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Nguyen HN, Sharp GM, Stahl-Rommel S, Velez Justiniano YA, Castro CL, Nelman-Gonzalez M, O’Rourke A, Lee MD, Williamson J, McCool C, Crucian B, Clark KW, Jain M, Castro-Wallace SL. Microbial isolation and characterization from two flex lines from the urine processor assembly onboard the international space station. Biofilm 2023; 5:100108. [PMID: 36938359 PMCID: PMC10020673 DOI: 10.1016/j.bioflm.2023.100108] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/13/2023] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Urine, humidity condensate, and other sources of non-potable water are processed onboard the International Space Station (ISS) by the Water Recovery System (WRS) yielding potable water. While some means of microbial control are in place, including a phosphoric acid/hexavalent chromium urine pretreatment solution, many areas within the WRS are not available for routine microbial monitoring. Due to refurbishment needs, two flex lines from the Urine Processor Assembly (UPA) within the WRS were removed and returned to Earth. The water from within these lines, as well as flush water, was microbially evaluated. Culture and culture-independent analysis revealed the presence of Burkholderia, Paraburkholderia, and Leifsonia. Fungal culture also identified Fusarium and Lecythophora. Hybrid de novo genome analysis of the five distinct Burkholderia isolates identified them as B. contaminans, while the two Paraburkholderia isolates were identified as P. fungorum. Chromate-resistance gene clusters were identified through pangenomic analysis that differentiated these genomes from previously studied isolates recovered from the point-of-use potable water dispenser and/or current NCBI references, indicating that unique populations exist within distinct niches in the WRS. Beyond genomic analysis, fixed samples directly from the lines were imaged by environmental scanning electron microscopy, which detailed networks of fungal-bacterial biofilms. This is the first evidence of biofilm formation within flex lines from the UPA onboard the ISS. For all bacteria isolated, biofilm potential was further characterized, with the B. contaminans isolates demonstrating the most considerable biofilm formation. Moreover, the genomes of the B. contaminans revealed secondary metabolite gene clusters associated with quorum sensing, biofilm formation, antifungal compounds, and hemolysins. The potential production of these gene cluster metabolites was phenotypically evaluated through biofilm, bacterial-fungal interaction, and hemolytic assays. Collectively, these data identify the UPA flex lines as a unique ecological niche and novel area of biofilm growth within the WRS. Further investigation of these organisms and their resistance profiles will enable engineering controls directed toward biofilm prevention in future space station water systems.
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Affiliation(s)
| | | | | | | | | | | | - Aubrie O’Rourke
- Exploration Research and Technology, NASA Kennedy Space Center, Merritt Island, FL, USA
| | | | - Jill Williamson
- Space Systems Department, NASA Marshall Space Flight Center, Huntsville, AL, USA
| | | | - Brian Crucian
- Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX, USA
| | | | - Miten Jain
- Department of Bioengineering, Department of Physics, Northeastern University, Boston, MA, USA
| | - Sarah L. Castro-Wallace
- Biomedical Research and Environmental Sciences Division, NASA Johnson Space Center, Houston, TX, USA
- Corresponding author.
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Gong H, Sioutas C, Linn WS, Clark KW, Terrell SL, Terrell LL, Anderson KR, Kim S, Chang MC. Controlled Human Exposures to Concentrated Ambient Fine Particles in Metropolitan Los Angeles: Methodology and Preliminary Health-Effect Findings. Inhal Toxicol 2016. [DOI: 10.1080/0895-8378.1987.11463186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Moore SM, Maffitt DR, Smith KE, Kirby JS, Clark KW, Freymann JB, Vendt BA, Tarbox LR, Prior FW. De-identification of Medical Images with Retention of Scientific Research Value. Radiographics 2016; 35:727-35. [PMID: 25969931 DOI: 10.1148/rg.2015140244] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Online public repositories for sharing research data allow investigators to validate existing research or perform secondary research without the expense of collecting new data. Patient data made publicly available through such repositories may constitute a breach of personally identifiable information if not properly de-identified. Imaging data are especially at risk because some intricacies of the Digital Imaging and Communications in Medicine (DICOM) format are not widely understood by researchers. If imaging data still containing protected health information (PHI) were released through a public repository, a number of different parties could be held liable, including the original researcher who collected and submitted the data, the original researcher's institution, and the organization managing the repository. To minimize these risks through proper de-identification of image data, one must understand what PHI exists and where that PHI resides, and one must have the tools to remove PHI without compromising the scientific integrity of the data. DICOM public elements are defined by the DICOM Standard. Modality vendors use private elements to encode acquisition parameters that are not yet defined by the DICOM Standard, or the vendor may not have updated an existing software product after DICOM defined new public elements. Because private elements are not standardized, a common de-identification practice is to delete all private elements, removing scientifically useful data as well as PHI. Researchers and publishers of imaging data can use the tools and process described in this article to de-identify DICOM images according to current best practices.
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Affiliation(s)
- Stephen M Moore
- From the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110 (S.M.M., D.R.M., K.E.S., K.W.C., B.A.V., L.R.T., F.W.P.); and Leidos Biomedical Research, Bethesda, Md (J.S.K., J.B.F.)
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Riedl MA, Diaz-Sanchez D, Linn WS, Gong H, Clark KW, Effros RM, Miller JW, Cocker DR, Berhane KT. Allergic inflammation in the human lower respiratory tract affected by exposure to diesel exhaust. Res Rep Health Eff Inst 2012:5-64. [PMID: 22852485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
To improve understanding of human health risks from exposure to diesel exhaust particles (DEP*), we tested whether immunologic effects previously observed in the human nose also occur in the lower airways. Our overall hypothesis was that cell influx and production of cytokines, chemokines, immunoglobulin E (IgE), and other mediators, which would be measurable in sputum and blood, occur in people with asthma after realistic controlled exposures to diesel exhaust (DE). In Phase 1 we tested for direct effects of DE in subjects with clinically undifferentiated mild asthma. In Phase 2 we tested whether DE exposure would exacerbate response to inhaled cat allergen in subjects with both asthma and cat sensitivity. The exposure facility was a controlled-environment chamber supplied with DE from an idling medium-duty truck with ultra-low-sulfur fuel and no catalytic converter. We exposed volunteers for 2 hours with intermittent exercise to exhaust with DEP mass concentration near 100 microg/m3. Exposures to nitrogen dioxide (NO2) near 0.35 ppm (similar to its concentration in DE) and to filtered air (FA) served as controls. Blood was drawn before exposure on day 1 and again the next morning (day 2). Sputum was induced only on day 2. Bronchial reactivity was measured -1 hour after exposure ended. Supplementary endpoints included measures of blood coagulation status, cardiopulmonary physiology, and symptoms. Each phase employed 15 subjects with asthma; 3 subjects participated in both phases. In Phase 1, airway reactivity was measured with inhaled methacholine; in Phase 2, with inhaled cat allergen. We found little biologic response to DE exposure compared with exposure to control atmospheres. In Phase 1, interleukin 4 (IL-4) in sputum showed an estimated 1.7-fold increase attributable to DE exposure, which was close to statistical significance; airway resistance increased modestly but significantly on day 2 after DE exposure; and nonspecific symptom scores increased significantly during DE exposure. In Phase 2, indicators of airway inflammation in sputum showed a possibly meaningful response: polymorphonuclear leukocytes (PMNs) and eosinophils increased after DE exposure, whereas macrophages decreased. IgE in sputum and the bronchoconstrictive response to cat allergen varied significantly between atmospheres, but not in patterns consistent with our primary hypothesis. Symptom score changes relatable to DE exposure were smaller than those in Phase 1 and not statistically significant. Controlled exposures, lasting 2 hours with intermittent exercise, to diluted DE at a particle mass concentration of 100 microg/m3 did not evoke clear and consistent lower-airway or systemic immunologic or inflammatory responses in mildly asthmatic subjects, with or without accompanying challenge with cat allergen. Likewise, these DE exposures did not significantly increase nonspecific or allergen-specific bronchial reactivity. A few isolated statistically significant or near-significant changes were observed during and after DE exposure, including increases in nonspecific symptoms (e.g., headache, nausea) suggestive of subtle, rapid-onset systemic effects. It is possible the lower respiratory tract is more resistant than the nose to adjuvant effects of diesel particles on allergic inflammation, so that no meaningful effects occur under exposure conditions like these. Alternatively, the experimental conditions may have been near a threshold for finding effects. That is, important lower respiratory effects may occur but may be detectable experimentally with slightly higher DEP concentrations, longer exposures, more invasive testing (e.g., bronchoalveolar lavage), or more susceptible subjects. However, ethical and practical barriers to such experiments are considerable.
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Affiliation(s)
- Marc A Riedl
- Department of Allergy and Immunology, University of California-Los Angeles, 90095, USA.
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5
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Gong H, Linn WS, Terrell SL, Anderson KR, Clark KW, Sioutas C, Cascio WE, Alexis N, Devlin RB. Exposures of Elderly Volunteers with and without Chronic Obstructive Pulmonary Disease (COPD) to Concentrated Ambient Fine Particulate Pollution. Inhal Toxicol 2008; 16:731-44. [PMID: 16036744 DOI: 10.1080/08958370490499906] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The elderly and individuals who have chronic obstructive pulmonary disease (COPD) may be sensitive to particulate matter (PM) air pollution. We evaluated short-term health responses of 13 elderly volunteers with COPD and 6 age-matched healthy adults to controlled exposures of ambient PM pollution in suburban Los Angeles. Using a Harvard particle concentrator and a whole-body chamber, we exposed each person on separate occasions to approximately 200 microg/m(3) concentrated ambient particles (CAP) less than 2.5 mum in diameter and to filtered air (FA). Each exposure lasted 2 h with intermittent mild exercise. We found no significant effects of CAP on symptoms, spirometry, or induced sputum. A significant negative effect of CAP on arterial oxygenation (measured by pulse oximetry) immediately postexposure was more pronounced in healthy subjects. Peripheral blood basophils increased after CAP in healthy but not in COPD subjects. In both groups, red cell counts increased slightly 1 day after exposure to FA but not to CAP. Preexposure ectopic heartbeats were infrequent in healthy subjects, but increased modestly during/after CAP exposure relative to FA. Ectopic beats were more frequent in COPD subjects, but decreased modestly during/after CAP relative to FA. Heart-rate variability over multi-hour intervals was lower after CAP than after FA in healthy elderly subjects but not in COPD subjects. Thus, in this initial small-scale study of older volunteers experimentally exposed to ambient PM, some acute cardiopulmonary responses were consistent with effects reported from epidemiologic studies. Unexpectedly, individuals with COPD appeared less susceptible than healthy elderly individuals. Further investigation of older adults is warranted to understand the pathophysiology and public health significance of these findings.
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Affiliation(s)
- Henry Gong
- Los Amigos Research and Education Institute, Downey, California 90242, USA.
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Clark KW, Gierada DS, Marquez G, Moore SM, Maffitt DR, Moulton JD, Wolfsberger MA, Koppel P, Phillips SR, Prior FW. Collecting 48,000 CT exams for the lung screening study of the National Lung Screening Trial. J Digit Imaging 2008; 22:667-80. [PMID: 18777192 DOI: 10.1007/s10278-008-9145-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Revised: 06/24/2008] [Accepted: 07/28/2008] [Indexed: 11/28/2022] Open
Abstract
From 2002-2004, the Lung Screening Study (LSS) of the National Lung Screening Trial (NLST) enrolled 34,614 participants, aged 55-74 years, at increased risk for lung cancer due to heavy cigarette smoking. Participants, randomized to standard chest X-ray (CXR) or computed tomography (CT) arms at ten screening centers, received up to three imaging screens for lung cancer at annual intervals. Participant medical histories and radiologist-interpreted screening results were transmitted to the LSS coordinating center, while all images were retained at local screening centers. From 2005-2007, all CT exams were uniformly de-identified and delivered to a central repository, the CT Image Library (CTIL), on external hard drives (94%) or CD/DVD (5.9%), or over a secure Internet connection (0.1%). Of 48,723 CT screens performed, only 176 (0.3%) were unavailable (lost, corrupted, compressed) while 48,547 (99.7%) were delivered to the CTIL. Described here is the experience organizing, implementing, and adapting the clinical-trial workflow surrounding the image retrieval, de-identification, delivery, and archiving of available LSS-NLST CT exams for the CTIL, together with the quality assurance procedures associated with those collection tasks. This collection of CT exams, obtained in a specific, well-defined participant population under a common protocol at evenly spaced intervals, and its attending demographic and clinical information, are now available to lung-disease investigators and developers of computer-aided-diagnosis algorithms. The approach to large scale, multi-center trial CT image collection detailed here may serve as a useful model, while the experience reported should be valuable in the planning and execution of future equivalent endeavors.
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Affiliation(s)
- Kenneth W Clark
- Mallinckrodt Institute of Radiology, Washington University, 510 South Kingshighway, Saint Louis, MO 63110, USA.
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7
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Gong H, Linn WS, Clark KW, Anderson KR, Sioutas C, Alexis NE, Cascio WE, Devlin RB. Exposures of healthy and asthmatic volunteers to concentrated ambient ultrafine particles in Los Angeles. Inhal Toxicol 2008; 20:533-45. [PMID: 18444007 DOI: 10.1080/08958370801911340] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Adult volunteers (17 healthy, 14 asthmatic) were exposed in a controlled environmental chamber to concentrated ultrafine particles (UFP) collected in a Los Angeles suburb with substantial motor vehicle pollution. Exposures lasted 2 h with intermittent exercise. Inhaled particle counts (mean 145,000/cm(3), range 39,000-312,000) were typically 7-8 times higher than ambient levels. Mass concentrations (mean 100 microg/m(3), range 13-277) were not highly correlated with counts. Volunteers were evaluated for lung function, symptoms, exhaled nitric oxide (eNO), Holter electrocardiography, and inflammatory markers in peripheral blood and induced sputum. Relative to control (filtered air) studies, UFP exposures were associated with a 0.5% mean fall in arterial O(2) saturation estimated by pulse oximetry (p < .01), a 2% mean fall in forced expired volume in 1 sec (FEV(1)) the morning after exposure (p < .05), and a transient slight decrease in low-frequency (sympathetic) power in Holter recordings during quiet rest (p < .05). Healthy and asthmatic subjects were not significantly different across most endpoints. Thus, this initial experimental study of human volunteers exposed to concentrated Los Angeles area ambient UFP showed some acute deleterious cardiopulmonary responses, which, although generally small and equivocal as in previous studies of larger sized concentrated ambient particles, might help to explain reported adverse health effects associated with urban particulate pollution.
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Affiliation(s)
- Henry Gong
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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8
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Sawant AA, Cocker DR, Miller JW, Taliaferro T, Diaz-Sanchez D, Linn WS, Clark KW, Gong H. Generation and characterization of diesel exhaust in a facility for controlled human exposures. J Air Waste Manag Assoc 2008; 58:829-837. [PMID: 18581813 DOI: 10.3155/1047-3289.58.6.829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
An idling medium-duty diesel truck operated on ultralow sulfur diesel fuel was used as an emission source to generate diesel exhaust for controlled human exposure. Repeat tests were conducted on the Federal Test Procedure using a chassis dynamometer to demonstrate the reproducibility of this vehicle as a source of diesel emissions. Exhaust was supplied to a specially constructed exposure chamber at a target concentration of 100 microg x m(-3) diesel particulate matter (DPM). Spatial variability within the chamber was negligible, whereas emission concentrations were stable, reproducible, and similar to concentrations observed on the dynamometer. Measurements of nitric oxide, nitrogen dioxide, carbon monoxide, particulate matter (PM), elemental and organic carbon, carbonyls, trace elements, and polycyclic aromatic hydrocarbons were made during exposures of both healthy and asthmatic volunteers to DPM and control conditions. The effect of the so-called "personal cloud" on total PM mass concentrations was also observed and accounted for. Conventional lung function tests in 11 volunteer subjects (7 stable asthmatic) did not demonstrate a significant change after 2-hr exposures to diesel exhaust. In summary, we demonstrated that this facility can be effectively and safely used to evaluate acute responses to diesel exhaust exposure in human volunteers.
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Affiliation(s)
- Aniket A Sawant
- Department of Chemical and Environmental Engineering and Center for Environmental Research and Technology, Bourns College of Engineering, University of California, Riverside, CA 92521, USA
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Clark KW, Gierada DS, Moore SM, Maffitt DR, Koppel P, Phillips SR, Prior FW. Creation of a CT Image Library for the Lung Screening Study of the National Lung Screening Trial. J Digit Imaging 2007; 20:23-31. [PMID: 16783598 PMCID: PMC3043889 DOI: 10.1007/s10278-006-0589-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The CT Image Library (CTIL) of the Lung Screening Study (LSS) network of the National Lung Screening Trial (NLST) consists of up to three annual screens using CT imaging from each of 17,308 participants with a significant history of smoking but no evidence of cancer at trial enrollment (Fall 2002-Spring 2004). Screens performed at numerous medical centers associated with 10 LSS-NLST screening centers are deidentified of protected health information and delivered to the CTIL via DVD, external hard disk, or Internet/Virtual Private Network transmission. The collection will be completed in late 2006. The CTIL is of potential interest to clinical researchers and software developers of nodule detection algorithms. Its attractiveness lies in its very specific, well-defined patient population, scanned via a common CT protocol, and in its collection of evenly spaced serial screens. In this work, we describe the technical details of the CTIL collection process from screening center retrieval through library storage.
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Affiliation(s)
- K W Clark
- Mallinckrodt Institute of Radiology, Washington University, 510 S. Kingshighway, St. Louis, MO, 63110, USA.
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10
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Moore SM, Gierada DS, Clark KW, Blaine GJ. Image quality assurance in the prostate, lung, colorectal, and ovarian cancer screening trial network of the National Lung Screening Trial. J Digit Imaging 2005; 18:242-50. [PMID: 15924251 PMCID: PMC3046711 DOI: 10.1007/s10278-005-5153-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The National Lung Screening Trial is evaluating the effectiveness of low-dose spiral CT and conventional chest X-ray as screening tests for persons who are at high risk for developing lung cancer. This multicenter trial requires quality assurance (QA) for the image quality and technical parameters of the scans. The electronic system described here helps manage the QA process. The system includes a workstation at each screening center that de-identifies the data, a DICOM storage service at the QA Coordinating Center, and Web-based systems for presenting images and QA evaluation forms to the QA radiologists. Quality assurance data are collated and analyzed by an independent statistical organization. We describe the design and implementation of this electronic QA system, emphasizing issues relating to data security and privacy, the various obstacles encountered in the installation of a common system at different participating screening centers, and the functional success of the system deployed.
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Affiliation(s)
- Stephen M Moore
- Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO, USA.
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Gong H, Linn WS, Clark KW, Anderson KR, Geller MD, Sioutas C. Respiratory responses to exposures with fine particulates and nitrogen dioxide in the elderly with and without COPD. Inhal Toxicol 2005; 17:123-32. [PMID: 15788373 DOI: 10.1080/08958370590904481] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Elderly people, with and without chronic obstructive pulmonary disease (COPD), may be susceptible to particulate matter (PM) air pollution. However, the respiratory impacts of inhaled PM combined with copollutant(s) in controlled exposure studies are unclear and warrant investigation since exposures to PMgas mixtures constitute realistic scenarios. Thus, we exposed 6 healthy subjects and 18 volunteers with COPD (mean age 71 yr) on separate days to (a) filtered air (FA); (b) 0.4 ppm NO2; (c) concentrated ambient particles (CAP), predominantly in the fine (PM2.5) size range, at concentrations near 200 microg/m3; and (d) CAP and NO2 together. Each 2-h exposure included exercise for 15 min every half hour. Most respiratory responses, including symptoms, spirometry, and total and differential counts of induced sputum cells, showed no statistically significant responses attributable to separate or combined effects of CAP and NO2. However, maximal mid-expiratory flow and arterial O2 saturation (measured by pulse oximetry) showed small but statistically significant decrements associated with CAP, greater in healthy than COPD subjects. CAP exposure was also associated with decreased percentages of columnar epithelial cells in sputum. The results suggest that the respiratory effect of the PMNO2 mixture may be primarily PM driven since coexposure to NO2 did not significantly enhance the responses. In conclusion, older adults exposed to urban fine particles may experience acute small-airways dysfunction with impaired gas exchange. Healthy subjects appear more susceptible, suggesting that the respiratory effect may be related to efficient penetration and deposition of inhaled toxic particles in distal small airways. More clinical investigation of the elderly population is warranted.
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Affiliation(s)
- Henry Gong
- Environmental Health Service, Los Amigos Research and Education Institute, Downey, California 90242, USA.
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12
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Gong H, Linn WS, Terrell SL, Clark KW, Geller MD, Anderson KR, Cascio WE, Sioutas C. Altered heart-rate variability in asthmatic and healthy volunteers exposed to concentrated ambient coarse particles. Inhal Toxicol 2004; 16:335-43. [PMID: 15204749 DOI: 10.1080/08958370490439470] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Twelve mildly asthmatic and four healthy adults were exposed to filtered air (FA) and concentrated ambient coarse particles (CCP) supplied to a whole-body exposure chamber via a coarse particle concentrator with 15 parallel virtual impactors. Exposures were conducted in a Los Angeles suburb with high levels of motor-vehicle pollution and lasted 2 h with intermittent exercise. Mean CCP concentration was 157 microg/m(3) (range: 56-218 microg/m(3)) measured by continuous monitoring with a tapered-element oscillating microbalance (TEOM). On average, 80% of mass was coarse (2.5-10 microm aerodynamic diameter) and the rest <2.5 microm. Relative to FA, CCP exposure did not significantly alter respiratory symptoms, spirometry, arterial oxygen saturation, or airway inflammation according to exhaled nitric oxide and total and differential cell counts of induced sputum. After CCP exposure, Holter electrocardiograms showed small (p <.05) increases in heart rate and decreases in heart-rate variability, which were larger in healthy than in asthmatic subjects. Cardiac ectopy did not increase. In conclusion, acute exposure to elevated concentrations of ambient coarse particles elicited no obvious pulmonary effects but appeared to alter the autonomic nervous system of the heart in adult volunteers.
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Affiliation(s)
- Henry Gong
- University of Southern California Keck School of Medicine, Los Angeles, USA.
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Clark KW, Melson DL, Moore SM, James Blaine GJ, Moulton RA, Clayton WK, Peterson CS, Vendt BA. Tools for managing image flow in the modality to clinical-image-review chain. J Digit Imaging 2003; 16:310-7. [PMID: 14669066 PMCID: PMC3045259 DOI: 10.1007/s10278-003-1724-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Web-based clinical-image viewing is commonplace in large medical centers. As demands for product and performance escalate, physicians, sold on the concept of "any image, anytime, anywhere," fret when image studies cannot be viewed in a time frame to which they are accustomed. Image delivery pathways in large medical centers are oftentimes complicated by multiple networks, multiple picture archiving and communication systems (PACS), and multiple groups responsible for image acquisition and delivery to multiple destinations. When studies are delayed, it may be difficult to rapidly pinpoint bottlenecks. Described here are the tools used to monitor likely failure points in our modality to clinical-image-viewing chain and tools for reporting volume and throughput trends. Though perhaps unique to our environment, we believe that tools of this type are essential for understanding and monitoring image-study flow, re-configuring resources to achieve better throughput, and planning for anticipated growth. Without such tools, quality clinical-image delivery may not be what it should.
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Affiliation(s)
- Kenneth W Clark
- Mallinckrodt Institute of Radiology, Electronic Radiology Laboratory, Washington University School of Medicine, 510 South Kingshighway, Saint Louis, MO 63110, USA.
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Gong H, Linn WS, Sioutas C, Terrell SL, Clark KW, Anderson KR, Terrell LL. Controlled exposures of healthy and asthmatic volunteers to concentrated ambient fine particles in Los Angeles. Inhal Toxicol 2003; 15:305-25. [PMID: 12635001 DOI: 10.1080/08958370304455] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Information about health effects from controlled exposure to particulate matter (PM) air pollution is relatively limited but potentially critical in urban locations such as Los Angeles, where abundant mobile sources generate combustion-related particles. Nonsmoking healthy (n = 12) and asthmatic (n = 12) volunteers, age 18-45 yr, were exposed to concentrated ambient particulates (CAP) in the fine (PM(2.5)) size range at an average concentration of 174 micro g/m(3) (range 99-224), and to filtered air (FA). Exposures used a two-stage Harvard virtual-impactor concentrator and whole-body chamber and lasted 2 h with alternating rest-exercise periods. Neither group showed significant (p <.05) changes in spirometry or routine hematologic measurements attributable to CAP exposure, relative to FA. Both groups showed CAP-related decreases of columnar cells in postexposure induced sputum, slight changes in certain mediators of blood coagulability and systemic inflammation, and modest increases in parasympathetic stimulation of heart rate variability. Systolic blood pressure decreased in asthmatics and increased in healthy subjects during CAP exposure relative to FA. Cardiovascular (but not respiratory) symptoms increased slightly with CAP in both groups. In summary, the urban fine PM exposures elicited different biologic endpoints with statistically significant differences between CAP and FA. The observed changes in blood inflammation and heart-rate variability were consistent with systemic (rather than respiratory) effects reported from other laboratory and epidemiologic studies. Further studies involving other biologic endpoints, PM size modes, and risk factors will be needed to clarify these results.
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Affiliation(s)
- Henry Gong
- Rancho Los Amigos National Rehabilitation Center, Downey, CA 90242, USA.
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Abstract
We compared laser- and CCD-digitized images for perceived image quality differences in a radiologist-observer study. Films of 50 two- and three-view studies (ankles, chests, c-spines, shoulders) were digitized on calibrated laser (Kodak Lumisys 75) and CCD (VIDAR SIERRA Plus) digitizers. Six radiologists independently compared digitized images on twin high-resolution monochrome monitors. Matching images were randomly presented on left/right monitors to support blinded comparisons. Observers scored image quality (for several diagnostic criteria) as "no different," left or right image "slightly" or "significantly" different. Of 7324 responses, 77.8% scored "no different" and 21.9% "slightly different" (5.9% favoring CCD, 16.0% favoring laser). In only 0.3% did observers score "significantly different." The Lumisys laser images were assessed as only slightly better than VIDAR SIERRA CCD images. Digitizer equipment-selection decisions can, therefore, be considered on the basis of price, reliability, support, ease-of-use, etc., rather than solely on the basis of image quality.
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Affiliation(s)
- Kenneth W Clark
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, Missouri 63110, USA.
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Clark KW, Francis S, Blaine GJ, Fritz K, Sadhra S, Blume H. Planning and implementing image delivery to outpatient specialty clinical practices in a large medical center. J Digit Imaging 2002; 15 Suppl 1:156-61. [PMID: 12105718 DOI: 10.1007/s10278-002-5068-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Softcopy image viewing using web-based technologies has been deployed to 3 specialty outpatient practices - Lung Center, Neurosurgery, Orthopedic Surgery - where films remain available. Physicians and staff use Philips Easyweb (a web-based image browser) and BJC HealthCare ClinDesk (a Java-based electronic patient record) clients in patient examination rooms and physician workrooms to retrieve images from a Mitra image server. Practice-specific planning and training preceded deployment; on-site training and support came with deployment; on-site and telephone support are available as needed. Softcopy viewing generally is accepted although a few physicians continue to use films. The unavailability of studies performed before the introduction of the image server remains an issue until the server builds a suitable archive. Softcopy-based clinical-image viewing can be supported with web-based technologies, but effective practice-specific planning, training, and technical support are crucial to successful deployment to those accepting softcopy image viewing.
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Affiliation(s)
- Kenneth W Clark
- Electronic Radiology Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
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17
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Melson DL, Moore SM, Blaine JG, Clark KW, Sadhra S, Blume H. Challenges in image acquisition and distribution for clinical image service. J Digit Imaging 2002; 15 Suppl 1:144-50. [PMID: 12105716 DOI: 10.1007/s10278-002-5010-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We have developed a centralized application for acquiring images from multiple picture archiving and communication systems (PACS) and distributing images to a clinical image web server and other repositories. Our flexible strategy addresses a number of administrative challenges associated with delivering images into clinical, research, and test environments. DICOM images flow from PACSs and modalities to a UNIX-based "distributor" application, which relays them to one or more destinations. Image volume and transmission times were collected and analyzed. Three distributors receive an average of 34 gigabytes of image data per day. Images are sent concurrently to two web-based image servers, one used clinically by physicians and one used for testing. Transmission of certain classes of studies is prioritized for key physician groups. Delivery to research systems is also supported. Acquiring images from multi-vendor PACS for distribution to a web server for clinical image viewing is a challenging task. Centralizing the acquisition and distribution process reduces both the administrative effort and the impact on clinical operations associated with maintaining dynamic clinical, testing, and research environments.
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Affiliation(s)
- David L Melson
- Computer Section and the Electronic Radiology Laboratory, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA.
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18
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Perlyn CA, Marsh JL, Vannier MW, Kane AA, Koppel P, Clark KW, Christensen GE, Knapp R, Lo LJ, Govier D. The craniofacial anomalies archive at St. Louis Children's Hospital: 20 years of craniofacial imaging experience. Plast Reconstr Surg 2001; 108:1862-70. [PMID: 11743369 DOI: 10.1097/00006534-200112000-00003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article describes how the Craniofacial Imaging Laboratory at the Cleft Palate and Craniofacial Deformities Institute, St. Louis Children's Hospital, Washington University Medical Center, has developed an electronic archive for the storage of computed tomography image digital data that is independent of scanner hardware and independent of units of storage media (i.e., floppy disks and optical disks). The archive represents one of the largest repositories of high-quality computed tomography data of children with craniofacial deformities in the world. Archiving reconstructed image data is essential for comparative imaging, surgical simulation, quantitative analysis, and use with solid model fabrication (e.g., stereolithography). One tertiary craniofacial center's experience in the establishment and maintenance of such an archive through three generations of storage technology is reported. The current archive is housed on an external 35-GB hard drive attached to a Windows-based desktop server. Data in the archive were categorized by specific demographics into groups of patients, number of scans, and diagnoses. The Craniofacial Imaging Laboratory archive currently contains computed tomography image digital data for 1827 individual scans. The earliest scan was done in 1980; the most recently stored scan for the purposes of this report occurred in May of 2000. The average number of scans archived per complete year was 94, with a range of 59 to 138. Of the 1827 total scans, 74 percent could be classified into specific diagnostic categories. The majority of the archive (55 percent) is composed of the following five diagnoses: sagittal synostosis (17 percent), unilateral coronal synostosis (11 percent), hemifacial microsomia (10 percent), plagiocephaly without synostosis (10 percent), and metopic synostosis (7 percent). Storage of computed tomography image data in a digital archive currently allows for continuous upgrading of image display and analysis and facilitates longitudinal and cross-sectional studies, both intramural and extramural. Internet access for clinical and research purposes is feasible, but contingent on protection of patient confidentiality. The future of digital imaging regarding craniofacial computed tomography scan storage and processing is also discussed.
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Affiliation(s)
- C A Perlyn
- Division of Plastic Surgery and the Mallinckrodt Institute of Radiology, Washington University School of Medicine, USA
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Du Pasquier RA, Clark KW, Smith PS, Joseph JT, Mazullo JM, De Girolami U, Letvin NL, Koralnik IJ. JCV-specific cellular immune response correlates with a favorable clinical outcome in HIV-infected individuals with progressive multifocal leukoencephalopathy. J Neurovirol 2001; 7:318-22. [PMID: 11517410 DOI: 10.1080/13550280152537175] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Most immunosuppressed individuals who develop progressive multifocal leukoencephalopathy (PML) have a rapid fatal outcome, whereas some become long-term survivors. We explored the impact of the cellular immune response against JC virus (JCV) on the clinical outcome of 7 HIV+ and 3 HIV- individuals with PML. Of the 4 HIV+/PML survivors, all had detectable cytotoxic T lymphocytes (CTL) specific for JCV T or VP 1 proteins compared to none of the 3 HIV+/PML progressors tested. Of the 3 HIV-/PML patients, 1 was recently diagnosed with PML and showed evidence of neurologic improvement without any treatment. This patient had CTL specific for the VP1 protein of JCV. The other 2 HIV-/PML survivors were stable 3-8 years after the diagnosis of PML. They did not have any detectable CTL against JCV. These findings suggest that JCV-specific immune response is associated with favorable outcome in HIV+ individuals with PML. The lack of detectable JCV-specific CTL in 2 HIV-/PML survivors might indicate a burnt-out disease without sufficient antigenic stimulation to maintain the cellular immune response. The detection of JCV-specific CTL in an HIV- patient recently diagnosed with PML, who was showing evidence of neurological improvement without any treatment, indicates that this finding may be used as a favorable prognostic marker of disease evolution in the clinical management of patients with PML. As the quest for an effective treatment of PML continues, JCV-specific cellular immune response deserves further attention because it appears to play a crucial role in the prevention of disease progression.
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Affiliation(s)
- R A Du Pasquier
- Department of Neurology and Division of Viral Pathogenesis, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
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Gong H, Linn WS, Terrell SL, Anderson KR, Clark KW. Anti-inflammatory and lung function effects of montelukast in asthmatic volunteers exposed to sulfur dioxide. Chest 2001; 119:402-8. [PMID: 11171715 DOI: 10.1378/chest.119.2.402] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Sulfur dioxide (SO(2)) gas may induce acute asthmatic responses when inhaled by individuals in the setting of community or occupational air pollution during exercise. Some asthma medications mitigate the SO(2) response, which is not fully understood but appears to involve multiple mechanisms. OBJECTIVE We tested the hypothesis that pretreatment with the cysteinyl-leukotriene inhibitor montelukast sodium protects against the inflammatory and bronchoconstrictive effects of SO(2) in the airways of asthmatic subjects. METHODS Asthmatic volunteers (enrolled, 12 subjects; completed study, 11 subjects) were exposed to 0.75 ppm SO(2) for 10-min periods during exercise (mean ventilation, 35 L/min) and were exposed similarly to filtered air (control condition) after double-blinded pretreatments with montelukast (10 mg/d for 3 days) and placebo. RESULTS After montelukast pretreatment, specific airways resistance, FEV(1), symptoms, and eosinophil counts in induced sputum showed statistically and clinically significant improvements in preexposure measurements and/or decreased responses to SO(2) exposure or exercise. The mean FEV(1) immediately after exposure was 95% of baseline FEV(1) with montelukast pretreatment vs 82% with placebo. CONCLUSION Montelukast significantly protects against airways eosinophilic inflammation and bronchoconstriction from SO(2) exposure during exercise. This implies a role for leukotrienes in SO(2)-induced lung effects.
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Affiliation(s)
- H Gong
- Environmental Health Service, Rancho Los Amigos, National Rehabilitation Center, Downey, CA 90242, USA.
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Linn WS, Gong H, Clark KW, Anderson KR. Day-to-day particulate exposures and health changes in Los Angeles area residents with severe lung disease. J Air Waste Manag Assoc 1999; 49:108-115. [PMID: 11002833 DOI: 10.1080/10473289.1999.10463890] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We measured particulate matter (PM2.5 and PM10) exposures, home temperature, arterial blood oxygen saturation, blood pressure, and lung function in 30 volunteer Los Angeles area residents during four-day intervals. Continuous Holter electrocardiograms were recorded in a subgroup on the first two days. Subjects recorded symptoms and time-activity patterns in diaries during monitoring, and during a reference period one week earlier/later. All subjects had severe chronic obstructive pulmonary disease. PM10 (24-hr mean) at monitoring stations near subjects' homes averaged 33 micrograms/m3, and ranged from 9 to 84 micrograms/m3. In longitudinal analyses, day-to-day changes in PM2.5 and PM10 outside subjects' homes significantly tracked concurrent station PM10 (r2 = 0.22 and 0.44, respectively). Indoor and personal concentrations were less related to station readings (r2 < or = 0.1), but tracked each other (r2 > or = 0.4). In-home temperatures tracked outdoor temperatures more for lows (r2 = 0.27) than for highs (r2 = 0.10). These longitudinal relationships of subject-oriented and station PM measurements were generally similar to cross-sectional relationships observed previously in similar subjects. Among health measurements, only blood pressure showed reasonably consistent unfavorable longitudinal associations with particulates, more with station or outdoor PM than with indoor or personal PM.
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Affiliation(s)
- W S Linn
- Environmental Health Service, Rancho Los Amigos Medical Center, Downey, California, USA
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Gong H, Linn WS, Shamoo DA, Anderson KR, Nugent CA, Clark KW, Lin AE. Effect of inhaled salmeterol on sulfur dioxide-induced bronchoconstriction in asthmatic subjects. Chest 1996; 110:1229-35. [PMID: 8915226 DOI: 10.1378/chest.110.5.1229] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
UNLABELLED This study tested the capability of a single 42-microgram dose of inhaled salmeterol xinafoate, a long-acting beta 2-agonist, to protect against bronchoconstrictive effects of exposure to 0.75 ppm sulfur dioxide (SO2) during exercise, for up to 24 h. Ten SO2-responsive adult volunteers with stable asthma were studied under 4 conditions of drug pretreatment/exposure, administered in random order, double-blind: salmeterol/SO2, placebo/SO2, salmeterol/clean air, and placebo/clean air. Each subject underwent 10-min exposure/exercise challenges in a chamber 1, 12, 18, and 24 h after pretreatment. Exercise ventilation rates averaged 29 L/min. Response was measured as the decrement in FEV1 between preexposure and postexposure (lowest value within 30 min). After salmeterol, mean decrement post-SO2 was 7% at 1 h and 12% at 12 h. At 18 and 24 h after salmeterol, and at all times after placebo, mean decrements were 25 to 30%. After 18 and 24 h, salmeterol still improved base-line FEV1 relative to placebo, although improvement was not statistically significant at 24 h. Acute symptom increases accompanied FEV1 decrements. CONCLUSION In our asthmatic subjects, pretreatment with salmeterol imparted clinically and statistically significant (p < 0.01) protection against bronchoconstriction induced by SO2/exercise for at least 12 h, and maintained an improvement in lung function for as much as 18 h.
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Affiliation(s)
- H Gong
- Environmental Health Service, Rancho Los Amigos Medical Center, Downey, Calif 90242, USA
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Clark KW, Anderson KR, Linn WS, Gong H. Influence of breathing-zone ammonia on human exposures to acid aerosol pollution. J Air Waste Manag Assoc 1995; 45:923-925. [PMID: 7496907 DOI: 10.1080/10473289.1995.10467425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Affiliation(s)
- K W Clark
- Environmental Health Service, Rancho Los Amigos Medical Center, University of Southern California School of Medicine, Downey, USA
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Linn WS, Gong H, Anderson KR, Clark KW, Shamoo DA. Exposures of health-care workers to ribavirin aerosol: a pharmacokinetic study. Arch Environ Health 1995; 50:445-51. [PMID: 8572723 DOI: 10.1080/00039896.1995.9935981] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We assessed health risks to nurses and therapists exposed occupationally to ribavirin aerosol, a known rodent teratogen, by measuring uptake as a function of exposure concentration. During a 4-d period, healthy, nonsmoking, young adult volunteers (N = 14) were exposed 4 h/d respirable ribavirin aerosol at concentrations that exceeded occupational levels. Intermittent exercise occurred during exposure, and all activities occurred in a simulated hospital room. Ribavirin was assayed in plasma, red cells, and urine; lung function and symptoms were also measured. In 7 volunteers who were exposed to 30 mg/m3 (i.e., received approximately 10% of therapeutic dose), postexposure ribavirin concentrations in plasma and urine were similar on all 4 d, averaging (0.89 mumol/l and 131 mumol/l, respectively. These concentrations decreased after exposure, with half-times of 37-39 h. Red-cell concentrations averaged 31 mumol/l on d 4, accounting for < 5% of inhaled ribavirin mass, and they remained stable for 4 d afterward. In 7 volunteers exposed to 3 mg/m3 (i.e., approximately 1% of therapeutic dose), plasma averaged 0.075 mumol/l and red cells averaged 3 mumol/l on d 4 (i.e., near detection limits). Small variations occurred in lung function, reported symptoms, and hematologic values for exposures to both 3 and 30 microgram/m3; therefore, these effects were most likely not caused by ribavirin. Typical occupational exposures to ribavirin, without recommended protective measures, should result in undetectable or barely detectable body burdens, i.e., approximately 0.1%-1% of levels reported to be toxic to laboratory animals.
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Affiliation(s)
- W S Linn
- Environmental Health Service, Rancho Los Amigos Medical Center, Downey, California, USA
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Drury HA, Clark KW, Hermes RE, Feser JM, Thomas LJ, Donis-Keller H. A graphical user interface for quantitative imaging and analysis of electrophoretic gels and autoradiograms. Biotechniques 1992; 12:892-8, 900-1. [PMID: 1642898] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
DNA/GUI (DNA Graphical User Interface) is an interactive software system for rapid and efficient analysis of images of the types used in genome mapping, such as autoradiograms and electrophoretic gels. Images are digitized using a commercially available charge-coupled-device (CCD) camera system and analyzed on a graphics workstation using a menu-driven user interface. DNA/GUI features automatic lane and band detection, simultaneous display of multiple images and a unique spatial-normalization algorithm. Images and their associated data are archived and easily available for later recall. Preliminary results indicate that DNA/GUI is a useful tool in the analysis and comparison of images used in a variety of applications such as genetic-linkage analysis and DNA restriction mapping. The interactive display software is based on the X Window System and is therefore readily portable to a variety of graphics workstations.
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Affiliation(s)
- H A Drury
- Biomedical Computer Laboratory, St. Louis, MO 63110
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26
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Linn WS, Shamoo DA, Peng RC, Clark KW, Avol EL, Hackney JD. Responses to sulfur dioxide and exercise by medication-dependent asthmatics: effect of varying medication levels. Arch Environ Health 1990; 45:24-30. [PMID: 1969262 DOI: 10.1080/00039896.1990.9935920] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Twenty-one volunteers with moderate to severe asthma were exposed to sulfur dioxide (SO2) at concentrations of 0 (control), 0.3, and 0.6 ppm in each of three medication states: (1) low (much of their usual asthma medication withheld), (2) normal (each subject on his own usual medication schedule), and (3) high (usual medication supplemented by inhaled metaproterenol before exposure). Theophylline, the medication usually taken by subjects, was often supplemented by beta-adrenergics. Exposures were for 10 min and were accompanied by continuous heavy exercise (ventilation approximately 50 l/min). Lung function and symptoms were measured before and after exposure. With normal medication, symptomatic bronchoconstriction occurred with exercise and was exacerbated by 0.6 ppm SO2, as reported for mildly unmedicated asthmatics studied previously. Both baseline and post-exposure lung function were noticeably worse in the low-medication state. High medication improved baseline lung function and prevented most bronchoconstrictive effects of SO2/exercise. High medication also increased heart rate and apparently induced tremor or nervousness in some individuals.
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Affiliation(s)
- W S Linn
- Environmental Health Service, Rancho Los Amigos Medical Center, University of Southern California, Downey
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27
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Hart WM, Hartz RK, Hagen RW, Clark KW. Color contrast perimetry. Invest Ophthalmol Vis Sci 1984; 25:400-13. [PMID: 6706504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
A method for color perimetry is proposed in which colored test objects are presented in a white surround, so that the luminance of the object and its surround are identical. The color of the test object then may be varied in its degree of saturation, while maintaining a constant luminance. A color video instrument controlled by a microcomputer is used as a tangent screen. Foveally viewed, colored test objects are adjusted initially in luminance by heterochromatic flicker photometry to match the luminance of a white background at 100 apostilb. The relative foveal scotoma for blue light requires that test objects large enough to include the perifoveal retina be used for flicker photometry of blue test objects. Due to the progressively increasing threshold for luminance contrast detection in extrafoveal retina, differences in luminance between the colored objects and the white surrounding, as the test objects are moved into the extrafoveal visual field, appear to remain subthreshold. Test object detection can thus be expected to be a perimetric measure of color contrast detection, relatively unaffected by luminance contrast detection. This strategy should simplify the use of colored objects for clinical perimetric testing and should provide a specific test of color vision in the extrafoveal visual field.
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Hackney JD, Spier CE, Anzar UT, Clark KW, Evans MJ. Effect of high concentrations of oxygen on reparative regeneration of damaged alveolar epithelium in mice. Exp Mol Pathol 1981; 34:338-44. [PMID: 7238843 DOI: 10.1016/0014-4800(81)90051-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Abstract
Twelve patients completed a double-blind, crossover antiarrhythmic drug trial in which 300 mg of quinidine, 500 mg of procainamide, 100 mg of phenytoin, or placebo was given four times daily on subsequent weeks. Analysis of 24-hour Holter tapes with a computerized analysis system (Argus/H) permitted accurate counting of premature ventricular complexes (PVCs) subclassified according to coupling interval. No antiarrhythmic agent demonstrated a significant overall reduction in the number of PVCs, but both quinidine and procainamide showed a statistically significant (p less than 0.05) reduction of PVCs with coupling intervals less than 400 msec. This effect was noted both in isolated PVCs (quinidine only) and in PVCs that were part of a couplet or run (both drugs). These findings demonstrate that clinically important effects of procainamide and quinidine can occur in the absence of an overall reduction in the number of PVCs.
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Kleinman MT, Bailey RM, Chang YT, Clark KW, Jones MP, Linn WS, Hackney JD. Exposures of human volunteers to a controlled atmospheric mixture of ozone, sulfur dioxide and sulfuric acid. Am Ind Hyg Assoc J 1981; 42:61-9. [PMID: 7223637 DOI: 10.1080/15298668191419361] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Nineteen human volunteers with normal pulmonary function and no history of asthma were exposed on two separate days to clean air and to an atmospheric mixture containing ozone (O3), 0.37 ppm, sulfur dioxide (SO2), 0.37 ppm, and sulfuric acid aerosol (B2SO4), 100 micrograms/m3. Subjects were exposed under carefully controlled conditions for two hours. During this period, the subjects alternately exercised for 15 minutes, at a level calculated to double minute ventilation, and rested for 15 minutes. The experimental goal was to determine whether the presence of the copollutants, H2SO4 and SO2, would significantly enhance the irritant potential of ozone, or cause decrements in pulmonary function on the order of 10 - 20 percent. Statistical analysis of the group averaged data suggested that the mixture may have been slightly more irritating to the subjects than was O3 alone. A large percentage of the subjects exhibited small decrements in pulmonary function. The group averaged FEV1.0 (forced expiratory volume in one second) on the exposure day was depressed 3.7 percent from the control value. One might expect O3 alone to depress FEV1.0 by about 2.8 percent under similar exposure conditions.
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Abstract
To determine whether vitamin E (dl-alpha-tocopherol) supplementation of the diet provides protection from inhaled oxidants such as ozone (O3) in community air pollution, its effects were studied in healthy adult volunteers, Experimental groups received 800 or 1600 IU of vitamin E for 9 wk or more; control groups received placebos. Double-blind conditions were maintained throughout the study. Biochemical parameters studied included red blood cell fragility; hematocrit and hemoglobin values; red cell glutathione concentration; and the enzymes acetylcholinesterase, glucose-6-phosphate dehydrogenase, and lactic acid dehydrogenase. No significant differences between the responses of the supplemented and placebo groups to a controlled O3 exposure (0.5 ppm for 2 h) were found for any of these parameters. The results indicate that vitamin E supplementation in humans, at the levels employed in this experiment, gives no added protection against blood biochemical effects of O3 in intermittently exercising subjects under exposure conditoins simulating summer ambient air pollution episodes.
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Linn WS, Jones MP, Bachmayer EA, Clark KW, Karuza SK, Hackney JD. Effect of low-level exposure to ozone on arterial oxygenation in humans. Am Rev Respir Dis 1979; 119:731-40. [PMID: 453699 DOI: 10.1164/arrd.1979.119.5.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
We investigated the effect on arterial blood oxygenation of exposure to 0.2 ppm of ozone in purified air for 2 hours with intermittent light exercise and heat stress. Similar exposures to purified air alone provided control data. In 12 healthy volunteers, blood gases were measured before and during exposure via an indwelling brachial cannula. Six of these subjects and 6 other subjects underwent separate similar studies in which "arterialized" earlobe capillary blood was sampled. Arterial Po2 and alveolar-arterial Po2 differences varied significantly among different experimental conditions, but the variability was similar in the presence or absence of ozone. Small significant variations in body temperature were observed; these did not appear to be sufficient to affect blood gas measurements substantially. Over-all, we found no evidence for an adverse effect of the exposure to ozone on arterial oxygenation.
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Mead CN, Moore SM, Clark KW, Spenner BF, Thomas LJ. A detection algorithm for multiform premature ventricular contractions. Med Instrum 1978; 12:337-9. [PMID: 85246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This paper reports an algorithm developed to identify and quantify multiform PVCs. The algorithm clusters PVCs of similar morphology using a combination of time-domain and frequency-domain analysis. Initially, PVCs are grouped together on the basis of four time-domain-based morphological feature measurements. However, these time-domain-based clusters many times are nonunique because commonly encountered signal changes can cause substantial variations in the feature measurements of clinically similar beats. These redundant clusters are consolidated using two frequency-domain parameters: The First Spectral Moment (FSM) (center of gravity) of the amplitude spectrum, and the 5-Hz phase angle.
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Abstract
Biochemical studies were performed on blood and lung tissue of squirrel monkeys (Saimiri sciureus) following acute exposure to 0.75 ppm ozone (O3) for 4 h/d for 4 consecutive days. One group of animals was sacrificed at the end of the last exposure day and another group was sacrificed 4 d later after the last exposure. Evidence was sought for oxidation-induced changes known to occur in rodents when high levels of O3 are inhaled. A significant increase in red blood cell membrane fragility was observed, as well as significant decreases in red blood cell glutathione and erythrocyte acetylcholinesterase; however, the red blood cell enzymes, lactic acid dehydrogenase (LDH), and glucose-6-phosphate dehydrogenase (G6PDH) were not changed significantly. Lung tissue analysis showed that lipid peroxidation was markedly increased and tissue vitamin E levels were significantly decreased. The tissue enzymes G6PDH, glutathione reductase, and LDH significantly increased in activity. No significant changes were seen in either superoxide dismutase or malic acid dehydrogenase. The results of this experiment indicate that O3, or reaction products resulting from O3-tissue interaction in the lung, pass the air-blood barrier and are capable of producing biochemical changes in blood as well as in lung tissue.
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Abstract
The performance of sheep and cattle grazing together was compared with that of sheep grazing only with sheep and of cattle grazing only with cattle. Comparisons were made at five stocking rates over three years at the Ginninderra Experiment Station, near Canberra, A.C.T. The cattle, Aberdeen Angus steers, gained less weight in autumn and winter if grazing with sheep (Merino ewes) than did cattle grazing only with cattle. During spring, however, they grew faster and, by late spring, differences between the groups were small and not significant. Sheep grazing with cattle grew more wool, and produced more lambs with higher weaner weights, than sheep grazing only with sheep. The effect of stocking rate on animal performance varied greatly through the year. In spring and summer, gains of young cattle were not greatly affected by stocking rate, and were sometimes highest at highest stocking rates. In autumn, winter, and early spring an additional one-eighth steers per acre decreased daily gains by 0.2 kg, or even more. Older steers at highest stocking rates gained much more in spring than did those on lowest stocking rates. Stocking rate affected all attributes of sheep when grazing alone, but had little effect on sheep grazing with cattle. This study indicates that there could be substantial advantages from running cattle with sheep. The performance of sheep would be improved, and that of cattle reduced only slightly, compared with systems running the species separately. Compensatory gains in spring offer considerable benefits to cattle management, but may limit the value of practices such as supplementary feeding of cattle in winter. Similar results are likely wherever cool temperate, improved pastures are grazed at high stocking rates. Different results are likely from native pastures, and semi-arid environments.
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