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Drummond J, Makdani A, Pawling R, Walker SC. Congenital Anosmia and Facial Emotion Recognition. Physiol Behav 2024; 278:114519. [PMID: 38490365 DOI: 10.1016/j.physbeh.2024.114519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 03/17/2024]
Abstract
Major functions of the olfactory system include guiding ingestion and avoidance of environmental hazards. People with anosmia report reliance on others, for example to check the edibility of food, as their primary coping strategy. Facial expressions are a major source of non-verbal social information that can be used to guide approach and avoidance behaviour. Thus, it is of interest to explore whether a life-long absence of the sense of smell heightens sensitivity to others' facial emotions, particularly those depicting threat. In the present, online study 28 people with congenital anosmia (mean age 43.46) and 24 people reporting no olfactory dysfunction (mean age 42.75) completed a facial emotion recognition task whereby emotionally neutral faces (6 different identities) morphed, over 40 stages, to express one of 5 basic emotions: anger, disgust, fear, happiness, or sadness. Results showed that, while the groups did not differ in their ability to identify the final, full-strength emotional expressions, nor in the accuracy of their first response, the congenital anosmia group successfully identified the emotions at significantly lower intensity (i.e. an earlier stage of the morph) than the control group. Exploratory analysis showed this main effect was primarily driven by an advantage in detecting anger and disgust. These findings indicate the absence of a functioning sense of smell during development leads to compensatory changes in visual, social cognition. Future work should explore the neural and behavioural basis for this advantage.
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Affiliation(s)
- James Drummond
- Research Centre for Brain & Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Adarsh Makdani
- Research Centre for Brain & Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Ralph Pawling
- Research Centre for Brain & Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Susannah C Walker
- Research Centre for Brain & Behaviour, School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK.
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Allen S, Loong L, Garrett A, Torr B, Durkie M, Drummond J, Callaway A, Robinson R, Burghel GJ, Hanson H, Field J, McDevitt T, McVeigh TP, Bedenham T, Bowles C, Bradshaw K, Brooks C, Butler S, Del Rey Jimenez JC, Hawkes L, Stinton V, MacMahon S, Owens M, Palmer-Smith S, Smith K, Tellez J, Valganon-Petrizan M, Waskiewicz E, Yau M, Eccles DM, Tischkowitz M, Goel S, McRonald F, Antoniou AC, Morris E, Hardy S, Turnbull C. Recommendations for laboratory workflow that better support centralised amalgamation of genomic variant data: findings from CanVIG-UK national molecular laboratory survey. J Med Genet 2024; 61:305-312. [PMID: 38154813 PMCID: PMC10982625 DOI: 10.1136/jmg-2023-109645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/28/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND National and international amalgamation of genomic data offers opportunity for research and audit, including analyses enabling improved classification of variants of uncertain significance. Review of individual-level data from National Health Service (NHS) testing of cancer susceptibility genes (2002-2023) submitted to the National Disease Registration Service revealed heterogeneity across participating laboratories regarding (1) the structure, quality and completeness of submitted data, and (2) the ease with which that data could be assembled locally for submission. METHODS In May 2023, we undertook a closed online survey of 51 clinical scientists who provided consensus responses representing all 17 of 17 NHS molecular genetic laboratories in England and Wales which undertake NHS diagnostic analyses of cancer susceptibility genes. The survey included 18 questions relating to 'next-generation sequencing workflow' (11), 'variant classification' (3) and 'phenotypical context' (4). RESULTS Widely differing processes were reported for transfer of variant data into their local LIMS (Laboratory Information Management System), for the formatting in which the variants are stored in the LIMS and which classes of variants are retained in the local LIMS. Differing local provisions and workflow for variant classifications were also reported, including the resources provided and the mechanisms by which classifications are stored. CONCLUSION The survey responses illustrate heterogeneous laboratory workflow for preparation of genomic variant data from local LIMS for centralised submission. Workflow is often labour-intensive and inefficient, involving multiple manual steps which introduce opportunities for error. These survey findings and adoption of the concomitant recommendations may support improvement in laboratory dataflows, better facilitating submission of data for central amalgamation.
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Affiliation(s)
- Sophie Allen
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Lucy Loong
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Alice Garrett
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Department of Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Bethany Torr
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, NEY Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - James Drummond
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Rachel Robinson
- Yorkshire Regional Genetics Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - George J Burghel
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Helen Hanson
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Department of Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Joanne Field
- Genomics and Molecular Medicine Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Trudi McDevitt
- Department of Clinical Genetics, CHI at Crumlin, Dublin, Ireland
| | - Terri P McVeigh
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Tina Bedenham
- West Midlands, Oxford and Wessex Genomic Laboratory Hub, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Christopher Bowles
- Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Kirsty Bradshaw
- East Midlands and East of England Genomics Laboratory, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claire Brooks
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Samantha Butler
- Central and South Genomic Laboratory Hub, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Lorraine Hawkes
- South East Genomics Laboratory Hub, Guy's Hospital, London, UK
| | - Victoria Stinton
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Suzanne MacMahon
- Centre for Molecular Pathology, Institute of Cancer Research Sutton, Sutton, UK
- Department of Molecular Diagnostics, The Royal Marsden NHS Foundation Trust, London, UK
| | - Martina Owens
- Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Sheila Palmer-Smith
- Institute of Medical Genetics, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Kenneth Smith
- South West Genomic Laboratory Hub, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - James Tellez
- North East and Yorkshire Genomic Laboratory Hub, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Mikel Valganon-Petrizan
- Centre for Molecular Pathology, Institute of Cancer Research Sutton, Sutton, UK
- Department of Molecular Diagnostics, The Royal Marsden NHS Foundation Trust, London, UK
| | - Erik Waskiewicz
- Institute of Medical Genetics, Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff, UK
| | - Michael Yau
- South East Genomics Laboratory Hub, Guy's Hospital, London, UK
| | - Diana M Eccles
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Shilpi Goel
- NHS England, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Fiona McRonald
- NHS England, National Disease Registration Service, London, UK
| | - Antonis C Antoniou
- Department of Public Health and Primary Care, University of Cambridge Centre for Cancer Genetic Epidemiology, Cambridge, UK
| | - Eva Morris
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Steven Hardy
- NHS England, National Disease Registration Service, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
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Brighi C, Waddington DEJ, Keall PJ, Booth J, O’Brien K, Silvester S, Parkinson J, Mueller M, Yim J, Bailey DL, Back M, Drummond J. The MANGO study: a prospective investigation of oxygen enhanced and blood-oxygen level dependent MRI as imaging biomarkers of hypoxia in glioblastoma. Front Oncol 2023; 13:1306164. [PMID: 38192626 PMCID: PMC10773871 DOI: 10.3389/fonc.2023.1306164] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024] Open
Abstract
Background Glioblastoma (GBM) is the most aggressive type of brain cancer, with a 5-year survival rate of ~5% and most tumours recurring locally within months of first-line treatment. Hypoxia is associated with worse clinical outcomes in GBM, as it leads to localized resistance to radiotherapy and subsequent tumour recurrence. Current standard of care treatment does not account for tumour hypoxia, due to the challenges of mapping tumour hypoxia in routine clinical practice. In this clinical study, we aim to investigate the role of oxygen enhanced (OE) and blood-oxygen level dependent (BOLD) MRI as non-invasive imaging biomarkers of hypoxia in GBM, and to evaluate their potential role in dose-painting radiotherapy planning and treatment response assessment. Methods The primary endpoint is to evaluate the quantitative and spatial correlation between OE and BOLD MRI measurements and [18F]MISO values of uptake in the tumour. The secondary endpoints are to evaluate the repeatability of MRI biomarkers of hypoxia in a test-retest study, to estimate the potential clinical benefits of using MRI biomarkers of hypoxia to guide dose-painting radiotherapy, and to evaluate the ability of MRI biomarkers of hypoxia to assess treatment response. Twenty newly diagnosed GBM patients will be enrolled in this study. Patients will undergo standard of care treatment while receiving additional OE/BOLD MRI and [18F]MISO PET scans at several timepoints during treatment. The ability of OE/BOLD MRI to map hypoxic tumour regions will be evaluated by assessing spatial and quantitative correlations with areas of hypoxic tumour identified via [18F]MISO PET imaging. Discussion MANGO (Magnetic resonance imaging of hypoxia for radiation treatment guidance in glioblastoma multiforme) is a diagnostic/prognostic study investigating the role of imaging biomarkers of hypoxia in GBM management. The study will generate a large amount of longitudinal multimodal MRI and PET imaging data that could be used to unveil dynamic changes in tumour physiology that currently limit treatment efficacy, thereby providing a means to develop more effective and personalised treatments.
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Affiliation(s)
- Caterina Brighi
- Image X Institute, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - David E. J. Waddington
- Image X Institute, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Paul J. Keall
- Image X Institute, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jeremy Booth
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
- Institute of Medical Physics, School of Physics, The University of Sydney, Sydney, NSW, Australia
| | | | - Shona Silvester
- Image X Institute, Sydney School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Jonathon Parkinson
- Department of Neurosurgery, Royal North Shore Hospital, Sydney, NSW, Australia
- The Brain Cancer Group Sydney, St Leonards, NSW, Australia
| | - Marco Mueller
- Siemens Healthcare Pty Ltd, Brisbane, QLD, Australia
| | - Jackie Yim
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
- The Brain Cancer Group Sydney, St Leonards, NSW, Australia
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Dale L. Bailey
- Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Michael Back
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
- The Brain Cancer Group Sydney, St Leonards, NSW, Australia
| | - James Drummond
- Department of Radiation Oncology, Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
- The Brain Cancer Group Sydney, St Leonards, NSW, Australia
- Department of Neuroradiology, Royal North Shore Hospital, Sydney, NSW, Australia
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Jeffrey A, Coyle LA, Samaranayake D, Boyle T, Drummond J, Fernando SL. Central Nervous System (CNS) T-Cell Lymphoma as the Presenting Manifestation of Late-Onset Combined Immunodeficiency. Case Rep Hematol 2023; 2023:6650410. [PMID: 37886671 PMCID: PMC10599841 DOI: 10.1155/2023/6650410] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/26/2023] [Accepted: 09/05/2023] [Indexed: 10/28/2023] Open
Abstract
Late-onset combined immunodeficiency (LOCID), considered now a subset of common variable immunodeficiency (CVID) disorders, is characterized by a predominantly T-cell immune defect. LOCID has a distinct phenotype from CVID with a greater risk of lymphoproliferative complications. As compared to the CVID cohort, LOCID patients also have increased rates of splenomegaly and granulomatous disease. We report a case of central nervous system (CNS) T-cell lymphoma in a 67-year-old male as the presenting manifestation of LOCID. The patient achieved a complete response to therapy after 4 cycles of MATRix (methotrexate, cytarabine, and thiotepa) and 2 cycles of ICE (etoposide, carboplatin, and ifosfamide) chemotherapy followed by CNS-directed autologous stem cell transplantation. Intravenous immunoglobulin replacement was commenced to address the underlying immunodeficiency. Pulmonary lesions consistent with a diagnosis of granulomatous and lymphocytic interstitial lung disease (GLILD) were identified as a second noninfectious complication of LOCID. The pulmonary lesions resolved after chemotherapy and immunoglobulin replacement. The patient remains well with no evidence of disease recurrence now more than 18 months after completion of therapy. This is the first reported case of T-cell lymphoma in an adult patient with LOCID. Further study is needed to elucidate the mechanisms of transformation of B- or T-cells to lymphoproliferation in primary immunodeficiency patients as well as research to inform evidence-based therapeutic strategies for this challenging cohort of patients.
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Affiliation(s)
- Anthony Jeffrey
- Department of Haematology, Royal North Shore Hospital, St Leonards, NSW, Australia
- Department of Medicine, The University of Sydney, Sydney, NSW, Australia
| | - Luke A. Coyle
- Department of Haematology, Royal North Shore Hospital, St Leonards, NSW, Australia
- Department of Medicine, The University of Sydney, Sydney, NSW, Australia
| | - Dishan Samaranayake
- Department of Haematology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Therese Boyle
- Department of Clinical Immunology and Allergy, Royal North Shore Hospital, St Leonards, NSW, Australia
- Immunology Laboratory, Royal North Shore Hospital, New South Wales Health Pathology, St Leonards, NSW, Australia
| | - James Drummond
- Department of Radiology, Royal North Shore Hospital, Sydney, Australia
| | - Suran L. Fernando
- Department of Medicine, The University of Sydney, Sydney, NSW, Australia
- Department of Clinical Immunology and Allergy, Royal North Shore Hospital, St Leonards, NSW, Australia
- Immunology Laboratory, Royal North Shore Hospital, New South Wales Health Pathology, St Leonards, NSW, Australia
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Loong L, Huntley C, McRonald F, Santaniello F, Pethick J, Torr B, Allen S, Tulloch O, Goel S, Shand B, Rahman T, Luchtenborg M, Garrett A, Barber R, Bedenham T, Bourn D, Bradshaw K, Brooks C, Bruty J, Burghel GJ, Butler S, Buxton C, Callaway A, Callaway J, Drummond J, Durkie M, Field J, Jenkins L, McVeigh TP, Mountford R, Nyanhete R, Petrides E, Robinson R, Scott T, Stinton V, Tellez J, Wallace AJ, Yarram-Smith L, Sahan K, Hallowell N, Eccles DM, Pharoah P, Tischkowitz M, Antoniou AC, Evans DG, Lalloo F, Norbury G, Morris E, Burn J, Hardy S, Turnbull C. Germline mismatch repair (MMR) gene analyses from English NHS regional molecular genomics laboratories 1996-2020: development of a national resource of patient-level genomics laboratory records. J Med Genet 2023; 60:669-678. [PMID: 36572524 PMCID: PMC10359571 DOI: 10.1136/jmg-2022-108800] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/18/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To describe national patterns of National Health Service (NHS) analysis of mismatch repair (MMR) genes in England using individual-level data submitted to the National Disease Registration Service (NDRS) by the NHS regional molecular genetics laboratories. DESIGN Laboratories submitted individual-level patient data to NDRS against a prescribed data model, including (1) patient identifiers, (2) test episode data, (3) per-gene results and (4) detected sequence variants. Individualised per-laboratory algorithms were designed and applied in NDRS to extract and map the data to the common data model. Laboratory-level MMR activity audit data from the Clinical Molecular Genetics Society/Association of Clinical Genomic Science were used to assess early years' missing data. RESULTS Individual-level data from patients undergoing NHS MMR germline genetic testing were submitted from all 13 English laboratories performing MMR analyses, comprising in total 16 722 patients (9649 full-gene, 7073 targeted), with the earliest submission from 2000. The NDRS dataset is estimated to comprise >60% of NHS MMR analyses performed since inception of NHS MMR analysis, with complete national data for full-gene analyses for 2016 onwards. Out of 9649 full-gene tests, 2724 had an abnormal result, approximately 70% of which were (likely) pathogenic. Data linkage to the National Cancer Registry demonstrated colorectal cancer was the most frequent cancer type in which full-gene analysis was performed. CONCLUSION The NDRS MMR dataset is a unique national pan-laboratory amalgamation of individual-level clinical and genomic patient data with pseudonymised identifiers enabling linkage to other national datasets. This growing resource will enable longitudinal research and can form the basis of a live national genomic disease registry.
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Affiliation(s)
- Lucy Loong
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Catherine Huntley
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Fiona McRonald
- NHS Digital, National Disease Registration Service, London, UK
| | - Francesco Santaniello
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Joanna Pethick
- NHS Digital, National Disease Registration Service, London, UK
| | - Bethany Torr
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Sophie Allen
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Oliver Tulloch
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Shilpi Goel
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Brian Shand
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Tameera Rahman
- NHS Digital, National Disease Registration Service, London, UK
- Health Data Insight CIC, Cambridge, UK
| | - Margreet Luchtenborg
- NHS Digital, National Disease Registration Service, London, UK
- Centre for Cancer, Society & Public Health, King's College London, London, UK
| | - Alice Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Richard Barber
- Central and South Genomic Laboratory Hub, West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - Tina Bedenham
- West Midlands, Oxford and Wessex Genomic Laboratory Hub, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - David Bourn
- North East and Yorkshire Genomic Laboratory Hub, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Kirsty Bradshaw
- East Midlands and East of England Genomics Laboratory, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Claire Brooks
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jonathan Bruty
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - George J Burghel
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Samantha Butler
- Central and South Genomic Laboratory Hub, West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - Chris Buxton
- Bristol Genetics Laboratory, Southmead Hospital, Bristol, UK
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury, UK
| | - Jonathan Callaway
- Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury, UK
| | - James Drummond
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Joanne Field
- East Midlands and East of England Genomics Laboratory, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Lucy Jenkins
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Terri P McVeigh
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Cancer Genetics Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Roger Mountford
- North West Genomic Laboratory Hub (Liverpool), Manchester Centre for Genomic Medicine, Liverpool, UK
| | - Rodney Nyanhete
- Sheffield Diagnostic Genetics Service, North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Evgenia Petrides
- West Midlands, Oxford and Wessex Genomic Laboratory Hub, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Rachel Robinson
- Yorkshire and North East Genomic Laboratory Hub, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Tracy Scott
- Yorkshire and North East Genomic Laboratory Hub, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Victoria Stinton
- North West Genomic Laboratory Hub (Liverpool), Manchester Centre for Genomic Medicine, Liverpool, UK
| | - James Tellez
- North East and Yorkshire Genomic Laboratory Hub, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Andrew J Wallace
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Kate Sahan
- The Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford Ethox Centre, Oxford, UK
| | - Nina Hallowell
- The Ethox Centre and Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford Ethox Centre, Oxford, UK
| | - Diana M Eccles
- Cancer Sciences, University of Southampton Faculty of Medicine, Southampton, UK
- Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paul Pharoah
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Antonis C Antoniou
- Department of Medical Genetics, NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - D Gareth Evans
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
- Division of Evolution & Genomic Sciences, The University of Manchester, Manchester, UK
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Gail Norbury
- South East Genomic Laboratory Hub, Guy's and St Thomas' Hospitals NHS Trust, London, UK
| | - Eva Morris
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - John Burn
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Steven Hardy
- NHS Digital, National Disease Registration Service, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Cancer Genetics Unit, Royal Marsden Hospital NHS Trust, London, UK
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Ferreira ES, Drummond J, Veiga AT, Sibellas A, Brown S, Cranston ED, Martinez DM. Mapping absorbency in cellulosic fibres with iron tracers. Carbohydr Polym 2023; 311:120785. [PMID: 37028851 DOI: 10.1016/j.carbpol.2023.120785] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023]
Abstract
Understanding water absorbency in paper is challenging as fibre swelling and out-of-plane deformation occur simultaneously during liquid imbibition. Liquid absorption is commonly accessed by gravimetric tests, which provides limited information on the local spatial and temporal distribution of fluid in the substrate. In this work, we developed iron tracers to map liquid imbibition in paper by in situ precipitation of iron oxide nanoparticles during passage of the wetting front. The iron oxide tracers were found to be robustly attached to the cellulosic fibres. After liquid absorption tests, absorbency was investigated by mapping the distribution of iron in 3D using X-ray micro-computed tomography (μCT) and in 2D using energy-dispersive X-ray spectroscopy. We demonstrate a difference in tracer distribution between the wetting front and the fully saturated region supporting that imbibition proceeds in two phases, i.e. liquid percolation through the cell wall initially prior to filling of the external pore spaces. Critically, we demonstrate that these iron tracers enhance image contrast and allow for new imaging modalities in μCT for fibre networks.
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7
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Speight B, Hanson H, Turnbull C, Hardy S, Drummond J, Khorashad J, Wragg C, Page P, Parkin NW, Rio-Machin A, Fitzgibbon J, Kulasekararaj AG, Hamblin A, Talley P, McVeigh TP, Snape K. Germline predisposition to haematological malignancies: Best practice consensus guidelines from the UK Cancer Genetics Group (UKCGG), CanGene-CanVar and the NHS England Haematological Oncology Working Group. Br J Haematol 2023; 201:25-34. [PMID: 36744544 DOI: 10.1111/bjh.18675] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 02/07/2023]
Abstract
The implementation of whole genome sequencing and large somatic gene panels in haematological malignancies is identifying an increasing number of individuals with either potential or confirmed germline predisposition to haematological malignancy. There are currently no national or international best practice guidelines with respect to management of carriers of such variants or of their at-risk relatives. To address this gap, the UK Cancer Genetics Group (UKCGG), CanGene-CanVar and the NHS England Haematological Oncology Working Group held a workshop over two days on 28-29th April 2022, with the aim of establishing consensus guidelines on relevant clinical and laboratory pathways. The workshop focussed on the management of disease-causing germline variation in the following genes: DDX41, CEBPA, RUNX1, ANKRD26, ETV6, GATA2. Using a pre-workshop survey followed by structured discussion and in-meeting polling, we achieved consensus for UK best practice in several areas. In particular, high consensus was achieved on issues regarding standardised reporting, variant classification, multidisciplinary team working and patient support. The best practice recommendations from this meeting may be applicable to an expanding number of other genes in this setting.
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Affiliation(s)
- Beverley Speight
- East Anglian Medical Genetics Service, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, UK
| | - Helen Hanson
- South West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK
- Institute of Cancer Research, Sutton, London, UK
| | - Clare Turnbull
- Institute of Cancer Research, Sutton, London, UK
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Steven Hardy
- National Disease Registration Service, NHS Digital, London, UK
| | - James Drummond
- East Anglian Medical Genetics Service, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, UK
| | | | - Christopher Wragg
- South West Genomics Laboratory Hub, Bristol Genetics Laboratory, North Bristol NHS Trust, Pathology Building, Southmead Hospital, Bristol, UK
| | - Paula Page
- West Midlands Regional Genetics Laboratory, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Nicholas W Parkin
- Molecular Pathology Laboratory, Synnovis Analytics, King's College Hospital, London, UK
| | - Ana Rio-Machin
- Centre for Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Jude Fitzgibbon
- Centre for Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Austin Gladston Kulasekararaj
- King's College Hospital NHS Foundation Trust, London, UK
- National Institute for Health and Care Research and Wellcome King's Research Facility, London, UK
- King's College London, London, UK
| | - Angela Hamblin
- Oxford University Hospitals NHS Foundation Trust and Central and South Genomic Laboratory Hub, Oxford, UK
| | - Polly Talley
- Genomics Unit, NHS UK and NHS Improvement, Leeds, UK
- North East and Yorkshire Genomic Laboratory Hub, Leeds, UK
| | - Terri P McVeigh
- Institute of Cancer Research, Sutton, London, UK
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, UK
| | - Katie Snape
- South West Thames Regional Genetics Service, St George's University Hospitals NHS Foundation Trust, London, UK
- King's College Hospital NHS Foundation Trust, London, UK
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8
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Boyle T, Fernando SL, Drummond J, Fontes A, Parratt J. Phenotyping variants of tumefactive demyelinating lesions according to clinical and radiological features-A case series. Front Neurol 2023; 14:1092373. [PMID: 36816572 PMCID: PMC9935935 DOI: 10.3389/fneur.2023.1092373] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
Background Tumefactive demyelinating lesions (TDLs) are defined as lesions >2 cm on MRI of the brain. They are identified in a range of demyelinating diseases including massive demyelination due to Marburg's acute MS, Schilder's Disease, Balo's concentric sclerosis, and Tumefactive MS. Apart from the rare demyelinating variants which are often diagnosed histologically, there are no detailed data to phenotype TDLs. Methods We describe the clinical and radiological features of four similar patients with very large TDLs (>4 cm), that are not consistent with the rare demyelinating variants and may represent a distinct phenotype. Results All patients presented with hemiplegia and apraxia. The mean age at onset was 37 years with an equal sex distribution. All patients were diagnosed with Tumefactive demyelination based on MRI and CSF analysis, precluding the need for brain biopsy. All responded to potent immunotherapy (including high dose corticosteroids, plasma exchange, rituximab, and/or cyclophosphamide). The mean lag from diagnosis to treatment was 1 day. The median EDSS at presentation was six and recovery to a median EDSS of two occurred over 6 months. Conclusion We propose that Tumefactive lesions larger than 4 cm are termed "Giant demyelinating lesions" (GDLs) not only on the basis of size, but a rapid and fulminant demyelinating presentation leading to acute, severe neurological disability that is, nonetheless, responsive to immunotherapy. Further clinical studies are required to ratify this proposed phenotype, establish the immunological profile and best treatment for such patients.
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Affiliation(s)
- Thérèse Boyle
- Clinical Immunology and Allergy, Royal North Shore Hospital, St Leonards, NSW, Australia,Immunology Laboratory, Royal North Shore Hospital, St Leonards, NSW, Australia,Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia,*Correspondence: Thérèse Boyle ✉
| | - Suran L. Fernando
- Clinical Immunology and Allergy, Royal North Shore Hospital, St Leonards, NSW, Australia,Immunology Laboratory, Royal North Shore Hospital, St Leonards, NSW, Australia,Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - James Drummond
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia,Department of Neuroradiology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Ariadna Fontes
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia,Department of Neurology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - John Parratt
- Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia,Department of Neurology, Royal North Shore Hospital, St Leonards, NSW, Australia
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9
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Hanson H, Durkie M, Lalloo F, Izatt L, McVeigh TP, Cook JA, Brewer C, Drummond J, Butler S, Cranston T, Casey R, Tan T, Morganstein D, Eccles DM, Tischkowitz M, Turnbull C, Woodward ER, Maher ER. UK recommendations for SDHA germline genetic testing and surveillance in clinical practice. J Med Genet 2023; 60:107-111. [PMID: 35260474 PMCID: PMC9887350 DOI: 10.1136/jmedgenet-2021-108355] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 02/13/2022] [Indexed: 02/03/2023]
Abstract
SDHA pathogenic germline variants (PGVs) are identified in up to 10% of patients with paraganglioma and phaeochromocytoma and up to 30% with wild-type gastrointestinal stromal tumours. Most SDHA PGV carriers present with an apparently sporadic tumour, but often the pathogenic variant has been inherited from parent who has the variant, but has not developed any clinical features. Studies of SDHA PGV carriers suggest that lifetime penetrance for SDHA-associated tumours is low, particularly when identified outside the context of a family history. Current recommended surveillance for SDHA PGV carriers follows an intensive protocol. With increasing implementation of tumour and germline large panel and whole-genome sequencing, it is likely more SDHA PGV carriers will be identified in patients with tumours not strongly associated with SDHA, or outside the context of a strong family history. This creates a complex situation about what to recommend in clinical practice considering low penetrance for tumour development, surveillance burden and patient anxiety. An expert SDHA working group was formed to discuss and consider this situation. This paper outlines the recommendations from this working group for testing and management of SDHA PGV carriers in clinical practice.
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Affiliation(s)
- Helen Hanson
- South West Thames Regional Genetic Services, St George's University Hospitals NHS Foundation Trust, London, UK
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, North East and Yorkshire Genomic Laboratory Hub, Sheffield, UK
| | - Fiona Lalloo
- Clinical Genetics Service, Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Louise Izatt
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Terri P McVeigh
- Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, UK
| | - Jackie A Cook
- Department of Clinical Genetics, Sheffield Children's NHS FoundationTrust, Sheffield, UK
| | - Carole Brewer
- Department of Clinical Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - James Drummond
- East NHS Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospital Foundation Trust, Cambridge, UK
| | - Samantha Butler
- Molecular Genetics, West Midlands Regional Genetics Laboratory, Birmingham, West Midlands, UK
| | - Treena Cranston
- Oxford Molecular Genetics Laboratory, Churchill Hospital, Oxford, UK
| | - Ruth Casey
- Department of Endocrinology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Medical Genetics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Tricia Tan
- Section of Investigative Medicine, Imperial College London, London, UK
| | | | - Diana M Eccles
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Emma Roisin Woodward
- Clinical Genetics Service, Manchester Centre for Genomic Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | - Eamonn R Maher
- Department of Medical Genetics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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10
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Brighi C, Waddington D, Keall P, Booth J, O'Brien K, Parkinson J, Yim J, Bailey D, Back M, Drummond J. NIMG-70. MAGNETIC RESONANCE HYPOXIA IMAGING FOR RADIATION TREATMENT GUIDANCE IN GLIOBLASTOMA MULTIFORME - A DIAGNOSTIC/PROGNOSTIC CLINICAL IMAGING STUDY. Neuro Oncol 2022. [PMCID: PMC9660750 DOI: 10.1093/neuonc/noac209.688] [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: 11/16/2022] Open
Abstract
Abstract
Local recurrence in glioblastoma (GBM) patients is caused by the ability of tumour cells to develop treatment resistance mechanisms. Hypoxia, which is present in subregions of GBM tumours, is the leading cause of resistance to radiotherapy and is associated with worse clinical outcomes in GBM. Current standard of care treatment does not account for tumour hypoxia. The ability to image tumour hypoxia at various stages of treatment offers opportunities to personalise and improve treatment for GBM patients. Preoperative imaging of tumour hypoxia offers the opportunity for supramarginal resections in surgical planning beyond current neurosurgical standard of care guidelines. Imaging hypoxia prior to radiotherapy enables selective dose escalation strategies to radioresistant tumour regions, increasing the likelihood of local control. Identifying hypoxic tumour regions harbouring progression at follow up is key to intervening at an early stage of tumour recurrence and personalising therapy tailored to the tumour response to treatment. Imaging of tumour hypoxia in routine clinical practice is challenging, as it requires 18FMISO PET, which is not available in most clinical centres. In this clinical imaging study, we aim to investigate the role of oxygen enhanced (OE) and blood-oxygen level dependent (BOLD) MRI as imaging biomarkers of hypoxia in GBM. Aiming to recruit 20 GBM patients, this study involves the addition of OE/BOLD MRI and 18FMISO PET imaging at several timepoints during the course of treatment. The primary objective is to investigate the ability of OE/BOLD MRI to map tumour hypoxia on preoperative scans using 18FMISO PET as the ground truth. Secondary objectives include evaluating the role of hypoxia imaging biomarkers for dose-painting radiotherapy planning and treatment response assessment in GBM. Overall, by validating the role of MRI biomarkers of hypoxia we ought to provide a non-invasive and more accessible means to more effective, personalised treatment to GBM patients.
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Affiliation(s)
- Caterina Brighi
- ACRF Image X Institute, Sydney School of Health Sciences, The University of Sydney & Ingham Institute for Applied Medical Research, Sydney , Australia
| | | | - Paul Keall
- The University of Sydney , Sydney, New South Wales , Australia
| | - Jeremy Booth
- Northern Sydney Cancer Centre, Royal North Shore Hospital , Sydney, New South Wales , Australia
| | - Kieran O'Brien
- Siemens Healthcare Pty Ltd, Brisbane , Queensland , Australia
| | | | - Jackie Yim
- Royal North Shore Hospital , Sydney, New South Wales , Australia
| | - Dale Bailey
- Royal North Shore Hospital , Sydney, New South Wales , Australia
| | - Michael Back
- Royal North Shore Hospital , Sydney, New South Wales , Australia
| | - James Drummond
- Northern Sydney Cancer Centre, Royal North Shore Hospital , Sydney, New South Wales , Australia
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11
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Back M, Horsley P, Yim J, Drummond J. RADT-25. UNDERSTANDING PATTERNS OF TUMOUR INFILTRATION IN PATIENTS WITH MULTIFOCAL GLIOBLASTOMA AND IMPACT ON SURVIVAL OUTCOMES. Neuro Oncol 2022. [PMCID: PMC9660809 DOI: 10.1093/neuonc/noac209.215] [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: 11/16/2022] Open
Abstract
Abstract
BACKGROUND
Multifocal glioblastoma(MF-G) are often clustered with presumed uniform worse prognosis. This study explores varying patterns of infiltration of MF-G in relation to radiological features, including presence of contiguous MRI T2-weighted abnormalities and adjacent neural tract pathway involvement.
METHODS
Consecutive patients with glioblastoma from 2016-2020 managed under EORTC-NCI(Stupp60Gy) Protocol had manual tumour segmentation on T1gd and T2w sequences. Multifocal disease was defined as T1gd or solid T2w-abnormality a minimum of 10mm from the dominant lesion. Number of foci, maximum dimension, cortical/white matter site and distance from dominant lesion were recorded. Presence of contiguous T2w-abnormality was recorded, and correlated to ten major neural tract pathways. Progression-free(PFS) and overall survival(OS) were analysed.
RESULTS
Forty of 177 patients(23%) were identified with MF-G. These had less near-total resection(p = 0.001), but no difference in ECOG(p = 0.16), or MGMT-methylation(p=0.23). Foci had median size of 14.5mm (q1-3: 10-20); 73% enhancing and 58% solitary. Median distance from dominant lesion was 23mm (q1-3:15-25). Contiguous T2w abnormality and involvement of identified neural tract was evident in 78% and 83% respectively. The multifocal lesion was based in cortex in 33%, and white matter in 67%. Survival outcomes were worse with MF-G: OS (p < 0.01) was 16.0 months (95%CI: 13.6-18.4) versus 19.9 months (95%CI: 17.6-22.2); and PFS (p = 0.01) was 10.8 months (95%CI: 9.9-11.7) versus 13.6 months (95%CI: 11.1-16.1). Improved PFS was associated with larger lesion size(p = 0.04), and cortical lesions(0.04). Those MF-G with contiguous T2w-abnormality(p = 0.06); identified neural tract(p = 0.07) or enhancement(p = 0.08) had trend to worse PFS. MGMT(p = 0.10), ECOG(p = 0.62) and extent of resection(p = 0.07) were not associated with PFS, nor radiological factors of foci number(p = 0.19) and lesion distance(p = 0.16).
CONCLUSIONS
Radiological pattern of infiltration in MF-G is associated with different natural history. Improved PFS was associated with cortical foci without contiguous T2 abnormality or tract involvement. Recognising infiltration patterns may impact on RT target volume delineation and understanding prognosis.
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Affiliation(s)
- Michael Back
- Royal North Shore Hospital , Sydney, New South Wales , Australia
| | - Patrick Horsley
- Northern Sydney Cancer Centre , Sydney, New South Wales , Australia
| | - Jackie Yim
- Royal North Shore Hospital , Sydney, New South Wales , Australia
| | - James Drummond
- Northern Sydney Cancer Centre, Royal North Shore Hospital , Sydney, New South Wales , Australia
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12
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Mishra M, Nichols L, Dave AA, Pittman EH, Cheek JP, Caroland AJV, Lotwala P, Drummond J, Bridges CC. Molecular Mechanisms of Cellular Injury and Role of Toxic Heavy Metals in Chronic Kidney Disease. Int J Mol Sci 2022; 23:ijms231911105. [PMID: 36232403 PMCID: PMC9569673 DOI: 10.3390/ijms231911105] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 01/10/2023] Open
Abstract
Chronic kidney disease (CKD) is a progressive disease that affects millions of adults every year. Major risk factors include diabetes, hypertension, and obesity, which affect millions of adults worldwide. CKD is characterized by cellular injury followed by permanent loss of functional nephrons. As injured cells die and nephrons become sclerotic, remaining healthy nephrons attempt to compensate by undergoing various structural, molecular, and functional changes. While these changes are designed to maintain appropriate renal function, they may lead to additional cellular injury and progression of disease. As CKD progresses and filtration decreases, the ability to eliminate metabolic wastes and environmental toxicants declines. The inability to eliminate environmental toxicants such as arsenic, cadmium, and mercury may contribute to cellular injury and enhance the progression of CKD. The present review describes major molecular alterations that contribute to the pathogenesis of CKD and the effects of arsenic, cadmium, and mercury on the progression of CKD.
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Affiliation(s)
- Manish Mishra
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Larry Nichols
- Department of Pathology and Clinical Sciences Education, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Aditi A. Dave
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Elizabeth H Pittman
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - John P. Cheek
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Anasalea J. V. Caroland
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Purva Lotwala
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - James Drummond
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
| | - Christy C. Bridges
- Department of Biomedical Sciences, Mercer University School of Medicine, Macon, GA 31207, USA
- Correspondence: ; Tel.: +1-(478)-301-2086
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13
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Speight B, Colvin E, Epurescu ED, Drummond J, Verhoef S, Pereira M, Evans DG, Tischkowitz M. Low-level constitutional mosaicism of BRCA1 in two women with young onset ovarian cancer. Hered Cancer Clin Pract 2022; 20:32. [PMID: 36068545 PMCID: PMC9446595 DOI: 10.1186/s13053-022-00237-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
Germline pathogenic variants in BRCA1 and BRCA2 cause hereditary breast and ovarian cancer. The vast majority of these variants are inherited from a parent. De novo constitutional pathogenic variants are rare. Even fewer cases of constitutional mosaicism have been reported and these have mostly been described in women with breast cancer. Here we report low-level constitutional mosaicism identified by Next Generation Sequencing in two women with ovarian cancer. A BRCA1 c.5074G > A p.(Asp1692Asn) variant detected in the first female at 42 years, classed as likely pathogenic, was found in ~ 52% of reads in DNA extracted from tumour, ~ 10% of reads in DNA extracted from peripheral blood leukocytes and ~ 10% of reads in DNA extracted from buccal mucosa. The second BRCA1 c.2755_2758dupCCTG p.(Val920AlafsTer6) variant was detected in a female aged 53 years, classed as pathogenic, and was found in ~ 59% of reads in DNA extracted from tumour, ~ 14% of reads in DNA extracted from peripheral blood leukocytes and similarly in ~ 14% of reads in both DNA extracted from buccal mucosa and urine sample. Sanger sequencing confirmed the presence of these variants at a corresponding low level consistent with mosaicism that may not have been detected by this method alone. This report demonstrates the clinical benefit for two women of BRCA1/BRCA2 germline NGS testing at a depth that can detect low-level mosaicism. As well as informing appropriate treatments, tumour sequencing results may facilitate the detection and interpretation of low-level mosaic variants in the germline. Both results have implications for other cancer risks and for relatives when providing a family cancer risk assessment and reproductive risk. The implications for laboratory practice, clinical genetics management and genetic counselling for constitutional mosaicism of BRCA1/BRCA2 are discussed.
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Affiliation(s)
- B Speight
- East Anglian Medical Genetics Service, Cambridge Biomedical Campus, Box 134, Level 6, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
| | - E Colvin
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK
| | - E D Epurescu
- Oncology & Haematology Directorate, Norfolk & Norwich University Hospital, Colney Lane, Norwich, NR4 7UY, UK
| | - J Drummond
- East Anglian Medical Genetics Service, Cambridge Biomedical Campus, Box 134, Level 6, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
| | - S Verhoef
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK.,Department of Clinical Genetics, Leiden University Medical Center, 2333 ZA, Leiden, Netherlands
| | - M Pereira
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK
| | - D G Evans
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester, M13 9WL, UK.,Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - M Tischkowitz
- East Anglian Medical Genetics Service, Cambridge Biomedical Campus, Box 134, Level 6, Addenbrooke's Treatment Centre, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.,Academic Department of Medical Genetics, University of Cambridge, Cambridge, UK
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14
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Loong L, Garrett A, Allen S, Choi S, Durkie M, Callaway A, Drummond J, Burghel GJ, Robinson R, Torr B, Berry IR, Wallace AJ, Eccles DM, Ellard S, Baple E, Evans DG, Woodward ER, Kulkarni A, Lalloo F, Tischkowitz M, Lucassen A, Hanson H, Turnbull C. Reclassification of clinically-detected sequence variants: Framework for genetic clinicians and clinical scientists by CanVIG-UK (Cancer Variant Interpretation Group UK). Genet Med 2022; 24:1867-1877. [PMID: 35657381 DOI: 10.1016/j.gim.2022.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Variant classifications may change over time, driven by emergence of fresh or contradictory evidence or evolution in weighing or combination of evidence items. For variant classifications above the actionability threshold, which is classification of likely pathogenic or pathogenic, clinical actions may be irreversible, such as risk-reducing surgery or prenatal interventions. Variant reclassification up or down across the actionability threshold can therefore have significant clinical consequences. Laboratory approaches to variant reinterpretation and reclassification vary widely. METHODS Cancer Variant Interpretation Group UK is a multidisciplinary network of clinical scientists and genetic clinicians from across the 24 Molecular Diagnostic Laboratories and Clinical Genetics Services of the United Kingdom (NHS) and Republic of Ireland. We undertook surveys, polls, and national meetings of Cancer Variant Interpretation Group UK to evaluate opinions about clinical and laboratory management regarding variant reclassification. RESULTS We generated a consensus framework on variant reclassification applicable to cancer susceptibility genes and other clinical areas, which provides explicit recommendations for clinical and laboratory management of variant reclassification scenarios on the basis of the nature of the new evidence, the magnitude of evidence shift, and the final classification score. CONCLUSION In this framework, clinical and laboratory resources are targeted for maximal clinical effect and minimal patient harm, as appropriate to all resource-constrained health care settings.
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Affiliation(s)
- Lucy Loong
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Alice Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Sophie Allen
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Subin Choi
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, NHS North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, Central and South Genomics Laboratory Hub, Salisbury NHS Foundation Trust, Salisbury District Hospital, Salisbury, Wiltshire, United Kingdom
| | - James Drummond
- Cambridge Genomic Laboratory, East Genomic Laboratory Hub, Cambridge University Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - George J Burghel
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Rachel Robinson
- North East and Yorkshire Genomic Laboratory Hub, The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Beth Torr
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Ian R Berry
- Bristol Genetics Laboratory, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Andrew J Wallace
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Diana M Eccles
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sian Ellard
- Exeter Genomics Laboratory, South West Genomic Laboratory Hub, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom; University of Exeter Medical School, Exeter, United Kingdom
| | - Emma Baple
- University of Exeter Medical School, Exeter, United Kingdom; Genomics England, London, United Kingdom
| | - D Gareth Evans
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom; Division of Evolution & Genomic Sciences, The University of Manchester, Manchester, United Kingdom
| | - Emma R Woodward
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom; Division of Evolution & Genomic Sciences, The University of Manchester, Manchester, United Kingdom
| | - Anjana Kulkarni
- Southeast Thames Regional Genetics Service, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, United Kingdom
| | - Anneke Lucassen
- Wellcome Centre for Human Genetics/Centre for Personalised Medicine, University of Oxford, Oxford, United Kingdom; Clinical Ethics and Law, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Helen Hanson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom; Department of Clinical Genetics, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom; Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom.
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15
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Chatterton S, Helou J, Drummond J, Gill AJ, Ward C, Coyle L, Kerridge I, Ng K. Unusual presentations of central nervous system myeloid sarcoma. Intern Med J 2022; 52:1083-1088. [PMID: 35718731 DOI: 10.1111/imj.15813] [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: 08/04/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/27/2022]
Abstract
Myeloid sarcoma (MS), also termed 'chloroma' or 'granulocytic sarcoma', is a tumour mass consisting of myeloid blasts occurring at an anatomical site other than the bone marrow. MS occurs in up to 8% of patients with acute myeloid leukaemia. While MS typically involves the skin or lymph nodes, almost any tissue can be affected, and symptoms largely depend on the organ involved and subsequent mass effect. We present a case series of patients that presented to a tertiary hospital with MS affecting the central nervous system over a 4-month period. These three cases demonstrate the vast spectrum of clinical presentations of MS and, furthermore, show rare examples of intramedullary spinal cord involvement and disseminated intraparenchymal brain disease.
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Affiliation(s)
- Sophie Chatterton
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacob Helou
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - James Drummond
- Department of Radiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Brain Imaging Laboratory, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Christopher Ward
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Luke Coyle
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ian Kerridge
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Karl Ng
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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16
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Yuile AK, Kastelan M, Lee APS, Back M, Drummond J, Wheeler HR. The use of Sonidegib in the adjuvant and advanced phases of Sonic Hedge Hog Mutant Medulloblastomas. Oxf Med Case Reports 2022; 2022:omac019. [PMID: 35316996 PMCID: PMC8931813 DOI: 10.1093/omcr/omac019] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 01/20/2022] [Accepted: 01/20/2022] [Indexed: 11/14/2022] Open
Abstract
ABSTRACT
Medulloblastomas are rare embryonal primary brain tumours originating in the cerebellum. Most medulloblastomas arising in adults are associated with mutations in the Sonic Hedge Hog (SHH) pathway. Patient 1 was prescribed Sonidegib for recurrent metastatic SHH mutated medulloblastoma multiple lines of treatment. His leptomeningeal disease responded after 3 months of therapy. The drug was continued for a further 3 months until progressive central nervous system (CNS) and leptomeningeal disease arose. Progression free survival (PFS) from initiation of Sonidegib of 3 months was observed (overall survival 8.8 years). Patient 2 presented with un-resectable SHH mutated meduloblastoma with high risk of relapse who received 14 months of adjuvant Sonidegib. Following biopsy she was treated with chemotherapy and cranio-spinal radiotherapy, followed by 14 months of adjuvant Sonigedib. She remains free of disease over 51 months later. Both clinical scenarios are poorly described in the literature or evaluated in clinical trials with Sonidegib.
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Affiliation(s)
- Alexander K Yuile
- Medical Oncology, Royal North Shore Hospital, Sydney 2065, Australia
| | - Marina Kastelan
- The Brain Cancer Group, North Shore Private Hospital, Sydney 2065, Australia
| | - Adrian PS Lee
- Medical Oncology, Royal North Shore Hospital, Sydney 2065, Australia
| | - Michael Back
- Radiation Oncology, Royal North Shore Hospital, Sydney 2065, Australia
| | - James Drummond
- Radiology, Royal North Shore Hospital, Sydney 2065, Australia
| | - Helen R Wheeler
- Medical Oncology, Royal North Shore Hospital, Sydney 2065, Australia
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17
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Garrett A, Loveday C, King L, Butler S, Robinson R, Horton C, Yussuf A, Choi S, Torr B, Durkie M, Burghel GJ, Drummond J, Berry I, Wallace A, Callaway A, Eccles D, Tischkowitz M, Tatton-Brown K, Snape K, McVeigh T, Izatt L, Woodward ER, Burnichon N, Gimenez-Roqueplo AP, Mazzarotto F, Whiffin N, Ware J, Hanson H, Pesaran T, LaDuca H, Buffet A, Maher ER, Turnbull C. Quantifying evidence toward pathogenicity for rare phenotypes: The case of succinate dehydrogenase genes, SDHB and SDHD. Genet Med 2021; 24:41-50. [PMID: 34906457 PMCID: PMC8759765 DOI: 10.1016/j.gim.2021.08.004] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 03/26/2021] [Accepted: 08/10/2021] [Indexed: 10/25/2022] Open
Abstract
PURPOSE The weight of the evidence to attach to observation of a novel rare missense variant in SDHB or SDHD in individuals with the rare neuroendocrine tumors, pheochromocytomas and paragangliomas (PCC/PGL), is uncertain. METHODS We compared the frequency of SDHB and SDHD very rare missense variants (VRMVs) in 6328 and 5847 cases of PCC/PGL, respectively, with that of population controls to generate a pan-gene VRMV likelihood ratio (LR). Via windowing analysis, we measured regional enrichments of VRMVs to calculate the domain-specific VRMV-LR (DS-VRMV-LR). We also calculated subphenotypic LRs for variant pathogenicity for various clinical, histologic, and molecular features. RESULTS We estimated the pan-gene VRMV-LR to be 76.2 (54.8-105.9) for SDHB and 14.8 (8.7-25.0) for SDHD. Clustering analysis revealed an SDHB enriched region (ɑɑ 177-260, P = .001) for which the DS-VRMV-LR was 127.2 (64.9-249.4) and an SDHD enriched region (ɑɑ 70-114, P = .000003) for which the DS-VRMV-LR was 33.9 (14.8-77.8). Subphenotypic LRs exceeded 6 for invasive disease (SDHB), head-and-neck disease (SDHD), multiple tumors (SDHD), family history of PCC/PGL, loss of SDHB staining on immunohistochemistry, and succinate-to-fumarate ratio >97 (SDHB, SDHD). CONCLUSION Using methodology generalizable to other gene-phenotype dyads, the LRs relating to rarity and phenotypic specificity for a single observation in PCC/PGL of a SDHB/SDHD VRMV can afford substantial evidence toward pathogenicity.
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Affiliation(s)
- Alice Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Chey Loveday
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Laura King
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Samantha Butler
- Central and South Genomic Laboratory Hub, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | - Rachel Robinson
- North East and Yorkshire Genomic Laboratory Hub, Central Lab, The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | | | - Subin Choi
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Beth Torr
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Miranda Durkie
- North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - George J Burghel
- The Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - James Drummond
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Ian Berry
- North East and Yorkshire Genomic Laboratory Hub, Central Lab, The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Andrew Wallace
- The Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Alison Callaway
- Central and South Genomics Laboratory Hub, Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury District Hospital, Salisbury, United Kingdom
| | - Diana Eccles
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; East Anglian Medical Genetics Unit, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - Katrina Tatton-Brown
- St. George's University, London, United Kingdom; Department of Clinical Genetics, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Katie Snape
- St. George's University, London, United Kingdom; Department of Clinical Genetics, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Terri McVeigh
- Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Louise Izatt
- Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Emma R Woodward
- Manchester Centre for Genomic Medicine, Manchester Academic Health Sciences Centre (MAHSC), Manchester University NHS Foundation Trust, Manchester, United Kingdom; Division of Evolution and Genomic Sciences, School of Biological Sciences, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Manchester, United Kingdom
| | - Nelly Burnichon
- University of Paris, PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France; Genetics Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Anne-Paule Gimenez-Roqueplo
- University of Paris, PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France; Genetics Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Francesco Mazzarotto
- National Heart and Lung Institute and MRC London Institute of Medical Sciences, Imperial College London, London, United Kingdom; Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Nicola Whiffin
- The Wellcome Centre for Human Genetics, University of Oxford, Oxford, United Kingdom; The Centre for Personalised Medicine, St Anne's College, University of Oxford, Oxford, United Kingdom
| | - James Ware
- National Heart and Lung Institute and MRC London Institute of Medical Sciences, Imperial College London, London, United Kingdom; Royal Brompton and Harefield Hospitals, London, United Kingdom
| | - Helen Hanson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom; Department of Clinical Genetics, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | | | - Alexandre Buffet
- University of Paris, PARCC, INSERM, Equipe Labellisée par la Ligue contre le Cancer, Paris, France; Genetics Department, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Paris, France
| | - Eamonn R Maher
- Department of Medical Genetics, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom; Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom.
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18
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Loong L, Cubuk C, Choi S, Allen S, Torr B, Garrett A, Loveday C, Durkie M, Callaway A, Burghel GJ, Drummond J, Robinson R, Berry IR, Wallace A, Eccles DM, Tischkowitz M, Ellard S, Ware JS, Hanson H, Turnbull C. Quantifying prediction of pathogenicity for within-codon concordance (PM5) using 7541 functional classifications of BRCA1 and MSH2 missense variants. Genet Med 2021; 24:552-563. [PMID: 34906453 PMCID: PMC8896276 DOI: 10.1016/j.gim.2021.11.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 08/04/2021] [Revised: 10/21/2021] [Accepted: 11/12/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Conditions and thresholds applied for evidence weighting of within-codon concordance (PM5) for pathogenicity vary widely between laboratories and expert groups. Because of the sparseness of available clinical classifications, there is little evidence for variation in practice. METHODS We used as a truthset 7541 dichotomous functional classifications of BRCA1 and MSH2, spanning 311 codons of BRCA1 and 918 codons of MSH2, generated from large-scale functional assays that have been shown to correlate excellently with clinical classifications. We assessed PM5 at 5 stringencies with incorporation of 8 in silico tools. For each analysis, we quantified a positive likelihood ratio (pLR, true positive rate/false positive rate), the predictive value of PM5-lookup in ClinVar compared with the functional truthset. RESULTS pLR was 16.3 (10.6-24.9) for variants for which there was exactly 1 additional colocated deleterious variant on ClinVar, and the variant under examination was equally or more damaging when analyzed using BLOSUM62. pLR was 71.5 (37.8-135.3) for variants for which there were 2 or more colocated deleterious ClinVar variants, and the variant under examination was equally or more damaging than at least 1 colocated variant when analyzed using BLOSUM62. CONCLUSION These analyses support the graded use of PM5, with potential to use it at higher evidence weighting where more stringent criteria are met.
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Affiliation(s)
- Lucy Loong
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Cankut Cubuk
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Subin Choi
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Sophie Allen
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Beth Torr
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Alice Garrett
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Chey Loveday
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, NHS North East and Yorkshire Genomic Laboratory Hub, Sheffield Children's NHS Foundation Trust, Sheffield, United Kingdom
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, United Kingdom; Human Genetics and Genomic Medicine, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - George J Burghel
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - James Drummond
- East Genomic Laboratory Hub, Cambridge University Hospitals Genomic Laboratory, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Rachel Robinson
- North East and Yorkshire Genomic Laboratory Hub, The Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Ian R Berry
- Bristol Genetics Laboratory, Pathology Sciences, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Andrew Wallace
- Manchester Centre for Genomic Medicine and North West Genomic Laboratory Hub, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Diana M Eccles
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, NIHR Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, United Kingdom
| | - Sian Ellard
- Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - James S Ware
- National Heart and Lung Institute, Faculty of Medicine, and MRC London Institute of Medical Sciences, Imperial College London, London, United Kingdom; NIHR Royal Brompton Cardiovascular Research Centre, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom
| | - Helen Hanson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom; Department of Clinical Genetics, St. George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Clare Turnbull
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, United Kingdom; Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom.
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19
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Garrett A, Durkie M, Callaway A, Burghel GJ, Robinson R, Drummond J, Torr B, Cubuk C, Berry IR, Wallace AJ, Ellard S, Eccles DM, Tischkowitz M, Hanson H, Turnbull C. Combining evidence for and against pathogenicity for variants in cancer susceptibility genes: CanVIG-UK consensus recommendations. J Med Genet 2020; 58:297-304. [PMID: 33208383 PMCID: PMC8086256 DOI: 10.1136/jmedgenet-2020-107248] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/07/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022]
Abstract
Accurate classification of variants in cancer susceptibility genes (CSGs) is key for correct estimation of cancer risk and management of patients. Consistency in the weighting assigned to individual elements of evidence has been much improved by the American College of Medical Genetics (ACMG) 2015 framework for variant classification, UK Association for Clinical Genomic Science (UK-ACGS) Best Practice Guidelines and subsequent Cancer Variant Interpretation Group UK (CanVIG-UK) consensus specification for CSGs. However, considerable inconsistency persists regarding practice in the combination of evidence elements. CanVIG-UK is a national subspecialist multidisciplinary network for cancer susceptibility genomic variant interpretation, comprising clinical scientist and clinical geneticist representation from each of the 25 diagnostic laboratories/clinical genetic units across the UK and Republic of Ireland. Here, we summarise the aggregated evidence elements and combinations possible within different variant classification schemata currently employed for CSGs (ACMG, UK-ACGS, CanVIG-UK and ClinGen gene-specific guidance for PTEN, TP53 and CDH1). We present consensus recommendations from CanVIG-UK regarding (1) consistent scoring for combinations of evidence elements using a validated numerical 'exponent score' (2) new combinations of evidence elements constituting likely pathogenic' and 'pathogenic' classification categories, (3) which evidence elements can and cannot be used in combination for specific variant types and (4) classification of variants for which there are evidence elements for both pathogenicity and benignity.
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Affiliation(s)
- Alice Garrett
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, London, UK
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury, Wiltshire, UK.,Human Genetics and Genomic Medicine, University of Southampton Faculty of Medicine, Southampton, UK
| | - George J Burghel
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rachel Robinson
- Yorkshire Regional Genetics Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - James Drummond
- East Anglian Medical Genetics Service, Addenbrooke's Hospital, Cambridge, Cambridgeshire, UK
| | - Bethany Torr
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, London, UK
| | - Cankut Cubuk
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, London, UK
| | - Ian R Berry
- Yorkshire Regional Genetics Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Andrew J Wallace
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Sian Ellard
- Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | - Diana M Eccles
- Cancer Sciences Research Group, University of Southampton Faculty of Medicine, Southampton, UK
| | - Marc Tischkowitz
- Department of Medical Genetics and National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Helen Hanson
- Department of Clinical Genetics, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, London, UK .,Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, UK
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20
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Abstract
BACKGROUND Transient lesions in the splenium of the corpus callosum have been identified in many clinical cases, and often correspond to a metabolic insult to the brain. The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL syndrome) is a rare but under-recognised headache syndrome. CASE A 47-year-old man presented to our hospital with a 2-week history of intermittent headache, and acute right sided hemisensory deficit. A CSF lymphocytosis was found and a diagnosis of HaNDL was made. A lesion in the splenium of the corpus callosum was identified on MRI. CSF lymphocytosis and the splenial lesion resolved on follow up 4 weeks later. CONCLUSION These two entities are uncommon but increasingly recognised. The co-incidence in this patient raises the possibility of similar underlying pathological mechanisms, including vasomotor changes in blood vessels, cortical spreading depression and glutamate excitotoxicity leading to intra-myelinic oedema. Awareness of these entities will allow prompt diagnosis, preventing unnecessary tests and treatment, and allow appropriate patient management.
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Affiliation(s)
- Ruaridh Cameron Smail
- Department of Neurology and Neurophysiology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Northern Clinical School, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Jonathan Baird-Gunning
- Department of Neurology and Neurophysiology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - James Drummond
- Department of Neuroradiology, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Karl Ng
- Department of Neurology and Neurophysiology, Royal North Shore Hospital, St Leonards, NSW, Australia.,Northern Clinical School, Kolling Institute, Royal North Shore Hospital, St Leonards, NSW, Australia.,Sydney Medical School, University of Sydney, NSW, Australia
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21
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Garrett A, Callaway A, Durkie M, Cubuk C, Alikian M, Burghel GJ, Robinson R, Izatt L, Talukdar S, Side L, Cranston T, Palmer-Smith S, Baralle D, Berry IR, Drummond J, Wallace AJ, Norbury G, Eccles DM, Ellard S, Lalloo F, Evans DG, Woodward E, Tischkowitz M, Hanson H, Turnbull C. Cancer Variant Interpretation Group UK (CanVIG-UK): an exemplar national subspecialty multidisciplinary network. J Med Genet 2020; 57:829-834. [PMID: 32170000 PMCID: PMC7691806 DOI: 10.1136/jmedgenet-2019-106759] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/14/2022]
Abstract
Advances in technology have led to a massive expansion in the capacity for genomic analysis, with a commensurate fall in costs. The clinical indications for genomic testing have evolved markedly; the volume of clinical sequencing has increased dramatically; and the range of clinical professionals involved in the process has broadened. There is general acceptance that our early dichotomous paradigms of variants being pathogenic–high risk and benign–no risk are overly simplistic. There is increasing recognition that the clinical interpretation of genomic data requires significant expertise in disease–gene-variant associations specific to each disease area. Inaccurate interpretation can lead to clinical mismanagement, inconsistent information within families and misdirection of resources. It is for this reason that ‘national subspecialist multidisciplinary meetings’ (MDMs) for genomic interpretation have been articulated as key for the new NHS Genomic Medicine Service, of which Cancer Variant Interpretation Group UK (CanVIG-UK) is an early exemplar. CanVIG-UK was established in 2017 and now has >100 UK members, including at least one clinical diagnostic scientist and one clinical cancer geneticist from each of the 25 regional molecular genetics laboratories of the UK and Ireland. Through CanVIG-UK, we have established national consensus around variant interpretation for cancer susceptibility genes via monthly national teleconferenced MDMs and collaborative data sharing using a secure online portal. We describe here the activities of CanVIG-UK, including exemplar outputs and feedback from the membership.
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Affiliation(s)
- Alice Garrett
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - Alison Callaway
- Wessex Regional Genetics Laboratory, Salisbury Hospital NHS Foundation Trust, Salisbury, UK.,Human Genetics and Genomic Medicin, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Miranda Durkie
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Cankut Cubuk
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK.,William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Mary Alikian
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK
| | - George J Burghel
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Rachel Robinson
- Yorkshire Regional Genetics Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Louise Izatt
- Department of Clinical Genetics, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | - Sabrina Talukdar
- Department of Clinical Genetics, Saint George's University Hospitals NHS Foundation Trust, London, UK
| | - Lucy Side
- Wessex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Treena Cranston
- Oxford Molecular Genetics Laboratory, Churchill Hospital, Oxford, UK
| | | | - Diana Baralle
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ian R Berry
- Yorkshire Regional Genetics Service, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - James Drummond
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Andrew J Wallace
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - Gail Norbury
- Regional Genetics Service, Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sian Ellard
- Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Fiona Lalloo
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University NHS Foundation Trust, Manchester, UK
| | - D Gareth Evans
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | - Emma Woodward
- Manchester Centre for Genomic Medicine and NW Laboratory Genetics Hub, Manchester University NHS Foundation Trust, Manchester, UK.,Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health, Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Helen Hanson
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK.,Department of Clinical Genetics, Saint George's University Hospitals NHS Foundation Trust, London, UK
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, UK .,Cancer Genetics Unit, Royal Marsden NHS Foundation Trust, London, UK
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22
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Kumar R, Palmer E, Gardner AE, Carroll R, Banka S, Abdelhadi O, Donnai D, Elgersma Y, Curry CJ, Gardham A, Suri M, Malla R, Brady LI, Tarnopolsky M, Azmanov DN, Atkinson V, Black M, Baynam G, Dreyer L, Hayeems RZ, Marshall CR, Costain G, Wessels MW, Baptista J, Drummond J, Leffler M, Field M, Gecz J. Expanding Clinical Presentations Due to Variations in THOC2 mRNA Nuclear Export Factor. Front Mol Neurosci 2020; 13:12. [PMID: 32116545 PMCID: PMC7026477 DOI: 10.3389/fnmol.2020.00012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 01/15/2020] [Indexed: 12/31/2022] Open
Abstract
Multiple TREX mRNA export complex subunits (e.g., THOC1, THOC2, THOC5, THOC6, THOC7) have now been implicated in neurodevelopmental disorders (NDDs), neurodegeneration and cancer. We previously implicated missense and splicing-defective THOC2 variants in NDDs and a broad range of other clinical features. Here we report 10 individuals from nine families with rare missense THOC2 variants including the first case of a recurrent variant (p.Arg77Cys), and an additional individual with an intragenic THOC2 microdeletion (Del-Ex37-38). Ex vivo missense variant testing and patient-derived cell line data from current and published studies show 9 of the 14 missense THOC2 variants result in reduced protein stability. The splicing-defective and deletion variants result in a loss of small regions of the C-terminal THOC2 RNA binding domain (RBD). Interestingly, reduced stability of THOC2 variant proteins has a flow-on effect on the stability of the multi-protein TREX complex; specifically on the other NDD-associated THOC subunits. Our current, expanded cohort refines the core phenotype of THOC2 NDDs to language disorder and/or ID, with a variable severity, and disorders of growth. A subset of affected individuals' has severe-profound ID, persistent hypotonia and respiratory abnormalities. Further investigations to elucidate the pathophysiological basis for this severe phenotype are warranted.
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Affiliation(s)
- Raman Kumar
- Adelaide Medical School and the Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Elizabeth Palmer
- Genetics of Learning Disability Service, Hunter Genetics, Waratah, NSW, Australia
- School of Women’s and Children’s Health, University of New South Wales, Randwick, NSW, Australia
| | - Alison E. Gardner
- Adelaide Medical School and the Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Renee Carroll
- Adelaide Medical School and the Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Siddharth Banka
- Faculty of Biology, Medicine and Health, Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Centre for Genomic Medicine, St. Mary’s Hospital, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, United Kingdom
| | - Ola Abdelhadi
- Manchester Centre for Genomic Medicine, St. Mary’s Hospital, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, United Kingdom
| | - Dian Donnai
- Faculty of Biology, Medicine and Health, Division of Evolution and Genomic Sciences, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
- Manchester Centre for Genomic Medicine, St. Mary’s Hospital, Manchester University NHS Foundation Trust, Health Innovation Manchester, Manchester, United Kingdom
| | - Ype Elgersma
- Department of Neuroscience, Erasmus MC University Medical Center, Rotterdam, Netherlands
- ENCORE Expertise Centre for Neurodevelopmental Disorders, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Cynthia J. Curry
- Genetic Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, United States
| | - Alice Gardham
- North West Thames Regional Genetics Service, Northwick Park Hospital, Harrow, United Kingdom
| | - Mohnish Suri
- Nottingham Clinical Genetics Service, Nottingham University Hospitals NHS Trust, and the 100,000 Genomes Project and the Genomics England Research Consortium, Nottingham, United Kingdom
| | - Rishikesh Malla
- Division of Pediatric Neurology, Medical University of South Carolina, Charleston, SC, United States
| | - Lauren Ilana Brady
- Department of Pediatrics, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Mark Tarnopolsky
- Department of Pediatrics, McMaster University Medical Centre, Hamilton, ON, Canada
| | - Dimitar N. Azmanov
- Department of Diagnostic Genomics, PathWest, Nedlands, WA, Australia
- Division of Pathology and Laboratory Medicine, Medical School, University of Western Australia, Crawley, WA, Australia
| | - Vanessa Atkinson
- Department of Diagnostic Genomics, PathWest, Nedlands, WA, Australia
- Division of Pathology and Laboratory Medicine, Medical School, University of Western Australia, Crawley, WA, Australia
| | - Michael Black
- Department of Diagnostic Genomics, PathWest, Nedlands, WA, Australia
- Division of Pathology and Laboratory Medicine, Medical School, University of Western Australia, Crawley, WA, Australia
| | - Gareth Baynam
- Faculty of Health and Medical Sciences, University of Western Australia Medical School, Perth, WA, Australia
| | - Lauren Dreyer
- Genetic Services of Western Australia, Undiagnosed Diseases Program, Department of Health, Government of Western Australia, Perth, WA, Australia
- Linear Clinical Research, Perth, WA, Australia
| | - Robin Z. Hayeems
- Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, and Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Christian R. Marshall
- Genome Diagnostics, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Gregory Costain
- Department of Paediatrics, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Marja W. Wessels
- Department of Clinical Genetics, Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Julia Baptista
- Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - James Drummond
- Neuroradiology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Melanie Leffler
- Genetics of Learning Disability Service, Hunter Genetics, Waratah, NSW, Australia
| | - Michael Field
- Genetics of Learning Disability Service, Hunter Genetics, Waratah, NSW, Australia
| | - Jozef Gecz
- Adelaide Medical School and the Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
- Childhood Disability Prevention, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
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Warburton DW, Feldsine PT, Falbo-Nelson MT, Ackerl J, Adamik D, Aldenrath S, Allain P, Arling V, Beaton L, Bowen B, Brocklehurst F, Catherwood K, Cavadini J, Coignaud C, Cooper A, Coulter R, Davis T, Douey D, Downey W, Drummond J, Durzi S, Dzogan S, Foster R, Fox C, Gibson E, Gour L, Gover G, Gray M, Heidebrecht P, Kerwood J, Krohn G, Kupskay B, LaFreniere D, Massicotte R, McDonagh S, Molleken B, Oggle J, Perlette M, Pugh P, Purvis U, Saint W, Trottier Y, Vinet J, West D, Wheeler B, Zebchuk A. Modified Immunodiffusion Method for Detection of Salmonella in Raw Flesh and Highly Contaminated Foods: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/78.1.59] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
A total of 19 government and private industry laboratories in Canada and the United States participated in the collaborative study. Naturally contaminated ground poultry and animal meals, as well as inoculated raw shrimp, were examined for presence of Salmonella by both the modified immunodiffusion method and the Bacteriological Analytical Manual culture method, resulting in an agreement rate of 93.1%. The 2 methods are statistically equivalent for all food types at each inoculation level and for all lots of naturally contaminated foods evaluated in this study. The modification of the AOAC Official Method 989.13, immunodiffusion (1–2 TEST) method for detection of motile Salmonella in all foods, has been adopted revised first action by AOAC INTERNATIONAL.
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Affiliation(s)
- Donald W Warburton
- Health Canada, Health Protection Branch, Food Directorate, Bureau of Microbial Hazards, Evaluation Division, Sir Frederick G. Banting Research Center, Ottawa, ON, K1A OL2, Canada
| | - Philip T Feldsine
- BioControl Systems, Inc., 19805 North Creek Parkway, Bothell, WA 98011
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24
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Nael K, Drummond J, Costa AB, De Leacy RA, Fung MM, Mocco J. Differential Subsampling with Cartesian Ordering for Ultrafast High-Resolution MRA in the Assessment of Intracranial Aneurysms. J Neuroimaging 2019; 30:40-44. [PMID: 31721362 DOI: 10.1111/jon.12677] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 09/09/2019] [Revised: 10/29/2019] [Accepted: 10/29/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND PURPOSE We aimed to evaluate the feasibility of an ultrafast whole head contrast-enhanced MRA (CE-MRA) in morphometric assessment of intracranial aneurysms in comparison to routinely used time-of-flight (TOF)-MRA. METHODS In this prospective single institutional study, patients with known untreated intracranial aneurysm underwent MRA. Routine multislab TOF-MRA was obtained with a 3D voxel sizes of .6 × .6 × 1 (6-minute acquisition time). CE-MRA of whole head was obtained using Differential Subsampling with Cartesian Ordering (DISCO) and 2D Auto-calibrating Reconstruction for Cartesian imaging with a 3D voxel-sizes of .75 × .75 × 1 mm3 during a 6-second temporal resolution. Morphometric features of intracranial aneurysms, including size, aneurysm sac morphology, and the presence of intraluminal thrombosis, were assessed on both techniques. Statistical analysis was performed using a combination of Kappa test, Bland-Altman, and correlation coefficient analysis. RESULTS A total of 34 aneurysms in 28 patients were included. Aneurysm size measurements (mean ± SD) were similar between DISCO-MRA (4.1 ± 2.3 mm) and TOF-MRA (4.3 ± 2.8 mm) (P = .27). Bland-Altman analysis showed a mean difference of .4 mm and there was excellent correlation r = .91 (95% CI: .87-.96). In six aneurysms (17.6%), TOF-MRA was nonconfidant to exclude intraluminal thrombosis. In seven aneurysms (20%), TOF-MRA was unable or nonconfidant in depicting aneurysm sac morphology. CONCLUSIONS Described ultrafast high spatial-resolution MRA is superior to routinely used TOF-MRA in assessment of morphometric features of intracranial aneurysms, such as intraluminal thrombosis and aneurysm morphology, and is obtained in a fraction of the time (6 seconds).
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Affiliation(s)
- Kambiz Nael
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - James Drummond
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Anthony B Costa
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Reade A De Leacy
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - J Mocco
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY
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25
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Page M, Drummond J, Magdy M, Vedelago J, Kuzinkovas V. Imaging appearance on CT post laparoscopic Roux-en-Y gastric bypass using bioabsorbable prosthesis with fibrin glue fixation to prevent a Petersen's space hernia. BJR Case Rep 2019; 5:20180111. [PMID: 31555470 PMCID: PMC6750627 DOI: 10.1259/bjrcr.20180111] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 11/21/2022] Open
Abstract
Imaging post bariatric surgery is becoming more common over the past decade due to increasing incidence of obesity in the population and subsequent treatment. In recent years, the use of topical haemostatic agents and bioabsorbable prostheses has increased leading to higher likelihood of encountering these agents on post-operative imaging. Imaging in the post-operative period is occasionally performed to assess for complications such as obstruction, leak and abscess formation. Familiarity with these agents is crucial in preventing incorrect diagnosis. Laparoscopic Roux-en-Y gastric bypass (RYGB) is favoured over the open approach as it is safer and more effective, with a mortality rate of 0.5% and morbidity around 7–14 %. The main cause of late post-RYGB complications is the development of internal hernias such as a Petersen’s hernia. During the procedure, a space between the alimentary loop of the small bowel and the transverse mesocolon is created and is called the Petersen’s defect. Subsequently, a part of the small bowel can herniate through this orifice. As this operation is becoming more common, the incidence of internal herniation has been increasing. This case report describes a new bariatric surgical technique and the associated post-operative radiological appearances on CT. The surgical technique has been pioneered in Sydney, Australia and involves a laparoscopic RYGB using bioabsorbable prosthesis with fibrin glue fixation to prevent a Petersen’s space hernia.
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Affiliation(s)
- Mark Page
- Department of Radiology, Tel Aviv Sourasky Medical Center, Israel
| | | | - Mark Magdy
- Department of Surgery, St George Private Hospital, Sydney, Australia
| | - John Vedelago
- Department of Radiology, St Mary's Hospital, London, UK
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Urriola N, Soosapilla K, Drummond J, Thieben M. Fulminant thymomatous AMPAR-antibody limbic encephalitis with hypertonic coma, bruxism, an isoelectric electroencephalogram and temporal cortical atrophy, with recovery. BMJ Case Rep 2019; 12:12/2/e227893. [PMID: 30796080 DOI: 10.1136/bcr-2018-227893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Autoimmune encephalitides are a potentially devastating group of treatable disorders with a wide variety of clinical presentations. The most studied autoimmune encephalitis is caused by antibodies to the N-methyl-D-aspartate glutamate receptor. A rarer cause is due to antibodies against the evolutionarily related α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR). The full assortment of electroencephalogram (EEG) and clinical descriptions of the latter are yet to be fully described. A 44-year-old woman with impaired consciousness and subsequent coma characterised by an isoelectric EEG was diagnosed with AMPAR-antibody limbic encephalitis. MRI revealed temporal T2 hyperintensities that improved with immunosuppression, although leaving marked cortical atrophy. Gradual clinical improvement saw the development of aggressive bruxism requiring botulinum toxin injection with eventual meaningful clinical recovery. This case expands the clinical spectrum of AMPAR limbic encephalitis to include aggressive bruxism, and highlights that despite poor clinical and EEG findings at the outset, recovery is still possible.
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Affiliation(s)
- Nicolás Urriola
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | | | | | - Mark Thieben
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia
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27
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Drummond J, Foster J, Gürdoğan Ö. Cluster Adjacency Properties of Scattering Amplitudes in N=4 Supersymmetric Yang-Mills Theory. Phys Rev Lett 2018; 120:161601. [PMID: 29756907 DOI: 10.1103/physrevlett.120.161601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Indexed: 06/08/2023]
Abstract
We conjecture a new set of analytic relations for scattering amplitudes in planar N=4 super Yang-Mills theory. They generalize the Steinmann relations and are expressed in terms of the cluster algebras associated to Gr(4,n). In terms of the symbol, they dictate which letters can appear consecutively. We study heptagon amplitudes and integrals in detail and present symbols for previously unknown integrals at two and three loops which support our conjecture.
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Affiliation(s)
- James Drummond
- School of Physics & Astronomy, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
| | - Jack Foster
- School of Physics & Astronomy, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
| | - Ömer Gürdoğan
- School of Physics & Astronomy, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
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Schon K, Rytina E, Drummond J, Simmonds J, Abbs S, Sandford R, Tischkowitz M. Evaluation of universal immunohistochemical screening of sebaceous neoplasms in a service setting. Clin Exp Dermatol 2018; 43:410-415. [PMID: 29333623 DOI: 10.1111/ced.13359] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Muir-Torre syndrome (MTS) is a subtype of Lynch syndrome, which encompasses the combination of sebaceous skin tumours or keratoacanthomas and internal malignancy, due to mutations in DNA mismatch repair genes. Sebaceous neoplasms (SNs) may occur before other malignancies, and may lead to the diagnosis, which allows testing of other family members, cancer surveillance, risk-reducing surgery or prevention therapies. AIM To evaluate the efficacy of universal immunohistochemistry (IHC) screening of SNs in a service setting. METHODS Patients with SNs were ascertained by a regional clinical pathology service over a 3-year period. Results of tumour IHC, clinical genetics notes and germline genetic testing were retrospectively reviewed. RESULTS In total, 62 patients presented with 71 SNs; 9 (15%) of these patients had previously diagnosed MTS. Tumour IHC was performed for 50 of the 53 remaining patients (94%); 26 (52%) had loss of staining of one or more mismatch repair proteins. Fifteen patients were referred to the Clinical Genetics department, and 10 patients underwent germline genetic testing. Two had a new diagnosis of MTS confirmed, with heterozygous pathogenic mutations detected in the MSH2 and PMS2 genes (diagnostic yield 20%). The PMS2 mutation was identified in a 57-year-old woman with a sebaceous adenoma and history of endometrial cancer; to our knowledge, this is the first time a PMS2 mutation has been reported in MTS. CONCLUSIONS Universal IHC screening of SNs is an effective method to identify cases for further genetic evaluation. Rates of referral to clinical genetics were only moderate (58%). Increased awareness of MTS could help improve the rate of onward referral.
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Affiliation(s)
- K Schon
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - E Rytina
- Histopathology Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - J Drummond
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - J Simmonds
- Yorkshire Regional Genetics Laboratories, St James's University Hospital, Leeds, UK
| | - S Abbs
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - R Sandford
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Histopathology Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Yorkshire Regional Genetics Laboratories, St James's University Hospital, Leeds, UK.,Academic Department of Medical Genetics, University of Cambridge, Cambridge, UK
| | - M Tischkowitz
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Academic Department of Medical Genetics, University of Cambridge, Cambridge, UK
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29
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Talia AJ, Drummond J, Muirhead C, Tran P. Using a Structured Checklist to Improve the Orthopedic Ward Round: A Prospective Cohort Study. Orthopedics 2017; 40:e663-e667. [PMID: 28504810 DOI: 10.3928/01477447-20170509-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/28/2017] [Indexed: 02/03/2023]
Abstract
Comprehensive and timely documentation on orthopedic ward rounds continues to be problematic, leading to delayed or inappropriate patient care and miscommunication between health care providers. The authors introduced a simple checklist to improve the documentation on orthopedic ward rounds in their institution. A prospective cohort study was performed. Standard care was provided for cohort A. During a 2-week period, the documentation of patient care by physicians following a ward round was assessed in terms of venous thromboembolism prophylaxis, fasting status, wound or dressing plan, weight-bearing status, and important surgical details. The physicians were blinded to this initial review. For cohort B, a structured ward round checklist was introduced during a 2-week period. A total of 132 patient encounters were recorded in cohort A. Important issues that were rarely discussed included vital signs (11.4%), venous thromboembolism prophylaxis (9.8%), and bowel status (3.8%). Issues that were poorly documented included fasting status (9.1%), wound or dressing plan (6.8%), and weight-bearing status (11.4%). After introduction of the checklist, daily documentation of surgical details improved from 38.6% to 85.3% of patient encounters. Fasting status documentation improved from 9.1% to 70.6% of patient encounters. Venous thromboembolism prophylaxis discussion increased from 9.8% to 45.6% of the time, while its documentation improved from 6.8% to 92.6%. Documentation of weight-bearing status improved from 11.4% to 83.8% (all P<.0001). The use of a structured checklist during orthopedic ward rounds led to significant improvement in both the consideration and the documentation of key aspects of surgical care. [Orthopedics. 2017; 40(4):e663-e667.].
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Abstract
INTRODUCTION Greater trochanteric pain syndrome (GTPS), previously referred as trochanteric bursitis, is a debilitating condition characterised by chronic lateral hip pain. The syndrome is thought to relate to gluteal tendinopathy, with most cases responding to non-operative treatment. A number of open and endoscopic surgical techniques targeting the iliotibial band, trochanteric bursa and gluteal tendons have, however, been described for severe recalcitrant cases. We report the outcomes of one such endoscopic approach here. MATERIALS AND METHODS We retrospectively reviewed 49 patients (57 operations) who had undergone endoscopic longitudinal vertical iliotibial band release and trochanteric bursectomy. Inclusion criteria included diagnosed GTPS with a minimum of six months of non-operative treatment. Exclusion criteria included concomitant intra- or extra-articular hip pathology and previous hip surgery including total hip arthroplasty. Outcomes were assessed using the Visual Analogue Scale, Oxford hip Score and International Hip Outcome Tool (iHOT-33). RESULTS The series included 42 females and 7 males with a mean age of 65.0 years (26.7-88.6). Mean follow-up time was 20.7 months (5.3-41.2). Eight patients had full thickness gluteal tendon tears, of which 7 were repaired. Adjuvant PRP was injected intraoperatively in 38 of 57 operations (67.2 %). At follow-up, overall mean Visual Analogue Scale values had decreased from 7.8 to 2.8 (p < 0.001), Oxford hip Scores had increased from 20.4 to 37.3 (p < 0.001) and iHOT-33 scores had increased from 23.8 to 70.2 (p < 0.001). Of the 57 operations performed, patients reported feeling very satisfied with the surgical outcome in 28 operations (49.1 %), satisfied in 17 operations (29.8 %) and less than satisfied in 12 operations (21.1 %). CONCLUSIONS While the majority of patients with GTPS will improve with non-operative management, endoscopic iliotibial band release, trochanteric bursectomy and gluteal tendon repair is a safe and effective treatment for severe recalcitrant cases.
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Affiliation(s)
- James Drummond
- Western Health, Melbourne, VIC, Australia. .,Department of Orthopaedic Surgery, Western Hospital, Level 1 South, 160 Gordon St, Footscray, VIC, 3011, Australia.
| | - Camdon Fary
- Western Health, Melbourne, VIC, Australia.,Department of Orthopaedic Surgery, Western Hospital, Level 1 South, 160 Gordon St, Footscray, VIC, 3011, Australia
| | - Phong Tran
- Western Health, Melbourne, VIC, Australia.,Department of Orthopaedic Surgery, Western Hospital, Level 1 South, 160 Gordon St, Footscray, VIC, 3011, Australia
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Plaskocinska I, Shipman H, Drummond J, Thompson E, Buchanan V, Newcombe B, Hodgkin C, Barter E, Ridley P, Ng R, Miller S, Dann A, Licence V, Webb H, Tan LT, Daly M, Ayers S, Rufford B, Earl H, Parkinson C, Duncan T, Jimenez-Linan M, Sagoo GS, Abbs S, Hulbert-Williams N, Pharoah P, Crawford R, Brenton JD, Tischkowitz M. New paradigms for BRCA1/BRCA2 testing in women with ovarian cancer: results of the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study. J Med Genet 2016; 53:655-61. [PMID: 27208206 PMCID: PMC5099175 DOI: 10.1136/jmedgenet-2016-103902] [Citation(s) in RCA: 48] [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: 03/15/2016] [Revised: 04/13/2016] [Accepted: 04/19/2016] [Indexed: 01/26/2023]
Abstract
BACKGROUND Over recent years genetic testing for germline mutations in BRCA1/BRCA2 has become more readily available because of technological advances and reducing costs. OBJECTIVE To explore the feasibility and acceptability of offering genetic testing to all women recently diagnosed with epithelial ovarian cancer (EOC). METHODS Between 1 July 2013 and 30 June 2015 women newly diagnosed with EOC were recruited through six sites in East Anglia, UK into the Genetic Testing in Epithelial Ovarian Cancer (GTEOC) study. Eligibility was irrespective of patient age and family history of cancer. The psychosocial arm of the study used self-report, psychometrically validated questionnaires (Depression Anxiety and Stress Scale (DASS-21); Impact of Event Scale (IES)) and cost analysis was performed. RESULTS 232 women were recruited and 18 mutations were detected (12 in BRCA1, 6 in BRCA2), giving a mutation yield of 8%, which increased to 12% in unselected women aged <70 years (17/146) but was only 1% in unselected women aged ≥70 years (1/86). IES and DASS-21 scores in response to genetic testing were significantly lower than equivalent scores in response to cancer diagnosis (p<0.001). Correlation tests indicated that although older age is a protective factor against any traumatic impacts of genetic testing, no significant correlation exists between age and distress outcomes. CONCLUSIONS The mutation yield in unselected women diagnosed with EOC from a heterogeneous population with no founder mutations was 8% in all ages and 12% in women under 70. Unselected genetic testing in women with EOC was acceptable to patients and is potentially less resource-intensive than current standard practice.
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Affiliation(s)
- Inga Plaskocinska
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - Hannah Shipman
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - James Drummond
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - Edward Thompson
- East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | | | - Barbara Newcombe
- Cambridge Cancer Trials Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - Charlotte Hodgkin
- Cambridge Cancer Trials Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - Elisa Barter
- Department of Oncology, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, Peterborough, UK
| | - Paul Ridley
- Cancer Services, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK
| | - Rita Ng
- Cancer Services, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK
| | - Suzanne Miller
- Clinical Cancer Services, Hinchingbrooke Health Care NHS Trust, Huntingdon, Cambridgeshire, UK
| | - Adela Dann
- Cancer Research Team, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK
| | - Victoria Licence
- Cancer Research Team, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK
| | - Hayley Webb
- Department of Oncology, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK
| | - Li Tee Tan
- Clinical Cancer Services, Hinchingbrooke Health Care NHS Trust, Huntingdon, Cambridgeshire, UK
| | - Margaret Daly
- Department of Oncology, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK
| | - Sarah Ayers
- Department of Oncology, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, Peterborough, UK
| | - Barnaby Rufford
- Cancer Services, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, UK
| | - Helena Earl
- Department of Oncology, University of Cambridge, NIHR Cambridge Biomedical Research Centre, Cambridge, Cambridgeshire, UK
| | - Christine Parkinson
- Cancer Services, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - Timothy Duncan
- Department of Obstetrics and Gynaecology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK
| | - Mercedes Jimenez-Linan
- Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - Gurdeep S Sagoo
- PHG Foundation, Cambridge, UK Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Stephen Abbs
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK
| | | | - Paul Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Robin Crawford
- Cancer Services, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
| | - James D Brenton
- Cancer Services, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK Cancer Research UK Cambridge Institute, Cambridge, Cambridgeshire, UK
| | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridgeshire, UK East Anglian Medical Genetics Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, Cambridgeshire, UK
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Baker EH, Drummond J, Stefanidis D, Iannitti DA, Naumann RW. Use of a Novel, Cordless Ultrasonic Dissector for Gynecologic Minimally Invasive Surgical Procedures. J Minim Invasive Gynecol 2016; 22:S43-S44. [PMID: 27679240 DOI: 10.1016/j.jmig.2015.08.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- E H Baker
- General Surgery, Division of Hepatopancreatobiliary Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - J Drummond
- General Surgery, Division of Hepatopancreatobiliary Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - D Stefanidis
- General Surgery, Division of Hepatopancreatobiliary Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - D A Iannitti
- General Surgery, Division of Hepatopancreatobiliary Surgery, Carolinas Medical Center, Charlotte, North Carolina
| | - R W Naumann
- Obstetrics and Gynecology, Division of Gynecologic Oncology, Carolinas Medical Center, Charlotte, North Carolina
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Wentlandt K, Bracaglia A, Drummond J, Handren L, McCann J, Clarke C, Degendorfer N, Chan CK. Evaluation of the physician quality improvement initiative: the expected and unexpected opportunities. BMC Med Educ 2015; 15:230. [PMID: 26694493 PMCID: PMC4687152 DOI: 10.1186/s12909-015-0511-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 12/11/2015] [Indexed: 05/09/2023]
Abstract
BACKGROUND The Physician Quality Improvement Initiative (PQII) uses a well-established multi-source feedback program, and incorporates an additional facilitated feedback review with their department chief. The purpose of this mixed methods study was to examine the value of the PQII by eliciting feedback from various stakeholders. METHODS All participants and department chiefs (n = 45) were invited to provide feedback on the project implementation and outcomes via survey and/or an interview. The survey consisted of 12 questions focused on the value of the PQII, it's influence on practice and the promotion of quality improvement and accountability. RESULTS A total of 5 chiefs and 12 physician participants completed semi structured interviews. Participants found the PQII process, report and review session helpful, self-affirming or an opportunity for self-reflection, and an opportunity to engage their leaders about their practice. Chiefs indicated the sessions strengthened their understanding, ability to communicate and engage physicians about their practice, best practices, quality improvement and accountability. Thirty participants (66.7 %) completed the survey; of the responders 75.9, 89.7, 86.7 % found patient, co-worker, and physician colleague feedback valuable, respectively. A total of 67.9 % valued their facilitated review with their chief and 55.2 % indicated they were contemplating change due to their feedback. Participants believed the PQII promoted quality improvement (27/30, 90.0 %), and accountability (28/30, 93.3 %). CONCLUSIONS The PQII provides an opportunity for physician development, affirmation and reflection, but also a structure to further departmental quality improvement, best practices, and finally, an opportunity to enhance communication, accountability and relationships between the organization, department chiefs and their staff.
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Affiliation(s)
- Kirsten Wentlandt
- Department of Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, ON, Canada.
- Medical Affairs, University Health Network, Toronto, ON, Canada.
- Toronto General Hospital, UHN, 9NU-925, 200 Elizabeth St, Toronto, ON, M5G 2C4, Canada.
| | - Andrea Bracaglia
- School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada.
| | - James Drummond
- School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada.
| | - Lindsay Handren
- School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada.
| | - Joshua McCann
- School of Public Policy and Governance, University of Toronto, Toronto, ON, Canada.
| | - Catherine Clarke
- Human Resources, University Health Network, Toronto, ON, Canada.
| | - Niki Degendorfer
- Corporate Planning, University Health Network, Toronto, ON, Canada.
| | - Charles K Chan
- Medical Affairs, University Health Network, Toronto, ON, Canada.
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, ON, Canada.
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Gould A, Udalski A, Shin IG, Porritt I, Skowron J, Han C, Yee JC, Kozłowski S, Choi JY, Poleski R, Wyrzykowski Ł, Ulaczyk K, Pietrukowicz P, Mróz P, Szymański MK, Kubiak M, Soszyński I, Pietrzyński G, Gaudi BS, Christie GW, Drummond J, McCormick J, Natusch T, Ngan H, Tan TG, Albrow M, DePoy DL, Hwang KH, Jung YK, Lee CU, Park H, Pogge RW, Abe F, Bennett DP, Bond IA, Botzler CS, Freeman M, Fukui A, Fukunaga D, Itow Y, Koshimoto N, Larsen P, Ling CH, Masuda K, Matsubara Y, Muraki Y, Namba S, Ohnishi K, Philpott L, Rattenbury NJ, Saito T, Sullivan DJ, Sumi T, Suzuki D, Tristram PJ, Tsurumi N, Wada K, Yamai N, Yock PCM, Yonehara A, Shvartzvald Y, Maoz D, Kaspi S, Friedmann M. Exoplanet detection. A terrestrial planet in a ~1-AU orbit around one member of a ~15-AU binary. Science 2014; 345:46-9. [PMID: 24994642 DOI: 10.1126/science.1251527] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Using gravitational microlensing, we detected a cold terrestrial planet orbiting one member of a binary star system. The planet has low mass (twice Earth's) and lies projected at ~0.8 astronomical units (AU) from its host star, about the distance between Earth and the Sun. However, the planet's temperature is much lower, <60 Kelvin, because the host star is only 0.10 to 0.15 solar masses and therefore more than 400 times less luminous than the Sun. The host itself orbits a slightly more massive companion with projected separation of 10 to 15 AU. This detection is consistent with such systems being very common. Straightforward modification of current microlensing search strategies could increase sensitivity to planets in binary systems. With more detections, such binary-star planetary systems could constrain models of planet formation and evolution.
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Affiliation(s)
- A Gould
- Department of Astronomy, Ohio State University, 140 West 18th Avenue, Columbus, OH 43210, USA
| | - A Udalski
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - I-G Shin
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - I Porritt
- Turitea Observatory, Palmerston North, New Zealand
| | - J Skowron
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - C Han
- Department of Physics, Chungbuk National University, Cheongju 371-763, Republic of Korea.
| | - J C Yee
- Department of Astronomy, Ohio State University, 140 West 18th Avenue, Columbus, OH 43210, USA. Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138, USA
| | - S Kozłowski
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - J-Y Choi
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - R Poleski
- Department of Astronomy, Ohio State University, 140 West 18th Avenue, Columbus, OH 43210, USA. Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - Ł Wyrzykowski
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland. Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, UK
| | - K Ulaczyk
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - P Pietrukowicz
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - P Mróz
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - M K Szymański
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - M Kubiak
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - I Soszyński
- Warsaw University Observatory, Aleje Ujazdowskie 4, 00-478 Warszawa, Poland
| | - G Pietrzyński
- Department of Astronomy, Ohio State University, 140 West 18th Avenue, Columbus, OH 43210, USA. Universidad de Concepción, Departamento de Astronomia, Casilla 160-C, Concepción, Chile
| | - B S Gaudi
- Department of Astronomy, Ohio State University, 140 West 18th Avenue, Columbus, OH 43210, USA
| | | | - J Drummond
- Possum Observatory, Patutahi, New Zealand
| | - J McCormick
- Farm Cove Observatory, Centre for Backyard Astrophysics, Pakuranga, Auckland, New Zealand
| | - T Natusch
- Possum Observatory, Patutahi, New Zealand. Auckland University of Technology, Auckland, New Zealand
| | - H Ngan
- Possum Observatory, Patutahi, New Zealand
| | - T-G Tan
- Perth Exoplanet Survey Telescope, Perth, Australia
| | - M Albrow
- Department of Physics and Astronomy, University of Canterbury, Private Bag 4800, Christchurch, New Zealand
| | - D L DePoy
- Department of Physics and Astronomy, Texas A&M University, College Station, TX 77843-4242, USA
| | - K-H Hwang
- Department of Physics, Chungbuk National University, Cheongju 371-763, Republic of Korea
| | - Y K Jung
- Department of Physics, Chungbuk National University, Cheongju 371-763, Republic of Korea
| | - C-U Lee
- Korea Astronomy and Space Science Institute, Daejeon 305-348, Republic of Korea
| | - H Park
- Department of Physics, Chungbuk National University, Cheongju 371-763, Republic of Korea
| | - R W Pogge
- Department of Astronomy, Ohio State University, 140 West 18th Avenue, Columbus, OH 43210, USA
| | - F Abe
- Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya 464-8601, Japan
| | - D P Bennett
- University of Notre Dame, Department of Physics, 225 Nieuwland Science Hall, Notre Dame, IN 46556-5670, USA
| | - I A Bond
- Institute of Information and Mathematical Sciences, Massey University, Private Bag 102-904, North Shore Mail Centre, Auckland, New Zealand
| | - C S Botzler
- Department of Physics, University of Auckland, Private Bag 92-019, Auckland 1001, New Zealand
| | - M Freeman
- Department of Physics, University of Auckland, Private Bag 92-019, Auckland 1001, New Zealand
| | - A Fukui
- Okayama Astrophysical Observatory, National Astronomical Observatory of Japan, Asakuchi, Okayama 719-0232, Japan
| | - D Fukunaga
- Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya 464-8601, Japan
| | - Y Itow
- Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya 464-8601, Japan
| | - N Koshimoto
- Department of Earth and Space Science, Osaka University, Osaka 560-0043, Japan
| | - P Larsen
- Department of Physics, University of Auckland, Private Bag 92-019, Auckland 1001, New Zealand. Institute of Astronomy, University of Cambridge, Madingley Road, Cambridge CB3 0HA, UK
| | - C H Ling
- Institute of Information and Mathematical Sciences, Massey University, Private Bag 102-904, North Shore Mail Centre, Auckland, New Zealand
| | - K Masuda
- Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya 464-8601, Japan
| | - Y Matsubara
- Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya 464-8601, Japan
| | - Y Muraki
- Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya 464-8601, Japan
| | - S Namba
- Department of Earth and Space Science, Osaka University, Osaka 560-0043, Japan
| | - K Ohnishi
- Nagano National College of Technology, Nagano 381-8550, Japan
| | - L Philpott
- Department of Earth, Ocean and Atmospheric Sciences, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - N J Rattenbury
- Department of Physics, University of Auckland, Private Bag 92-019, Auckland 1001, New Zealand
| | - To Saito
- Tokyo Metropolitan College of Aeronautics, Tokyo 116-8523, Japan
| | - D J Sullivan
- School of Chemical and Physical Sciences, Victoria University, Wellington, New Zealand
| | - T Sumi
- Department of Earth and Space Science, Osaka University, Osaka 560-0043, Japan
| | - D Suzuki
- Department of Earth and Space Science, Osaka University, Osaka 560-0043, Japan
| | - P J Tristram
- Mount John University Observatory, Post Office Box 56, Lake Tekapo 8770, New Zealand
| | - N Tsurumi
- Solar-Terrestrial Environment Laboratory, Nagoya University, Nagoya 464-8601, Japan
| | - K Wada
- Department of Earth and Space Science, Osaka University, Osaka 560-0043, Japan
| | - N Yamai
- Department of Physics, Faculty of Science, Kyoto Sangyo University, Kyoto 603-8555, Japan
| | - P C M Yock
- Department of Physics, University of Auckland, Private Bag 92-019, Auckland 1001, New Zealand
| | - A Yonehara
- Department of Physics, Faculty of Science, Kyoto Sangyo University, Kyoto 603-8555, Japan
| | - Y Shvartzvald
- School of Physics and Astronomy, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - D Maoz
- School of Physics and Astronomy, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - S Kaspi
- School of Physics and Astronomy, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - M Friedmann
- School of Physics and Astronomy, Tel-Aviv University, Tel-Aviv 69978, Israel
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Wang L, Swierczek SI, Lanikova L, Kim SJ, Hickman K, Walker K, Wang K, Drummond J, Doddapaneni H, Reid JG, Muzny DM, Gibbs RA, Wheeler DA, Prchal JT. The relationship of JAK2(V617F) and acquired UPD at chromosome 9p in polycythemia vera. Leukemia 2014; 28:938-41. [PMID: 24463469 DOI: 10.1038/leu.2014.20] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- L Wang
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - S I Swierczek
- Division of Hematology, The University of Utah School of Medicine Pathology/ARUP, and VAH, Salt Lake City, UT 84132, USA
| | - L Lanikova
- Division of Hematology, The University of Utah School of Medicine Pathology/ARUP, and VAH, Salt Lake City, UT 84132, USA
| | - S J Kim
- Division of Hematology, The University of Utah School of Medicine Pathology/ARUP, and VAH, Salt Lake City, UT 84132, USA
| | - K Hickman
- Division of Hematology, The University of Utah School of Medicine Pathology/ARUP, and VAH, Salt Lake City, UT 84132, USA
| | - K Walker
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - K Wang
- Zilkha Neurogenetic Institute and Norris Comprehensive Cancer Center, The University of Southern California, Los Angeles, CA 90089, USA
| | - J Drummond
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - H Doddapaneni
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - J G Reid
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - D M Muzny
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - R A Gibbs
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - D A Wheeler
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - J T Prchal
- Division of Hematology, The University of Utah School of Medicine Pathology/ARUP, and VAH, Salt Lake City, UT 84132, USA
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Wang L, Swierczek SI, Drummond J, Hickman K, Kim SJ, Walker K, Doddapaneni H, Muzny DM, Gibbs RA, Wheeler DA, Prchal JT. Whole-exome sequencing of polycythemia vera revealed novel driver genes and somatic mutation shared by T cells and granulocytes. Leukemia 2014; 28:935-8. [PMID: 24413320 DOI: 10.1038/leu.2014.7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- L Wang
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - S I Swierczek
- Division of Hematology, The University of Utah School of Medicine and VAH, Salt Lake City, UT 84132, USA
| | - J Drummond
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - K Hickman
- Division of Hematology, The University of Utah School of Medicine and VAH, Salt Lake City, UT 84132, USA
| | - S J Kim
- Division of Hematology, The University of Utah School of Medicine and VAH, Salt Lake City, UT 84132, USA
| | - K Walker
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - H Doddapaneni
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - D M Muzny
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - R A Gibbs
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - D A Wheeler
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - J T Prchal
- Division of Hematology, The University of Utah School of Medicine and VAH, Salt Lake City, UT 84132, USA
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Abstract
This article outlines the subjects presented and discussed at the December 2012 IADR Dental Materials Innovation Workshop held at King’s College London. Incorporating new materials and techniques into clinical practice was considered from 4 perspectives: (1) Accelerating the “research to regulatory approval” process was presented with current developments in the United States, with the National Institutes of Health/Food and Drug Administration process as a working example; (2) intellectual property and regulatory requirements were discussed across the well-established US and EU frameworks, as well as the more recently developed procedures across Brazil, Russia, India, and China; (3) the challenges and opportunities of incorporating innovations into dental education were considered with reference to the future needs of both students and faculty; and (4) the key but difficult and unpredictable step of translating such innovations into routine dental practice was then explored. Constructive and far-ranging discussion among the broadly based Workshop participants (from dental research, education, practice, and industry, as well as environmental organizations and the World Health Organization) mapped out key issues for the future. The focus was on facilitating the more timely adoption of improvements in both materials and techniques to improve patient health and health systems, while minimizing environmental impact.
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Affiliation(s)
- N.B. Pitts
- Dental Innovation and Translation Centre (ITC), King’s College London Dental Institute, Floor 18, Tower Wing, Guy’s Hospital, London SE1 9RT, UK
| | | | | | | | - S. Johnston
- FDI World Dental Federation and British Dental Association, UK
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Chambers AR, Drummond J. MEASUREMENT OF PHYSICAL MODIFICATION OF DISTILLERY MALTS BY THE SCLEROMETER. Journal of the Institute of Brewing 2013. [DOI: 10.1002/j.2050-0416.1963.tb06350.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Delon I, Taylor A, Molenda A, Drummond J, Oakhill K, Girling A, Liu H, Whittaker J, Treacy R, Tischkowitz M. A germline mosaic BRCA1 exon deletion in a woman with bilateral basal-like breast cancer. Clin Genet 2012; 84:297-9. [PMID: 23216102 DOI: 10.1111/cge.12057] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 10/24/2012] [Accepted: 11/06/2012] [Indexed: 11/29/2022]
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Drumm BR, Bourke B, Drummond J, McNicholas F, Quinn S, Broderick A, Taaffe S, Twomey J, Rowland M. Cyclical vomiting syndrome in children: a prospective study. Neurogastroenterol Motil 2012; 24:922-7. [PMID: 22762244 DOI: 10.1111/j.1365-2982.2012.01960.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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: 12/17/2022]
Abstract
BACKGROUND Cyclical vomiting syndrome (CVS) is a disorder that affects all ages and is characterized by episodes of severe nausea and vomiting with symptom-free intervals between episodes. The incidence in children is 3.15/100 000 children per year. Our objective was to evaluate the natural history of CVS and examine factors that predict symptom resolution. METHODS Thirty newly diagnosed children (mean 9.15 years, SD 3.31 range 3.5-15.7) were enrolled. All children had a follow-up interview at 3 months, 27/30 at 6 months, and 22/30 at 9 months. KEY RESULTS Following diagnosis of CVS, only 5/22(22.7%) children had no further episodes of vomiting at 9 months, whereas 17/22 (77.3%) continued to vomit. In the year prior to diagnosis, 15/30 (50%) children were admitted to hospital. Of the 22 children with follow-up for 9 months, only one child required hospital admission. Children who continued to vomit had higher internalizing scores on CBCL compared with those who stopped vomiting (P = NS). The Pediatric Quality-of-Life Score suggested those who continued to vomit had a poorer quality of life at diagnosis compared with those who stopped vomiting (P < 0.05). CONCLUSIONS & INFERENCES Making a positive diagnosis of CVS and providing families with information is very important in the management of CVS. Although 75% of children reported regular episodes of vomiting 9 months after diagnosis, there was a significant reduction in the frequency and severity of symptoms in addition to a marked reduction in the use of medical services.
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Affiliation(s)
- B R Drumm
- UCD School of Medicine and Medical Sciences, Dublin Academic Medical Centre, Dublin 7, Ireland
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Pancari G, Fan H, Smith S, Joshi A, Haimbach R, Clark D, Li Y, Hua J, McKelvey T, Ou Y, Drummond J, Cope L, Montgomery D, McNeely T. Characterization of the mechanism of protection mediated by CS-D7, a monoclonal antibody to Staphylococcus aureus iron regulated surface determinant B (IsdB). Front Cell Infect Microbiol 2012; 2:36. [PMID: 22919628 PMCID: PMC3417506 DOI: 10.3389/fcimb.2012.00036] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Accepted: 03/03/2012] [Indexed: 11/13/2022] Open
Abstract
We previously reported the development of a human monoclonal antibody (CS-D7, IgG1) with specificity and affinity for the iron regulated surface determinant B (IsdB) of Staphylococcus aureus. CS-D7 mediates opsonophagocytic killing in vitro and protection in a murine sepsis model. In light of recent data indicating that IsdB specific T cells (CD4+, Th17), not Ab, mediate protection after vaccination with IsdB, it is important to investigate the mechanism of protection mediated by CS-D7. The mAb was examined to determine if it blocked heme binding to IsdB in vitro. The mAb was not found to have heme blocking activity, nor did it prevent bacterial growth under in vivo conditions, in an implanted growth chamber. To assess the role of the mAb Fc a point mutation was introduced at aa 297 (CS-D7·N297A). This point mutation removes Fc effector functions. In vitro analysis of the mutein confirmed that it lacked measurable binding to FcγR, and that it did not fix complement. The mutein had dramatically reduced in vitro opsonic OP activity compared to CS-D7. Nonetheless, the mutein conferred protection equivalent to the wild type mAb in the murine sepsis model. Both wild type and mutein mAbs were efficacious in FcγR deletion mice (including both FcγRII−/− mice and FcγRIII−/− mice), indicating that these receptors were not essential for mAb mediated protection in vivo. Protection mediated by CS-D7 was lost in Balb/c mice depleted of C3 with cobra venom factor (CFV), was lost in mice depleted of superoxide dismutase (SOD) in P47phox deletion mice, and as previously reported, was absent in SCID mice (Joshi et al., 2012). Enhanced clearance of S. aureus in the liver of CS-D7 treated mice and enhanced production of IFN-γ, but not of IL17, may play a role in the mechanism of protection mediated by the mAb. CS-D7 apparently mediates survival in challenged mice through a mechanism involving complement, phagocytes, and lymphocytes, but which does not depend on interaction with FcγR, or on blocking heme uptake.
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Affiliation(s)
- Gregory Pancari
- Department of Vaccine Basic Research, Merck Research Labs, Merck/MSD, West Point PA, USA
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Abstract
Sixteen mixed age Angora does were synchronised by progesterone injections and superovulated with either PMSG or FSH in 1982 and six synchronised Angora and seven Saanens were superovulated with FSH in 1983. All donors entire mated and were subjected to egg recovery by a uterine flush conducted during surgery about five days after oestrus. The mean ovulation rate and number of transferable embryos recovered from Angoras treated with PMSG in 1982 was 9.1 and 5.1, respectively, and for FSH treated donors was 15.1 and 11.0. Results for Angoras treated in 1983 were 5.3 and 5.0 and for Saanens were 29.3 and 25.3. Each year recipient feral and Angora does were synchronised, and 329 embryos were transferred surgically to 151 recipients. One hundred and sixteen (77%) of the recipients kidded producing 191 kids (58% embryo survival). Well fed Angora and Saanen donors superovulated with FSH produced 8 and 17 offspring, respectively, in the year of surgery. This rate of reproduction is about 8 times faster than normal and about double that achieved when donors are superovulateb with PMSG.
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Affiliation(s)
- H R Tervit
- Ruakura Animal Research Station, Private Bag, Hamilton
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Gika AD, Siddiqui A, Hulse AJ, Edward S, Fallon P, Mcentagart ME, Jan W, Josifova D, Lerman-Sagie T, Drummond J, Thompson E, Refetoff S, Bönnemann CG, Jungbluth H. White matter abnormalities and dystonic motor disorder associated with mutations in the SLC16A2 gene. Dev Med Child Neurol 2010; 52:475-82. [PMID: 19811520 PMCID: PMC5800746 DOI: 10.1111/j.1469-8749.2009.03471.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [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: 11/27/2022]
Abstract
AIM Mutations in the SLC16A2 gene have been implicated in Allan-Herndon-Dudley syndrome (AHDS), an X-linked learning disability* syndrome associated with thyroid function test (TFT) abnormalities. Delayed myelination is a non-specific finding in individuals with learning disability whose genetic basis is often uncertain. The aim of this study was to describe neuroimaging findings and neurological features in males with SLC16A2 gene mutations. METHOD We reviewed brain magnetic resonance imaging (MRI) findings and neurological features in a cohort of five males aged between 1 year 6 months and 6 years (median 4y) from four families harbouring SLC16A2 gene mutations. RESULTS The participants presented aged between 4 and 9 months with initial hypotonia and subsequent spastic paraparesis with dystonic posturing and superimposed paroxysmal dyskinesias. Dystonic cerebral palsy was the most common initial clinical diagnosis, and AHDS was suspected only retrospectively, considering the characteristically abnormal thyroid function tests, with high serum tri-iodothyronine (T(3)), as the most consistent finding. Brain MRI showed absent or markedly delayed myelination in all five participants, prompting the suspicion of Pelizaeus-Merzbacher disease in one patient. INTERPRETATION Our findings indicate a consistent association between defective neuronal T(3) uptake and delayed myelination. SLC16A2 involvement should be considered in males with learning disability, an associated motor or movement disorder, and evidence of delayed myelination on brain MRI. Although dysmorphic features suggestive of AHDS are not always present, T(3) measurement is a reliable screening test.
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Affiliation(s)
- Artemis D Gika
- Department of Paediatric Neurology, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Ata Siddiqui
- Department of Paediatric Radiology, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - Anthony J Hulse
- Department of Paediatrics, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | | | - Penny Fallon
- Department of Paediatric Neurology, St George's Hospital, London, UK
| | | | - Wajanat Jan
- Department of Paediatric Radiology, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | | | | | - James Drummond
- East Anglian Medical Genetics Service, Addenbrooke's Hospital, Cambridge, UK
| | - Edward Thompson
- East Anglian Medical Genetics Service, Addenbrooke's Hospital, Cambridge, UK
| | - Samuel Refetoff
- Departments of Medicine, Paediatrics, and Genetics, The University of Chicago, Chicago, IL, USA
| | - Carsten G Bönnemann
- Division of Neurology, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Heinz Jungbluth
- Department of Paediatric Neurology, Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK,Clinical Neuroscience Division, King's College, London, UK
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Caruso JF, Ramey E, Hastings LP, Monda JK, Coday MA, McLagan J, Drummond J. Anthropometry as a predictor of high speed performance. Int J Sports Med 2009; 30:522-5. [PMID: 19484698 DOI: 10.1055/s-0029-1202335] [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: 10/20/2022]
Abstract
To assess anthropometry as a predictor of high-speed performance, subjects performed four seated knee- and hip-extension workouts with their left leg on an inertial exercise trainer (Impulse Technologies, Newnan GA). Workouts, done exclusively in either the tonic or phasic contractile mode, entailed two one-minute sets separated by a 90-second rest period and yielded three performance variables: peak force, average force and work. Subjects provided the following anthropometric data: height, weight, body mass index, as well as total, upper and lower left leg lengths. Via multiple regression, anthropometry attempted to predict the variance per performance variable. Anthropometry explained a modest (R2=0.27-0.43) yet significant degree of variance from inertial exercise trainer workouts. Anthropometry was a better predictor of peak force variance from phasic workouts, while it accounted for a significant degree of average force and work variance solely from tonic workouts. Future research should identify variables that account for the unexplained variance from high-speed exercise performance.
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Affiliation(s)
- J F Caruso
- Department of Exercise & Sport Sciences Program, University of Tulsa, 600 S. College Avenue, Tulsa, OK 74104, United States.
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Drummond J. XVIII. On some points of analogy between the molecular structure of ice and glass; with special reference to Professor Erman's observations on the structural divisions of ice on Lake Baikal. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/14786445908642730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Steinberg AD, Bashook PG, Drummond J, Ashrafi S, Zefran M. Assessment of Faculty Perception of Content Validity of PerioSim©, a Haptic-3D Virtual Reality Dental Training Simulator. J Dent Educ 2007. [DOI: 10.1002/j.0022-0337.2007.71.12.tb04434.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Arnold D. Steinberg
- Department of Periodontics; College of Dentistry; University of Illinois at Chicago
| | - Philip G. Bashook
- Department of Medical Education; College of Medicine; University of Illinois at Chicago
| | - James Drummond
- Department of Restorative Dentistry; College of Dentistry; College of Engineering; University of Illinois at Chicago
| | - Seema Ashrafi
- Department of Periodontics; College of Dentistry; University of Illinois at Chicago
| | - Milos Zefran
- Department of Electrical and Computer Engineering; College of Engineering; University of Illinois at Chicago
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Steinberg AD, Bashook PG, Drummond J, Ashrafi S, Zefran M. Assessment of faculty perception of content validity of PerioSim, a haptic-3D virtual reality dental training simulator. J Dent Educ 2007; 71:1574-1582. [PMID: 18096883] [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: 05/25/2023]
Abstract
Haptic technology (sense of touch) along with 3D-virtual reality (VR) graphics, creating lifelike training simulations, was used to develop a dental training simulator system (PerioSim). This preliminary study was designed to evaluate whether faculty considered PerioSim realistic and useful for training and evaluating basic procedural skills of students. The haptic device employed was a PHANToM and the simulator a Dell Xeon 530 workstation with 3D, VR oral models and instruments viewed on a stereoscopic monitor. An onscreen VR periodontal probe or explorer was manipulated by operating the PHANToM for sensing lifelike contact and interactions with the teeth and gingiva. Thirty experienced clinical dental and dental hygiene faculty judged the realism of the system. A PowerPoint presentation on one screen provided instructions for the simulator use with the 3D, VR simulator on a second stereoscopic monitor viewed with 3D goggles. Faculty/practitioners found the images very realistic for teeth and instruments, but less so for gingiva. Tactile sensation was realistic for teeth but not so for gingiva. The onscreen instructions were very useful with high potential for teaching. Faculty members anticipated incorporating this device into teaching and were enthusiastic about its potential for evaluating students' basic procedural skills. This study suggests that the preliminary "evidence-of-concept" was successful and PerioSim may aid students in developing necessary dental tactile skills.
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Affiliation(s)
- Arnold D Steinberg
- Department of Periodontics, College of Dentistry, 801 S. Paulina Street, University of Illinois at Chicago, IL 60612, USA.
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Robinson I, Oh E, Drummond J, Sharma A. A novel function for syndapin at Drosophila neuromuscular junctions. Comp Biochem Physiol A Mol Integr Physiol 2007. [DOI: 10.1016/j.cbpa.2007.01.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Meech KJ, Ageorges N, A'Hearn MF, Arpigny C, Ates A, Aycock J, Bagnulo S, Bailey J, Barber R, Barrera L, Barrena R, Bauer JM, Belton MJS, Bensch F, Bhattacharya B, Biver N, Blake G, Bockelée-Morvan D, Boehnhardt H, Bonev BP, Bonev T, Buie MW, Burton MG, Butner HM, Cabanac R, Campbell R, Campins H, Capria MT, Carroll T, Chaffee F, Charnley SB, Cleis R, Coates A, Cochran A, Colom P, Conrad A, Coulson IM, Crovisier J, deBuizer J, Dekany R, de Léon J, Dello Russo N, Delsanti A, DiSanti M, Drummond J, Dundon L, Etzel PB, Farnham TL, Feldman P, Fernández YR, Filipovic MD, Fisher S, Fitzsimmons A, Fong D, Fugate R, Fujiwara H, Fujiyoshi T, Furusho R, Fuse T, Gibb E, Groussin O, Gulkis S, Gurwell M, Hadamcik E, Hainaut O, Harker D, Harrington D, Harwit M, Hasegawa S, Hergenrother CW, Hirst P, Hodapp K, Honda M, Howell ES, Hutsemékers D, Iono D, Ip WH, Jackson W, Jehin E, Jiang ZJ, Jones GH, Jones PA, Kadono T, Kamath UW, Käufl HU, Kasuga T, Kawakita H, Kelley MS, Kerber F, Kidger M, Kinoshita D, Knight M, Lara L, Larson SM, Lederer S, Lee CF, Levasseur-Regourd AC, Li JY, Li QS, Licandro J, Lin ZY, Lisse CM, LoCurto G, Lovell AJ, Lowry SC, Lyke J, Lynch D, Ma J, Magee-Sauer K, Maheswar G, Manfroid J, Marco O, Martin P, Melnick G, Miller S, Miyata T, Moriarty-Schieven GH, Moskovitz N, Mueller BEA, Mumma MJ, Muneer S, Neufeld DA, Ootsubo T, Osip D, Pandea SK, Pantin E, Paterno-Mahler R, Patten B, Penprase BE, Peck A, Petitas G, Pinilla-Alonso N, Pittichova J, Pompei E, Prabhu TP, Qi C, Rao R, Rauer H, Reitsema H, Rodgers SD, Rodriguez P, Ruane R, Ruch G, Rujopakarn W, Sahu DK, Sako S, Sakon I, Samarasinha N, Sarkissian JM, Saviane I, Schirmer M, Schultz P, Schulz R, Seitzer P, Sekiguchi T, Selman F, Serra-Ricart M, Sharp R, Snell RL, Snodgrass C, Stallard T, Stecklein G, Sterken C, Stüwe JA, Sugita S, Sumner M, Suntzeff N, Swaters R, Takakuwa S, Takato N, Thomas-Osip J, Thompson E, Tokunaga AT, Tozzi GP, Tran H, Troy M, Trujillo C, Van Cleve J, Vasundhara R, Vazquez R, Vilas F, Villanueva G, von Braun K, Vora P, Wainscoat RJ, Walsh K, Watanabe J, Weaver HA, Weaver W, Weiler M, Weissman PR, Welsh WF, Wilner D, Wolk S, Womack M, Wooden D, Woodney LM, Woodward C, Wu ZY, Wu JH, Yamashita T, Yang B, Yang YB, Yokogawa S, Zook AC, Zauderer A, Zhao X, Zhou X, Zucconi JM. Deep Impact: observations from a worldwide Earth-based campaign. Science 2005; 310:265-9. [PMID: 16150977 DOI: 10.1126/science.1118978] [Citation(s) in RCA: 158] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
On 4 July 2005, many observatories around the world and in space observed the collision of Deep Impact with comet 9P/Tempel 1 or its aftermath. This was an unprecedented coordinated observational campaign. These data show that (i) there was new material after impact that was compositionally different from that seen before impact; (ii) the ratio of dust mass to gas mass in the ejecta was much larger than before impact; (iii) the new activity did not last more than a few days, and by 9 July the comet's behavior was indistinguishable from its pre-impact behavior; and (iv) there were interesting transient phenomena that may be correlated with cratering physics.
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Affiliation(s)
- K J Meech
- Institute for Astronomy, University of Hawaii at Manoa, 2680 Woodlawn Drive, Honolulu, HI 96822, USA
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