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Abstract
The World Organisation for Animal Health (OIE) regional vaccine banks are established for priority diseases, following a business model that depends largely on financial support from donors (with vaccine also purchased directly by individual countries and international organisations that have been granted access by the OIE to the mechanism), and is based on the concept of starting small and scaling up. The OIE vaccine bank for rabies was established in 2012 with a first production order of just 50,000 doses, but as of 31 December 2016, after five years, the OIE had ordered almost 16 million doses of rabies vaccines for deliveries in 24 countries. It was set up on the basis of OIE internationally recognised procurement procedures and the outcome of an international call for tender. Vaccine manufacturers are contracted to produce and supply high-quality vaccine on demand, but they also keep vaccines available at any moment so that they can deliver small quantities of vaccines for emergencies.
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Schlosser RJ, Smith TL, Mace J, Soler ZM. Asthma quality of life and control after sinus surgery in patients with chronic rhinosinusitis. Allergy 2017; 72:483-491. [PMID: 27638398 DOI: 10.1111/all.13048] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Patients with chronic rhinosinusitis (CRS) often have comorbid asthma. Prior studies have not examined the impact of CRS or endoscopic sinus surgery (ESS) upon asthma quality of life (QOL) and asthma control using validated outcome metrics. METHODS Patients with CRS, both with and without polyps, and comorbid asthma completed the Mini Asthma QOL Questionnaire (miniAQLQ) and Asthma Control Test (ACT) at baseline and 6 months postoperatively as part of a multi-institutional, prospective study. RESULTS Baseline metrics were available on 86 patients. Patients undergoing ESS reported improved miniAQLQ [0.5 (SD ±1.1), 95% CI: 0.2-0.7; P = 0.002] and ACT scores [1.3 (±4.1), 95% CI: 0.2-2.4; P = 0.025]. Uncontrolled baseline asthma (ACT < 20) was present in 51% of patients undergoing ESS. In uncontrolled patients, ESS resulted in a minimal clinically important difference 57% of the time for miniAQLQ scores (≥0.5 points) and 50% of the time for ACT scores (≥3.0 points). After adjustment with linear regression, baseline miniAQLQ scores were worse in patients with comorbid allergy (P = 0.045) and chronic obstructive pulmonary disease (COPD; P = 0.015). Adjusted baseline ACT scores were worse in patients with COPD (P = 0.004). Covariates associated with changes in miniAQLQ scores after ESS were pre-operative corticosteroid dependency (P = 0.011) and change in total SNOT-22 score (P = 0.010). Covariate associated with significantly less improvement in ACT scores was obstructive sleep apnea (P = 0.016). CONCLUSIONS Patients with CRS often present with uncontrolled asthma, and ESS improves both miniAQLQ and ACT. Approximately half of patients with uncontrolled asthma improve after ESS, yet there are few CRS-specific factors associated with asthma QOL or control or ESS outcomes.
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Affiliation(s)
- R. J. Schlosser
- Department of Otolaryngology - Head and Neck Surgery; Medical University of South Carolina; Charleston SC USA
| | - T. L. Smith
- Department of Otolaryngology - Head and Neck Surgery; Oregon Health Sciences University; Portland OR USA
| | - J. Mace
- Department of Otolaryngology - Head and Neck Surgery; Oregon Health Sciences University; Portland OR USA
| | - Z. M. Soler
- Department of Otolaryngology - Head and Neck Surgery; Medical University of South Carolina; Charleston SC USA
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Wheelton A, Mace J, Khan WS, Anand S. Biomaterials and Fabrication to Optimise Scaffold Properties for Musculoskeletal Tissue Engineering. Curr Stem Cell Res Ther 2016:CSCRT-EPUB-76503. [PMID: 27297035] [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] [Received: 05/14/2015] [Accepted: 05/01/2016] [Indexed: 06/06/2023]
Abstract
Tissue engineering has emerged as a promising scientific field potentially yielding in vitro developed tissue to replace degenerative or injured tissues in vivo, thus avoiding the donor site morbidity associated with reconstructive surgery. Integral to the process is the role of scaffolds and the biomaterials used to form them. This review explores the concept of scaffold based tissue engineering and design considerations. The scaffold needs to have certain mechanical and architectural properties, it needs to be biocompatible and biodegradable, and allow combination with bioactive molecules. We also discuss scaffolding techniques, different biomaterial options and fabrication technologies, and future areas of development.
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Affiliation(s)
| | | | - W S Khan
- Clinical Lecturer, University College London Institute of Orthopaedics and Musculoskeletal Science, Royal National Orthopaedic Hospital, Stanmore, London, HA7 4LP, UK.
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4
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Abstract
Over a 15-year prospective period, 201 infants with a clinically unstable hip at neonatal screening were subsequently reviewed in a ‘one stop’ clinic where they were assessed clinically and sonographically. Their mean age was 1.62 weeks (95% confidence interval (CI) 1.35 to 1.89). Clinical neonatal hip screening revealed a sensitivity of 62% (mean, 62.6 95%CI 50.9 to 74.3), specificity of 99.8% (mean, 99.8, 95% CI 99.7 to 99.8) and positive predictive value (PPV) of 24% (mean, 26.2, 95% CI 19.3 to 33.0). Static and dynamic sonography for Graf type IV dysplastic hips had a 15-year sensitivity of 77% (mean, 75.8 95% CI 66.9 to 84.6), specificity of 99.8% (mean, 99.8, 95% CI 99.8 to 99.8) and a PPV of 49% (mean, 55.1, 95% CI 41.6 to 68.5). There were 36 infants with an irreducible dislocation of the hip (0.57 per 1000 live births), including six that failed to resolve with neonatal splintage. Most clinically unstable hips referred to a specialist clinic are female and stabilise spontaneously. Most irreducible dislocations are not identified from this neonatal instability group. There may be a small subgroup of females with instability of the hip which may be at risk of progression to irreducibility despite early treatment in a Pavlik harness. A controlled study is required to assess the value of neonatal clinical screening programmes. Cite this article: Bone Joint J 2015;97-B:265-9.
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Affiliation(s)
- J. Mace
- Royal Blackburn Hospital, Haslingden
Road, Blackburn, Lancashire
BB2 3HH, UK
| | - R. W. Paton
- University of Manchester, Oxford
Road, Manchester M13 9PL, UK
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Shahawy S, Chan NK, Ellard S, Young E, Shahawy H, Mace J, Peverini R, Chinnock R, Njolstad PR, Hattersley AT, Hathout E. A pathway to insulin independence in newborns and infants with diabetes. J Perinatol 2011; 31:567-70. [PMID: 21796147 DOI: 10.1038/jp.2011.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Permanent neonatal diabetes was previously assumed to require insulin injection or infusion for life. Recently, permanent neonatal diabetes resulting from mutations in the two protein subunits of the adenosine triphosphate-sensitive potassium channel (Kir6.2 and SUR1) has proven to be successfully treatable with high doses of sulfonylureas rather than insulin. Many patients with these mutations first develop hyperglycemia in the nursery or intensive care unit. The awareness of the neonatolgist of this entity can have dramatic effects on the long-term care and quality of life of these patients and their families. In this study, we present the experience of our center, highlighting aspects relevant to neonatal diagnosis and treatment.
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Affiliation(s)
- S Shahawy
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA
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6
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Bonomi PD, Mace J, Mandanas RD, Min M, Zhang Y, Rowinsky E, Youssoufian H. Phase II randomized, open-label study of cetuximab (Cet) and bevacizumab (Bev) in combination with paclitaxel (P) and carboplatin (C) in patients with stageIII/IV non-small cell lung cancer (NSCLC). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.8046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8046^ Background: Cet, a monoclonal antibody (mAb) that specifically targets epidermal growth factor receptor (EGFR) and Bev (anti-VEGF mAb) combined with chemotherapy has resulted in superior survival compared to chemotherapy alone in some stage IV NSCLC trials. Combining both mAb's with chemotherapy might increase survival in stage IV NSCLC pts. Methods: Chemotherapy naïve advanced NSCLC patients with ECOG status <1, adequate hematologic, hepatic, and renal function received Cet (400 mg/m2 on Day 1 as initial dose and weekly thereafter at 250 mg/m2) plus Bev (15 mg/kg on Day 8 of each 3-week cycle) for 6 cycles in combination with either 6 cycles (Arm A) or 3 cycles (Arm B) of P (200 m/kg) and C (AUC=6) on Day 1 of each 3-week cycle. Patients without progressive disease (PD) after 6 cycles continued Cet until PD or other withdrawal criteria were met. Comparison of progression-free survival (PFS) for arm A vs B is the primary objective. Results: Accrual is completed. Data are available for 85 pts: 47% women, median age 65 yrs, and 88% Caucasian. Median PFS for arm A was 6.0 vs 4.2 months for arm B, hazard ratio of 0.57 for arm A relative to arm B. Objective response was Arm A=31% and B=30%. Most frequent AEs ≥Grade 3 in pts were neutropenia [9 (10.6%), A=8, B=1], fatigue [8 (9.4%), A=4, B=4], dermatitis acneiform [6 (7.1%), A=3, B=3].13 pts withdrew due to AEs (A=4, B=9), 4 were related to Cet (2 per arm). Two pts discontinued due to death (A=2, B=0) unrelated to Cet. Conclusions: Adding both mAb's to PC resulted in acceptable toxicity. The trend for superior PFS with 6 courses of PC suggests that 3 courses of PC are not optimal. [Table: see text] ASCO Conflict of Interest Policy and Exceptions In compliance with the guidelines established by the ASCO Conflict of Interest Policy (J Clin Oncol. 2006 Jan 20;24[3]:519–521) and the Accreditation Council for Continuing Medical Education (ACCME), ASCO strives to promote balance, independence, objectivity, and scientific rigor through disclosure of financial and other interests, and identification and management of potential conflicts. According to the ASCO Conflict of Interest Policy, the following financial and other relationships must be disclosed: employment or leadership position, consultant or advisory role, stock ownership, honoraria, research funding, expert testimony, and other remuneration (J Clin Oncol. 2006 Jan 20;24[3]:520). The ASCO Conflict of Interest Policy disclosure requirements apply to all authors who submit abstracts to the Annual Meeting. For clinical trials that began accrual on or after April 29, 2004, ASCO's Policy places some restrictions on the financial relationships of principal investigators (J Clin Oncol. 2006 Jan 20;24[3]:521). If a principal investigator holds any restricted relationships, his or her abstract will be ineligible for placement in the 2009 Annual Meeting unless the ASCO Ethics Committee grants an exception. Among the circumstances that might justify an exception are that the principal investigator (1) is a widely acknowledged expert in a particular therapeutic area; (2) is the inventor of a unique technology or treatment being evaluated in the clinical trial; or (3) is involved in international clinical oncology research and has acted consistently with recognized international standards of ethics in the conduct of clinical research. NIH-sponsored trials are exempt from the Policy restrictions. Abstracts for which authors requested and have been granted an exception in accordance with ASCO's Policy are designated with a caret symbol (^) in the Annual Meeting Proceedings. For more information about the ASCO Conflict of Interest Policy and the exceptions process, please visit www.asco.org/conflictofinterest .
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Affiliation(s)
- P. D. Bonomi
- Rush University Medical Center, Chicago, IL; Gulfcoast Oncology Associates; Maryland Hematology Oncology Associates; ImClone Systems
| | - J. Mace
- Rush University Medical Center, Chicago, IL; Gulfcoast Oncology Associates; Maryland Hematology Oncology Associates; ImClone Systems
| | - R. D. Mandanas
- Rush University Medical Center, Chicago, IL; Gulfcoast Oncology Associates; Maryland Hematology Oncology Associates; ImClone Systems
| | - M. Min
- Rush University Medical Center, Chicago, IL; Gulfcoast Oncology Associates; Maryland Hematology Oncology Associates; ImClone Systems
| | - Y. Zhang
- Rush University Medical Center, Chicago, IL; Gulfcoast Oncology Associates; Maryland Hematology Oncology Associates; ImClone Systems
| | - E. Rowinsky
- Rush University Medical Center, Chicago, IL; Gulfcoast Oncology Associates; Maryland Hematology Oncology Associates; ImClone Systems
| | - H. Youssoufian
- Rush University Medical Center, Chicago, IL; Gulfcoast Oncology Associates; Maryland Hematology Oncology Associates; ImClone Systems
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Sakata N, Tan A, Chan N, Obenaus A, Mace J, Peverini R, Sowers L, Chinnock R, Hathout E. Efficacy comparison between intraportal and subcapsular islet transplants in a murine diabetic model. Transplant Proc 2009; 41:346-9. [PMID: 19249553 DOI: 10.1016/j.transproceed.2008.08.155] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Accepted: 08/10/2008] [Indexed: 02/07/2023]
Abstract
BACKGROUND It is important to determine the efficacy of intraportal (IP) islet transplantation in comparison with other transplant sites. In this study, we sought to determine the optimal number of islets to achieve normoglycemia following transplantation into the liver versus the kidney using a mouse model. METHODS Streptozotocin-induced diabetic mice (Balb/C) were transplanted with syngeneic islets via the IP versus renal subcapsular (SC) routes. The transplanted islet numbers were 0 to 800 (n = 3-5). We assessed the correlation between parameters and islet numbers, comparing IP versus SC groups. The parameters were: (1) percentage of normoglycemia; (2) postoperative days to normoglycemia; (3) mean blood glucose levels at various points from pretransplantation to the end of the study (postoperative day 28); (4) mean serum insulin; and (5) area under the curve of blood glucose levels after glucose injection. RESULTS Two hundred islets yielded normoglycemia in renal subcapsular grafts, while 800 islets were the minimum required for normoglycemia with IP transplantation. The transplant efficacy in SC transplantation was 2 to 5 times greater than that of IP transplantation. The days to normoglycemia were significantly different between IP versus renal SC islets (13.25 +/- 4.38 days vs 4.50 +/- 0.81 days; P = .007). CONCLUSION The efficacy of islet transplantation in murine diabetic models was significantly greater under the kidney capsule. Clinical islet transplantation could benefit from trials of alternative transplant sites.
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Affiliation(s)
- N Sakata
- Islet Transplant Laboratory, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California 92354, USA.
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Mace J, Gordon MJ, Giapis KP. Evidence of simultaneous double-electron promotion in F+ collisions with surfaces. Phys Rev Lett 2006; 97:257603. [PMID: 17280394 DOI: 10.1103/physrevlett.97.257603] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2006] [Indexed: 05/13/2023]
Abstract
A high-flux beam of mass-filtered F+ at low energy (100-1300 eV) was scattered off Al and Si surfaces to study core-level excitations of F0 and F+. Elastic scattering behavior for F+ was observed at energies <300 (500) eV off Al (Si) for a 90 degrees lab angle. However, above this energy threshold, orbital mixing in the hard collision step results in electronic excitation of F via molecular orbital promotion along the 4f sigma (F-2p), significantly reducing the observed ion exit energy. In addition, despite the electronegativity of F, scattering at energies >450 (700) eV off Al (Si) produces F2+-behavior which is remarkably similar to Ne+ off the same surfaces. Inelasticities measured for single collision events agree well with the energy deficits required to form (doubly excited) F** and F+** states from F0 and F+, respectively; these excited species most likely decay to inelastic F+ and F2+ via autoionization.
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Affiliation(s)
- J Mace
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, California 91125, USA
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9
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Miao G, Ostrowski RP, Mace J, Hough J, Hopper A, Peverini R, Chinnock R, Zhang J, Hathout E. Dynamic production of hypoxia-inducible factor-1alpha in early transplanted islets. Am J Transplant 2006; 6:2636-43. [PMID: 17049056 DOI: 10.1111/j.1600-6143.2006.01541.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
More than half of transplanted beta-cells undergo apoptotic cell death triggered by nonimmunological factors within a few days after transplantation. To investigate the dynamic hypoxic responses in early transplanted islets, syngeneic islets were transplanted under the kidney capsule of balb/c mice. Hypoxia-inducible factor-1alpha (HIF-1alpha) was strongly expressed at post-transplant day (POD) 1, increased on POD 3, and gradually diminished on POD 14. Insulin secretion decreased on POD 3 in association with a significant increase of HIF-1alpha-related beta-cell death, which can be suppressed by short-term hyperbaric oxygen therapy. On POD 7, apoptosis was not further activated by continually produced HIF-1alpha. In contrast, improvement of nerve growth factor and duodenal homeobox factor-1 (PDx-1) production resulted in islet graft recovery and remodeling. In addition, significant activation of vascular endothelial growth factor in islet grafts on POD 7 correlated with development of massive newly formed microvessels, whose maturation is advanced on POD 14 with gradual diminution of HIF-1alpha. We conclude that (1) transplanted islets strongly express HIF-1alpha in association with beta-cell death and decreased insulin production until adequate revascularization is established and (2) early suppression of HIF-1alpha results in less beta-cell death thereby minimizing early graft failure.
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Affiliation(s)
- G Miao
- Islet Transplant Laboratory, Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, California, USA
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10
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Abstract
OBJECTIVE Development of the Edmonton protocol was a pivotal contribution to clinical islet transplantation (ITx). Persistent limitations to ITx include insufficient supply and posttransplant functional failure of islets. In this study, nerve growth factor (NGF) was used to enhance both cultured and transplanted beta-cell function, thus achieving prolonged graft survival. METHODS Fluorescence microscopy with ethidium bromide and SYTO green staining was used to evaluate balb/c mouse islet viability. Islets were syngeneically transplanted under the kidney capsule of recipients with streptozotocin-induced diabetes. Intraperitoneal glucose tolerance was used to test posttransplant function. RESULTS Improved viability was found in murine islets cultured for 48 hours in 500 ng/mL NGF (P < .05). A submarginal islet mass (260 islet equivalents/recipient) was used for ITx. The NGF-culture resulted in prolonged islet survival (24.7 days vs 5.5 days without NFG culture, n = 6). Intravenous injection of NGF (6 mug) on the day of transplant and postoperative days (POD) 1 + 2 prolonged islet survival from 4.1 days (no treatment) to 13.2 days (n = 6). Glucose tolerance testing performed at posttransplant day 4 showed improvement at 60 and 120 minutes in recipients treated intravenously with NGF (blood glucose of 95 +/- 15 vs 210 +/- 78 and 57 +/- 6 vs 176 +/- 70 mg/dL, respectively). CONCLUSION NGF may improve beta-cell function and result in prolonged survival of both cultured and transplanted islets.
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Affiliation(s)
- G Miao
- Department of Pediatrics, Loma Linda University, 11175 Campus Street, Loma Linda, CA 92354, USA
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11
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Xie C, Mace J, Dinno MA, Li YQ, Tang W, Newton RJ, Gemperline PJ. Identification of Single Bacterial Cells in Aqueous Solution Using Confocal Laser Tweezers Raman Spectroscopy. Anal Chem 2005; 77:4390-7. [PMID: 16013851 DOI: 10.1021/ac0504971] [Citation(s) in RCA: 170] [Impact Index Per Article: 8.9] [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: 11/28/2022]
Abstract
We report on a rapid method for reagentless identification and discrimination of single bacterial cells in aqueous solutions using a combination of laser tweezers and confocal Raman spectroscopy (LTRS). The optical trapping enables capturing of individual bacteria in aqueous solution in the focus of the laser beam and levitating the captured cell well off the cover plate, thus maximizing the excitation and collection of Raman scattering from the cell and minimizing the unwanted background from the cover plate and environment. Raman spectral patterns excited by a near-infrared laser beam provide intrinsic molecular information for reagentless analysis of the optically isolated bacterium. In our experiments, six species of bacteria were used to demonstrate the capability of the confocal LTRS in the identification and discrimination between the diverse bacterial species at various growth conditions. We show that synchronized bacterial cells can be well-discriminated among the six species using principal component analyses (PCA). Unsynchronized bacterial cells that are cultured at stationary phases can also be well-discriminated by the PCA, as well as by a hierarchical cluster analysis (HCA) of their Raman spectra. We also show that unsynchronized bacteria selected from random growth phases can be classified with the help of a generalized discriminant analysis (GDA). These findings demonstrate that the LTRS may find valuable applications in rapid sensing of microbial cells in diverse aqueous media.
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Affiliation(s)
- C Xie
- Department of Physics, Biology, and Chemistry, East Carolina University, Greenville, North Carolina 27858-4353, USA
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Hathout E, Wagner P, Ryan E, Tran L, Beeson L, Sharkey J, Mace J. 325 DEVELOPMENT OF A PEDIATRIC DIABETES RISK SCORE. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Mace J. Who knows more? Adm Radiol 1992; 11:48-9. [PMID: 10118532] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- J Mace
- Riverside Methodist Hospitals, Columbus, OH
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Baum MF, Cutler DC, Fricker FJ, Trimm RF, Mace J. Session VII: Physiologic and psychological growth and development in pediatric heart transplant recipients. J Heart Lung Transplant 1991; 10:848-55. [PMID: 1720661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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15
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Candillier MP, Mace J, Agher JP, Calvet P. [Value of the psychologist's intervention in the maternity of a general hospital]. Ann Med Psychol (Paris) 1991; 149:221-3. [PMID: 1929078] [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] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Mace J. Vocational training. My year as a guinea pig. Br Dent J 1989; 166:265-6. [PMID: 2706169 DOI: 10.1038/sj.bdj.4806792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In the twilight of the first year of the new Vocational Training Scheme I am reflecting on my metamorphosis from a naive dental student to vocational trainee and ultimately (hopefully) to competent clinician.
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Toomey FB, Bailey LL, Bui RD, Kanahriyeh M, Petry E, Mathis C, Johnston J, Mace J, Grill B, Klooster M. Chest radiography in infant cardiac allotransplantation. AJR Am J Roentgenol 1988; 150:369-72. [PMID: 3276090 DOI: 10.2214/ajr.150.2.369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Heart transplants were performed in seven infants at Loma Linda University Medical Center from 1985 to 1987. Five of these seven patients survived. In this report, the radiographic appearance of the chest is presented before surgery, immediately after surgery, and during a documented episode of rejection. The most current available chest radiograph is also presented. Acute rejection was confirmed by clinical, echocardiographic, and ECG findings. The only pulmonary infection encountered was mycoplasma pneumonitis. Four patients developed gastrointestinal rotavirus infections and were shown to have dilated proximal small-bowel folds on upper gastrointestinal studies. At the time of this writing, the prognosis for the five surviving infants is good. We conclude that the radiographs of infants who have received heart transplants show an unusual cardiac contour and slight cardiomegaly. Increasing cardiomegaly can alert one to early rejection. Prominent folds in the small bowel are of uncertain origin and significance, but they may be related to infection resulting from immunosuppression.
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Affiliation(s)
- F B Toomey
- Department of Radiology, Loma Linda University Medical Center, CA 92354
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Rodriguez WJ, Bui RH, Connor JD, Kim HW, Brandt CD, Parrott RH, Burch B, Mace J. Environmental exposure of primary care personnel to ribavirin aerosol when supervising treatment of infants with respiratory syncytial virus infections. Antimicrob Agents Chemother 1987; 31:1143-6. [PMID: 3662474 PMCID: PMC174887 DOI: 10.1128/aac.31.7.1143] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The potential exposure to ribavirin aerosol in the environment was assessed in nurses caring for infants and children with severe lower respiratory tract infections due to respiratory syncytial virus. Ribavirin aerosol was administered via a ventilator, oxygen tent, or oxygen hood. Participants worked directly with infants receiving ribavirin for 20.0 to 35.0 h over a 3-day period. No toxic or adverse effects of ribavirin aerosol were observed in any of the 19 nurses studied, and ribavirin was not detected in erythrocytes, plasma, or urine collected after the potential exposure period.
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Affiliation(s)
- W J Rodriguez
- Children's Hospital National Medical Center, George Washington University School of Medicine and the Health Sciences, Washington, D.C. 20010
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Barnass S, Mace J, Steele J, Torres P, Gervasoni B, Ravioli R, Terencio J, Rook GA, Waters MF. Prevalence and specificity of the enhancing effect of three types of interleukin 2 on T cell responsiveness in 97 lepromatous leprosy patients of mixed ethnic origin. Clin Exp Immunol 1986; 64:41-9. [PMID: 2426020 PMCID: PMC1542157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Peripheral blood mononuclear cells from 97 predominantly lepromatous leprosy patients and 11 control subjects were tested in a lymphoproliferative assay for response to Mycobacterium leprae (whole and sonicated), and sonicated M. vaccae, M. tuberculosis, and M. scrofulaceum, in the presence and absence of three types of interleukin 2 (IL-2) (crude, purified, and recombinant). IL-2 enhanced the response to sonicated M. tuberculosis and M. leprae organisms more often in patients than in control subjects, but not significantly so and only in a minority of patients. This effect was significantly more common (though still only found in a minority of 46%) using M. leprae organisms as antigen, than when using sonicates of M. leprae (19%) or M. vaccae (19%). However it was nearly as frequent using sonicated M. tuberculosis, or M. scrofulaceum. Thus in only nine patients was the effect specific to M. leprae. Enhancement by IL-2 could not be related to the type of IL-2 used, the dose of antigen, or the amount of endogenous IL-2 released by the cells tested. Similarly it was not related to the extent to which IL-2 caused increased background proliferation in control wells, which occurred to an equal extent using cells from control subjects, nor was it related to the extent of antigen-driven proliferation. The data have also been analysed in relation to duration of disease (50 years to a few weeks) and ethnic origin. No correlations have been revealed. Thus enhancement by IL-2 of the lymphoproliferative response to mycobacterial antigens does occur using cells from lepromatous leprosy patients, but it is found in a minority of patients, it is not specific to M. leprae, and can occur with cells from normal donors.
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Rook GA, Steele J, Barnass S, Mace J, Stanford JL. Responsiveness to live M. tuberculosis, and common antigens, of sonicate-stimulated T cell lines from normal donors. Clin Exp Immunol 1986; 63:105-10. [PMID: 3082544 PMCID: PMC1577333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Live mycobacteria are more efficient vaccines against mycobacterial disease than killed ones. A possible explanation is the existence of important protective antigens released by live bacilli, which are not present in any significant quantity in dead ones. Conversely, internal mycobacterial antigens may be irrelevant to protection if not released by live bacilli. We show here, using T cell lines derived by limiting dilution from the peripheral blood of normal donors stimulated with sonicated BCG, that a variable percentage of sonicate responsive T cells is unable to respond to live M. tuberculosis. The possibility that such lines have an immunopathological, rather than protective role, is discussed.
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Mace J, Amundson S, Schneider S. Letter: Absence of pituitary gland vs congenital hypopituitarism. J Pediatr 1976; 89:515-6. [PMID: 956987 DOI: 10.1016/s0022-3476(76)80572-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Rowland D, Mace J. Caffeine (no-doz) poisoning in childhood. West J Med 1976; 124:52-53. [PMID: 18747633 PMCID: PMC1129979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Mace J. The significance of an unusual odor in infants. West J Med 1974; 120:404-405. [PMID: 18747382 PMCID: PMC1130154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Mace J, Winters K, Vyhmeister N. Etiology of pneumonia in children. N Engl J Med 1973; 288:1244-5. [PMID: 4700562 DOI: 10.1056/nejm197306072882319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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