curtis J, Saag K, Flahive J, Adachi J, Anderson F, Chapurlat R, Cooper C, Diez-Perez A, Greenspan S, Hooven F, Le Croix A, March L, Netelenbos JC, Nieves J, Pfeilschifter J, Rossini M, Roux C, Siris E, Watts N, Compston J. International management of bone health in glucocorticoid-exposed individuals in the observational GLOW study. Osteoporos Int 2015; 26:419-20. [PMID: 25257932 PMCID: PMC4873770 DOI: 10.1007/s00198-014-2883-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 08/28/2014] [Indexed: 11/30/2022]
Affiliation(s)
- S Silverman
- Division of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Anderson F, Savulescu AF, Rudolph K, Schipke J, Cohen I, Ibiricu I, Rotem A, Grünewald K, Sodeik B, Harel A. Targeting of viral capsids to nuclear pores in a cell-free reconstitution system. Traffic 2014; 15:1266-81. [PMID: 25131140 DOI: 10.1111/tra.12209] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 08/13/2014] [Accepted: 08/13/2014] [Indexed: 11/28/2022]
Abstract
Many viruses deliver their genomes into the nucleoplasm for viral transcription and replication. Here, we describe a novel cell-free system to elucidate specific interactions between viruses and nuclear pore complexes (NPCs). Nuclei reconstituted in vitro from egg extracts of Xenopus laevis, an established biochemical system to decipher nuclear functions, were incubated with GFP-tagged capsids of herpes simplex virus, an alphaherpesvirus replicating in the nucleus. Capsid binding to NPCs was analyzed using fluorescence and field emission scanning electron microscopy. Tegument-free capsids or viral capsids exposing inner tegument proteins on their surface bound to nuclei, while capsids inactivated by a high-salt treatment or covered by inner and outer tegument showed less binding. There was little binding of the four different capsid types to nuclei lacking functional NPCs. This novel approach provides a powerful system to elucidate the molecular mechanisms that enable viral structures to engage with NPCs. Furthermore, this assay could be expanded to identify molecular cues triggering viral genome uncoating and nuclear import of viral genomes.
Collapse
Affiliation(s)
- Fenja Anderson
- Institute of Virology, OE 5230, Hannover Medical School, Carl-Neuberg-Straße 1, D-30623, Hannover, Germany
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Bachand PAM, Bachand S, Fleck J, Anderson F, Windham-Myers L. Differentiating transpiration from evaporation in seasonal agricultural wetlands and the link to advective fluxes in the root zone. Sci Total Environ 2014; 484:232-248. [PMID: 24296049 DOI: 10.1016/j.scitotenv.2013.11.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2012] [Revised: 11/05/2013] [Accepted: 11/05/2013] [Indexed: 06/02/2023]
Abstract
The current state of science and engineering related to analyzing wetlands overlooks the importance of transpiration and risks data misinterpretation. In response, we developed hydrologic and mass budgets for agricultural wetlands using electrical conductivity (EC) as a natural conservative tracer. We developed simple differential equations that quantify evaporation and transpiration rates using flow rates and tracer concentrations at wetland inflows and outflows. We used two ideal reactor model solutions, a continuous flow stirred tank reactor (CFSTR) and a plug flow reactor (PFR), to bracket real non-ideal systems. From those models, estimated transpiration ranged from 55% (CFSTR) to 74% (PFR) of total evapotranspiration (ET) rates, consistent with published values using standard methods and direct measurements. The PFR model more appropriately represents these non-ideal agricultural wetlands in which check ponds are in series. Using a flux model, we also developed an equation delineating the root zone depth at which diffusive dominated fluxes transition to advective dominated fluxes. This relationship is similar to the Peclet number that identifies the dominance of advective or diffusive fluxes in surface and groundwater transport. Using diffusion coefficients for inorganic mercury (Hg) and methylmercury (MeHg) we calculated that during high ET periods typical of summer, advective fluxes dominate root zone transport except in the top millimeters below the sediment-water interface. The transition depth has diel and seasonal trends, tracking those of ET. Neglecting this pathway has profound implications: misallocating loads along different hydrologic pathways; misinterpreting seasonal and diel water quality trends; confounding Fick's First Law calculations when determining diffusion fluxes using pore water concentration data; and misinterpreting biogeochemical mechanisms affecting dissolved constituent cycling in the root zone. In addition, our understanding of internal root zone cycling of Hg and other dissolved constituents, benthic fluxes, and biological irrigation may be greatly affected.
Collapse
Affiliation(s)
| | - S Bachand
- Tetra Tech, Davis, CA, United States
| | - J Fleck
- U.S. Geological Survey, California Water Science Center, Sacramento, CA, United States
| | - F Anderson
- U.S. Geological Survey, California Water Science Center, Sacramento, CA, United States
| | - L Windham-Myers
- U.S. Geological Survey, National Research Program, Menlo Park, CA, United States
| |
Collapse
|
24
|
Abstract
Since viruses are obligate intracellular parasites, viral particles, subviral structures, and viral proteins enlist the support of host proteins to foster intracellular transport, viral gene expression, replication, and evasion from antiviral host responses. We have devised a biochemical in vitro method to analyze specific interactions of cytosolic factors with capsids of herpes simplex virus and to characterize host proteins that specifically coprecipitate with different types of viral particles by immunoblotting, mass spectrometry, and immunoelectron microscopy. Our method bridges the gap between assays such as co-immunoprecipitation and yeast-two-hybrid approaches that determine direct binding between individual subunits of protein complexes and microscopy methods that analyze the dynamic interplay between intact viral particles and host factor complexes in intact cells. Our protocol can be extended to functional analyses of herpesvirus capsids and other viral structures with more complex host structures such as microtubule transport, genome uncoating at nuclear pores, or capsid envelopment at host membranes.
Collapse
Affiliation(s)
- Kerstin Radtke
- Département de Pathologie et Biologie Cellulaire, Université de Montréal, 2900 Blvd. Édouard-Montpetit Montréal, QC, Canada
| | | | | |
Collapse
|
25
|
|
26
|
Porwal M, Cohen S, Snoussi K, Popa-Wagner R, Anderson F, Dugot-Senant N, Wodrich H, Dinsart C, Kleinschmidt JA, Panté N, Kann M. Parvoviruses cause nuclear envelope breakdown by activating key enzymes of mitosis. PLoS Pathog 2013; 9:e1003671. [PMID: 24204256 PMCID: PMC3814971 DOI: 10.1371/journal.ppat.1003671] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 07/16/2013] [Indexed: 11/18/2022] Open
Abstract
Disassembly of the nuclear lamina is essential in mitosis and apoptosis requiring multiple coordinated enzymatic activities in nucleus and cytoplasm. Activation and coordination of the different activities is poorly understood and moreover complicated as some factors translocate between cytoplasm and nucleus in preparatory phases. Here we used the ability of parvoviruses to induce nuclear membrane breakdown to understand the triggers of key mitotic enzymes. Nuclear envelope disintegration was shown upon infection, microinjection but also upon their application to permeabilized cells. The latter technique also showed that nuclear envelope disintegration was independent upon soluble cytoplasmic factors. Using time-lapse microscopy, we observed that nuclear disassembly exhibited mitosis-like kinetics and occurred suddenly, implying a catastrophic event irrespective of cell- or type of parvovirus used. Analyzing the order of the processes allowed us to propose a model starting with direct binding of parvoviruses to distinct proteins of the nuclear pore causing structural rearrangement of the parvoviruses. The resulting exposure of domains comprising amphipathic helices was required for nuclear envelope disintegration, which comprised disruption of inner and outer nuclear membrane as shown by electron microscopy. Consistent with Ca++ efflux from the lumen between inner and outer nuclear membrane we found that Ca++ was essential for nuclear disassembly by activating PKC. PKC activation then triggered activation of cdk-2, which became further activated by caspase-3. Collectively our study shows a unique interaction of a virus with the nuclear envelope, provides evidence that a nuclear pool of executing enzymes is sufficient for nuclear disassembly in quiescent cells, and demonstrates that nuclear disassembly can be uncoupled from initial phases of mitosis. Parvoviruses are small non-enveloped DNA viruses successfully used in gene therapy. Their nuclear replication requires transit of the nuclear envelope. Analyzing the interaction between parvoviruses and the nucleus, we showed that despite their small size, they did not traverse the nuclear pore, but attached directly to proteins of the nuclear pore complex. We observed that this binding induced structural changes of the parvoviruses and that the structural rearrangement was essential for triggering a signal cascade resulting in disintegration of the nuclear envelope. Physiologically such nuclear envelope breakdown occurs late during prophase of mitosis. Our finding that the parvovirus-mediated nuclear envelope breakdown also occurred in the absence of soluble cytosolic factors allowed us to decipher the intra nuclear pathways involved in nuclear envelope destabilization. Consistently with the physiological disintegration we found that key enzymes of mitosis were essential and we further identified Ca++ as the initial trigger. Thus our data not only show a unique pathway of how a DNA virus interacts with the nucleus but also describes a virus-based system allowing the first time to analyze selectively the intranuclear pathways leading to nuclear envelope disintegration.
Collapse
Affiliation(s)
- Manvi Porwal
- Institute of Medical Virology, University of Giessen, Giessen, Germany
- Univ. de Bordeaux, Microbiologie fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
- CNRS, Microbiologie fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | - Sarah Cohen
- Department of Zoology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kenza Snoussi
- Univ. de Bordeaux, Microbiologie fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
- CNRS, Microbiologie fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | | | - Fenja Anderson
- Institute of Medical Virology, University of Giessen, Giessen, Germany
- Institute of Virology, Hannover Medical School, Hannover, Germany
| | | | - Harald Wodrich
- Univ. de Bordeaux, Microbiologie fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
- CNRS, Microbiologie fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
| | | | | | - Nelly Panté
- Department of Zoology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Kann
- Institute of Medical Virology, University of Giessen, Giessen, Germany
- Univ. de Bordeaux, Microbiologie fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
- CNRS, Microbiologie fondamentale et Pathogénicité, UMR 5234, Bordeaux, France
- CHU de Bordeaux, Bordeaux, France
- * E-mail:
| |
Collapse
|
27
|
Anderson F, Mbatha SZ, Thomson SR. The early management of pancreatitis associated with hypertriglyceridaemia. S AFR J SURG 2011; 49:82-84. [PMID: 21614978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION In triglyceridaemia-associated pancreatitis, decreasing the serum triglyceride level below 5.65 mmol/l alleviates abdominal pain and is purported to improve outcome. We analysed hypertriglyceride level normalisation and outcome in a patient cohort of acute pancreatitis. PATIENTS AND METHODS Patients presenting with pancreatitis and hypertriglyceridaemia were assessed. All patients with presenting triglycerides levels >10 mmol/l were assessed for resolution to a level below 5.65 mmol/l at days 3 and 5. Patients with triglyceride levels in excess of 10 mmol/l were treated with either standard supportive therapy or an insulin dextrose infusion. RESULTS In the period June 2001 to April 2008, there were 503 admissions of 439 patients with a diagnosis of acute pancreatitis; 26 (6%) had hypertriglyceridaemia >10 mmol/l at admission. Standard therapy was used in all patients; in 6 patients, it was the sole therapy. A dextrose and insulin infusion was used in 20 cases. On day 3, 7 (32%) of the measured triglyceride levels had fallen below 5.65 mmol/l and, on day 5, all but 4 (83%) were <5.65 mmol/l. Three patients died. CONCLUSION Standard therapy was equivalent to the use of dextrose and insulin in the resolution of hypertriglyceridaemia. Our methods to reduce triglyceride levels produce morbidity and mortality rates similar to those attained when alternate lipid-lowering strategies are employed.
Collapse
Affiliation(s)
- F Anderson
- Department of Surgery, Addington Hospital and Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban
| | | | | |
Collapse
|
28
|
Cohen A, Liaw J, Bryant K, Kyriakides P, Cen P, Anderson F, Saggi R, Fallon M, Machicao V, Rubin MN, Mieles L. Abstract No. 194: Local regional intervention in hepatocellular carcinoma (HCC): pathological complete response (pCR) to pre-transplant treatment correlates with improved survival. J Vasc Interv Radiol 2010. [DOI: 10.1016/j.jvir.2009.12.355] [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] Open
|
29
|
Schofield SJ, Nathwani D, Anderson F, Monie R, Watson M, Davis MH. Consultants in Scotland: survey of educational qualifications, experience and needs of Scottish consultants. Scott Med J 2009; 54:25-9. [PMID: 19725279 DOI: 10.1258/rsmsmj.54.3.25] [Citation(s) in RCA: 3] [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] [Indexed: 11/18/2022]
Abstract
AIMS To survey Scotland's NHS consultants regarding their teaching roles; educational qualifications/training; attitudes to educational qualifications; perceptions of health boards' attitudes to educational activities; usefulness of various educational courses and preferred delivery methods. METHODS Postal questionnaire (n=3615). RESULTS Sixty two percent response rate (n=2246). 98% had one or more roles in education/training. 54% spent more time in educational roles than job-plan allocations. 6% had educational qualifications. 30% rated educational qualifications valuable to their educational role; 21% to their career. 48% had not attended any educational training. 19% of respondents rated their health board as supportive of their educational activities. Respondents rated dealing with underperforming students (74%), dealing with challenging behaviour (63%), appraising students (63%), trainee assessment (61%) and feedback (58%) as the most useful topics. CONCLUSIONS Scottish consultant involvement in educational activities is virtually universal but consultants perceive they need more time than allocated in job plans. Most consultants had no teaching qualifications. Nearly half had no formal training for educational activities. Educational qualifications were valued by a minority regarding both career development and educational activities. Increased access to staff development for teaching is required as NHS sources are not meeting the need for teacher training of consultant staff.
Collapse
Affiliation(s)
- S J Schofield
- Centre for Medical Education, University of Dundee, Tay Park House, Dundee DD2 1LR.
| | | | | | | | | | | |
Collapse
|
30
|
Anderson F, Thomson SR, Clarke DL, Buccimazza I. Dyslipidaemic pancreatitis clinical assessment and analysis of disease severity and outcomes. Pancreatology 2009; 9:252-7. [PMID: 19407479 DOI: 10.1159/000212091] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2008] [Accepted: 08/07/2008] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The relationship between pancreatitis and dyslipidaemia is unclear. PATIENTS AND METHODS Admissions with acute pancreatitis were prospectively evaluated. A comparison of the demographic profile, aetiology, disease severity scores, complications and deaths was made in relationship to the lipid profiles. RESULTS From June 2001 to May 2005, there were 230 admissions. The pancreatitis was associated with alcohol (63%), gallstones (18%), idiopathic (9%) and isolated dyslipidaemia (10%). Dyslipidaemia was significantly different between the two predominant race groups: Indian 50.5% and African 17.9% (p < 0.000017). Seventy-eight (34%) had associated dyslipidaemia and 152 (66%) were normolipaemic at admission. The average body mass index was higher in the dyslipidaemic group (27 +/- 6) than in the normolipaemic group (24.5 +/- 6.20; p = 0.004). The mortality rate was similar between the dyslipidaemic and normolipaemic patients (10 and 8%, respectively) and unrelated to race (p = 0.58). The 9 deaths in the dyslipidaemic group occurred in those with persistent hypertriglyceridaemia irrespective of its level (p = 0.003). CONCLUSION Dyslipidaemic pancreatitis was more common in the Indian ethnic group. Adverse outcomes in those with dyslipidaemia were predominantly associated with hypertriglyceridaemia.
Collapse
Affiliation(s)
- F Anderson
- Department of Surgery, Nelson R. Mandela School of Medicine and Addington Hospital, College of Health Sciences, University of Kwa Zulu Natal, Durban, South Africa
| | | | | | | |
Collapse
|
31
|
Bhorat N, Thomson SR, Anderson F. Preduodenal portal vein: a potential laparoscopic cholecystectomy nightmare. S AFR J SURG 2009; 47:17-18. [PMID: 19405333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Variations of biliary anatomy are well described. Those of most relevance to the operative surgeon are the variations of the extrahepatic ducts and their relationships to the right hepatic artery and its branches. We describe another even rarer congenital anomaly of a preduodenal portal vein. Its embryological derivation and presentation are discussed to heighten awareness of its recognition and reduce the potential of a serious operative misadventure.
Collapse
Affiliation(s)
- N Bhorat
- Department of Surgery, Nelson R Mandela School of Medicine, University of Natal, Durban
| | | | | |
Collapse
|
32
|
|
33
|
|
34
|
Anderson F, Thomson SR, Clarke DL, Loots E. Acute pancreatitis: demographics, aetiological factors and outcomes in a regional hospital in South Africa. S AFR J SURG 2008; 46:83-86. [PMID: 18807304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION The spectrum of aetiologies and outcomes of acute pancreatitis in South African settings is under-reported. We report our experience at a regional hospital and compare it with international norms. PATIENTS AND METHODS Data were prospectively collected on all admissions of patients with acute pancreatitis to a regional hospital during the period June 2001-April 2006. The causes of the pancreatitis were noted and complications and mortality rate were determined. RESULTS From June 2001 to April 2006 there were 322 admissions of 282 patients with acute pancreatitis. The median age was 37 years (range 13-73 years). There were 94 females and 188 males. Episodes of pancreatitis were associated with alcohol consumption in 62% of cases and with gallstones in 14%; 4% of cases were associated with both gallstones and alcohol consumption, 8% with dyslipidaemia and 5% with retroviral disease. In 15% of admissions local complications developed, and 9% of admissions ended in death of the patient. Of the 28 deaths, 71% occurred in the first 2 weeks. CONCLUSIONS As in other South African reports, alcohol was the main cause of pancreatitis. Outcomes in this series are similar to those in Western studies except that the majority of deaths occurred early, implying that improved supportive care may improve overall survival.
Collapse
Affiliation(s)
- F Anderson
- Department of Surgery, Addington Hospital and Nelson R Mandela School of Medicine, University of Kwa-Zulu-Natal
| | | | | | | |
Collapse
|
35
|
Loots E, Anderson F, Thomson SR. Primary pancreatic lymphoma in an HIV patient: dilemmas in diagnosis and management. S AFR J SURG 2008; 46:28-29. [PMID: 18468421] [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: 05/26/2023]
Affiliation(s)
- E Loots
- Department of General Surgery, Addington Hospital and Nelson R. Mandela School of Medicine, University of Natal, Durban
| | | | | |
Collapse
|
36
|
Clarke DL, Thomson SR, Bissetty T, Madiba TE, Buccimazza I, Anderson F. A single surgical unit's experience with abdominal tuberculosis in the HIV/AIDS era. World J Surg 2007; 31:1087-96; discussion 1097-8. [PMID: 17426896 DOI: 10.1007/s00268-007-0402-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [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: 11/25/2022]
Abstract
INTRODUCTION Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) has resulted in a resurgence of abdominal tuberculosis in South Africa, and these patients often present to general surgeons. We describe a single-hospital experience in a region of high HIV prevalence. METHODS A prospective database of all patients with suspected abdominal tuberculosis was maintained from January 2003 until July 2005. RESULTS There were 67 patients (20 men, 47 women) with an average age of 32 years (range 27-61 years). The erythrocyte sedimentation rate was universally elevated (105 +/- 23). Altogether, 23 patients were HIV-positive and 7 were HIV-negative. The status was unknown in the remainder. Chest radiographs demonstrated an abnormality in 17 patients (22%). Abdominal ultrasonography was performed in 59 patients and computed tomography in 12. Twelve laparotomies were performed, seven as emergencies. None in the elective laparotomy group died, whereas the mortality rate in the emergency group was 60%. Laparoscopy was insufficient for a variety of reasons. Two patients underwent appendectomy and two excision of a perianal fistula. Two patients underwent biopsy of a palpable subcutaneous node, which confirmed the diagnosis in both cases. A definitive diagnosis was achieved in all 12 patients subjected to laparotomy and at colonoscopic biopsy in 2, lymph node biopsy in 2, appendectomy in 2, perianal fistulectomy in 2, and percutaneous drainage in 2. In the remaining 47 patients the diagnosis was made on the basis of the clinical presentation and radiologic imaging. The patients were commenced on antituberculous therapy. The in-hospital mortality in this group was 10%. Therapy was continued at a centralized tuberculosis facility independent of the hospital. Surgical follow-up was poor, with only five (7%) patients completing the 6-month review at a surgical clinic. CONCLUSIONS A resurgence in tuberculosis during the HIV era produces a new spectrum of presentations for the surgeon. Emergency surgery is associated with high mortality. Bacterial and histologic evidence of infection are difficult to obtain, and indirect clinical and imaging evidence are used to commence a trial of therapy. A short-term clinical response is regarded as proof of disease. Lack of follow-up means that the efficacy of this strategy is unproven. Health policy changes are needed to enable appropriate surgical follow-up to determine the most effective management algorithm.
Collapse
Affiliation(s)
- D L Clarke
- Department of General Surgery, Nelson R Mandela School of Medicine, University of Kwa-Zulu Natal, Congella, Durban, South Africa
| | | | | | | | | | | |
Collapse
|
37
|
Smith H, Anderson F, Raphael H, Maslin P, Crozier S, Cooper C. Effect of annual intramuscular vitamin D on fracture risk in elderly men and women a population-based, randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford) 2007; 46:1852-7. [PMID: 17998225 DOI: 10.1093/rheumatology/kem240] [Citation(s) in RCA: 279] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- H Smith
- Department of Primary Care, Division of Community-based Clinical Sciences, Geriatric Medicine Group, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK
| | | | | | | | | | | |
Collapse
|
38
|
Simoneau G, Decouzus H, Delcey V, Guimiot O, Anderson F, Bergmann JF. Comparaison entre la France et le reste de monde du traitement préventif de la thrombose veineuse chez des patients hospitalisés pour une affection médicale aiguë: un registre prospectif. Rev Med Interne 2007. [DOI: 10.1016/j.revmed.2007.03.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
39
|
Clarke DL, Pillay Y, Anderson F, Thomson SR. The current standard of care in the periprocedural management of the patient with obstructive jaundice. Ann R Coll Surg Engl 2007; 88:610-6. [PMID: 17132306 PMCID: PMC1963825 DOI: 10.1308/003588406x149327] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This review provides a literature-based guide to the optimal management of the patient with obstructive jaundice with emphasis placed on prevention of complications.
Collapse
Affiliation(s)
- D L Clarke
- Department of General Surgery, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Durban, South Africa
| | | | | | | |
Collapse
|
40
|
Sherman M, Yoshida EM, Deschenes M, Krajden M, Bain VG, Peltekian K, Anderson F, Kaita K, Simonyi S, Balshaw R, Lee SS. Peginterferon alfa-2a (40KD) plus ribavirin in chronic hepatitis C patients who failed previous interferon therapy. Gut 2006; 55:1631-8. [PMID: 16709661 PMCID: PMC1860092 DOI: 10.1136/gut.2005.083113] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The management of patients with chronic hepatitis C who have relapsed or failed to respond to interferon based therapies is an important issue facing hepatologists. AIMS We evaluated the efficacy and safety of peginterferon alfa-2a (40KD) plus ribavirin in this population by conducting a multicentre open label study. PATIENTS Data from adults with detectable serum hepatitis C virus (HCV) RNA who had not responded or had relapsed after previous conventional interferon or conventional interferon/ribavirin combination therapy were analysed. METHODS Patients were retreated with peginterferon alfa-2a (40KD) 180 microg/week plus ribavirin 800 mg/day for 24 or 48 weeks at the investigators' discretion. The study was conceived before the optimal dose of ribavirin (1000/1200 mg/day) for patients with genotype 1 was known. The primary endpoint was sustained virological response (SVR), defined as undetectable HCV RNA (<50 IU/ml) after 24 weeks of follow up. The analysis was conducted by intention to treat. RESULTS A total of 312 patients (212 non-responders, 100 relapsers) were included. Of these, 28 patients were treated for 24 weeks and 284 for 48 weeks. Baseline characteristics between non-responders and relapsers were similar although more non-responders had genotype 1 infection (87% v 69%). Overall SVR rates were 23% (48/212) for non-responders and 41% (41/100) for relapsers. When data were analysed by genotype, SVR rates were 24% (61/253) in genotype 1 and 47% (28/59) in genotype 2/3. CONCLUSIONS These results in a large patient cohort demonstrate that it is possible to cure a proportion of previous non-responders and relapsers by retreating with peginterferon alfa-2a (40KD) plus ribavirin.
Collapse
Affiliation(s)
- M Sherman
- Toronto General Hospital, 200 Elizabeth St, Toronto, Ontario, M5G 2C4 Canada.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Gregory SG, Barlow KF, McLay KE, Kaul R, Swarbreck D, Dunham A, Scott CE, Howe KL, Woodfine K, Spencer CCA, Jones MC, Gillson C, Searle S, Zhou Y, Kokocinski F, McDonald L, Evans R, Phillips K, Atkinson A, Cooper R, Jones C, Hall RE, Andrews TD, Lloyd C, Ainscough R, Almeida JP, Ambrose KD, Anderson F, Andrew RW, Ashwell RIS, Aubin K, Babbage AK, Bagguley CL, Bailey J, Banerjee R, Beasley H, Bethel G, Bird CP, Bray-Allen S, Brown JY, Brown AJ, Bryant SP, Buckley D, Burford DC, Burrill WDH, Burton J, Bye J, Carder C, Chapman JC, Clark SY, Clarke G, Clee C, Clegg SM, Cobley V, Collier RE, Corby N, Coville GJ, Davies J, Deadman R, Dhami P, Dovey O, Dunn M, Earthrowl M, Ellington AG, Errington H, Faulkner LM, Frankish A, Frankland J, French L, Garner P, Garnett J, Gay L, Ghori MRJ, Gibson R, Gilby LM, Gillett W, Glithero RJ, Grafham DV, Gribble SM, Griffiths C, Griffiths-Jones S, Grocock R, Hammond S, Harrison ESI, Hart E, Haugen E, Heath PD, Holmes S, Holt K, Howden PJ, Hunt AR, Hunt SE, Hunter G, Isherwood J, James R, Johnson C, Johnson D, Joy A, Kay M, Kershaw JK, Kibukawa M, Kimberley AM, King A, Knights AJ, Lad H, Laird G, Langford CF, Lawlor S, Leongamornlert DA, Lloyd DM, Loveland J, Lovell J, Lush MJ, Lyne R, Martin S, Mashreghi-Mohammadi M, Matthews L, Matthews NSW, McLaren S, Milne S, Mistry S, oore MJFM, Nickerson T, O'Dell CN, Oliver K, Palmeiri A, Palmer SA, Pandian RD, Parker A, Patel D, Pearce AV, Peck AI, Pelan S, Phelps K, Phillimore BJ, Plumb R, Porter KM, Prigmore E, Rajan J, Raymond C, Rouse G, Saenphimmachak C, Sehra HK, Sheridan E, Shownkeen R, Sims S, Skuce CD, Smith M, Steward C, Subramanian S, Sycamore N, Tracey A, Tromans A, Van Helmond Z, Wall J. M. Wallis M, White S, Whitehead SL, Wilkinson JE, Willey DL, Williams H, Wilming L, Wray PW, Wu Z, Coulson A, Vaudin M, Sulston JE, Durbin R, Hubbard T, Wooster R, Dunham I, Carter NP, McVean G, Ross MT, Harrow J, Olson MV, Beck S, Rogers J, Bentley DR. Erratum: The DNA sequence and biological annotation of human chromosome 1. Nature 2006. [DOI: 10.1038/nature05152] [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: 11/09/2022]
|
42
|
Ayappa I, Norman R, Whiting D, Anderson F, Donnelly E, Rapoport D. P391 Automated detection of irregular respiration: A marker of wakefulness. Sleep Med 2006. [DOI: 10.1016/j.sleep.2006.07.200] [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: 10/24/2022]
|
43
|
Gregory SG, Barlow KF, McLay KE, Kaul R, Swarbreck D, Dunham A, Scott CE, Howe KL, Woodfine K, Spencer CCA, Jones MC, Gillson C, Searle S, Zhou Y, Kokocinski F, McDonald L, Evans R, Phillips K, Atkinson A, Cooper R, Jones C, Hall RE, Andrews TD, Lloyd C, Ainscough R, Almeida JP, Ambrose KD, Anderson F, Andrew RW, Ashwell RIS, Aubin K, Babbage AK, Bagguley CL, Bailey J, Beasley H, Bethel G, Bird CP, Bray-Allen S, Brown JY, Brown AJ, Buckley D, Burton J, Bye J, Carder C, Chapman JC, Clark SY, Clarke G, Clee C, Cobley V, Collier RE, Corby N, Coville GJ, Davies J, Deadman R, Dunn M, Earthrowl M, Ellington AG, Errington H, Frankish A, Frankland J, French L, Garner P, Garnett J, Gay L, Ghori MRJ, Gibson R, Gilby LM, Gillett W, Glithero RJ, Grafham DV, Griffiths C, Griffiths-Jones S, Grocock R, Hammond S, Harrison ESI, Hart E, Haugen E, Heath PD, Holmes S, Holt K, Howden PJ, Hunt AR, Hunt SE, Hunter G, Isherwood J, James R, Johnson C, Johnson D, Joy A, Kay M, Kershaw JK, Kibukawa M, Kimberley AM, King A, Knights AJ, Lad H, Laird G, Lawlor S, Leongamornlert DA, Lloyd DM, Loveland J, Lovell J, Lush MJ, Lyne R, Martin S, Mashreghi-Mohammadi M, Matthews L, Matthews NSW, McLaren S, Milne S, Mistry S, Moore MJF, Nickerson T, O'Dell CN, Oliver K, Palmeiri A, Palmer SA, Parker A, Patel D, Pearce AV, Peck AI, Pelan S, Phelps K, Phillimore BJ, Plumb R, Rajan J, Raymond C, Rouse G, Saenphimmachak C, Sehra HK, Sheridan E, Shownkeen R, Sims S, Skuce CD, Smith M, Steward C, Subramanian S, Sycamore N, Tracey A, Tromans A, Van Helmond Z, Wall M, Wallis JM, White S, Whitehead SL, Wilkinson JE, Willey DL, Williams H, Wilming L, Wray PW, Wu Z, Coulson A, Vaudin M, Sulston JE, Durbin R, Hubbard T, Wooster R, Dunham I, Carter NP, McVean G, Ross MT, Harrow J, Olson MV, Beck S, Rogers J, Bentley DR, Banerjee R, Bryant SP, Burford DC, Burrill WDH, Clegg SM, Dhami P, Dovey O, Faulkner LM, Gribble SM, Langford CF, Pandian RD, Porter KM, Prigmore E. The DNA sequence and biological annotation of human chromosome 1. Nature 2006; 441:315-21. [PMID: 16710414 DOI: 10.1038/nature04727] [Citation(s) in RCA: 170] [Impact Index Per Article: 9.4] [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] [Received: 12/24/2005] [Accepted: 03/13/2006] [Indexed: 11/08/2022]
Abstract
The reference sequence for each human chromosome provides the framework for understanding genome function, variation and evolution. Here we report the finished sequence and biological annotation of human chromosome 1. Chromosome 1 is gene-dense, with 3,141 genes and 991 pseudogenes, and many coding sequences overlap. Rearrangements and mutations of chromosome 1 are prevalent in cancer and many other diseases. Patterns of sequence variation reveal signals of recent selection in specific genes that may contribute to human fitness, and also in regions where no function is evident. Fine-scale recombination occurs in hotspots of varying intensity along the sequence, and is enriched near genes. These and other studies of human biology and disease encoded within chromosome 1 are made possible with the highly accurate annotated sequence, as part of the completed set of chromosome sequences that comprise the reference human genome.
Collapse
Affiliation(s)
- S G Gregory
- The Wellcome Trust Sanger Institute, The Wellcome Trust Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Arnold A, Schwartz M, Thelen D, Anderson F, Jonkers I, Delp S. Muscle-actuated simulation and analysis of swing-phase knee motion during normal gait: implications for the treatment of crouch gait. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)83326-9] [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]
|
45
|
Jonkers I, Liu M, Arnold A, Thelen D, Anderson F, Patten C, Delp S. Factors that impede forward progression during hemiparetic gait: a simulation-based case study. J Biomech 2006. [DOI: 10.1016/s0021-9290(06)83263-x] [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]
|
46
|
Terrault NA, Pawlotsky JM, McHutchison J, Anderson F, Krajden M, Gordon S, Zitron I, Perrillo R, Gish R, Holodniy M, Friesenhahn M. Clinical utility of viral load measurements in individuals with chronic hepatitis C infection on antiviral therapy. J Viral Hepat 2005; 12:465-72. [PMID: 16108760 DOI: 10.1111/j.1365-2893.2005.00615.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Both absolute viral load and log decline in viral load from baseline were found clinically useful in predicting sustained virological response and lack of sustained virological response (non-sustained virological response, NSVR) to treatment. We assessed the clinical utility of hepatitis C virus (HCV) RNA quantitation and changes in viral load using the VERSANT HCV RNA 3.0 Assay (bDNA) in 351 HCV-infected individuals treated with interferon plus ribavirin. We show that viral load decision thresholds provided negative predictive values (NPVs) of >95% at week 4 using a 100 000 IU/mL cut-off and at weeks 8 and 12 using 10 000 IU/mL cut-offs. A 2-log decline from baseline provided NPVs >95% at weeks 8 and 12. Combinations of absolute viral loads and changes in viral load from baseline did not enhance the performance of the decision rules for predicting NSVR. The positive predictive values (PPVs) at weeks 8 and 12 were 59.1 and 67.3%. This study highlights the critical importance of viral quantitation in gauging therapeutic response in patients with chronic HCV infection on antiviral therapy. Early changes in viral load, measured as absolute viral loads or change in viral load from baseline, are highly predictive of NSVR at 8 and 12 weeks. PPVs are modest but these data may provide encouragement to patients who are in the early phases of treatment when side effects are frequent. Additionally, we demonstrated the need for cautious interpretation of stopping rules when the values are at or near the decision thresholds.
Collapse
Affiliation(s)
- N A Terrault
- Division of Gastroenterology, Department of Medicine, University of California San Francisco, San Francisco, CA 94143-0538, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Hesketh EA, Anderson F, Bagnall GM, Driver CP, Johnston DA, Marshall D, Needham G, Orr G, Walker K. Using a 360 degrees diagnostic screening tool to provide an evidence trail of junior doctor performance throughout their first postgraduate year. Med Teach 2005; 27:219-33. [PMID: 16011945 DOI: 10.1080/01421590500098776] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
New medical graduates in the UK are known as Preregistration House Officers (PRHOs). At the end of this first postgraduate year, the Postgraduate Dean is responsible for allowing the PRHO to be fully registered with the General Medical Council. During the period 1999-2002 Professor Miriam Friedman Ben-David designed a more robust approach to appraisal and assessment of PRHOs, which provided educational feedback to all trainees, allowed any poor performers to be detected at an early stage, and provided 'hard' observable evidence for certification decisions. This paper describes the more recent development of her work resulting from further piloting of her system. The key tool, a 360 degrees diagnostic questionnaire, is designed to identify strengths and weaknesses in individual performance. It is presently being used as a screening tool to identify any trainees needing additional support and further assessment. The tool also forms part of an evidence trail for all PRHOs and helps inform formative assessment as well as contributing, along with other evidence, to full registration decisions. The evaluation of this tool, also described in this paper, shows the feasibility of implementing such a system on a wider scale and illustrates the successful balance made between robustness and feasibility.
Collapse
Affiliation(s)
- E A Hesketh
- NHS Education for Scotland, East Deanery, Dundee, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Bradley WG, Anderson F, Gowda N, Miller RG. Changes in the management of ALS since the publication of the AAN ALS practice parameter 1999. Amyotroph Lateral Scler Other Motor Neuron Disord 2004; 5:240-4. [PMID: 15799554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE To determine if the publication in 1999 of the AAN Practice Parameter on ALS was associated with an improvement in the standard of management of the disease. METHODS Data on 646 patients enrolled in the ALS CARE database and on 465 patients who died in the period May 2001 to November 2002 were compared with similar data obtained from the database from 1996 to May 1999. RESULTS The specialty ALS clinics were the most important source of information about ALS. The internet was a source for 39%. The treatment of sialorrhea, pseudobulbar emotional lability, and failure of swallowing and breathing had all improved significantly in the period after the publication of the Practice Parameter. However many patients still did not receive a gastrostomy tube or non-invasive positive pressure ventilation when indicated by the Practice Parameter, mainly because of lack of patient compliance. Cost was the main reason why 41% of patients did not receive riluzole, though they spent a third of the cost of this medication on alternative medicines. CONCLUSIONS The publication of the AAN Practice Parameter was associated with improvement in the standard of care. Most cases in the database come from specialized ALS centers, and further information on the community care of ALS patients is needed.
Collapse
Affiliation(s)
- W G Bradley
- University of Miami School of Medicine, Department of Neurology, Miami, FL 33101, USA.
| | | | | | | |
Collapse
|
49
|
Anderson F, Clarke DL, Thomson SR. Preoperative biliary stenting--a prequel to pancreatic resection in selected patients. S AFR J SURG 2004; 42:128-30. [PMID: 15682731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
INTRODUCTION Biliary drainage is necessary to improve immediate survival in patients with profound co-morbidities associated with jaundice. We report on our experience with this category of patients in whom subsequent pancreaticoduodenectomy was performed. PATIENTS AND METHODS In the period January 2001-June 2002, 6 patients underwent biliary drainage to reverse potentially fatal complications or to optimise nutritional status. There were 2 female and 4 male patients (age range 50-70 years). The reasons for biliary drainage were suboptimal albumin levels in all patients, cholangitis in 4 patients and renal impairment in 2 male patients and profound acute jaundice in 1. RESULTS There was failure of stent placement at endoscopic retrograde cholangiopancreatography (ERCP) in 3 patients. Two had an ERCP performed before referral and had a metal stent deployed at percutaneous transhepatic cholangiography (PTC). In the other a plastic stent was placed at a combined PTC/ERCP session. The 3 others had stents placed by ERCP. None of the patients had complications related to the stenting procedure. All the lesions were deemed resectable following imaging by ultrasound and computed tomography (CT) scan. Laparotomy with intent to resect was planned once the complications had resolved. The average duration of stenting before surgery was 46 days (range 12-100 days). All patients underwent pancreatoduodenectomy. One patient developed postoperative superficial wound sepsis, which resolved with topical management. There were no perioperative deaths. The postoperative hospital stay ranged from 10 to 21 days. Histological examination revealed pancreatic adenocarcinomas in 4 patients, an ampullary tumour in 1 patient and a non-functioning islet cell tumour in the other. CONCLUSION Biliary drainage for complications should not be regarded as definitive treatment. It optimises co-morbidity factors and allows staging so that resection can be carried out successfully in selected patients.
Collapse
Affiliation(s)
- F Anderson
- Department of General Surgery, Addington Hospital and the Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban
| | | | | |
Collapse
|
50
|
Guelke R, Heydenrych JCR, Anderson F. Measurement of Radioactivity and Temperature in Narrow Boreholes, and the Development of Instruments for this Purpose. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0950-7671/26/5/303] [Citation(s) in RCA: 3] [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: 11/12/2022]
|