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Ehdaie B, Tempany CM, Holland F, Sjoberg DD, Kibel AS, Trinh QD, Durack JC, Akin O, Vickers AJ, Scardino PT, Sperling D, Wong JYC, Yuh B, Woodrum DA, Mynderse LA, Raman SS, Pantuck AJ, Schiffman MH, McClure TD, Sonn GA, Ghanouni P. MRI-guided focused ultrasound focal therapy for patients with intermediate-risk prostate cancer: a phase 2b, multicentre study. Lancet Oncol 2022; 23:910-918. [PMID: 35714666 PMCID: PMC9400094 DOI: 10.1016/s1470-2045(22)00251-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [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: 02/16/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Men with grade group 2 or 3 prostate cancer are often considered ineligible for active surveillance; some patients with grade group 2 prostate cancer who are managed with active surveillance will have early disease progression requiring radical therapy. This study aimed to investigate whether MRI-guided focused ultrasound focal therapy can safely reduce treatment burden for patients with localised grade group 2 or 3 intermediate-risk prostate cancer. METHODS In this single-arm, multicentre, phase 2b study conducted at eight health-care centres in the USA, we recruited men aged 50 years and older with unilateral, MRI-visible, primary, intermediate-risk, previously untreated prostate adenocarcinoma (prostate-specific antigen ≤20 ng/mL, grade group 2 or 3; tumour classification ≤T2) confirmed on combined biopsy (combining MRI-targeted and systematic biopsies). MRI-guided focused ultrasound energy, sequentially titrated to temperatures sufficient for tissue ablation (about 60-70°C), was delivered to the index lesion and a planned margin of 5 mm or more of normal tissue, using real-time magnetic resonance thermometry for intraoperative monitoring. Co-primary outcomes were oncological outcomes (absence of grade group 2 and higher cancer in the treated area at 6-month and 24-month combined biopsy; when 24-month biopsy data were not available and grade group 2 or higher cancer had occurred in the treated area at 6 months, the 6-month biopsy results were included in the final analysis) and safety (adverse events up to 24 months) in all patients enrolled in the study. This study is registered with ClinicalTrials.gov, NCT01657942, and is no longer recruiting. FINDINGS Between May 4, 2017, and Dec 21, 2018, we assessed 194 patients for eligibility and treated 101 patients with MRI-guided focused ultrasound. Median age was 63 years (IQR 58-67) and median concentration of prostate-specific antigen was 5·7 ng/mL (IQR 4·2-7·5). Most cancers were grade group 2 (79 [78%] of 101). At 24 months, 78 (88% [95% CI 79-94]) of 89 men had no evidence of grade group 2 or higher prostate cancer in the treated area. No grade 4 or grade 5 treatment-related adverse events were reported, and only one grade 3 adverse event (urinary tract infection) was reported. There were no treatment-related deaths. INTERPRETATION 24-month biopsy outcomes show that MRI-guided focused ultrasound focal therapy is safe and effectively treats grade group 2 or 3 prostate cancer. These results support focal therapy for select patients and its use in comparative trials to determine if a tissue-preserving approach is effective in delaying or eliminating the need for radical whole-gland treatment in the long term. FUNDING Insightec and the National Cancer Institute.
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Affiliation(s)
- Behfar Ehdaie
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Clare M Tempany
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
| | - Ford Holland
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Daniel D Sjoberg
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Adam S Kibel
- Division of Urology, Brigham and Women's Hospital, Boston, MA, USA
| | - Quoc-Dien Trinh
- Division of Urology, Brigham and Women's Hospital, Boston, MA, USA
| | - Jeremy C Durack
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Cordis-X, Miami Lakes, FL, USA
| | - Oguz Akin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Vickers
- Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Peter T Scardino
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Jeffrey Y C Wong
- Department of Radiation Oncology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Bertram Yuh
- Department of Urology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | | | | | - Steven S Raman
- Department of Radiology, University of California Los Angeles, Los Angeles, CA, USA
| | - Allan J Pantuck
- Department of Urology, University of California Los Angeles, Los Angeles, CA, USA
| | - Marc H Schiffman
- Department of Radiology, Weill Cornell Medical College, New York, NY, USA
| | - Timothy D McClure
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
| | - Geoffrey A Sonn
- Department of Urology, Stanford University, Stanford, CA, USA
| | - Pejman Ghanouni
- Department of Radiology, Stanford University, Stanford, CA, USA
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Lelieveld J, Bourtsoukidis E, Brühl C, Fischer H, Fuchs H, Harder H, Hofzumahaus A, Holland F, Marno D, Neumaier M, Pozzer A, Schlager H, Williams J, Zahn A, Ziereis H. The South Asian monsoon-pollution pump and purifier. Science 2018; 361:270-273. [PMID: 29903882 DOI: 10.1126/science.aar2501] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 05/30/2018] [Indexed: 11/02/2022]
Abstract
Air pollution is growing fastest in monsoon-affected South Asia. During the dry winter monsoon, the fumes disperse toward the Indian Ocean, creating a vast pollution haze, but their fate during the wet summer monsoon has been unclear. We performed atmospheric chemistry measurements by aircraft in the Oxidation Mechanism Observations campaign, sampling the summer monsoon outflow in the upper troposphere between the Mediterranean and the Indian Ocean. The measurements, supported by model calculations, show that the monsoon sustains a remarkably efficient cleansing mechanism by which contaminants are rapidly oxidized and deposited to Earth's surface. However, some pollutants are lofted above the monsoon clouds and chemically processed in a reactive reservoir before being redistributed globally, including to the stratosphere.
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Affiliation(s)
- J Lelieveld
- Max Planck Institute for Chemistry, 55128 Mainz, Germany. .,The Cyprus Institute, 1645 Nicosia, Cyprus
| | | | - C Brühl
- Max Planck Institute for Chemistry, 55128 Mainz, Germany
| | - H Fischer
- Max Planck Institute for Chemistry, 55128 Mainz, Germany
| | - H Fuchs
- Institute for Energy and Climate Research, Research Center Jülich, 52425 Jülich, Germany
| | - H Harder
- Max Planck Institute for Chemistry, 55128 Mainz, Germany
| | - A Hofzumahaus
- Institute for Energy and Climate Research, Research Center Jülich, 52425 Jülich, Germany
| | - F Holland
- Institute for Energy and Climate Research, Research Center Jülich, 52425 Jülich, Germany
| | - D Marno
- Max Planck Institute for Chemistry, 55128 Mainz, Germany
| | - M Neumaier
- Karlsruhe Institute of Technology, 76021 Karlsruhe, Germany
| | - A Pozzer
- Max Planck Institute for Chemistry, 55128 Mainz, Germany
| | - H Schlager
- Institute of Atmospheric Physics, Germany Aerospace Center, 82234 Oberpfaffenhofen, Germany
| | - J Williams
- Max Planck Institute for Chemistry, 55128 Mainz, Germany.,The Cyprus Institute, 1645 Nicosia, Cyprus
| | - A Zahn
- Karlsruhe Institute of Technology, 76021 Karlsruhe, Germany
| | - H Ziereis
- Institute of Atmospheric Physics, Germany Aerospace Center, 82234 Oberpfaffenhofen, Germany
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Elshorbany YF, Kleffmann J, Hofzumahaus A, Kurtenbach R, Wiesen P, Brauers T, Bohn B, Dorn HP, Fuchs H, Holland F, Rohrer F, Tillmann R, Wegener R, Wahner A, Kanaya Y, Yoshino A, Nishida S, Kajii Y, Martinez M, Kubistin D, Harder H, Lelieveld J, Elste T, Plass-Dülmer C, Stange G, Berresheim H, Schurath U. HOxbudgets during HOxComp: A case study of HOxchemistry under NOx-limited conditions. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2011jd017008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Rabbitt P, McInnes L, Diggle P, Holland F, Bent N, Abson V, Pendleton N, Horan M. The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age, 1983 through 2003. Aging, Neuropsychology, and Cognition 2010. [DOI: 10.1080/13825580490511116] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- P.M.A. Rabbitt
- a Age and Cognitive Performance Research Centre , University of Manchester , Manchester, UK
| | - L. McInnes
- b University of Northumbria at Newcastle , Manchester, UK
| | - P. Diggle
- c University of Lancaster , Manchester, UK
| | - F. Holland
- d Smith, Klein & Beecham Inc. , Uxbridge, UK
| | - N. Bent
- e University of Leeds , Uxbridge, UK
| | - V. Abson
- f North East Age Research Centre , University of Newcastle upon Tyne , Uxbridge, UK
| | - N. Pendleton
- g Department of Geriatric Medicine , University of Manchester, Hope Hospital , Uxbridge, UK
| | - M. Horan
- g Department of Geriatric Medicine , University of Manchester, Hope Hospital , Uxbridge, UK
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Hofzumahaus A, Rohrer F, Lu K, Bohn B, Brauers T, Chang CC, Fuchs H, Holland F, Kita K, Kondo Y, Li X, Lou S, Shao M, Zeng L, Wahner A, Zhang Y. Amplified Trace Gas Removal in the Troposphere. Science 2009; 324:1702-4. [DOI: 10.1126/science.1164566] [Citation(s) in RCA: 465] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Wiedensohler A, Cheng YF, Nowak A, Wehner B, Achtert P, Berghof M, Birmili W, Wu ZJ, Hu M, Zhu T, Takegawa N, Kita K, Kondo Y, Lou SR, Hofzumahaus A, Holland F, Wahner A, Gunthe SS, Rose D, Su H, Pöschl U. Rapid aerosol particle growth and increase of cloud condensation nucleus activity by secondary aerosol formation and condensation: A case study for regional air pollution in northeastern China. ACTA ACUST UNITED AC 2009. [DOI: 10.1029/2008jd010884] [Citation(s) in RCA: 154] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Takegawa N, Miyakawa T, Kuwata M, Kondo Y, Zhao Y, Han S, Kita K, Miyazaki Y, Deng Z, Xiao R, Hu M, van Pinxteren D, Herrmann H, Hofzumahaus A, Holland F, Wahner A, Blake DR, Sugimoto N, Zhu T. Variability of submicron aerosol observed at a rural site in Beijing in the summer of 2006. ACTA ACUST UNITED AC 2009. [DOI: 10.1029/2008jd010857] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Payton A, Holland F, Diggle P, Rabbitt P, Horan M, Davidson Y, Gibbons L, Worthington J, Ollier WER, Pendleton N. Cathepsin D exon 2 polymorphism associated with general intelligence in a healthy older population. Mol Psychiatry 2003; 8:14-8. [PMID: 12556904 DOI: 10.1038/sj.mp.4001239] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [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: 11/08/2022]
Abstract
General intelligence is a heritable trait that is a risk factor for both the onset of dementia and the rate of cognitive decline in community-dwelling older persons. Previous studies screening for quantitative trait loci (QTLs) that influence general intelligence in healthy individuals have identified four loci, two of which are located within the genes insulin-like growth factor 2 receptor (IGF2R) and the Msx1 homeobox. Here, we report the finding of another QTL associated with general intelligence that is located within exon 2 of the cathepsin D (CTSD) gene. A group of 767 healthy adults with a follow-up period of over 15 years have been analyzed for cross-sectional and longitudinal trends in cognitive change using the Heim intelligence test score (AH4-1). We observed a significant association (P = 0.01) between a functional C > T (Ala > Val) transition within exon 2 of the CTSD gene that increases the secretion of pro-CTSD from the cell, and the AH4-1 score at initial testing on entry to the longitudinal study. Interestingly, CTSD is transported by IGF2R from the trans Golgi network to the lysosome.
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Affiliation(s)
- A Payton
- Centre for Integrated Genomic Medical Research, Manchester University, UK.
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Siese M, Becker KH, Brockmann KJ, Geiger H, Hofzumahaus A, Holland F, Mihelcic D, Wirtz K. Direct measurement of OH radicals from ozonolysis of selected alkenes: a EUPHORE simulation chamber study. Environ Sci Technol 2001; 35:4660-4667. [PMID: 11770768 DOI: 10.1021/es010150p] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Reactions of ozone with alkenes can be a significant source of hydroxyl radicals in the atmosphere. In the present paper, the formation of OH radicals in the ozonolysis of selected alkenes under atmospheric conditions was directly observed. The experiments were carried out in the European photoreactor EUPHORE (Valencia, Spain). OH radicals were quantitatively detected by means of laser-induced fluorescence (LIF) using a new analytical instrument, which has been constructed on the basis of an existing setup already established in field studies. The OH radicals observed resulted directly from the reaction of ozone with the corresponding alkene. There was no indication that OH radicals were produced in the system by secondary processes. The experimentally observed concentration-time profiles of OH and ozone were excellently described by chemical modeling using explicit reaction mechanisms. The following OH yields were derived: 2,3-dimethyl-2-butene: (1.00 +/- 0.25); 2-methyl-2-butene: (0.89 +/- 0.22); trans-2-butene: (0.75 +/- 0.19); alpha-pinene: (0.91 +/- 0.23). In addition, the experiments carried out were modeled using the Regional Atmospheric Chemistry Mechanism (RACM), an established condensed chemical model applied in tropospheric chemistry. For 2,3-dimethyl-2-butene, 2-methyl-2-butene, and trans-2-butene the calculated concentration-time profiles of OH and ozone are in quite good agreement with the experimental data. However, in the case of alpha-pinene, the model fails for the simulation of OH due to the high grade of mechanism condensation, which results in a poor characterization of the primary reaction products.
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Affiliation(s)
- M Siese
- Institut für Chemie und Dynamik der Geosphäre, Institut II, Jülich, Germany
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Rabbitt P, Diggle P, Smith D, Holland F, Mc Innes L. Identifying and separating the effects of practice and of cognitive ageing during a large longitudinal study of elderly community residents. Neuropsychologia 2001; 39:532-43. [PMID: 11254936 DOI: 10.1016/s0028-3932(00)00099-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In protracted longitudinal studies of cognitive changes in old age volunteers must be repeatedly tested. Even with intervals of several years between assessment, this raises the possibility that improvements due to practice mask other changes. This problem is much more acute in brief studies of cognitive changes associated with progressive pathologies such as Alzheimer's disease or the effects of clinical interventions. Both types of study also encounter problems of selective dropout of frail and less able individuals leaving relatively 'elite' survivors. An analysis of data from repeated testing at 2-3 years intervals on the AH4 (1) intelligence test is presented to illustrate how a random effects model can be used to identify and disassociate age-related changes and practice effects at the population level, after effects of selective dropout and of background demographical variables have been taken into consideration. This analysis also provides some new, substantive empirical findings. Age-related changes are relatively slight between 49 and 70 years but much more marked between 70 and 80 years. Even with assessment points, several years apart the population average effect of practice is large relative to that of age-related change. Variation between individuals increases as samples age, providing the first clear evidence from a longitudinal study for marked individual differences in trajectories of cognitive ageing.
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Affiliation(s)
- P Rabbitt
- Age and Cognitive Performance Research Centre, University of Manchester, Coupland 1, Oxford Road, M13 9PL, Manchester, UK.
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Fichtenbaum CJ, Koletar S, Yiannoutsos C, Holland F, Pottage J, Cohn SE, Walawander A, Frame P, Feinberg J, Saag M, Van der Horst C, Powderly WG. Refractory mucosal candidiasis in advanced human immunodeficiency virus infection. Clin Infect Dis 2000; 30:749-56. [PMID: 10816143 DOI: 10.1086/313765] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/1999] [Revised: 08/17/1999] [Indexed: 11/03/2022] Open
Abstract
We conducted a multicenter, prospective study of the risk factors, natural history, and outcome of fluconazole-refractory mucosal candidiasis (FRMC) in 832 persons with advanced human immunodeficiency virus (HIV) infection (median CD4 cell count, 14/mm3) during 1994-1996. FRMC was defined as mucosal candidiasis that failed to resolve despite 14 days of therapy with daily doses (> or =200 mg) of fluconazole. Thirty-six persons (4.3%) had FRMC (35, oral; 1, esophageal), for an incidence of 4.2 per 100 person-years (859.7 total years of follow-up). In a multivariate model, the use of trimethoprim-sulfamethoxazole within 6 months of enrollment (relative risk [RR], 2.39; P=.04) and the use of fluconazole daily or every other day (RR, 5.64; P=.004) were significantly associated with the development of FRMC. The median survival after the development of FRMC was 32.6 weeks. In conclusion, the annual incidence of FRMC was <5%. Refractory candidiasis was a poor prognostic indicator. Daily or every-other-day use of fluconazole was associated with the development of refractory infection.
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Affiliation(s)
- C J Fichtenbaum
- Washington University School of Medicine, St. Louis, MO, USA.
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Delpit B, Lamy J, Holland F, Chalchat JC, Garry RP. Clonal Selection of Sabinene Hydrate-Rich Thyme (Thymus vulgaris). Yield and Chemical Composition of Essential Oils. Journal of Essential Oil Research 2000. [DOI: 10.1080/10412905.2000.9699543] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Hamad AM, Wisniewski A, Range SP, Small T, Holland F, Knox AJ. The effect of the nitric oxide synthase inhibitor, L-NMMA, on sodium metabisulphite-induced bronchoconstriction and refractoriness in asthma. Eur Respir J 1999; 14:702-5. [PMID: 10543296 DOI: 10.1034/j.1399-3003.1999.14c34.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Refractoriness to indirect bronchoconstrictor stimuli, is a feature of asthma but the mechanism is poorly understood. This study tested the hypothesis that endogenous nitric oxide (NO) produced during a first bronchoconstrictor challenge protects against subsequent challenge and therefore has a role in the refractory process. The effect of an NO synthase inhibitor, N(G)-mono-methyl-L-arginine (L-NMMA), on refractoriness to sodium metabisulphite (MBS) was investigated in 20 subjects with mild asthma. On visit one, the dose of MBS which caused a 20% fall in forced expiratory volume in one second (FEV1) (PD20) was determined. On visit two, the refractory index (RI) to MBS was determined by challenging the subjects twice with their PD20 of MBS, the second challenge proceeding after recovery from the first. Those showing a refractory index of approximately 30% (10 subjects) inhaled either L-NMMA or placebo followed 5 min later by two challenges with their PD20 of MBS in a double-blind cross over study at two further visits. The dose of L-NMMA used was shown to reduce exhaled NO for a duration sufficient to cover the second MBS challenge However, no significant difference was found between L-NMMA and placebo in maximum fall in FEV1% and area under the curve (AUC) during first or second MBS challenges or in RI on the two study days. It is concluded that subjects with mild asthma show refractoriness to sodium metabisulphite, but that endogenous nitric oxide is unlikely to be involved either in the refractory process or in the response to sodium metabisulphite per se.
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Affiliation(s)
- A M Hamad
- Dept of Respiratory Medicine, City Hospital, Nottingham, UK
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Abstract
The aim of the study was to define the respiratory morbidity caused by lymphocytic interstitial pneumonitis (LIP) in children with vertically acquired HIV infection. A retrospective case note review was performed on 95 children attending three London hospitals. Clinical and radiological evidence of LIP, acute lower respiratory tract infections, and chronic lung disease was obtained using a structured protocol. A diagnosis of LIP had been made in 33%, and an acute admission due to acute lower respiratory tract infection had occurred in 42% of all children (despite 99% taking regular cotrimoxazole prophylaxis). Admission rates because of acute lower respiratory tract infection were significantly higher in the LIP group (0.38 admissions/child year) than in the non-LIP group (0.17 admissions/child year) (p = 0.0002). Encapsulated bacteria (Streptococcus pneumoniae, Haemophilus influenzae) were most frequently isolated. Improved methods of prevention of acute lower respiratory tract infection may help to reduce the severe respiratory morbidity seen in children with LIP and HIV infection.
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Affiliation(s)
- M Sharland
- Paediatric Infectious Disease Unit, St George's Hospital, London
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Affiliation(s)
- F Holland
- Cardiac Surgeons for Northwest Ohio, Inc., Toledo 43606, USA
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Ades AE, Parker S, Cubitt D, Davison C, Holland F, Berry T, Hjelm M, Wilcox AH, Peckham CS. Two methods for assessing the risk-factor composition of the HIV-1 epidemic in heterosexual women: southeast England, 1988-1991. AIDS 1992; 6:1031-6. [PMID: 1388892 DOI: 10.1097/00002030-199209000-00018] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The prevalence of HIV-1 in the heterosexual population in southeast England between 1988 and 1991 was examined using two methods. DESIGN AND METHODS First, district neonatal seroprevalence was compared on a geographical basis to social and demographic variables reflecting risk-factor prevalence. Second, over the same period eight children who developed AIDS within the first 12 months of life were born. RESULTS The differences in seroprevalence between districts could be explained by the proportion of livebirths to women born in parts of Africa. An estimated 92% of neonatal seropositives could be associated with this demographic variable. The proportions of livebirths to women born in other countries, the prevalence of notified injecting drug use, and area measures of social deprivation, were only poorly related to HIV seroprevalence, and had no additional explanatory value. Seven of the eight (87.5%) children who developed AIDS in the first year were born to black women from Africa. CONCLUSIONS Both methods suggest that a high proportion of heterosexually transmitted HIV in southeast England has been imported.
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Affiliation(s)
- A E Ades
- Epidemiology and Biostatistics Unit, Institute of Child Health, London, UK
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Huber KP, Holland F, Coxon JA. Jet emission spectroscopy of OH and OD near 1850 Å: First observation of a2Π→2Π electronic transition of OD. J Chem Phys 1992. [DOI: 10.1063/1.462187] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Dutch workers have proposed that people with asthma and those smokers who develop chronic airflow obstruction share a common allergic constitution. To study whether smoking itself is associated with indicators of allergy, we have examined 237 men aged 51-61 years (120 smokers, 73 ex-smokers, and 44 non-smokers) who were recruited to a long term study of lung function in 1974, at which time men with a clinical diagnosis of asthma were excluded. Smokers, ex-smokers, and non-smokers did not differ in personal or family history of allergic disease, but the prevalence of positive responses to skinprick tests was greater in ex-smokers (59%) than in the other two groups (33% and 34%). In men with negative responses to skinprick tests total serum IgE was greater in smokers (log10 mean 1.41 IU/ml) and in ex-smokers (log10 mean 1.53 IU/ml) than in non-smokers (log10 mean 1.12 IU/ml). In men with positive skin test responses serum IgE was similar in the three groups (log10 mean ranging from 1.68 to 1.78 IU/ml). Geometric mean total white cell counts in the peripheral blood were higher in smokers (7.34 X 10(9)/l) than in non-smokers (5.82 X 10(9)/l); the value in ex-smokers (6.16 X 10(9)/l) was intermediate. Absolute blood eosinophil counts were increased in smokers disproportionately to the increase in total white cell count. Thus smoking is associated with small increases in some markers of allergy. These changes are probably acquired after the onset of smoking but sequential studies are required to amplify these cross sectional observations. Smokers whose skin test responses are positive appear more likely to give up smoking.
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Taylor RG, Joyce H, Gross E, Holland F, Pride NB. Bronchial reactivity to inhaled histamine and annual rate of decline in FEV1 in male smokers and ex-smokers. Thorax 1985; 40:9-16. [PMID: 3969664 PMCID: PMC459970 DOI: 10.1136/thx.40.1.9] [Citation(s) in RCA: 123] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We examined the relations between bronchial reactivity, baseline FEV1, and annual decline of height corrected FEV1 (delta FEV1/ht3) over 7.5 years in 227 men (117 smokers, 71 ex-smokers, and 39 non-smokers). Men with a clinical diagnosis of asthma or receiving bronchodilator treatment were excluded. Bronchial reactivity was determined as the provocation concentration (PC20) of inhaled histamine sufficient to reduce FEV1 by 20%; subjects were divided into reactors (PC20 less than or equal to 16 mg/ml) and non-reactors (PC20 greater than 16 mg/ml). Thirty per cent of smokers, 24% of ex-smokers, and 5% of non-smokers were reactors. When smokers who were reactors were compared with non-reactors, the reactors showed a lower baseline FEV1 as percentage predicted in 1981-2 (85% v 108%), and a faster delta FEV1/ht3 (14.1 v 9.2 ml/y/m3). Baseline FEV1 correlated with PC20 in both smokers (rs = 0.51) and ex-smokers (rs = 0.61), and all 15 subjects with an FEV1 under 80% of the predicted value were reactors. In ex-smokers delta FEV1/ht3 was similar in reactors and non-reactors (m 9.0 v 7.4 ml/y/m3), despite significant differences in baseline FEV1. When analysis was confined to men with a baseline FEV1 over 80% predicted, the prevalence of reactors was significantly increased among smokers and slightly increased among ex-smokers compared with non-smokers, though the mean FEV1 was higher in the non-smokers. Bronchial reactivity was not increased in smokers aged 35 years or less. In smokers delta FEV1/ht3 was faster in those with a personal history of allergy (usually allergic rhinitis), but was not related to a family history of allergic disease, total serum immunoglobulin E level, absolute blood eosinophil count, or skinprick test score. delta FEV1/ht3 was also faster in all subjects taking beta blocker drugs. Thus increased bronchial reactivity was associated with accelerated decline of FEV1 in smokers. Although the association could be a consequence of a lower lower baseline FEV1, a trend towards increased reactivity was found in smokers with normal baseline FEV1 and delta FEV1/ht3 was dissociated from increased reactivity in ex-smokers. These findings are compatible with the "Dutch hypothesis," but the association between allergic features and accelerated delta FEV1/ht3 was relatively weak, and increased reactivity may follow rather than precede the onset of smoking.
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Taylor R, Gross F, Joyce H, Holland F, Pride N. Relation Between Bronchial Reactivity to Inhaled Histamine and Annual Decline in FEV 1 in Male Smokers and Exsmokers. Chest 1984. [DOI: 10.1378/chest.85.6_supplement.22s] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Weiss RB, Tormey DC, Holland F, Weinberg VE, Lesnick G, Perloff M, Falkson G, Glidewell OJ. A randomized trial of postoperative five-versus three-drug chemotherapy after mastectomy: a Cancer and Leukemia Group B (CALGB) study. Recent Results Cancer Res 1982; 80:170-6. [PMID: 7036280 DOI: 10.1007/978-3-642-81685-7_28] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The Cancer and Leukemia Group B (CALB) has conducted a randomized study of adjuvant chemotherapy in patients with breast cancer who have involved axillary nodes at the time of mastectomy. Five-drug treatment (CMFVP) was compared with three-drug treatment (CMF). For patients with more than three involved nodes, the CMFVP regimen produced a significantly prolonged disease-free survival in comparison to the CMF regimen.
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Ehrlich K, Holland F, Turnham T, Klein E. Osmotic concentration of polypeptides from hemofiltrate of uremic patients. Clin Nephrol 1980; 14:31-5. [PMID: 7408253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Hemofiltrate from uremic patients was concentrated 15- to 40-fold by osmotic removal of water across a reverse osmosis membrane which retains salts and proteins. Salts and low molecular weight components were removed from the concentrate by partial dialysis using a highly impermeable cellulose membrane. Following this desalting step, 100- to 500-fold concentration could be achieved by evaporation at low pressure. The concentrate was fractionated on Sephadex G15 columns. Fractions were tested for their toxicity to human cells in culture. Fractions containing components with molecular weights greater than 700 daltons inhibited 3H-thymidine incorporation into the DNA of HeLa and skin fibroblast cells more than did low molecular weight peptides and an iso-osmolar control. Components eluting in the molecular weight range of angiotensin I and vitamin B-12 were most inhibitory. These studies show that hemofiltrate from uremic patients is a readily available source of toxic polypeptides. The osmotic concentration and gel chromatographic procedures described should make available large amounts of these molecules for further studies.
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