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Jackson S, Marshall JL, Mawer A, Lopez-Ramon R, Harris SA, Satti I, Hughes E, Preston-Jones H, Cabrera Puig I, Longet S, Tipton T, Laidlaw S, Doherty RP, Morrison H, Mitchell R, Tanner R, Ateere A, Stylianou E, Wu MS, Fredsgaard-Jones TPW, Breuer J, Rapeport G, Ferreira VM, Gleeson F, Pollard AJ, Carroll M, Catchpole A, Chiu C, McShane H. Safety, tolerability, viral kinetics, and immune correlates of protection in healthy, seropositive UK adults inoculated with SARS-CoV-2: a single-centre, open-label, phase 1 controlled human infection study. Lancet Microbe 2024:S2666-5247(24)00025-9. [PMID: 38703782 DOI: 10.1016/s2666-5247(24)00025-9] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND A SARS-CoV-2 controlled human infection model (CHIM) has been successfully established in seronegative individuals using a dose of 1×101 50% tissue culture infectious dose (TCID50) pre-alpha SARS-CoV-2 virus. Given the increasing prevalence of seropositivity to SARS-CoV-2, a CHIM that could be used for vaccine development will need to induce infection in those with pre-existing immunity. Our aim was to find a dose of pre-alpha SARS-CoV-2 virus that induced infection in previously infected individuals. METHODS Healthy, UK volunteers aged 18-30 years, with proven (quantitative RT-PCR or lateral flow antigen test) previous SARS-CoV-2 infection (with or without vaccination) were inoculated intranasally in a stepwise dose escalation CHIM with either 1×101, 1×102, 1×10³, 1×104, or 1×105 TCID50 SARS-CoV-2/human/GBR/484861/2020, the same virus used in the seronegative CHIM. Post-inoculation, volunteers were quarantined in functionally negative pressure rooms (Oxford, UK) for 14 days and until 12-hourly combined oropharyngeal-nasal swabs were negative for viable virus by focus-forming assay. Outpatient follow-up continued for 12 months post-enrolment, with additional visits for those who developed community-acquired SARS-CoV-2 infection. The primary objective was to identify a safe, well tolerated dose that induced infection (defined as two consecutive SARS-CoV-2 positive PCRs starting 24 h after inoculation) in 50% of seropositive volunteers. This study is registered with ClinicalTrials.gov (NCT04864548); enrolment and follow-up to 12 months post-enrolment are complete. FINDINGS Recruitment commenced on May 6, 2021, with the last volunteer enrolled into the dose escalation cohort on Nov 24, 2022. 36 volunteers were enrolled, with four to eight volunteers inoculated in each dosing group from 1×101 to 1×105 TCID50 SARS-CoV-2. All volunteers have completed quarantine, with follow-up to 12 months complete. Despite dose escalation to 1×105 TCID50, we were unable to induce sustained infection in any volunteers. Five (14%) of 36 volunteers were considered to have transient infection, based on the kinetic of their PCR-positive swabs. Transiently infected volunteers had significantly lower baseline mucosal and systemic SARS-CoV-2-specific antibody titres and significantly lower peripheral IFNγ responses against a CD8+ T-cell SARS-CoV-2 peptide pool than uninfected volunteers. 14 (39%) of 36 volunteers subsequently developed breakthrough infection with the omicron variant after discharge from quarantine. Most adverse events reported by volunteers in quarantine were mild, with fatigue (16 [44%]) and stuffy nose (16 [44%]) being the most common. There were no serious adverse events. INTERPRETATION Our study demonstrates potent protective immunity induced by homologous vaccination and homologous or heterologous previous SARS-CoV-2 infection. The community breakthrough infections seen with the omicron variant supports the use of newer variants to establish a model with sufficient rate of infection for use in vaccine and therapeutic development. FUNDING Wellcome Trust and Department for Health and Social Care.
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Affiliation(s)
- Susan Jackson
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Julia L Marshall
- Department of Paediatrics, University of Oxford, Oxford, UK; The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, Australia
| | - Andrew Mawer
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | | | - Iman Satti
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Eileen Hughes
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | | | - Stephanie Longet
- The Wellcome Centre for Human Genetics and Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Tom Tipton
- The Wellcome Centre for Human Genetics and Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Stephen Laidlaw
- The Wellcome Centre for Human Genetics and Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Hazel Morrison
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | - Rachel Tanner
- Department of Paediatrics, University of Oxford, Oxford, UK
| | - Alberta Ateere
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | - Meng-San Wu
- Department of Paediatrics, University of Oxford, Oxford, UK
| | | | - Judith Breuer
- Institute of Child Health, University College London, London, UK
| | - Garth Rapeport
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | - Fergus Gleeson
- Oxford Radiology Research Unit, University of Oxford, Oxford, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Miles Carroll
- The Wellcome Centre for Human Genetics and Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Christopher Chiu
- Department of Infectious Disease, Imperial College London, London, UK
| | - Helen McShane
- Department of Paediatrics, University of Oxford, Oxford, UK.
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Ahmad MS, Hicks SR, Watson R, Ahmed RA, Jones L, Vaselli M, Wu MS, Hayat F, Ratcliffe L, McKenna M, Hine P, Defres S, Wingfield T. A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK. Wellcome Open Res 2022; 6:222. [PMID: 35118199 PMCID: PMC8787571 DOI: 10.12688/wellcomeopenres.17163.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/20/2022] Open
Abstract
Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe’s first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) backgrounds. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of “Practice Pointers” posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME backgrounds, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.
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Affiliation(s)
- Muhammad Shamsher Ahmad
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
| | - Scott Rory Hicks
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Rebecca Watson
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Rajia Akter Ahmed
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Lewis Jones
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Marcella Vaselli
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Meng-San Wu
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Fatima Hayat
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Libuse Ratcliffe
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Mark McKenna
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Paul Hine
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
| | - Sylviane Defres
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
| | - Tom Wingfield
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
- WHO Collaborating Centre for Social Medicine and Tuberculosis, Department of Global Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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Valaiyapathi R, Wu MS, McGregor A. Ground glass opacities are not always COVID-19: a case of acute eosinophilic pneumonitis caused by daptomycin. Lancet 2022; 399:270. [PMID: 35033220 PMCID: PMC8758180 DOI: 10.1016/s0140-6736(22)00009-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/18/2021] [Accepted: 12/10/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Rajalakshmi Valaiyapathi
- Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK.
| | - Meng-San Wu
- Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK
| | - Alastair McGregor
- Department of Infectious Diseases, Northwick Park Hospital, London North West University Healthcare NHS Trust, Harrow, UK
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Li HR, Zeng AL, Liu JG, Wu MS. [Research progress on organoids in stomatology]. Zhonghua Kou Qiang Yi Xue Za Zhi 2021; 56:1150-1154. [PMID: 34763414 DOI: 10.3760/cma.j.cn112144-20210524-00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The organoid is a kind of distinctive micro-organ formed by stem cells with the ability of self-renewal, which can be cultured in three-dimensional scaffold in vitro. With the development of cell culture system, organoids have been gradually applied in researches such as in vitro organ model establishment, drug testing and even the repairing or replacing damage organs. It shows significantly promising prospects. This review article aims to summarize the latest research progress and provide the theoretical foundation and prospects for the development of organoids in stomatology.
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Affiliation(s)
- H R Li
- School of Stomatology, Zunyi Medical University, Special Key Laboratory of Oral Diseases Research, Higher Education Institution in Guizhou Province, Zunyi Key Laboratory of Oral Diseases Research, Zunyi 563000, China
| | - A L Zeng
- Department of Endodontics, School and Hospital of Stomatology, Zunyi Medical University, Special Key Laboratory of Oral Diseases Research, Higher Education Institution in Guizhou Province, Zunyi Key Laboratory of Oral Diseases Research, Zunyi 563000, China
| | - J G Liu
- School of Stomatology, Zunyi Medical University, Special Key Laboratory of Oral Diseases Research, Higher Education Institution in Guizhou Province, Zunyi Key Laboratory of Oral Diseases Research, Zunyi 563000, China
| | - M S Wu
- School of Stomatology, Zunyi Medical University, Special Key Laboratory of Oral Diseases Research, Higher Education Institution in Guizhou Province, Zunyi Key Laboratory of Oral Diseases Research, Zunyi 563000, China
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Ahmad MS, Hicks SR, Watson R, Ahmed RA, Jones L, Vaselli M, Wu MS, Hayat F, Ratcliffe L, McKenna M, Hine P, Defres S, Wingfield T. A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK. Wellcome Open Res 2021; 6:222. [DOI: 10.12688/wellcomeopenres.17163.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe’s first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) background. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of “Practice Pointers” posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME background, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.
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6
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Stockdale AJ, Fyles F, Farrell C, Lewis J, Barr D, Haigh K, Abouyannis M, Hankinson B, Penha D, Fernando R, Wiles R, Sharma S, Santamaria N, Chindambaram V, Probert C, Ahmed MS, Cruise J, Fordham I, Hicks R, Maxwell A, Moody N, Paterson T, Stott K, Wu MS, Beadsworth M, Todd S, Joekes E. Sensitivity of SARS-CoV-2 RNA polymerase chain reaction using a clinical and radiological reference standard. J Infect 2021; 82:260-268. [PMID: 33892014 PMCID: PMC8057690 DOI: 10.1016/j.jinf.2021.04.012] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/02/2021] [Accepted: 04/14/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Diagnostic tests for SARS-CoV-2 are important for epidemiology, clinical management, and infection control. Limitations of oro-nasopharyngeal real-time PCR sensitivity have been described based on comparisons of single tests with repeated sampling. We assessed SARS-CoV-2 PCR clinical sensitivity using a clinical and radiological reference standard. METHODS Between March-May 2020, 2060 patients underwent thoracic imaging and SARS-CoV-2 PCR testing. Imaging was independently double- or triple-reported (if discordance) by blinded radiologists according to radiological criteria for COVID-19. We excluded asymptomatic patients and those with alternative diagnoses that could explain imaging findings. Associations with PCR-positivity were assessed with binomial logistic regression. RESULTS 901 patients had possible/probable imaging features and clinical symptoms of COVID-19 and 429 patients met the clinical and radiological reference case definition. SARS-CoV-2 PCR sensitivity was 68% (95% confidence interval 64-73), was highest 7-8 days after symptom onset (78% (68-88)) and was lower among current smokers (adjusted odds ratio 0.23 (0.12-0.42) p < 0.001). CONCLUSIONS In patients with clinical and imaging features of COVID-19, PCR test sensitivity was 68%, and was lower among smokers; a finding that could explain observations of lower disease incidence and that warrants further validation. PCR tests should be interpreted considering imaging, symptom duration and smoking status.
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Affiliation(s)
- Alexander J Stockdale
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom.
| | - Fred Fyles
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Catriona Farrell
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Joe Lewis
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom
| | - David Barr
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom
| | - Kathryn Haigh
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, United Kingdom
| | - Michael Abouyannis
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Beth Hankinson
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Diana Penha
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Rashika Fernando
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Rebecca Wiles
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Sheetal Sharma
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Nuria Santamaria
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Vijay Chindambaram
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Cairine Probert
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Muhammad Shamsher Ahmed
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - James Cruise
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Imogen Fordham
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Rory Hicks
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Alice Maxwell
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Nick Moody
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Tamsin Paterson
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Katharine Stott
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom; Institute of Systems, Molecular and Integrative Biology, University of Liverpool, United Kingdom
| | - Meng-San Wu
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Michael Beadsworth
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Stacy Todd
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
| | - Elizabeth Joekes
- Department of Radiology, Liverpool University Hospitals NHS Foundation Trust, United Kingdom
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7
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Wu MS, Watson R, Hayat F, Ratcliffe L, Beadsworth MB, McKenna M, Corney D, Plum C, Macfarlane JL, Matareed M, Butt S, Gupta S, Hine P, Defres S, Wingfield T. What do people hospitalised with COVID-19 think about their care? Results of a satisfaction survey during the first wave of COVID-19 in Liverpool. Future Healthc J 2021; 8:e70-e75. [PMID: 33791480 DOI: 10.7861/fhj.2020-0260] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Despite huge advances in vaccines, testing and treatments for COVID-19, there is negligible evidence on the perceptions of people hospitalised with COVID-19 about the care they received. To address this, we developed a satisfaction survey for people with COVID-19 admitted to our hospital during the first COVID-19 wave in Liverpool. Of those invited, 98/160 (61%) responded, of whom 94/98 (96%) completed the survey. Respondents rated overall care highly (mean 4.7/5) and 89/94 (95%) reported that they would recommend the hospital to friends and/or family. Most respondents felt safe on the ward (94%), with privacy maintained (93%) and pain well managed (90%). Fewer than two-thirds (63%) of respondents considered themselves adequately consulted regarding medications and side effects. Sleep and food/drink quality were also highlighted as areas for improvement. To overcome the issues raised, we generated a 'COVID-19 practice pointers' poster within an integrated educational bundle on COVID-19 wards. The impact of the bundle on perceptions of people hospitalised with COVID-19 will be evaluated in people hospitalised with COVID-19 in Liverpool in 2021. Whether hospitalised for COVID-19 or other conditions, our survey results are a timely reminder of the importance of involving patients in shaping the care that they receive.
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Affiliation(s)
- Meng-San Wu
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK and Imperial College Healthcare NHS Trust, London, UK
| | - Rebecca Watson
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Fatima Hayat
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Libuse Ratcliffe
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | - Mark McKenna
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | | | | | | | - Sundas Butt
- George Eliot Hospital NHS Trust, Nuneaton, UK
| | | | - Paul Hine
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK and Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sylviane Defres
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK, University of Liverpool, Liverpool, UK and Liverpool School of Tropical Medicine, Liverpool, UK
| | - Tom Wingfield
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK, University of Liverpool, Liverpool, UK, Liverpool School of Tropical Medicine, Liverpool, UK and Karolinska Institutet, Stockholm, Sweden
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8
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Kelly S, Waters L, Cevik M, Collins S, Lewis J, Wu MS, Blanchard TJ, Geretti AM. Pneumocystis pneumonia, a COVID-19 mimic, reminds us of the importance of HIV testing in COVID-19. Clin Med (Lond) 2020; 20:590-592. [PMID: 33199326 DOI: 10.7861/clinmed.2020-0565] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
While clinical environments are highly focused on COVID-19, reports of missed or delayed treatment for conditions that imitate COVID-19, such as pneumonia caused by the fungus Pneumocystis jirovecii, are emerging. Given the uncertain spectrum of COVID-19 presentations and variable sensitivity of laboratory tests for SARS-CoV-2, there is a risk that, without a high index of suspicion, alternative aetiologies may be overlooked while pursuing a diagnosis of COVID-19. The British HIV Association has been calling for the inclusion of HIV testing in all patients admitted to hospital with suspected COVID-19. In this article we reflect on the importance of including HIV testing to prevent avoidable morbidity and mortality in our patients.
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Affiliation(s)
- Sophie Kelly
- University of Liverpool, Liverpool, UK and Royal Liverpool Hospital, Liverpool, UK
| | | | - Muge Cevik
- University of St Andrews, St Andrews, UK
| | | | - Joe Lewis
- University of Liverpool, Liverpool, UK and Royal Liverpool Hospital, Liverpool, UK
| | | | - Tom J Blanchard
- University of Liverpool, Liverpool, UK and Royal Liverpool Hospital, Liverpool, UK
| | - Anna M Geretti
- University of Liverpool, Liverpool, UK and Royal Liverpool Hospital, Liverpool, UK
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9
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Affiliation(s)
- Meng-San Wu
- Imperial College Healthcare NHS Trust, London, UK
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK
| | - Fatima Hayat
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK
| | - Libuse Ratcliffe
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK
| | - Mike B J Beadsworth
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sylviane Defres
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK
- Liverpool School of Tropical Medicine, Liverpool, UK
- University of Liverpool, Liverpool, UK
| | - Tom Wingfield
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals NHS Trust, Liverpool, UK
- Liverpool School of Tropical Medicine, Liverpool, UK
- Karolinksa Institutet, Stockholm, Sweden
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10
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Du CH, Lü S, Zhang Y, Li SZ, Xiong MT, He ZH, Li ZH, Wu MS, Sun JY, Ren YB, Chen CQ, Gu Q, Wang YS, Dong Y. [Molecular identification of Tricula spp. and the parasitized trematode cercariae in schistosomiasis-endemic areas of Yunnan Province]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2020; 32:159-167. [PMID: 32458605 DOI: 10.16250/j.32.1374.2019187] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To characterize a species of the genus Tricula and parasitized trematodes in schistosomiasis-endemic areas of Yunnan Province using a molecular analysis, so as to understand their taxonomic positions. METHODS Tricula spp. and Oncomelania snails were collected from Xiangyun County, Yunnan Province, and cercaria parasitizing snails were observed using crushing followed by microscopy. Cercaria parasitizing Tricula snails at various morphologies were sampled using a shedding method. Genomic DNA was extracted from snail soft tissues and cercariae, and the 16S rRNA, COI, 28S rDNA genes in snails and the ND1 and 28S rDNA genes in cercariae were amplified using a PCR assay and sequenced. The species of Tricula snails and their parasitized trematodes was characterized using sequence alignment and phylogenetic analysis. RESULTS Among 382 Tricula snails detected, there were three types of trematode cercariae found, including the non-forked (20.94%, 80/382), double-forked (3.40%, 13/382) and swallow shapes (7.07%, 27/382). Sequence and phylogenetic analyses showed that the 16S rRNA, COI and 28S rDNA gene sequences of this species of Tricula had high homology to those in Delavaya dianchiensis, and were clustered in a branch. Sequencing analysis of the ND1 and 28S rDNA genes revealed that the non-forked cercariae belonged to the family Pleu- rogenidae, the swallow-shaped cercariae belonged to the family Opecoelidae, and the double-forked cercariae belonged to another species of the genus Schistosoma that was different from S. sinensium and S. ovuncatum. CONCLUSIONS The species and taxonomy of Triculla spp. and their parasitized trematodes are preliminarily determined in schistosomiasis-endemic areas of Yunnan Province; however, further studies are required to investigate the more definite taxonomy and pathogenicity.
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Affiliation(s)
- C H Du
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - S Lü
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, China.,Co-first author
| | - Y Zhang
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - S Z Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Chinese Center for Tropical Diseases Research, China
| | - M T Xiong
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Z H He
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Z H Li
- Xiangyun Station of Schistosomiasis Control, Yunnan Province, China
| | - M S Wu
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - J Y Sun
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Y B Ren
- Xiangyun Station of Schistosomiasis Control, Yunnan Province, China
| | - C Q Chen
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Q Gu
- Xiangyun Station of Schistosomiasis Control, Yunnan Province, China
| | - Y S Wang
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Y Dong
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
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11
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Huang NB, Feng XG, Dong Y, Zhang Y, Wu MS. [Survival analysis of laboratory - bred smooth - shelled Oncomelania snails in Yunnan Province]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2020; 32:198-199. [PMID: 32458612 DOI: 10.16250/j.32.1374.2019075] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To investigate the survival period of Yunnan Province-derived smooth-shelled Oncomelania snails bred in laboratory. METHODS Oncomelania snails were sampled from Heqing and Yongsheng counties where schistosomiasis is endemic, and uninfected adult snails were collected and bred in laboratory. The survival period of snails sampled from these two counties was compared. RESULTS The 1-, 2-, 3- and 4-year survival rates of laboratory-bred smooth-shelled snails sampled from Yunnan Province were 72.36%, 29.11%, 13.08% and 0.21%, respectively, and were 74.66%, 38.91%, 19.46% and 0.45% for snails derived from Heqing County, and 70.36%, 20.55%, 7.51% and 0 for snails sampled from Yongsheng County, respectively. The mean and median survival period of Yunnan Province-derived adult snails was 20.90 and 20.67 months, and there were significant differences between the snails sampled from Heqing and Yongsheng counties in terms of the mean (22.94 vs. 19.13 months, P < 0.05) and median survival period (21.63 vs. 19.81 months, P < 0.05). CONCLUSIONS The mean survival period of Yunnan Province-derived smooth-shelled adult snails is approximately 20 months in laboratory, and the survival varies in geographical areas.
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Affiliation(s)
- N B Huang
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - X G Feng
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Y Dong
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - Y Zhang
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
| | - M S Wu
- Yunnan Institute of Endemic Diseases Control and Prevention, Dali 671000, China
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12
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Yan KX, Zhang YJ, Han L, Huang Q, Zhang ZH, Fang X, Zheng ZZ, Yawalkar N, Chang YL, Zhang Q, Jin L, Qian DF, Li XY, Wu MS, Xu QH, Zhang XJ, Xu JH. TT genotype of rs10036748 in TNIP1 shows better response to methotrexate in a Chinese population: a prospective cohort study. Br J Dermatol 2019; 181:778-785. [PMID: 31020648 DOI: 10.1111/bjd.17704] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Methotrexate (MTX) is an efficacious treatment for psoriasis; however, its widespread application is limited by its unpredictable efficacy. OBJECTIVES To investigate the association of clinical factors and variants of psoriasis susceptibility genes with clinical responses to MTX in a prospective cohort. METHODS A total of 221 patients with psoriasis were recruited. Patients who achieved Psoriasis Area and Severity Index (PASI) improvement ≥ 75% at week 12 were defined as responders, whereas those with PASI improvement < 50% were defined as nonresponders. In 90 screening patients, genetic variants for 18 single-nucleotide polymorphisms in 14 susceptibility genes, and HLA-Cw6 status were initially compared for responders and nonresponders. Statistically significant associations in genetic variants were verified in all 221 patients. RESULTS Overall, 49% and 45% of patients achieved PASI 75 improvement during screening and verification stages, respectively. Concomitant arthritis with psoriasis and high body mass index (BMI) negatively affect the efficacy of MTX. TT genotype of rs10036748 in TNIP1 was significantly associated with PASI 75 response at week 12 (54% and 37%, P < 0·05). A significantly higher PASI 90 response was observed in patients with TT genotype of rs10036748 (27% vs. 12%, P < 0·01) and TC/TT genotype of rs4112788 in LCE3D (25% vs. 13%, P < 0·05) at week 12 compared with those who had other genotypes. After adjustment for all confounding factors, only BMI (P < 0·05), arthritis (P < 0·05) and genotype of rs10036748 (P < 0·05) were significantly associated with clinical responses to MTX. CONCLUSIONS Patients with psoriasis with TT genotype of rs10036748 in TNIP1, with lower BMI, without arthritis will achieve a better response to MTX.
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Affiliation(s)
- K X Yan
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Y J Zhang
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - L Han
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Q Huang
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Z H Zhang
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - X Fang
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Z Z Zheng
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - N Yawalkar
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, 3012, Switzerland
| | - Y L Chang
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Q Zhang
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - L Jin
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - D F Qian
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - X Y Li
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - M S Wu
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Q H Xu
- Institute of Dermatology and Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230032, China
| | - X J Zhang
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - J H Xu
- Shanghai Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, 200040, China
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13
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Wang X, Liu G, Liu RF, Luo WW, Wu MS, Sun BZ, Lei XL, Ouyang CY, Xu B. Strain-tunable molecular doping in germanane: a first-principles study. Nanotechnology 2018; 29:465202. [PMID: 30203785 DOI: 10.1088/1361-6528/aae046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Germanane, fully hydrogenated germanene, has recently attracted great interest, both theoretical and experimental. In this paper we thoroughly study strain-tunable n/p-type doping in germanane by adsorption of tetrathiafulvalene (TTF)/tetracyanoquinodimethane (TCNQ) molecules through first-principles calculations. The results show that both TTF and TCNQ molecules can non-covalently functionalize the electronic properties of germanane. Not surprisingly, TTF molecular adsorption induces n-type doping in germanane because the TTF molecule is a typical electron donor. Moreover, a linearly tunable band gap of germanane and differing n-type doping strengths can be realized by a biaxial strain ranging from -3% to 3%. Analysis indicates that tensile strain would promote the doping effect whereas compressive strain would inhibit it. Comparatively, TCNQ molecular adsorption induces a germanane/TCNQ system which exhibits metallic characteristics. Surprisingly, however, under a tensile strain of 2.5%, a strong p-type doping effect is achieved in germanene/TCNQ. In particular, with increasing tensile strain over the range 2.5%-3%, the strain-tunable p-type doping effect decreases gradually. Such a multiple effect of molecular adsorption and strain on the electronic properties of germanane could be helpful for potential future applications of germanane-based electron devices.
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Affiliation(s)
- X Wang
- College of Physics and Communication Electronics, Laboratory of Computational Material Physics, Jiangxi Normal University, Nanchang 330022, People's Republic of China
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14
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Huang YT, Cheng JF, Liu YT, Mao YC, Wu MS, Liu PY. Genome-based analysis of virulence determinants of a Serratia marcescens strain from soft tissues following a snake bite. Future Microbiol 2017; 13:331-343. [PMID: 29105506 DOI: 10.2217/fmb-2017-0202] [Citation(s) in RCA: 4] [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: 11/21/2022] Open
Abstract
AIM Serratia marcescens wound infection after snakebite is often associated with aggressive presentations. However, the virulence determinants remain understudied. MATERIALS & METHODS Whole-genome sequencing was performed on S. marcescens VGH107, an isolate from wound infection secondary to Trimeresurus mucrosquamatus bite. Comparative genomics approach coupled with multivirulent-locus sequencing typing was applied to systematically predict potential virulence factors. RESULTS Multivirulent-locus sequencing typing indicated VGH107 falls within the cluster of high pathogenic strains. Comparative analysis identified virulence genes unique in VGH107, including ecpD and ecpE genes for periplasmic chaperone-pilus subunit complex and cdiA and cdiB genes for contact-dependent growth inhibition system. CONCLUSION The data established here provide foundation for further research regarding the virulence and resistance of S. marcescens.
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Affiliation(s)
- Yao-Ting Huang
- Department of Computer Science & Information Engineering, National Chung Cheng University, Chia-Yi, Taiwan
| | - Jan-Fang Cheng
- Department of Energy, Joint Genome Institute, Walnut Creek, CA 94598, USA
| | - Yi-Ting Liu
- Department of Computer Science & Information Engineering, National Chung Cheng University, Chia-Yi, Taiwan
| | - Yan-Chiao Mao
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Meng-San Wu
- Division of Infection & Immunity, University College London, London, UK
| | - Po-Yu Liu
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Rong Hsing Research Center for Translational Medicine, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan
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15
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Liu PC, Wu MS, Hsieh MC, Suk FM. Hepatobiliary and Pancreatic: Development from gallbladder stone to gallstone ileus. J Gastroenterol Hepatol 2017; 32:1539. [PMID: 28845586 DOI: 10.1111/jgh.13832] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 05/21/2017] [Indexed: 12/09/2022]
Affiliation(s)
- P C Liu
- Division of Gastroenterology, Department of Internal Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - M S Wu
- Division of Gastroenterology, Department of Internal Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - M C Hsieh
- Division of General Surgery, Department of Surgery, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - F M Suk
- Division of Gastroenterology, Department of Internal Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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16
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Liu HD, Xiong W, Liu QY, Li JH, Wu MS, Zhang J, Dong SS. [Role of CMKLR1 on mouse vascular smooth muscle cells proliferation and related mechanism]. Zhonghua Xin Xue Guan Bing Za Zhi 2016; 44:605-9. [PMID: 27530946 DOI: 10.3760/cma.j.issn.0253-3758.2016.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the proliferation property of vascular smooth muscle cells (VSMCs) in the stable CMKLR1 gene knock-down mouse VSMCs line and explore related mechanism. METHODS The short hairpin RNA sequence targeting to knockdown the coding regions of mouse CMKLR1 mRNA was synthesized and subsequently employed to construct recombinant lentivirus vector.Mouse VSMCs were cultured and infected with the recombinant lentivirus (knockdown VSMCs). mRNA and protein CMKLR1 expression in Knockdown VSMCs was measured by real-time PCR and Western blot and compared with those in normal VSMCs (vehicle VSMCs) and lentivirus control VSMCs (control VSMCs). The proliferation of normal, knockdown and control VSMCs was induced by platelet-derived growth factor-BB (PDGF VSMCs) and measured by cell number counting and BrdU.The phosphorylated c-Jun N-terminal kinase (p-JNK) protein was investigated by Western blot. RESULTS The relative level of CMKLR1 mRNA in knockdown VSMCs (0.23±0.04) was significantly downregulated compared with which in vehicle VSMCs (1.05±0.05) as well as control VSMCs (0.99±0.04) (P<0.01). The relative level of CMKLR1 protein in knockdown VSMCs (0.29±0.04) was also significantly decreased, compared with which in vehicle VSMCs (1.06±0.04) as well as control VSMCs (0.95±0.02) (P<0.01). The VSMCs number ((50.33±1.20)×10(3)/cm(2)) and BrdU A450 nm value (1.80±0.05) in PDGF VSMCs were significantly increased in vehicle VSMCs ((42.02±1.53)×10(3)/cm(2,) 1.55±0.04) (both P<0.05). Compared with those in vehicle VSMCs, the VSMCs number ((23.33±2.03)×10(3)/cm(2)) and BrdU A450 nm value (1.32±0.02) in knockdown VSMCs were significantly decreased.The proliferation property between PDGF VSMCs and control VSMCs was similar(P>0.05). Compared with the relative level of p-JNK protein (1.03±0.03) in vehicle VSMCs, the p-JNK protein level was significantly increased in PDGF VSMCs (1.36±0.02, P<0.05) and significantly downregulated in knockdown VSMCs (0.79±0.05, P<0.05). CONCLUSION Knockdowning CMKLR1 gene can reduce the proliferation of mouse vascular smooth muscle cells, which was related with the down-regulation of p-JNK expression.
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Affiliation(s)
- H D Liu
- Department of Cardiology, Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen 518020, China
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17
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Liu G, Lei XL, Wu MS, Xu B, Ouyang CY. Comparison of the stability of free-standing silicene and hydrogenated silicene in oxygen: a first principles investigation. J Phys Condens Matter 2014; 26:355007. [PMID: 25078142 DOI: 10.1088/0953-8984/26/35/355007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The stability of free-standing silicene in oxygen is worthwhile discussing. In this letter, the oxygen adsorption and dissociation on free-standing silicene is studied using first principles. It is found that free-standing silicene is not stable in oxygen because O2 molecules can be easily adsorbed and dissociated into O atoms on a silicene surface without overcoming any energy barrier. Moreover, dissociated oxygen atoms are difficult to migrate on and desorb from silicene surfaces, leading to the formation of Si-O compounds. To enhance the stability of free-standing silicene in oxygen, fully hydrogenated silicene is used as a stabiliser. Interestingly, compared with no energy barrier on pristine silicene, there are two minor energy barriers of O2 molecule adsorption and dissociation on fully hydrogenated silicene, indicating that hydrogenated silicene has higher stability than free-standing silicene in oxygen. However, once the O2 molecule dissociates into two O atoms on hydrogenated silicene, desorption of O atoms will be very difficult due to its high energy barrier. This work will be helpful to understand the detail of O2 molecule dissociation and dissociation-induced O atoms adsorption on free-standing and hydrogenated silicene in oxygen and will be useful to the application of silicene.
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Affiliation(s)
- G Liu
- College of Physics and Communication Electronics, Jiangxi Normal University, Nanchang 330022, People's Republic of China. Key Laboratory of Photoelectronic and Telecommunication of Jiangxi Province, Nanchang 330022, People's Republic of China
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18
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Wu MS, Tan SC, Xiong T. Indirect comparison of randomised controlled trials: comparative efficacy of dexlansoprazole vs. esomeprazole in the treatment of gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2013; 38:190-201. [PMID: 23718547 DOI: 10.1111/apt.12349] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 04/16/2013] [Accepted: 05/07/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Dexlansoprazole is a new proton pump inhibitor (PPI) with a dual delayed-release system. Both dexlansoprazole and esomeprazole are an enantiomer of lansoprazole and omeprazole respectively. However, there is no head-to-head trial data or indirect comparison analyses between dexlansoprazole and esomeprazole. AIM To compare the efficacy of dexlansoprazole with esomeprazole in healing erosive oesophagitis (EO), the maintenance of healed EO and the treatment of non-erosive reflux disease (NERD). METHODS Randomised Controlled Trials (RCTs) comparing dexlansoprazole or esomeprazole with either placebo or another PPI were systematically reviewed. Random-effect meta-analyses and adjusted indirect comparisons were conducted to compare the treatment effect of dexlansoprazole and esomeprazole using a common comparator. The relative risk (RR) and 95% confidence interval (CI) were calculated. RESULTS The indirect comparisons revealed significant differences in symptom control of heartburn in patients with NERD at 4 weeks. Dexlansoprazole 30 mg was more effective than esomeprazole 20 mg or 40 mg (RR: 2.01, 95% CI: 1.15-3.51; RR: 2.17, 95% CI: 1.39-3.38). However, there were no statistically significant differences between the two drugs in EO healing and maintenance of healed EO. Comparison of symptom control in healed EO was not able to be made due to different definitions used in the RCTs. CONCLUSIONS Adjusted indirect comparisons based on currently available RCT data suggested significantly better treatment effect in symptom control of heartburn in patients with NERD for dexlansoprazole against esomeprazole. No statistically significant differences were found in other EO outcomes. However, these study findings need to be interpreted with caution due to small number of studies and other limitations.
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Affiliation(s)
- M S Wu
- Department of Internal Medicine, Taiwan National University, Taipei, Taiwan
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19
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Wagner JA, Larson PJ, Weiss S, Miller JL, Doebber TW, Wu MS, Moller DE, Gottesdiener KM. Individual and Combined Effects of Peroxisome Proliferator-Activated Receptor α and γ Agonists, Fenofibrate and Rosiglitazone, on Biomarkers of Lipid and Glucose Metabolism in Healthy Nondiabetic Volunteers. J Clin Pharmacol 2013; 45:504-13. [PMID: 15831773 DOI: 10.1177/0091270004273136] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [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: 11/16/2022]
Abstract
This open-label, randomized, placebo-controlled, incomplete-block, 3-period crossover pilot study investigated the effects of peroxisome proliferator-activated receptor alpha- and gamma-agonists on biomarkers of lipid and glucose metabolism in 12 nondiabetic subjects. Plasma samples were collected before and after each 14-day treatment with placebo, fenofibrate (201 mg/d), rosiglitazone (4 mg twice daily), and combined fenofibrate (201 mg/d) plus rosiglitazone (4 mg twice daily). Except for triglycerides (P < .042) and free fatty acids (P < .074), no significant interaction was demonstrated between fenofibrate and rosiglitazone; thus, the effect due to each drug alone was evaluated (presence/absence of drug). Fenofibrate significantly (P < .050) increased lipoprotein lipase activity (35%) and decreased apolipoproteins B (13%) and C-III (20%). Rosiglitazone significantly (P < .050) decreased fasting glucose (7.3%) and increased apolipoprotein C-III (19%) and adiponectin (137%). Fenofibrate and rosiglitazone also produced effects on triglycerides and free fatty acids, but it was not possible to determine if these effects were synergistic in nature.
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Affiliation(s)
- J A Wagner
- Department of Clinical Pharmacology, Merck Research Laboratories, 126 East Lincoln Avenue, P.O. Box 2000, RY34-A548, Rahway, NJ 07065, USA
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20
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Affiliation(s)
- C T Chao
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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21
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Zhou K, Nazarov AA, Wu MS. Competing relaxation mechanisms in a disclinated nanowire: temperature and size effects. Phys Rev Lett 2007; 98:035501. [PMID: 17358691 DOI: 10.1103/physrevlett.98.035501] [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: 05/29/2006] [Indexed: 05/14/2023]
Abstract
This Letter reports a molecular dynamics study of the temperature and size dependence of disclination relaxation in a bicrystalline titanium nanowire. The simulations show that an unstable disclination may relax via crack nucleation and/or structural transformation. The critical disclination strength to nucleate a crack decreases with the nanowire diameter at 0 K, but an inverse relation may exist at higher temperatures. Similar relaxation mechanisms are operative in other hcp materials. The results suggest that grain boundaries in nanostructured materials can be disordered through disclinations which relax via amorphization.
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Affiliation(s)
- K Zhou
- School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798
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22
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Zhu J, Lum PY, Lamb J, GuhaThakurta D, Edwards SW, Thieringer R, Berger JP, Wu MS, Thompson J, Sachs AB, Schadt EE. An integrative genomics approach to the reconstruction of gene networks in segregating populations. Cytogenet Genome Res 2005; 105:363-74. [PMID: 15237224 DOI: 10.1159/000078209] [Citation(s) in RCA: 176] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2003] [Accepted: 12/09/2003] [Indexed: 11/19/2022] Open
Abstract
The reconstruction of genetic networks in mammalian systems is one of the primary goals in biological research, especially as such reconstructions relate to elucidating not only common, polygenic human diseases, but living systems more generally. Here we propose a novel gene network reconstruction algorithm, derived from classic Bayesian network methods, that utilizes naturally occurring genetic variations as a source of perturbations to elucidate the network. This algorithm incorporates relative transcript abundance and genotypic data from segregating populations by employing a generalized scoring function of maximum likelihood commonly used in Bayesian network reconstruction problems. The utility of this novel algorithm is demonstrated via application to liver gene expression data from a segregating mouse population. We demonstrate that the network derived from these data using our novel network reconstruction algorithm is able to capture causal associations between genes that result in increased predictive power, compared to more classically reconstructed networks derived from the same data.
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Affiliation(s)
- J Zhu
- Rosetta Inpharmatics, Seattle, WA, USA
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A JY, Wang GJ, Sun JG, Gu YC, Wu MS, Liu JH. Identification of phase I and phase II metabolites of Guanfu base A hydrochloride in human urine. Eur J Drug Metab Pharmacokinet 2004; 28:265-72. [PMID: 14743967 DOI: 10.1007/bf03220178] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Guanfu base A is a novel arrhythmic drug candidate isolated from the tuber of a traditional Chinese herb. Phase I and Phase II metabolites of Guanfu base A (GFA) Hydrochloride were studied in human urine by means of liquid chromatography mass spectrometry (LC/MSD) and tandem mass spectrometry (MS/MS). For phase I metabolites, Guanfu base I (GFI) was separated by HPLC and identified by comparison with authentic reference for their retention times, molecular ion peaks, fragment ions, and UV spectra. GFA oxide was also indicated to exist in human urine. For phase II metabolites, after human urine was treated either with glucuronidase or sulfatase, GFA occured in the chromatograms. It was suggested that there were GFA glucuronide and GFA sulfate in human urine. Further more, positive molecular ions, m/z 606 and m/z 510, of the two conjugates were detected in human urine by LC/MSD. In addition, characteristic ion of m/z 606 was identified as the precursor ion of m/z 177 [Glucuronic acid+H]+ by using MS/MS. Characteristic ion of m/z 430 [GFA+H]+ was also identified as a product ion of m/z 606 [GFA glucuronide+H]+. It was concluded that there were GFI. GFA oxide, GFA glucuronide and GFA sulfate in human urine.
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Affiliation(s)
- J Y A
- Department of Clinical Pharmacology, the First Affiliated Hospital of NanJing Medical University, NanJing, People's Republic of China
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Liang JT, Huang KC, Cheng AL, Jeng YM, Wu MS, Wang SM. Clinicopathological and molecular biological features of colorectal cancer in patients less than 40 years of age. Br J Surg 2003; 90:205-14. [PMID: 12555297 DOI: 10.1002/bjs.4015] [Citation(s) in RCA: 135] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND The aim of the present study was to identify the clinicopathological and molecular biological characteristics of early-onset colorectal cancers. METHODS The clinicopathological and molecular biological parameters of 138 consecutive patients with colorectal cancer aged less than 40 years were compared with those of 339 patients aged 60 years or more. RESULTS The younger patients with colorectal cancer had more mucin-producing (14.5 versus 4.7 per cent; P < 0.001) and poorly differentiated (7.2 versus 3.3 per cent; P = 0.015) tumours, a higher incidence of synchronous (5.8 versus 1.2 per cent; P = 0.007) and metachronous (4.0 versus 0.6 per cent; P = 0.023) colorectal cancers, and more advanced tumour stage (P < 0.001) than older patients. The operative mortality rate was lower (0.7 versus 5.0 per cent; P = 0.026), and cancer-specific survival was similar (in stage I, II and III disease; P > 0.05) or better (in stage IV disease; 95 per cent confidence interval 22.50 to 28.41 versus 12.61 to 17.05 months; P < 0.001). There was a higher percentage of normal p53 expression (61.1 versus 46.8 per cent; P = 0.023) and high-frequency microsatellite instability (MSI-H) (29.4 versus 6.3 per cent; P < 0.001), and a similar family history of cancer (17.5 versus 14.2 per cent; P > 0.05), compared with older patients. CONCLUSION Young patients with colorectal cancer have several distinct clinicopathological and molecular biological features. The mechanisms underlying the inconsistency between the presence of MSI-H and a family history of cancer in these early-onset colorectal cancers deserve further investigation.
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Affiliation(s)
- J T Liang
- Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan, Republic of China.
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Swain WE, Heydenburg Fuller D, Wu MS, Barr LJ, Fuller JT, Culp J, Burkholder J, Dixon RM, Widera G, Vessey R, Roy MJ. Tolerability and immune responses in humans to a PowderJect DNA vaccine for hepatitis B. Dev Biol (Basel) 2002; 104:115-9. [PMID: 11713809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
We are developing a DNA vaccine toward hepatitis-B virus (HBV) using PowderJect's proprietary needle-free technology to deliver DNA-coated gold particles directly into cells of the skin. Preclinical studies in animals showed that (i) microgram doses of the DNA vaccine were sufficient to immunize pigs and non-human primates to antibody levels comparable to those obtained with a commercial recombinant subunit vaccine; (ii) the DNA vaccine was effective in mouse strains that respond poorly to protein subunit vaccines; (iii) the vaccine induces robust cytotoxic T-cell responses, and (iv) the vaccine is non-toxic and well tolerated. Based on these findings, this DNA vaccine was evaluated for safety, tolerability, and the induction of immune responses in phase 1 clinical studies in healthy, hepatitis-naïve human volunteers. Preliminary results indicate that the vaccine is safe and well tolerated, and elicits both humoral and cellular immune responses in man.
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Affiliation(s)
- W E Swain
- PowderJect Vaccines, Inc., Madison, WI 53711, USA
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Shanmugasundaram M, Wu MS, Cheng CH. Nickel-catalyzed highly regio- and chemoselective cocyclotrimerization of propiolates with allenes: a novel route to polysubstituted benzene derivatives. Org Lett 2001; 3:4233-6. [PMID: 11784185 DOI: 10.1021/ol0169168] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The Ni(dppe)Br(2)/Zn system effectively catalyzes the cocyclotrimerization of propiolates with allenes. The reaction is highly regio- and chemoselective to afford polysubstituted benzene derivatives in good to excellent yields. [reaction: see text]
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Huang JY, Wu MS, Wu CH. The effect of an iron supplement on serum aluminum level and desferrioxamine mobilization test in hemodialysis patients. Ren Fail 2001; 23:789-95. [PMID: 11777318 DOI: 10.1081/jdi-100108190] [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: 11/03/2022] Open
Abstract
BACKGROUND The serum aluminum (Al) measurement with desferrioxamine (DFO) mobilization is a screening test for uremic patients with an Al overload. In these patients, body iron status is one of the factors affecting the serum Al level. This study is designed to elucidate the effects of iron supplements on the serum Al and the DFO mobilization test. METHODS Our study featured ten hemodialysis patients with iron deficiency anemia. The iron supplement was given intravenously with saccharated ferric oxide, 40 mg three times weekly, at the end of each hemodialysis. The total amount of iron supplement was 1,000 mg. All the patients underwent a DFO test at a dose of 5 mg/kg. The same test was repeated two weeks after completion of the iron supplement. RESULTS After the iron supplement, patients' iron deficiency anemia improved with a serum ferritin elevation from 312.4 +/- 589.5 to 748.2 +/- 566.2 microg/L (p < 0.01), and iron saturation from 21.6 +/- 20.3 to 41.1 +/- 21.7% (p = 0.06). The basal serum Al level decreased from 34.3 +/- 13.8 to 21.8 +/- 8.5 microg/L (p = 0.01). In the DFO mobilization test, the peak serum Al level decreased from 63.4 +/- 19.3 to 50.7 +/- 20.5 microg/L (p < 0.01). The amount of Al increment (deltaAl) in DFO test was not changed (29.1 +/- 12.0 vs. 28.9 +/- 15.9 microg/L, p = 0.86). The change in basal Al level tended to negatively correlate with the percentage of increment in iron saturation (r = -0.628, p = 0.05). CONCLUSION Results in this study suggest that iron supplements may significantly reduce the basal serum Al and peak Al in DFO mobilization test, without significant change of the mean deltaAl. The data presented indicate that in the interpretation of serum aluminum levels the iron status should be taken into account.
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Affiliation(s)
- J Y Huang
- Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
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Abstract
Leptospirosis is a re-emerging infectious disease, affecting both animals and humans worldwide. Multiple organ involvement may be encountered in leptospirosis, and early renal involvement is very common, characterized by tubulo-interstitial nephritis and tubular dysfunction. All 12 patients diagnosed in Chang Gung Memorial Hospital (Taiwan) between 1997 and 1999 had acute renal failure, with five patients requiring dialysis. Leptospira shermani is the main serovar encountered in Taiwan, and penicillin may dramatically rescue patients from multiple organ failure provided it is given early. To understand the mechanism behind tubular injuries by leptospira infection, outer membrane proteins (OMPs) extracted from pathogenic leptospira were given to tubular cells in culture. Our in vitro experiment showed that OMPs of pathogenic leptospira activate nuclear NFkappaB binding and stimulate downstream inducible nitric oxide (iNOS), monocyte chemoattractant protein-1 (MCP-1) and tumor necrosis factor-alpha (TNF-alpha) expression. These results indicate that leptospiral infection may induce tubulo-interstitial nephritis through a toxic component in the outer membrane followed by expression of inflammatory genes.
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Affiliation(s)
- C W Yang
- Department of Nephrology, Chang Gung Memorial Hospital and Graduate Institute of Veterinary Medicine, National Taiwan University, Taipei, Taiwan
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Liang RJ, Wang HP, Huang SP, Wu MS, Lin JT. Color Doppler sonography for ventral hernias in patients with acute abdomen: preliminary findings. J Clin Ultrasound 2001; 29:435-440. [PMID: 11745849 DOI: 10.1002/jcu.10003] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE We assessed the usefulness of color Doppler sonography (CDUS) in evaluating the vascular status of ventral hernias and distinguishing incarcerated from nonincarcerated ventral hernias. METHODS In this prospective study, 10 patients who presented with acute abdomen and had ventral hernias underwent CDUS from August 1999 to May 2000. Patient age and sex and the clinical severity, mode of therapy, and outcome in these 10 patients were evaluated in relationship to the CDUS findings. RESULTS Five patients had readily visible flow in the bowel within the hernial sac on CDUS. Two of these 5 had spontaneous reduction under conservative treatment, and 3 had asymptomatic ventral hernias with acute abdomen caused by spontaneous bacterial peritonitis. Barely visible flow was visualized in the bowel by CDUS in 4 other patients. Three of these underwent emergency surgery because of peritoneal signs; 2 of them were found to have ischemic changes in the bowel. The fourth patient underwent a successful manual reduction. The remaining patient had absent flow in the bowel on CDUS and underwent emergency surgery, which revealed gangrenous changes in the bowel. CONCLUSIONS The intensity of the Doppler signals on CDUS appears to be a promising predictor of bowel viability in cases of ventral hernia. Thus, CDUS should impact the determination of the treatment plan, including whether to provide conservative treatment or surgery.
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Affiliation(s)
- R J Liang
- Department of Internal Medicine, National Taiwan University Hospital, 7, Chung-Shan South Road, Taipei 10016, Taiwan
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Shun CT, Wu MS, Lin MT, Chang MC, Lin JT, Chuang SM. Immunohistochemical evaluation of cadherin and catenin expression in early gastric carcinomas: correlation with clinicopathologic characteristics and Helicobacter pylori infection. Oncology 2001; 60:339-45. [PMID: 11408802 DOI: 10.1159/000058530] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dysfunction of E-cadherin and catenin has been linked to invasiveness and differentiation of tumors. This study aimed to characterize the expression of cadherins and catenins in early gastric carcinoma and their relationship to clinicopathologic characteristics and Helicobacter pylori infection. E-cadherin and alpha-, beta- and gamma-catenins were strongly expressed in normal epithelium but abnormal immunoreactivity of at least one of these four proteins was noted in 48 (90.6%) of 53 early gastric carcinomas. Only 5 cases with intestinal-type tumors had intact expression of E-cadherin and alpha-, beta-, and gamma-catenins. Abnormal immunoreactivity in the tumor tissue was observed in 18 patients (34.0%) for E-cadherin, in 35 (66.0%) for alpha-catenin, in 20 (37.7%) for beta-catenin, and in 37 (69.8%) for gamma-catenin. In diffuse-type tumors, abnormal expression of E-cadherin (60.9 vs. 13.3%, p < 0.0005), alpha-catenin (82.6 vs. 53.3%, p < 0.05) and gamma-catenin (91.3 vs. 53.3%, p < 0.005) was more frequent than in the intestinal type. Ten tumors with lymph node metastasis showed a relatively higher frequency of abnormal expression of E-cadherin (70 vs. 25.6%, p < 0.05) but a lower frequency of abnormal expression of beta-catenin (10 vs. 44.1%, p = 0.07) than those without metastasis. No significant association was found between cadherin/catenin expression and the depth of invasion or the H. pylori status. It was concluded that abnormal expression of E-cadherin and the catenin-mediated cell-cell adhesion system occurs frequently in early gastric carcinogenesis and may play an important role in the genesis of histologic differentiation and in the mode of metastasis of early gastric carcinomas.
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Affiliation(s)
- C T Shun
- Departments of Pathology, Internal Medicine and Surgery, National Taiwan University Hospital, Taipei, Taiwan, ROC
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Lee YC, Wang HP, Huang SP, Chang YT, Wu CT, Yang CS, Wu MS, Lin JT. Obstructive jaundice caused by hepatocellular carcinoma: detection by endoscopic sonography. J Clin Ultrasound 2001; 29:363-366. [PMID: 11424104 DOI: 10.1002/jcu.1050] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Tumor thrombus in the extrahepatic biliary tree is a rare mechanism of obstructive jaundice. We present a patient with a minute hepatocellular carcinoma in the caudate lobe that invaded the common hepatic duct and caused biliary obstruction. Endoscopic sonography showed a tumor thrombus with central echogenicity and a "nodule-in-nodule" pattern and suggested the correct diagnosis.
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Affiliation(s)
- Y C Lee
- Department of Internal Medicine, College of Medicine, National Taiwan University, 1, Jen-Ai Road, Taipei, Taiwan
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Yu CC, Yang CW, Wu MS, Ko YC, Huang CT, Hong JJ, Huang CC. Mycophenolate mofetil reduces renal cortical inducible nitric oxide synthase mRNA expression and diminishes glomerulosclerosis in MRL/lpr mice. J Lab Clin Med 2001; 138:69-77. [PMID: 11433230 DOI: 10.1067/mlc.2001.115647] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Overexpression of inducible nitric oxide synthase (iNOS) has been implicated in the pathogenesis of lupus glomerulonephritis. Mycophenolate mofetil (MMF), a novel immunosuppressive agent, is currently used in organ transplantation and under evaluation for treatment of autoimmune disorders. Mycophenolic acid, the active metabolite of MMF, has been shown to suppress cytokine-induced nitric oxide production in vitro. The aim of this study was to evaluate the effect of MMF on the expression of renal cortical iNOS mRNA and protection against glomerulonephritis in MRL/lpr mice. Three-month-old MRL/lpr mice (n = 6) displaying clinical symptoms of glomerulonephritis were treated for 3 months with MMF (90 mg/kg/day) dissolved in a vehicle. Controls were age- and sex-matched mice (n = 6) that received the vehicle alone. By reverse-transcription competitive polymerase chain reaction, we found that the renal cortical iNOS/beta-actin mRNA ratio was reduced by 30.8% (P <.05) in MMF-treated mice. Furthermore, MMF significantly reduced urinary nitrite production and degree of glomerulosclerosis. The glomerular volume was reduced by 17.5% (P <.001). Proteinuria was also significantly reduced in the MMF-treated group. However, by electrophoretic mobility shift assay, the nuclear binding of nuclear factor-kappaB (NF-kappaB) was not affected by MMF treatment. We conclude that in addition to its immunosuppressive action, MMF may reduce renal cortical iNOS mRNA expression and diminish glomerulosclerosis in MRL/lpr mice independent of modulation of the NF-kappaB pathway.
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Affiliation(s)
- C C Yu
- Department of Nephrology, Chang Gung Memorial Hospital, 199 Tung-Hwa North Road, Taipei, 105, Taiwan
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Wu MS, Bens M, Yu HM, Vandewalle A. Cyclosporine reduces basolateral, but not apical, nitric oxide secretion in medullary thick ascending limb cells. Transpl Int 2001; 13 Suppl 1:S321-3. [PMID: 11112023 DOI: 10.1007/s001470050352] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Cyclosporine (CsA) reduces nitric oxide (NO) production in medullary thick ascending limb (mTAL) cells. We postulated that CsA affected NO secretion in a vectorial manner in polarized renal epithelial cells. The experiments were performed in a model of mTAL subcultured cells. The expression of iNOS in mTAL cells was confirmed by RT-PCR. The cells were grown on a non-permeable filter. Nitrite was measured by the modified Griess method. Transepithelial resistance was measured to ensure the integrity of the tight junction. CsA (100 ng/ml) reduced NO production by 22% in mTAL cells. The inhibitory effect was limited to the basolateral side (control: 165 +/- 11; plus CsA: 93 +/- 17 nM/10(6) cells, P < 0.001) without affecting apical NO secretion. The transepithelial resistance through the epithelial monolayer remained unchanged in CsA-treated cells. CsA reduced basolateral NO secretion without affecting apical secretion. The results suggest that CsA might affect intrarenal hemodynamics at the peritubular level.
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Affiliation(s)
- M S Wu
- Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan.
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Affiliation(s)
- Y T Chang
- National Taiwan University Hospital, Taipei, Taiwan
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Tien YW, Chang KJ, Jeng YM, Lee PH, Wu MS, Lin JT, Hsu SM. Tumor angiogenesis and its possible role in intravasation of colorectal epithelial cells. Clin Cancer Res 2001; 7:1627-32. [PMID: 11410499] [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: 02/20/2023]
Abstract
PURPOSE To determine whether an increase in tumor angiogenesis facilitates intravasation of colorectal epithelial cells, we compared intratumoral microvessel counts with the presence of circulating colorectal epithelial cells in the portal venous blood from patients with colorectal carcinomas. EXPERIMENTAL DESIGN Circulating colorectal epithelial cells were detected by a reverse transcription-PCR assay to amplify guanylyl cyclase C (GCC) transcripts. The extent of tumor vascularization was quantitatively assessed by immunohistochemical staining with anti-CD31 antibody. RESULTS Colorectal epithelial cells (as measured by GCC mRNA expression) were detected in the portal venous blood in 30 of 58 patients (52%). The mean (+/- SD) microvessel count in the tumors from patients with expression of GCC mRNA in their portal venous blood was 82.74 +/- 24.97. The corresponding values in the tumors from patients without expression of GCC mRNA in portal venous blood was 65.96 +/- 19. For each 10-microvessel increase per x200 field, the risk of colorectal epithelial cell presence in the portal venous blood increased 1.52-fold (95% confidence interval, 1.19-2.12; P = 0.005). CONCLUSION High intratumoral vessel count was noted to be a valuable factor for predicting the presence of colorectal epithelial cells in the portal venous blood.
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Affiliation(s)
- Y W Tien
- Departments of Surgery, National Taiwan University, Taipei 10002, Taiwan
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Cheng YS, Pan S, Lien GS, Suk FM, Wu MS, Chen JN, Chen SH. Adjuvant sclerotherapy after ligation for the treatment of esophageal varices: a prospective, randomized long-term study. Gastrointest Endosc 2001; 53:566-71. [PMID: 11323580 DOI: 10.1067/mge.2001.114061] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND To assess the efficacy of adjuvant sclerotherapy after banding for the treatment of esophageal varices, a randomized trial was carried out of endoscopic variceal ligation (EVL) alone with sequential sclerotherapy versus sequential ligation-sclerotherapy (SLS) after banding with respect to variceal eradication, associated complications, and recurrence of varices. METHODS One hundred patients qualified for this study. Fourteen patients were not included for the following reasons: 6 chose not to participate, 4 had fundal varices, and 4 had some form of cancer. Of the remaining 86 patients in the study, 42 underwent EVL alone and the other 44 SLS. Variceal ligation was begun in the region of the gastroesophageal junction, with subsequent ligatures applied cephalad 3 to 5 cm; ligation was repeated every 2 weeks until variceal obliteration. For SLS, ligation was also begun in the region of the gastroesophageal junction and repeated until varices were reduced to F1 size. Subsequently, these patients underwent sclerotherapy with between 6 and 8 mL of sodium tetradecyl sulfate (free hand technique). RESULTS No significant differences were found between EVL alone and SLS with regard to variceal eradication, development of associated complications, and recurrent bleeding during a follow-up of 2 years. The probability of variceal recurrence requiring further treatment after 1 year was 14% for the SLS group and 26% for EVL group patients. Another year later, the probability of variceal recurrence was 24% and 45%, respectively, for the SLS and EVL groups. CONCLUSIONS Because a significantly lower rate of variceal recurrence was found for SLS patients, sequential sclerotherapy followed by ligation to eradicate those varices too small to easily band may be a better procedure.
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Affiliation(s)
- Y S Cheng
- Department of Internal Medicine, Taipei Medical University, Taiwan
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Chang MC, Chang YT, Wu MS, Shun CT, Tien YW, Lin JT. K-ras mutation at codon 12 in stage I pancreatic adenocarcinoma: analysis by laser capture microdissection and direct sequencing. J Formos Med Assoc 2001; 100:352-4. [PMID: 11432318] [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: 02/20/2023] Open
Abstract
Pancreatic ductal adenocarcinoma has been reported to carry a rate mutation high in codon 12 of the K-ras oncogene. To avoid the pitfalls of conventional methods of tissue dissection that might affect the sensitivity and specificity of detecting K-ras mutation, laser capture microdissection (LCM) technique was used. Pancreatic adenocarcinoma tissues were obtained from 15 patients who underwent Whipple's procedure. Selected tissues procured by LCM were analyzed by direct sequencing after polymerase chain reaction amplification of K-ras sequences at codon 12. K-ras mutation was noted in nine patients. All mutations showed G to A substitution at codon 12. The mutational pattern (GGT to GAT) is similar in both western and eastern reports. LCM is a feasible method to effectively obtain pure tumor cells from a surgical specimen. It remains to be determined whether this low mutation rate is a result of relatively early stage of disease or different carcinogenesis in different geographic regions.
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Affiliation(s)
- M C Chang
- Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan
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Hibino H, Tani K, Sugiyama H, Suzuki S, Wu MS, Izawa K, Hase H, Nakazaki Y, Tanabe T, Ooi J, Izeki T, Tojo A, Saitoh I, Tanioka Y, Asano S. Haematopoietic progenitor cells from the common marmoset as targets of gene transduction by retroviral and adenoviral vectors. Eur J Haematol 2001; 66:272-80. [PMID: 11380607 DOI: 10.1034/j.1600-0609.2001.066004272.x] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To establish a new non-human primate model for human cytokine and gene therapy, we characterized lymphocytes and haematopoietic progenitor cells of the small New World monkey, the common marmoset. We first assessed the reactions of marmoset bone marrow (BM) and peripheral blood (PB) cells to mouse anti-human monoclonal antibodies (mAbs) for the purpose of isolating marmoset lymphocytes and haematopoietic progenitor cells. Both cell fractions stained with CD4 and CD8 mAbs were identified as lymphocytes by cell proliferation assay and morphological examination. Myeloid-specific mAbs such as CD14 and CD33 did not react with marmoset BM and PB cells. No available CD34 and c-kit mAbs could be used to purify the marmoset haematopoietic progenitor cells. Furthermore, we studied the in vitro transduction of the bacterial beta-galactosidase (LacZ) gene into CFU-GM derived from marmoset BM using retroviral and adenoviral vectors. The transduction efficiency was increased by using a mixed culture system consisting of marmoset BM stromal cells and retroviral producer cells. It was also possible to transduce LacZ gene into marmoset haematopoietic progenitor cells with adenoviral vectors as well as retroviral vectors. The percentage of adenovirally transduced LacZ-positive clusters was 15% at day 4 (multiplicity of infection=200), but only 1-2% at day 14. The differential use of viral vector systems is to be recommended in targeting different diseases. Our results suggested that marmoset BM progenitor cells were available to examine the transduction efficiency of various viral vectors in vitro.
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Affiliation(s)
- H Hibino
- Department of Hematology/Oncology, Institute of Medical Science, The University of Tokyo, Central Institute for Experimental Animals Laboratories Inc., Kawasaki, Kanagawa, Japan
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Abstract
The early renal response to unilateral ureteral occlusion (UUO) and its mechanism have been extensively studied in dogs but seldom discussed in the most frequently used laboratory animals, rats. The acute phase of the renal response to UUO was studied in female rats weighing 190-236 g. We recorded the ureteral pressure and changes in renal parameters throughout 120 minutes of UUO in control (US, UUO + saline, n = 10), L-arginine-treated (UA, n = 10), and right-nephrectomized rats (UO, UUO in one kidney, n = 9). Ureteral pressure increased in all three groups of rats after complete ureteral obstruction. The extent of the increase was not significantly different between US and UA rats but was significantly higher in the UO rats. In US rats, the cortical microvascular blood flow (CMVBF), measured by a laser Doppler flowmeter, declined significantly, from 321 +/- 10 perfusion units (PU) to 260 +/- 11 PU. The percentage of drop in CMVBF at 120 minutes of UUO was significantly greater in UO (25.7 +/- 3.8 %) than in US (19 +/- 2.1%) and in UA (14 +/- 2%) rats. Acute UUO reduced the glomerular filtration rate (GFR) in US and UO rats, whereas L-arginine attenuated this decrease. The excretion of nitrate/nitrite was increased after UUO. Giving N(G)-nitro-L-arginine methyl ester hydrochloride (L-NAME, 12 mg/kg/h) during UUO did not reduce CMVBF more severely. Western blot analysis of endothelial nitric oxide synthase expression in the renal cortex and medulla protein extracts revealed no differences between US and sham-operated rats. Acute UUO did not lead to renal hyperemia in rats. Reduction of nitric oxide during UUO might contribute to the decrease of renal circulation during UUO.
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Affiliation(s)
- C F Chen
- Department of Physiology, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.
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Abstract
Depending on its location, epiploic appendagitis may mimic nearly any acute abdominal condition. We present the case of a patient with left lower quadrant pain. Sonography demonstrated an ovoid, hyperechoic, noncompressible lesion at the point of tenderness but no inflammatory changes in the adjacent colonic wall. Color Doppler sonography showed no flow in the lesion. Based on the sonographic diagnosis of epiploic appendagitis, conservative treatment was given, with complete recovery in 5 days. Awareness of these sonographic findings may aid in the early diagnosis of epiploic appendagitis and avoid unnecessary treatment.
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Affiliation(s)
- Y C Lee
- Department of Emergency Medicine, College of Medicine, National Taiwan University, 1, Jen-Ai Road, Taipei, Taiwan
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Abstract
BACKGROUND/AIMS In spite of the better efficiency of on-line hemodiafiltration (HDF) compared with conventional hemodialysis (HD), it is relatively expensive. The aim of this study was to assess the advantages in the biochemical, hemodynamic and clinical effects in uremic patients treated with on-line HDF and with different frequencies of combination high-flux HD. METHODS One hundred eleven patients were divided into four groups receiving different frequencies of on-line HDF (thrice, twice, once per week) and high-flux HD. RESULTS Hemodynamic parameters including maximum drop of systolic blood pressure, episodes of symptomatic hypotension and mean saline infusion volumes during dialysis were reduced when frequencies of on-line HDF were increased. Significant improvements in urea kinetic were observed when frequencies of on-line HDF were increased. On-line HDF significantly reduced the amount of erythropoietin needed and improved intra- and inter-dialysis symptoms, physical well-being, menstruation and skin pigmentation when frequency of HDF is increased to three time per week. CONCLUSION On-line HDF offers a better cardiovascular stability and clinical improvement. Thrice weekly on-line HDF offers a significant benefit when compared with lower frequencies of HDF per week and high-flux HD.
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Affiliation(s)
- C L Lin
- Department of Nephrology. Chang Gung Memorial Hospital, Taipei, Taiwan
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Wu CH, Huang CC, Wu MS, Yang CW, Huang JY, Fang JT, Leu ML. Total creatinine appearance as indicator of risk of infectious complication in peritoneal dialysis. Adv Perit Dial 2001; 16:219-22. [PMID: 11045298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Peritonitis and exit-site infections are the main causes of complications in peritoneal dialysis. Death due to infectious complication is also one of the major causes of drop-out. The underlying cause of infection may include malnutrition. Total creatinine appearance (TCA) may reflect overall nutritional status. We determined TCA from the daily dialysate, urine, and estimated gut creatinine of patients and normalized it to actual body weight (nTCA). We examined the relationship between nTCA and the incidence of infection, and between nTCA and infection-related survival. The study included 323 adult patients in a single dialysis center. The mean nTCA of all patients was 19.73 +/- 4.75 mg/kg/day. The patients with an nTCA below 1 standard deviation from the mean (nTCA < 14.98 mg/kg/day) had a significantly higher peritonitis and exit-site infection rate (p < 0.01) and a higher chance of drop-out owing to infection-related complications (p < 0.0001). Our study concluded that the adult patient with malnutrition (nTCA < 14.98 mg/kg/day) has higher risk of infection.
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Affiliation(s)
- C H Wu
- Division of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan
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Wu MS, Chang MC, Huang SP, Tseng CC, Sheu JC, Lin YW, Shun CT, Lin MT, Lin JT. Correlation of histologic subtypes and replication error phenotype with comparative genomic hybridization in gastric cancer. Genes Chromosomes Cancer 2001. [PMID: 11107179 DOI: 10.1002/1098-2264(2000)9999:9999<::aid-gcc1062>3.0.co;2-r] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
To characterize phenotypic and genotypic changes in gastric cancer (GC), DNA copy number aberrations (CNAs) were assessed in 53 tumors using comparative genomic hybridization (CGH) and correlated with clinicopathologic characteristics and status of TP53 and replication error (RER). The number of CNAs per tumor was 6.8 (gain 5.3, loss 1.5), and the number of changes was significantly higher in tumors with advanced stage, TP53 mutation, and without RER than in those with early stage (7.7 vs. 3.0), no TP53 mutations (12.4 vs. 4.8) or RER phenotype (8.2 vs. 2.6). Frequent abnormalities included gains on chromosomal arms 8q (43%), 6q (26%), 11q (26%), 13q (24%), 7p (23%), 17q (23%), and 20q (23%), and losses on chromosomal arms 16q (26%), 19p (23%), 5q (19%), 3p (15%), 4q(15%), and 1p (15%). Advanced GC demonstrated a higher prevalence of gains of 8q (51% vs. 10%, P < 0.05) and loss of 16q (33% vs. 0%, P < 0.05) than early GC. Gains on 8q (64% vs. 20%, P < 0.05), 17q (39% vs. 4%, P < 0.05) and losses on 3p (25% vs. 4%, P = 0.05) and 5q (32% vs. 4%, P < 0.05) were higher in intestinal GC than in diffuse GC. On the other hand, gains on 13q were more common in the diffuse type (40% vs. 11%, P < 0.05). As compared with noncardia cancer, cardia cancer showed more gains on 7p (58% vs. 12%, P < 0.05) and 20q (58% vs. 12%, P < 0.05) and more losses on 4q (50% vs. 5%, P < 0.05). The finding of histology-related aberrations and the combination of CGH and molecular data thus provide additional evidence suggesting genetic heterogeneity of GC.
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Affiliation(s)
- M S Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Wu MS, Chang MC, Huang SP, Tseng CC, Sheu JC, Lin YW, Shun CT, Lin MT, Lin JT. Correlation of histologic subtypes and replication error phenotype with comparative genomic hybridization in gastric cancer. Genes Chromosomes Cancer 2001; 30:80-6. [PMID: 11107179 DOI: 10.1002/1098-2264(2000)9999:9999<::aid-gcc1062>3.0.co;2-r] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [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: 11/10/2022] Open
Abstract
To characterize phenotypic and genotypic changes in gastric cancer (GC), DNA copy number aberrations (CNAs) were assessed in 53 tumors using comparative genomic hybridization (CGH) and correlated with clinicopathologic characteristics and status of TP53 and replication error (RER). The number of CNAs per tumor was 6.8 (gain 5.3, loss 1.5), and the number of changes was significantly higher in tumors with advanced stage, TP53 mutation, and without RER than in those with early stage (7.7 vs. 3.0), no TP53 mutations (12.4 vs. 4.8) or RER phenotype (8.2 vs. 2.6). Frequent abnormalities included gains on chromosomal arms 8q (43%), 6q (26%), 11q (26%), 13q (24%), 7p (23%), 17q (23%), and 20q (23%), and losses on chromosomal arms 16q (26%), 19p (23%), 5q (19%), 3p (15%), 4q(15%), and 1p (15%). Advanced GC demonstrated a higher prevalence of gains of 8q (51% vs. 10%, P < 0.05) and loss of 16q (33% vs. 0%, P < 0.05) than early GC. Gains on 8q (64% vs. 20%, P < 0.05), 17q (39% vs. 4%, P < 0.05) and losses on 3p (25% vs. 4%, P = 0.05) and 5q (32% vs. 4%, P < 0.05) were higher in intestinal GC than in diffuse GC. On the other hand, gains on 13q were more common in the diffuse type (40% vs. 11%, P < 0.05). As compared with noncardia cancer, cardia cancer showed more gains on 7p (58% vs. 12%, P < 0.05) and 20q (58% vs. 12%, P < 0.05) and more losses on 4q (50% vs. 5%, P < 0.05). The finding of histology-related aberrations and the combination of CGH and molecular data thus provide additional evidence suggesting genetic heterogeneity of GC.
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Affiliation(s)
- M S Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Abstract
Acinar cell carcinoma is an uncommon malignancy with a reported incidence of 1% among exocrine tumors of the pancreas. The case of a 60-year-old Taiwanese man who presented with obstructive jaundice, abdominal pain, and body weight loss is described here. A mixed clinical picture of islet cell tumor and ductal carcinoma of the pancreas was shown to be a hypervascular tumor at the pancreatic head region with an irregular stricture at the common channel of the common bile and pancreatic ducts. The patient had normal levels of plasma carcinoembryonic antigen, carbohydrate antigen 19-9, alpha-fetoprotein, but an increase in plasma levels of insulin and C-peptide. Immunohistochemical stains and electron microscopic examination of the tumor was consistent with acinar cell carcinoma.
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Affiliation(s)
- J D Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei
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Affiliation(s)
- C W Hsu
- Department of Nephrology, Chang Gung Memorial Hospital, Taipei, Taiwan
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Abstract
The cause of hypereosinophilia (EO) in hemodialysis (HD) patients is multifactorial and is felt to be a benign laboratory abnormality related to dialysis or uremia. Kimura disease (KD) is an angiolymphoid proliferative disorder of unknown etiology. Many cases are associated with nephrotic syndrome in children; however, it has seldom been reported in children on dialysis. We report here a 13-year-old boy who developed persistent EO and subsequent anemia after maintenance HD; he later developed KD. The atypical clinical manifestation of KD and its relationship to HD and erythropoietin hyposensitive anemia in this patient are discussed.
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Affiliation(s)
- C C Hung
- Department of Nephrology, Chang Gung Memorial Hospital, 5, Fu Hsing Street, Kuei-Shan Hsian, Taoyuan, Taiwan.
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Wang HP, Huang SP, Sun MS, Chen JH, Wang HH, Lin CC, Chang YS, Yang CS, Wu MS, Lin JT. Urgent endoscopic nasobiliary drainage without fluoroscopic guidance: A useful treatment for critically ill patients with biliary obstruction. Gastrointest Endosc 2000; 52:741-4. [PMID: 11115906 DOI: 10.1067/mge.2000.109800] [Citation(s) in RCA: 12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND Endoscopic nasobiliary drainage (ENBD) is routinely performed under fluoroscopic control. This is a report of our experience with urgent ENBD without fluoroscopic guidance in critically ill patients. METHODS Twenty-six critically ill patients who underwent urgent ENBD for biliary obstruction were analyzed. ENBD was performed without fluoroscopic control because of high risk of transportation or inaccessibility of the x-ray facilities. A pig-tailed nasobiliary catheter was inserted into the bile duct with the help of a guidewire under endoscopic control to bypass the site of obstruction. Successful placement was confirmed by free flow of bile on aspiration via the nasobiliary catheter. RESULTS A nasobiliary catheter was successfully placed in 23 patients (88%). Adequate bile drainage was achieved in 20 patients with an overall success rate of 77%. There were no procedure-related complications. The mortality rate for patients with successful biliary drainage was 10% (2 of 20), in contrast to 83% (5 of 6) for the group in which drainage was unsuccessful. CONCLUSIONS Urgent ENBD is effective for patients with biliary obstruction. With experience, this procedure may be successfully performed in critically ill patients without fluoroscopic guidance at primary care hospitals or intensive care units where fluoroscopic facilities are not readily available.
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Affiliation(s)
- H P Wang
- Departments of Emergency Medicine and Internal Medicine, National Taiwan University Hospital, Taipei
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Chan P, Chang JJ, Chen FC, Wu MS, Tomlinson B, Cheng JT. Effects of trilinolein on superoxide dismutase activity and mrna levels in aortic smooth muscle cells. Clin Exp Pharmacol Physiol 2000; 27:1002-6. [PMID: 11117219 DOI: 10.1046/j.1440-1681.2000.03385.x] [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: 11/20/2022]
Abstract
1. Atherosclerotic cardiovascular disease is still the leading cause of death in Western countries. Oxygen free radicals are considered to be intimately involved in the development of atherosclerosis. Anti-oxidants may help to protect mammalian cells from the damage induced by these reactive oxygen species. Many reports have indicated that anti-oxidants used in the treatment or prevention of disease could modify the levels of superoxide dismutase (SOD). However, the effects of long-term anti-oxidant treatment on the levels of SOD in smooth muscle cells (SMC) is still unclear. In the present study, the effects of the lipophilic anti-oxidant trilinolein on the activity and gene expression of SOD in SMC were evaluated. 2. After 2 days incubation with 0.1 micromol/L trilinolein, the activity and mRNA levels of SOD were increased in rat aortic SMC (A7r5), but there was no significant change in these parameters with a higher concentration of 1 micromol/L trilinolein. 3. In contrast, after 7 days incubation with trilinolein, both the activity and mRNA levels of SOD were lowered in a dose-dependent manner. 4. These data emphasize the importance of choosing an optimal dosage for supplementation with anti-oxidants in humans for the scavenging of oxygen free radicals.
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Affiliation(s)
- P Chan
- Division of Cardiovascular Medicine and Surgery, Wan Fang Hospital, Taiwan
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Roy MJ, Wu MS, Barr LJ, Fuller JT, Tussey LG, Speller S, Culp J, Burkholder JK, Swain WF, Dixon RM, Widera G, Vessey R, King A, Ogg G, Gallimore A, Haynes JR, Heydenburg Fuller D. Induction of antigen-specific CD8+ T cells, T helper cells, and protective levels of antibody in humans by particle-mediated administration of a hepatitis B virus DNA vaccine. Vaccine 2000; 19:764-78. [PMID: 11115698 DOI: 10.1016/s0264-410x(00)00302-9] [Citation(s) in RCA: 255] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
A DNA vaccine against the hepatitis B virus (HBV) was evaluated for safety and induction of immune responses in 12 healthy, hepatitis-naïve human volunteers using the needle-free PowderJect system to deliver gold particles coated with DNA directly into cells of the skin. Three groups of four volunteers received three administrations of DNA encoding the surface antigen of HBV at one of the three dose levels (1, 2, or 4 microg). The vaccine was safe and well tolerated, causing only transient and mild to moderate responses at the site of administration. HBV-specific antibody and both CD4+ and CD8+ T cell responses were measured before and after each immunization. All the volunteers developed protective antibody responses of at least 10 mIU/ml. In volunteers who were positive for the HLA class I A2 allele, the vaccine also induced antigen-specific CD8+ T cells that bound HLA-A2/HBsAg(335-343) tetramers, secreted IFN-gamma, and lysed target cells presenting a hepatitis B surface antigen (HBsAg) CTL epitope. Enumeration of HBsAg-specific T cells producing cytokine indicated preferential induction of a Type 1 T helper cell response. These results provide the first demonstration of a DNA vaccine inducing protective antibody titers and both humoral and cell-mediated immune responses in humans.
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Affiliation(s)
- M J Roy
- PowderJect Vaccines Inc., 585 Science Drive, Madison, WI 53711, USA
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