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Ciavattone NG, Guan N, Farfel A, Stauff J, Desmond T, Viglianti BL, Scott PJ, Brooks AF, Luker GD. Evaluating immunotherapeutic outcomes in triple-negative breast cancer with a cholesterol radiotracer in mice. JCI Insight 2024; 9:e175320. [PMID: 38502228 DOI: 10.1172/jci.insight.175320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
Evaluating the response to immune checkpoint inhibitors (ICIs) remains an unmet challenge in triple-negative breast cancer (TNBC). The requirement for cholesterol in the activation and function of T cells led us to hypothesize that quantifying cellular accumulation of this molecule could distinguish successful from ineffective checkpoint immunotherapy. To analyze accumulation of cholesterol by T cells in the immune microenvironment of breast cancer, we leveraged the PET radiotracer, eFNP-59. eFNP-59 is an analog of cholesterol that our group validated as an imaging biomarker for cholesterol uptake in preclinical models and initial human studies. In immunocompetent mouse models of TNBC, we found that elevated uptake of exogenous labeled cholesterol analogs functions as a marker for T cell activation. When comparing ICI-responsive and -nonresponsive tumors directly, uptake of fluorescent cholesterol and eFNP-59 increased in T cells from ICI-responsive tumors. We discovered that accumulation of cholesterol by T cells increased in ICI-responding tumors that received anti-PD-1 checkpoint immunotherapy. In patients with TNBC, tumors containing cycling T cells had features of cholesterol uptake and trafficking within those populations. These results suggest that uptake of exogenous cholesterol analogs by tumor-infiltrating T cells allows detection of T cell activation and has potential to assess the success of ICI therapy.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Gary D Luker
- Department of Radiology, and
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
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Ciavattone NG, Guan J, Farfel A, Desmond T, Viglianti BL, Scott PJ, Brooks AF, Luker GD. Predicting efficacy of immunotherapy in mice with triple negative breast cancer using a cholesterol PET radiotracer. bioRxiv 2023:2023.10.02.560577. [PMID: 37873149 PMCID: PMC10592945 DOI: 10.1101/2023.10.02.560577] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Predicting the response to cancer immunotherapy remains an unmet challenge in triple-negative breast cancer (TNBC) and other malignancies. T cells, the major target of current checkpoint inhibitor immunotherapies, accumulate cholesterol during activation to support proliferation and signaling. The requirement of cholesterol for anti-tumor functions of T cells led us to hypothesize that quantifying cellular accumulation of this molecule could distinguish successful from ineffective checkpoint immunotherapy. To analyze accumulation of cholesterol by T cells in the immune microenvironment of breast cancer, we leveraged a novel positron emission tomography (PET) radiotracer, FNP-59. FNP-59 is an analog of cholesterol that our group has validated as an imaging biomarker for cholesterol uptake in pre-clinical models and initial human studies. In immunocompetent mouse models of TNBC, we found that elevated uptake of exogenous labeled cholesterol analogs functions as a marker for T cell activation. When comparing immune checkpoint inhibitor (ICI)-responsive EO771 tumors to non-responsive AT-3 tumors, we found significantly higher uptake of a fluorescent cholesterol analog in T cells of the ICI-responsive tumors both in vitro and in vivo. Using the FNP-59 radiotracer, we discovered that accumulation of cholesterol by T cells increased further in ICI-responding tumors that received ant-PD-1 checkpoint immunotherapy. We verified these data by mining single cell sequencing data from patients with TNBC. Patients with tumors containing cycling T cells showed gene expression signatures of cholesterol uptake and trafficking. These results suggest that uptake of exogenous cholesterol analogs by tumor-infiltrating T cells predict T cell activation and success of ICI therapy.
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Knudsen GM, Ganz M, Appelhoff S, Boellaard R, Bormans G, Carson RE, Catana C, Doudet D, Gee AD, Greve DN, Gunn RN, Halldin C, Herscovitch P, Huang H, Keller SH, Lammertsma AA, Lanzenberger R, Liow JS, Lohith TG, Lubberink M, Lyoo CH, Mann JJ, Matheson GJ, Nichols TE, Nørgaard M, Ogden T, Parsey R, Pike VW, Price J, Rizzo G, Rosa-Neto P, Schain M, Scott PJ, Searle G, Slifstein M, Suhara T, Talbot PS, Thomas A, Veronese M, Wong DF, Yaqub M, Zanderigo F, Zoghbi S, Innis RB. Guidelines for the content and format of PET brain data in publications and archives: A consensus paper. J Cereb Blood Flow Metab 2020; 40:1576-1585. [PMID: 32065076 PMCID: PMC7370374 DOI: 10.1177/0271678x20905433] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
It is a growing concern that outcomes of neuroimaging studies often cannot be replicated. To counteract this, the magnetic resonance (MR) neuroimaging community has promoted acquisition standards and created data sharing platforms, based on a consensus on how to organize and share MR neuroimaging data. Here, we take a similar approach to positron emission tomography (PET) data. To facilitate comparison of findings across studies, we first recommend publication standards for tracer characteristics, image acquisition, image preprocessing, and outcome estimation for PET neuroimaging data. The co-authors of this paper, representing more than 25 PET centers worldwide, voted to classify information as mandatory, recommended, or optional. Second, we describe a framework to facilitate data archiving and data sharing within and across centers. Because of the high cost of PET neuroimaging studies, sample sizes tend to be small and relatively few sites worldwide have the required multidisciplinary expertise to properly conduct and analyze PET studies. Data sharing will make it easier to combine datasets from different centers to achieve larger sample sizes and stronger statistical power to test hypotheses. The combining of datasets from different centers may be enhanced by adoption of a common set of best practices in data acquisition and analysis.
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Affiliation(s)
- Gitte M Knudsen
- Neurobiology Research Unit, Rigshospital and University of Copenhagen, Copenhagen, Denmark
| | - Melanie Ganz
- Neurobiology Research Unit, Rigshospital and University of Copenhagen, Copenhagen, Denmark
| | - Stefan Appelhoff
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Guy Bormans
- Laboratory for Radiopharmaceutical Research, KU, Leuven, Belgium
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, USA
| | - Ciprian Catana
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Department of Radiology, Boston, MA, USA
| | - Doris Doudet
- Department of Medicine/Neurology, Pacific Parkinson Research Center, Vancouver, Canada
| | - Antony D Gee
- Clinical PET Centre, King's College London, London, UK
| | - Douglas N Greve
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Department of Radiology, Boston, MA, USA
| | - Roger N Gunn
- Invicro and Division of Brain Sciences, Imperial College London, London, UK
| | - Christer Halldin
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Peter Herscovitch
- Department of Positron Emission Tomography, National Institutes of Health, Bethesda, USA
| | - Henry Huang
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, USA
| | - Sune H Keller
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Jeih-San Liow
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, USA
| | | | - Mark Lubberink
- Uppsala University, Department of Surgical Sciences/Radiology and Nuclear Medicine, Uppsala University Hospital, Department of Medical Physics, Sweden
| | - Chul H Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - J John Mann
- Department of Psychiatry, Molecular Imaging and Neuropathology Division, Columbia University, New York, USA
| | - Granville J Matheson
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm County Council, Stockholm, Sweden
| | - Thomas E Nichols
- Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Population Health, University of Oxford, UK
| | - Martin Nørgaard
- Neurobiology Research Unit, Rigshospital and University of Copenhagen, Copenhagen, Denmark
| | - Todd Ogden
- Columbia Mailman School of Public Health, Columbia University, New York, USA
| | - Ramin Parsey
- Department of Psychiatry, School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Victor W Pike
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, USA
| | - Julie Price
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital/Harvard Medical School, Department of Radiology, Boston, MA, USA
| | - Gaia Rizzo
- Invicro and Division of Brain Sciences, Imperial College London, London, UK
| | - Pedro Rosa-Neto
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada.,Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging, Douglas Mental Health University Institute, Montreal, Canada
| | - Martin Schain
- Columbia Mailman School of Public Health, Columbia University, New York, USA
| | - Peter Jh Scott
- Department of Radiology, University of Michigan, Ann Arbor, USA
| | - Graham Searle
- Invicro and Division of Brain Sciences, Imperial College London, London, UK
| | - Mark Slifstein
- Department of Psychiatry, School of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Tetsuya Suhara
- Institute for Quantum Life Science, National Institute for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Peter S Talbot
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Adam Thomas
- National Institute of Mental Health, Bethesda, USA
| | - Mattia Veronese
- Centre for Neuroimaging Sciences, King's College London, London, UK
| | - Dean F Wong
- Department of Radiology, Johns Hopkins Hospital, Baltimore, USA
| | - Maqsood Yaqub
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Sami Zoghbi
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, USA
| | - Robert B Innis
- Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, USA
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Abstract
Thirty chronic leg ulcers have been studied under controlled conditions until complete healing occurred. Measurement was performed weekly using a computer-linked stereocamera which is capable of measuring skin defects noninvasively with errors of less than 2%. There was a significant difference in healing rate for the first two weeks between clean ulcers entering the trial directly and ulcers admitted first for cleansing before joining the trial. The difference suggests that the weekly healing rate of an ulcer may take up to 2 weeks to respond to a new form of treatment. Absolute ulcer size, change in ulcer size and rate of epithelial migration did not correlate well with time to complete healing, but percentage change in area in the third week was found to be the parameter which gave the earliest close correlation with time to complete healing. Using this parameter, on the data available it was found that time to complete healing could be predicted to within one week for 50% of the ulcers, making this a simple and useful early predictor of treatment efficiency.
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Abstract
This paper describes a curricular model to support the production of quality research and development of occupational therapy professional students, prepared to become leaders in the production and utilization of evidence for practice. This model is designed for programs with faculty challenged by the dual mandate of program excellence and expectations for scholarly productivity needed for tenure and promotion: typically programs at research universities. The essence of the model is the paralleling of research and competencies for clinical practice where faculty and students participate as a community of scholars. It is based on the literature that addresses the tensions between achieving excellence in research and scholarly productivity, and excellence in teaching. The experience of one university with this model over a five-year period of time is shared with the student-faculty productivity outcomes. These outcomes include dissemination of 55 collaborative peer reviewed products and faculty has generated support for 25 paid graduate assistantships. The combination of student outcomes and faculty support for their research has strengthened the ability of the faculty to excel in meeting the University mandate of scholarship while providing a high quality professional educational program.
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Affiliation(s)
- P J Scott
- Occupational Therapy, Indiana University, Indianapolis, IN 46202, USA.
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Daly MJ, Finlay DD, Guldenring D, Scott PJ, Adgey AAJ, Harbinson MT. 042 EPICARDIAL POTENTIALS DERIVED FROM THE BODY SURFACE POTENTIAL MAP USING INVERSE ELECTROCARDIOGRAPHY IMPROVE DIAGNOSIS OF ACUTE MYOCARDIAL INFARCTION: A PROSPECTIVE STUDY. Heart 2013. [DOI: 10.1136/heartjnl-2013-304019.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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7
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Zeman MN, Scott PJ. Current imaging strategies in rheumatoid arthritis. Am J Nucl Med Mol Imaging 2012; 2:174-220. [PMID: 23133812 PMCID: PMC3477730] [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] [Subscribe] [Scholar Register] [Received: 02/05/2012] [Accepted: 02/28/2012] [Indexed: 06/01/2023]
Abstract
As remission has now become a realistic therapeutic goal in the clinical management of RA due to the introduction and widespread adoption of biologic agents, there is a greater need for earlier diagnoses and objective methods for evaluating disease activity and response to treatment. In this capacity, advanced imaging strategies are assuming an expansive clinical role, particularly as they take advantage of newer imaging technologies and the shift toward imaging at the molecular level. Molecular imaging utilizes target-specific probes to non-invasively visualize molecular, cellular, and physiological perturbations in response to the underlying pathology. Probes for nuclear and MR imaging have been and are being developed that react with discrete aspects of inflammatory and destructive pathways specific to RA. These probes in addition to new MR sequences and contrast agents have the potential to provide an earlier and more reliable assessment of clinical outcome, disease activity, severity, and location, and therapeutic response. Furthermore, these imaging strategies may enable a more fundamental understanding of critical pathophysiological processes and the advent of new molecular therapies. This review will discuss these advances in both nuclear medicine and MRI strategies for imaging RA with a particular emphasis on molecular imaging.
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Affiliation(s)
- Merissa N Zeman
- Department of Radiology, University of Michigan Medical School Ann Arbor, MI, USA
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Wang J, Jiang X, Blunt LA, Leach RK, Scott PJ. Efficiency of adaptive sampling in surface texture measurement for structured surfaces. ACTA ACUST UNITED AC 2011. [DOI: 10.1088/1742-6596/311/1/012017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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9
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Scott PJ, Altenburger PA, Kean J. A collaborative teaching strategy for enhancing learning of evidence-based clinical decision-making. J Allied Health 2011; 40:120-127. [PMID: 21927777] [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] [Received: 08/09/2010] [Accepted: 06/09/2011] [Indexed: 05/31/2023]
Abstract
The educational literature cites a lack of student motivation to learn how to use research evidence in clinical decision-making because the students do not observe clinicians using evidence. This lack of motivation presents a challenge to educators as they seek to instill the value of evidence-based clinical decision-making (EBCD) in students. One problem is that students in entry-level programs do not have the experience needed to know what to look for, and secondly, clinical decision-making is contextually based in a patient problem. Our approach offers one solution to bridging the gap between classroom teaching and real-world implementation of EBCD through a three-phase collaborative approach. Occupational and physical therapy students are partnered with clinicians to find and appraise evidence to answer the real-world questions posed by these therapists. This paper describes the implementation of the partnership, teaching/learning outcomes, logistics, and implications for clinicians. We found this approach increased student motivation and greatly enhanced the learning experience. Future directions include implementing a framework which allows for the assessment of the strategy on the facility and creates opportunities to integrate the use of EBCD in all aspects of facility practice.
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Affiliation(s)
- P J Scott
- Department of Occupational Therapy, Indiana University, Indianapolis, IN 46208, USA.
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10
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Murphy JC, Scott PJ, Shannon HJ, Glover B, Dougan J, Walsh SJ, Adgey AAJ. ST elevation on the exercise ECG in patients presenting with chest pain and no prior history of myocardial infarction. Heart 2009; 95:1792-7. [PMID: 19570758 DOI: 10.1136/hrt.2008.163691] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the aetiology, and prognosis of ST-segment elevation (STE) on the exercise electrocardiogram in patients with chest pain without a prior history of myocardial infarction (MI). METHODS Between January 1998 and December 2005, 14 941 exercise stress tests were performed to assess chest pain in patients without a prior history of MI. Those who developed STE were identified. RESULTS STE occurred in 0.78% (116/14 941). Coronary angiography was performed in 108 patients. All patients had at least one severe coronary artery stenosis (>70%). The site of STE on exercise ECG was shown to be 95.4% predictive of a severe stenosis in the coronary artery supplying that area. Lateral STE was rare (1/116). Ninety-eight patients underwent revascularisation; 67 patients had percutaneous coronary intervention (PCI) and 31 underwent coronary artery bypass grafting (CABG). Follow-up included recording of death, MI, cerebrovascular event, heart failure and target vessel revascularisation. The projected 7-year event-free survival probability was 62.1% for those undergoing CABG, 77.1% for those who had PCI and 68.6% for those not undergoing revascularisation (no difference between these three groups, log rank p = 0.802). CONCLUSIONS STE on the exercise ECG is rare but specific for ischaemic heart disease and is predictive of a severe stenosis in the corresponding coronary artery. Prognosis is favourable following revascularisation.
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Affiliation(s)
- J C Murphy
- The Heart Centre, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland
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12
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13
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Smith GI, Brennan PA, Scott PJ, Ilankovan V. Outcome after radial forearm, gastro-omental, and jejunal free flaps in oral and oropharyngeal reconstruction. Br J Oral Maxillofac Surg 2002; 40:330-3. [PMID: 12175835 DOI: 10.1016/s0266-4356(02)00132-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We undertook a retrospective study of the outcome of radial forearm, gastro-omental, and jejunal free tissue transfer for oral and oropharyngeal reconstruction in 30 patients (10 in each group). No significant differences were found between the type of free flap and the clinical outcome. More long-term difficulties were experienced with swallowing than with speech. The selection of free flap did not correlate with speech function (P=0.44), swallowing (P=0.68), or management of saliva (P=0.59). No significant difference was found between the patients' outcome and the site of resection of the tumour. There were more complications after gastro-omental flaps and this may influence the choice of reconstruction.
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Affiliation(s)
- G I Smith
- Specialist Registrar in Maxillofacial Surgery, Poole Hospital NHS Trust, Poole, Dorset, UK.
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14
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Abstract
This article, prepared in honor of Daria Haust, reviews some features of research into atherosclerosis and coronary heart disease over the past 150 years, and beyond. Attention is drawn to problems arising when people of strong personality dominate a particular field of research to the exclusion of pertinent observations that do not fit neatly into their particular paradigm. As the world becomes more complex and, in theory at least, communications between scientists become easier, these dangers are not necessarily diminished. Clinical medicine in its broadest sense must continue to relate in the traditional way to the specialties grouped within pathology. Undergraduates must receive instruction concerning the importance of the historical record and an understanding of the nature of science, its strengths, limitations, and boundaries.
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Affiliation(s)
- P J Scott
- University of Auckland, New Zealand.
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15
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Simmons D, Scott PJ. Does the "Thunderbirds syndrome" still exist. N Z Med J 1998; 111:456-8. [PMID: 9891566] [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: 02/09/2023]
Abstract
Rationing of resources within both the private and public health care systems is a fact of life. The Thunderbirds TV series encapsulated an idealistic philosophy that life should be saved independent of the pecuniary cost. Doctors, in particular, are trapped between their role as advocates for the patient within the "Thunderbirds" philosophy and as citizens with a responsibility to use resources wisely. This dichotomy is challenged by point of care rationing, which can conflict with clinical responsibilities, undermines the patient-doctor relationship and is often undertaken in a clandestine manner. This form of controlling health costs is difficult to justify from an ethical perspective, particularly when other forms of health care rationing and expenditure are frequently modulated by political expediency and inadequate economic modelling. Indeed, focusing on improving quality and disease prevention, rather than reducing marginal costs can often control the long-term growth in health expenditure. Doctors have a responsibility to ensure that rationing decisions are made but these should be made as part of a transparent, evidence-based and democratic process away from the point of care. While the resources to implement the "Thunderbirds Syndrome" have never been available, the philosophy must remain at the heart of patient-doctor relationship.
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Affiliation(s)
- D Simmons
- South Auckland Academic Division, Middlemore Hospital
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16
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Scott PJ. Consensus viewpoint on the treatment of postmenopausal osteoporosis. The Ad Hoc Group on Osteoporosis. N Z Med J 1997; 110:397-9. [PMID: 9397085] [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: 02/05/2023]
Abstract
Treatment for postmenopausal osteoporosis should be offered to those with a history of fractures following minimal trauma or with a bone density significantly below the range seen in young normal adults. Underlying diseases contributing to the reduced bone density should be sought and treated appropriately. Lifestyle issues such as smoking, alcohol intake and exercise should be addressed. A calcium intake of at least 1.5 g/day should be achieved. Hormone replacement therapy is the first line pharmacological intervention. The bisphosphonates provide a satisfactory alternative for those unable or unwilling to take hormone replacement therapy.
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Affiliation(s)
- P J Scott
- Department of Medicine, University of Auckland
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17
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Abstract
1. The effects of catecholamines and some adrenoceptor agonists and antagonists on isolated preparations of human colonic smooth muscle obtained from surgical resections were examined. 2. Strips of circular smooth muscle displayed rhythmic myogenic spontaneous contractions which were inhibited by catecholamines with an order of potency of isoprenaline (1.0) > noradrenaline (0.32) > adrenaline (0.2). Phentolamine (0.7 microM) significantly shifted the noradrenaline concentration-response curve (CRC) to the right but had no significant effect on isoprenaline or adrenaline. Propranolol (1 microM) significantly shifted the isoprenaline to the right but had no significant effect on noradrenaline or adrenaline. 3. Salbutamol (30 microM) had no inhibitory effect on the spontaneous activity and ICI 118,551 (1 microM) had no effect on inhibitory responses to isoprenaline. Betaxolol (1 microM) significantly shifted the CRC to isoprenaline to the right. BRL 37344 had no effect on spontaneous activity. 4. Responsiveness of circular strips to catecholamines was not affected by age of the patient and no consistent differences between males and females were shown. 5. Strips of taenia coli exhibited little or no spontaneous phasic activity. Noradrenaline and isoprenaline relaxed KCl-induced tone. The effects of noradrenaline and isoprenaline were antagonized by propranolol but not by phentolamine. BRL 37344 had no effect on KCl-induced tone. 6. In conclusion, catecholamines relaxed spontaneous activity of human colon circular smooth muscle through an action on both alpha- and beta-adrenoceptors. The alpha-adrenoceptors were of the alpha 1-subtype. The beta-adrenoceptor-mediated relaxation appeared to be primarily beta 1. In taenia coli, catecholamines relaxed KCl-induced tone via beta-adrenoceptors only.
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MESH Headings
- Adrenergic alpha-Agonists/pharmacology
- Adrenergic beta-Agonists/pharmacology
- Adrenergic beta-Antagonists/pharmacology
- Albuterol/pharmacology
- Analysis of Variance
- Betaxolol/pharmacology
- Catecholamines/pharmacology
- Colon/chemistry
- Colon/drug effects
- Dose-Response Relationship, Drug
- Humans
- Isoproterenol/antagonists & inhibitors
- Isoproterenol/pharmacology
- Muscle Contraction/drug effects
- Muscle, Smooth/chemistry
- Muscle, Smooth/drug effects
- Norepinephrine/antagonists & inhibitors
- Norepinephrine/pharmacology
- Receptors, Adrenergic, alpha-1/drug effects
- Receptors, Adrenergic, alpha-1/physiology
- Receptors, Adrenergic, beta/drug effects
- Receptors, Adrenergic, beta/physiology
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Affiliation(s)
- A MacDonald
- Department of Biological Sciences, Glasgow Caledonian University, UK
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18
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Affiliation(s)
- R L Logan
- Hutt Valley Health, Lower Hutt, New Zealand
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19
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Curtis JL, Kim S, Scott PJ, Buechner-Maxwell VA. Adhesion receptor phenotypes of murine lung CD4+ T cells during the pulmonary immune response to sheep erythrocytes. Am J Respir Cell Mol Biol 1995; 12:520-30. [PMID: 7537969 DOI: 10.1165/ajrcmb.12.5.7537969] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Understanding the molecular mechanisms of pulmonary lymphocyte recruitment is a crucial step toward selective control of immune lung diseases and infections in immunocompromised hosts. To dissect these mechanisms, we are studying the response induced in primed C57BL/6 mice by intratracheal challenge with the T cell-dependent antigen, sheep red blood cells (SRBC). This study used four-parameter flow cytometry to examine expression by CD4+ murine T cells in peripheral blood and lungs of receptors known to be differentially expressed on primed human lymphocytes (CD2, CD11a, CD44, CD45RB, CD49d, and L-selectin). Compared with peripheral blood, more lung CD4+ T cells recovered by bronchoalveolar lavage (BAL) showed a primed phenotype. Judged by low expression of CD45RB or L-selectin, 76 to 90% of BAL CD4+ T cells were primed at all times. Adhesion receptor phenotype of CD4+ T cells in BAL and lung interstitium agreed closely, although BAL contained a greater percentage of primed cells. The percentage of CD4+ T cells with high expression of CD44+ and CD49d increased late in the response. However, when considering only upregulated adhesion receptors which might mediate recruitment, 22 to 52% of CD4+ T cells in BAL did not have increased adhesion receptor expression. Longer duration between priming and challenge did not increase adhesion receptor upregulation. High adhesion receptor expression was least evident during the periods of maximal lymphocyte influx, suggesting that factors other than increased surface density of organ-nonspecific adhesion receptors contribute to lymphocyte recruitment during pulmonary immune responses.
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Affiliation(s)
- J L Curtis
- Department of Internal Medicine, University of Michigan, Ann Arbor, USA
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20
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McDonald A, MacDonald E, Fulton JD, Wadsworth RM, Scott PJ, Howie KA. No evidence for a general change in contractile responsiveness of the mesenteric artery with aging. J Gerontol A Biol Sci Med Sci 1995; 50A:B20-5. [PMID: 7814775 DOI: 10.1093/gerona/50a.1.b20] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Rings of human mesenteric artery (1-3 mm diameter) suspended in Krebs solution were contracted (maximal contraction relative to KCl 80 mM = 100%) by the thromboxane mimetic U46619 (190 +/- 10%), noradrenaline (162 +/- 9%), angiotensin II (107 +/- 11%), and 5-hydroxytryptamine (5-HT) (96 +/- 10%). Reducing extracellular Ca2+ strongly inhibited the maximal contraction to angiotensin II and 5-HT and moderately inhibited the maximal contraction to noradrenaline, but had less effect on the maximal contraction to U46619 (contraction in Ca2+ 1.3 microM was reduced to 24 +/- 5, 20 +/- 3, 38 +/- 4 and 52 +/- 4% respectively of the contraction in 2.5 mM Ca2+). Reducing extracellular Ca2+ lowered sensitivity to 5HT, angiotensin II, and U46619, but did not alter sensitivity to noradrenaline. The EC50 and maximal contraction for each of the 4 agonists did not change with patient age at 2.5 mM Ca2+ or in reduced extracellular Ca2+. It is concluded that aging does not affect the responsiveness of mesenteric arterial smooth muscle to physiological vasoconstrictors.
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Affiliation(s)
- A McDonald
- Department of Physiology and Pharmacology, University of Strathclyde, Glasgow, Scotland
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21
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Abstract
Fifty-five elderly patients with chronic antral gastritis (CAG) were studied to assess the relationship between Helicobacter pylori (H. pylori) status and CAG subtypes as specified in the Sydney System for Gastritis Classification. Twenty-eight patients (51%) were H. pylori positive and 27 (49%) H. pylori negative. H. pylori-positive patients had a significantly greater association with features of severe active CAG (chronic inflammation and polymorph activity) than H. pylori-negative patients. No association was apparent between H. pylori and more advanced stages of CAG (atrophy and intestinal metaplasia) thought to carry pre-malignant potential. The recognized association between dyspeptic symptoms in elderly people and an H. pylori-positive gastritis was confirmed. Use of NSAIDs correlated with a predominantly H. pylori-negative gastritis which was relatively asymptomatic.
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Curtis JL, Huffnagle GB, Chen GH, Warnock ML, Gyetko MR, McDonald RA, Scott PJ, Toews GB. Experimental murine pulmonary cryptococcosis. Differences in pulmonary inflammation and lymphocyte recruitment induced by two encapsulated strains of Cryptococcus neoformans. J Transl Med 1994; 71:113-26. [PMID: 8041111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Cryptococcus neoformans, the most common cause of lethal mycosis in AIDS, usually causes only subclinical pneumonitis in normal hosts. However, cryptococcosis can induce various pulmonary inflammatory reactions, and pulmonary cellular immunity is postulated to prevent dissemination. We hypothesized that cryptococcal strains possess different capacities to induce recruitment to the lungs of inflammatory cells, especially lymphocytes, which are necessary for cryptococcal clearance. EXPERIMENTAL DESIGN We examined the pulmonary response of CBA/J mice to intratracheal inoculation with C. neoformans of either of two strains: 52D (ATCC 24067), which rarely kills immunocompetent mice; and 145A (ATCC 62070), which is uniformly fatal. From 2-42 days after inoculation, lungs were either examined grossly and microscopically or were enzymatically digested and inflammatory cells counted and analyzed by flow cytometry. At 42 days, organism burden in lung and brain was quantified by colony-forming unit assay. RESULTS Pulmonary inflammation differed greatly between the two strains. Strain 52D induced dense perivascular and alveolar inflammation; infection progressed to day 21 and then waned. In contrast, strain 145A induced delayed, meager lymphocytic infiltration and slight alveolitis; organisms grew progressively. Recovery of inflammatory cells increased by day 13 with strain 52D, but not until day 31 with strain 145A. Although all lymphocyte subsets were greater in 52D infection, the disparity was greatest for CD4+ T cells. Nevertheless, lymphocytes from paratracheal nodes of infected mice proliferated in vitro to heat-killed cryptococci, indicating immune recognition of both strains. At day 42, strain 52D lightly infected lungs but not brain, whereas strain 145A heavily infected lungs and brain. CONCLUSIONS; Cryptococcal strains differ in their capacity to induce pulmonary cellular inflammation, especially CD4+ T cell recruitment. Our results suggest that strain-specific difference in the organism's ability to induce (or evade) pulmonary inflammation contributes to the outcome of infection.
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Affiliation(s)
- J L Curtis
- Pulmonary Section, Department of Veterans Affairs Medical Center, Ann Arbor, MI
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23
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Scott PJ, Essop AR, al-Ashab W, Deaner A, Parsons J, Williams G. Imaging of pulmonary vascular disease by intravascular ultrasound. Int J Card Imaging 1993; 9:179-84. [PMID: 8106796 DOI: 10.1007/bf01145319] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
To assess the ability of intravascular ultrasound (IVUS) to image changes in the pulmonary arterial wall associated with pulmonary hypertension (PHT), 10 subjects requiring diagnostic right and left heart catheterization were studied. In addition to measurements of pulmonary artery pressure and pulmonary vascular resistance and pulmonary angiography, when indicated, all underwent simultaneous IVUS imaging in the pulmonary arterial system using a 20 MHz ultrasound transducer mounted on a 2 mm diameter catheter. Four patients had normal pulmonary artery pressures and 6 had varying degrees of PHT. Satisfactory ultrasound images were obtained in 9 out of the 10 patients. In those with normal pulmonary artery pressures ultrasound showed a thin vessel wall with no distinction between separate layers. In patients with systemic PHT, a three-layered vessel wall was apparent and areas compatible with intimal proliferation were seen. In a patient with pulmonary embolic disease areas consistent with mural thrombus were detected at sites of luminal narrowing on the pulmonary angiogram. IVUS is capable of imaging some of the morphological changes in the wall of the pulmonary artery known to occur in longstanding PHT and may therefore become a useful adjunct to haemodynamic measurements and pulmonary angiography for the in vivo assessment of pulmonary vascular disease.
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Affiliation(s)
- P J Scott
- Non-Invasive Heart Unit, Killingbeck Hospital, Leeds, West Yorkshire, UK
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24
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Abstract
Human mesenteric artery rings (1-3 mm diameter obtained from bowel resections), precontracted with KCl 80 mM, were relaxed by cromakalim (IC50 = 0.39 +/- 0.04 microM, maximum inhibition 69 +/- 2%). Cromakalim was more effective at inhibiting KCl 40 mM than KCl 80 mM. Cromakalim also inhibited contraction produced by noradrenaline, and was a more potent inhibitor of the second phase of the noradrenaline contraction than of the first phase.
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Affiliation(s)
- A McDonald
- Department of Physiology and Pharmacology, University of Strathclyde, Glasgow, Scotland, UK
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25
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Abstract
Two patients with apical hypertrophic cardiomyopathy presented with angina at rest and giant inverted T waves in precordial leads on the electrocardiogram. At cardiac catheterisation one patient had mild coronary artery disease, the other had normal coronary arteries. In both, there was a systolic pressure gradient between the apex and main left ventricular cavity exceeding 100 mmHg. The presence of rest angina with the electrocardiographic findings lead to a mistaken, initial diagnosis of acute subendocardial myocardial infarction.
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Affiliation(s)
- A A Cubukçu
- Killingbeck Hospital, Non-invasive Unit, Leeds, UK
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Affiliation(s)
- A R Essop
- Regional Ultrasound and Cardiac Unit, Killingbeck Hospital, Leeds, England
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Affiliation(s)
- S Kim
- Pulmonary and Critical Care Medicine Division, Department of Veterans Affairs, Ann Arbor
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Mitchell IM, Essop AR, Scott PJ, Martin PG, Gupta NK, Saunders NR, Nair RU, Williams GJ. Bovine internal mammary artery as a conduit for coronary revascularization: long-term results. Ann Thorac Surg 1993; 55:120-2. [PMID: 8417657 DOI: 10.1016/0003-4975(93)90485-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [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: 01/30/2023]
Abstract
Graft patency after coronary artery bypass grafting depends largely on the choice of conduit. Because an increasing number of patients have insufficient or poor-quality autologous material, there is a need for a suitable synthetic graft that is readily available and easy to handle and that has good long-term patency. Early results suggest that the bovine internal mammary artery graft may meet these criteria. We have used a total of 26 such grafts in 18 patients. Postoperative angiography has been performed in 19 grafts in 14 patients, 3 to 23 months after operation; of these grafts, 3 are currently patent (15.8%, compared with 85.7% and 75.0% patency for native internal mammary artery and saphenous vein grafts in the same patients). We report the results of clotting studies and an analysis of lipid status. These patients do not, however, appear to represent any atypical group, either in terms of coagulopathy, native coronary artery size, or the type of vessel disease. Nevertheless, our poor results contrast markedly with the early enthusiasm reported from other centers.
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Affiliation(s)
- I M Mitchell
- Departments of Cardiac Surgery and Cardiology, Killingbeck Hospital, Leeds, England
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29
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Leslie C, Scott PJ, Caird FI. Principal alterations to drug kinetics and dynamics in the elderly. Med Lab Sci 1992; 49:319-25. [PMID: 1339936] [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: 12/26/2022]
Abstract
People over the age of 64 constitute 15% of the population in the UK, yet they consume approximately 30% of all National Health Service drug prescriptions, and adverse drug reactions account for 10.4% of all admissions to geriatric medical assessment wards. Many published studies concerning the pharmacology of old age are seriously flawed. Problems include failure to measure the drug bio-availability and the selection of subjects with overt or sub-clinical disease. It is difficult to make general rules about the effect of ageing on drug kinetics and dynamics. Each drug has to be tested separately.
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Affiliation(s)
- C Leslie
- Department of Geriatric Medicine, Stobhill General Hospital, Glasgow, Scotland, UK
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30
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Scott PJ, Deaner A. Intravascular ultrasonography in atheromatous disease. Br J Hosp Med (Lond) 1992; 48:533-5. [PMID: 1477708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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31
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Scott PJ, Blackburn ME, Wharton GA, Wilson N, Dickinson DF, Gibbs JL. Transoesophageal echocardiography in neonates, infants and children: applicability and diagnostic value in everyday practice of a cardiothoracic unit. Heart 1992; 68:488-92. [PMID: 1467035 PMCID: PMC1025194 DOI: 10.1136/hrt.68.11.488] [Citation(s) in RCA: 14] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To determine the applicability of and information obtained by transoesophageal echocardiography in neonates, infants, and children in every day practice of a cardiothoracic unit. DESIGN Four month prospective study. SETTING Supraregional centre for paediatric cardiothoracic services. PATIENTS AND METHODS 58 patients aged between four days and 16 years with a wide range of cardiovascular disease underwent transoesophageal echocardiography under sedation or general anaesthetic. One of two paediatric probes (6 or 7 mm diameter), or an adult probe (13 mm in diameter) was used. Whenever possible the investigation was immediately preceded by precordial echocardiography. MAIN OUTCOME MEASURES Success, failure, technical difficulties, and complications of probe introduction and, when possible, comparison of the information obtained with that obtained from precordial echocardiography. RESULTS Introduction of the probe was successful in 57 of the 58 patients. The only complication encountered was transient bradycardia during manipulation of the probe in a 2.2 kg baby. The adult (13 mm) probe was successfully used in children as small as 7.0 kg. Below this weight a smaller paediatric probe was required. In 56% of cases transoesophageal ultrasound provided information not obtained from the precordial approach. The technique was of particular value perioperatively and in the immediate postoperative period in neonates and infants and in the presence of valve prostheses and the investigation of mediastinal tumours in older children. CONCLUSIONS Transoesophageal echocardiography is a valuable additional investigative tool for children of all ages. It is of particular value when acquisition of precordial image is impaired around the time of and after operation and in children with prosthetic valves or mediastinal tumour. Image quality was superior with the adult probe and we recommend the use of this probe unless the patient's weight is below 7 kg, when a paediatric probe allows this technique to be used usefully and safely in babies as small as 2.2 kg.
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Affiliation(s)
- P J Scott
- Department of Paediatric Cardiology, Killingbeck Hospital, Leeds
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32
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Balsitis M, MacDonald E, McDonald A, Davidson I, Fulton JD, Scott PJ, Wadsworth R, Wilkinson M. Age-associated changes in mesenteric arteries. Age Ageing 1992; 21:328-32. [PMID: 1414668 DOI: 10.1093/ageing/21.5.328] [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: 12/26/2022] Open
Abstract
Vascular disease increases in incidence with age and is the commonest cause of morbidity and mortality among elderly people. Hypertension is associated with hypertrophy of the arterial media. This study was designed to investigate changes in arterial structure that may occur with age independent of blood pressure. Collapsed sections of human mesenteric arteries (external diameter 2-3 mm) were measured using a semi-automatic image analysis system. There was a nonlinear increase in both the wall/lumen area ratio and the relative intimal area with age. There were no significant relationships between blood pressure and either the wall/lumen ratio or the relative intimal area.
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Affiliation(s)
- M Balsitis
- Department of Physiology and Pharmacology, University of Strathclyde, Glasgow
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33
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Abstract
Repair of asymptomatic aortic valve disease was performed in 12 patients (9 female, 3 male, mean age 57.5 years) undergoing other cardiac surgery. Stenosis was the predominant aortic valve lesion in 7 (group A) with a mean gradient of 33.4 mmHg and regurgitation of mean grade 1.4 was predominant in 5 (group B). Cusp debridement +/- commissurotomy was performed in 9; commissural resuspension in 6 and repair of cusp perforation in 2. Perioperative transoesophageal echocardiography was used to assess the adequacy of repair in 4 patients. Prospective precordial echocardiographic follow-up is complete (mean 4.3 months). In group A there has been a significant reduction is peak aortic pressure gradient (33.4 vs 22.1 mmHg, p less than 0.05) and in cusp thickness (2.25 to 1.64 mm, p less than 0.05). In group B the degree of incompetence has improved in 3 of the 5 patients. Three patients have worsened valve disease following repair; in all these there was mixed valve disease of rheumatic origin. Aortic valve repair of asymptomatic disease during other cardiac surgery is a feasible technique which does not accelerate the disease process in the short term. Long-term follow-up is in progress to assess the prognosis of this preventive intervention.
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Affiliation(s)
- D A Waller
- Department of Cardiothoracic Surgery, Killingbeck Hospital, Leeds, UK
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34
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Abstract
A comparison between praecordial and transoesophageal cross-sectional echocardiography was undertaken in the follow-up of 14 patients who had previously undergone surgical excision of atrial myxoma. The mean interval between surgery and follow-up was 39 months. Evidence of recurrent tumour was seen in two patients by transoesophageal echocardiography but went undetected in one of these using the praecordial approach. Clear visualisation of the atria and interatrial septum was possible in all remaining cases using transoesophageal echocardiography and this allowed confident exclusion of tumour recurrence. Using praecordial echocardiography, technically inadequate studies meant that this was not possible in 4 patients. The significant late recurrence rate of excised atrial myxomas, emphasises the need for serial, postoperative echocardiographic studies. Praecordial echocardiography may be unreliable in the detection of recurrent atrial myxoma in its early stages and for this reason transoesophageal echocardiographic follow-up is justified in high risk patients.
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Affiliation(s)
- D A Waller
- Non-invasive Heart Unit, Killingbeck Hospital, Leeds, UK
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35
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Quinn MT, Curnutte JT, Parkos CA, Mullen ML, Scott PJ, Erickson RW, Jesaitis AJ. Reconstitution of defective respiratory burst activity with partially purified human neutrophil cytochrome B in two genetic forms of chronic granulomatous disease: possible role of Rap1A. Blood 1992; 79:2438-45. [PMID: 1315174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Neutrophil plasma membranes from patients with the X-linked and autosomal recessive forms of chronic granulomatous disease (CGD) that lack cytochrome b are incapable of generating superoxide anion (O2-) in vivo and in vitro. The O2- generating activity of these defective membranes was reconstituted with the addition of partially purified human neutrophil cytochrome b in a detergent-based, cell-free activation system. Depending on the detergent system used, 50% to 100% of the activity of control membranes was recovered, and this activity was directly dependent on the cytochrome b concentration. However, when cytochrome b was purified to 99% homogeneity, the reconstitutive capacity of the cytochrome was lost, possibly because of subtle denaturation of the cytochrome or the removal of an additional required cofactor. Examination of the latter possibility with respect to a protein known to coassociate with the cytochrome, ie, Rap1A, indicated that this ras-like protein was present in the partially purified cytochrome preparation used to reconstitute activity in CGD membranes, but was missing in the highly purified preparation. However, the finding that Rap1A was present in normal amounts in the neutrophil membranes from all four major types of CGD (including those missing cytochrome b) suggested that the conditions required of the reconstitution assay did not favor the reassociation of the membrane-derived Rap1A with exogenously added cytochrome b or that another unidentified membrane component was lost during the final purification step. The normal expression of Rap1A in CGD cell membranes also indicates that this protein is not responsible for the absence of O2- production in the X-linked and autosomal recessive cytochrome b-negative forms of CGD. Finally, these results show that the expression of Rap1A in the plasma membrane is not dependent on the coordinate expression of cytochrome b, despite the close association shown for these two proteins in the normal cell membrane.
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Affiliation(s)
- M T Quinn
- Department of Chemistry and Biochemistry, Montana State University, Bozeman 59717
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36
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MacDonald E, Lee WK, Hepburn S, Bell J, Scott PJ, Dominiczak MH. Advanced glycosylation end products in the mesenteric artery. Clin Chem 1992; 38:530-3. [PMID: 1314720] [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: 12/26/2022]
Abstract
We measured advanced glycosylation end products in the mesenteric artery of 37 patients (ages 29-82 years), 34 of whom were nondiabetic. Samples of arterial tissue were obtained during bowel resectioning. Advanced glycosylation end products were measured as collagen-linked fluorescence (excitation wavelength 370 nm, emission wavelength 440 nm) after collagenase digestion of tissue samples. Mean fluorescence of the arterial samples was 15 U/mg (range 5.3-27). Collagen fluorescence correlated with patients' age (r = 0.57; P less than 0.001). No difference in the collagen-linked fluorescence was observed between men and women (P = 0.63), hypertensive and normotensive patients (P = 0.44), smokers and nonsmokers (P = -0.52), and patients with and without symptomatic coronary heart disease (P = 0.7). This study demonstrates, for the first time, the relationship between collagen-linked fluorescence and patients' age in human arterial tissue ex vivo.
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Affiliation(s)
- E MacDonald
- Department of Biochemistry, Western Infirmary, Glasgow, Scotland, U.K
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37
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Abstract
Abstract
We measured advanced glycosylation end products in the mesenteric artery of 37 patients (ages 29-82 years), 34 of whom were nondiabetic. Samples of arterial tissue were obtained during bowel resectioning. Advanced glycosylation end products were measured as collagen-linked fluorescence (excitation wavelength 370 nm, emission wavelength 440 nm) after collagenase digestion of tissue samples. Mean fluorescence of the arterial samples was 15 U/mg (range 5.3-27). Collagen fluorescence correlated with patients' age (r = 0.57; P less than 0.001). No difference in the collagen-linked fluorescence was observed between men and women (P = 0.63), hypertensive and normotensive patients (P = 0.44), smokers and nonsmokers (P = -0.52), and patients with and without symptomatic coronary heart disease (P = 0.7). This study demonstrates, for the first time, the relationship between collagen-linked fluorescence and patients' age in human arterial tissue ex vivo.
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Affiliation(s)
- E MacDonald
- Department of Biochemistry, Western Infirmary, Glasgow, Scotland, U.K
| | - W K Lee
- Department of Biochemistry, Western Infirmary, Glasgow, Scotland, U.K
| | - S Hepburn
- Department of Biochemistry, Western Infirmary, Glasgow, Scotland, U.K
| | - J Bell
- Department of Biochemistry, Western Infirmary, Glasgow, Scotland, U.K
| | - P J Scott
- Department of Biochemistry, Western Infirmary, Glasgow, Scotland, U.K
| | - M H Dominiczak
- Department of Biochemistry, Western Infirmary, Glasgow, Scotland, U.K
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38
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Mylari BL, Beyer TA, Scott PJ, Aldinger CE, Dee MF, Siegel TW, Zembrowski WJ. Potent, orally active aldose reductase inhibitors related to zopolrestat: surrogates for benzothiazole side chain. J Med Chem 1992; 35:457-65. [PMID: 1738141 DOI: 10.1021/jm00081a006] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [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: 12/28/2022]
Abstract
A broad structure-activity program was undertaken in search of effective surrogates for the key benzothiazole side chain of the potent aldose reductase inhibitor, zopolrestat (1). A structure-driven approach was pursued, which spanned exploration of three areas: (1) 5/6 fused heterocycles such as benzoxazole, benzothiophene, benzofuran, and imidazopyridine; (2) 5-membered heterocycles, including oxadiazole, oxazole, thiazole, and thiadiazole, with pendant aryl groups, and (3) thioanilide as a formal equivalent of benzothiazole. Several benzoxazole- and 1,2,4-oxadiazole-derived analogues were found to be potent inhibitors of aldose reductase from human placenta and were orally active in preventing sorbitol accumulation in rat sciatic nerve, in an acute test of diabetic complications. 3,4-Dihydro-4-oxo-3-[(5,7-difluoro-2-benzoxazolyl)methyl]-1- phthalazineacetic acid (124) was the best of the benzoxazole series (IC50 = 3.2 x 10(-9) M); it suppressed accumulation of sorbitol in rat sciatic nerve by 78% at an oral dose of 10 mg/kg. Compound 139, 3,4-dihydro-4-oxo-3-[[(2-fluorophenyl)-1,2,4- oxadiazol-5-yl]methyl]-1-phthalazineacetic acid, with IC50 less than 1.0 x 10(-8) M, caused a 69% reduction in sorbitol accumulation in rat sciatic nerve at an oral dose of 25 mg/kg. The thioanilide side chain featured in 3-[2-[[3-(trifluoromethyl)phenyl]amino]-2-thioxoethyl]-3,4-dihydro - 4-oxo-1-phthalazineacetic acid (195) proved to be an effective surrogate for benzothiazole. Compound 195 was highly potent in vitro (IC50 = 5.2 x 10(-8) M) but did not show oral activity when tested at 100 mg/kg. Additional structure-activity relationships encompassing a variety of heterocyclic side chains are discussed.
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Affiliation(s)
- B L Mylari
- Central Research Division, Pfizer Inc, Groton, Connecticut 06340
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39
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Scott PJ. Our health and the New Zealand public health service. N Z Med J 1991; 104:466-8. [PMID: 1945171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- P J Scott
- University of Auckland School of Medicine
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40
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Abstract
Cardiovascular disease is the single largest cause of death in the elderly. Many of the published studies concerning the physiology and pharmacology of the aging cardiovascular system are seriously flawed. Problems include failure to measure the drug bioavailability and the selection of subjects with overt or subclinical disease. With exercise, the rise in heart rate is inversely proportional to age and maximum heart rate is reduced. Baroreceptor reflex activity appears to decline with age. Cardiac output is maintained in the elderly, with a slower heart rate and a greater stroke volume than in the young. Plasma noradrenaline (norepinephrine) levels increase in the elderly but there is no change in the sensitivity of the vasoconstrictor alpha 1-adrenoceptor. There is evidence for a decline in the activity of the vasodilator beta 2-adrenoceptor with age. It is difficult to make general rules about the effect of aging on the disposition and elimination of drugs. Each drug must be tested separately.
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Affiliation(s)
- I Stolarek
- Department of Geriatric Medicine, Stobhill General Hospital, Glasgow, Scotland
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41
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Abstract
We studied 70 patients with mitral valvar replacements by both transthoracic and transoesophageal echocardiography. Fifteen subjects had recently suffered a suspected embolic episode. The remainder (55) were studied for other clinical reasons. Transthoracic echocardiography demonstrated thrombus in only 1 of the 70 patients. By contrast, transoesophageal examination revealed thrombus in 8 out of 15 patients with recent suspected embolism and 3 out of 55 without. Thrombus was most commonly seen in patients with biological valvar prostheses whose anticoagulation had been discontinued. When patients with prosthetic mitral valves present with a suspected embolic episode, transoesophageal echocardiography is strongly recommended. This study also suggests that transoesophageal echocardiography may be useful for evaluating patients with biological valves if anticoagulation is withdrawn so as to identify formation of thrombus at the earliest possible stage.
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Affiliation(s)
- P J Scott
- Non-Invasive Heart Unit, Killingbeck Hospital, Leeds, U.K
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42
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Abstract
Normal velocities of flow in the aortic arch were recorded in a patient presenting with clinical signs of aortic coarctation. Angiography demonstrated complete coarctation with extensive collateral supply to the descending aorta: there was a systolic pressure difference of 40 mm Hg between the ascending and descending segments of the aorta. Despite reports of the value of Doppler ultrasound in the diagnosis of coarctation, the finding of normal velocities of flow within the aortic arch does not necessarily exclude the presence of an obstructive lesion.
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Affiliation(s)
- P J Scott
- Non-invasive Heart Unit, Killingbeck Hospital, Leeds, West Yorkshire, U.K
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43
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Scott PJ, Ettles DF, Wharton GA, Williams GJ. The value of transesophageal echocardiography in the investigation of acute prosthetic valve dysfunction. Clin Cardiol 1990; 13:541-4. [PMID: 2397617 DOI: 10.1002/clc.4960130807] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
When patients present with suspected prosthetic valve dysfunction, investigation is usually instituted to delineate the site and cause thereof. Precordial cross-sectional echocardiography is often helpful in this respect, but in the patient with acute pulmonary edema, imaging may be impaired because of discomfort and respiratory distress. The information obtained may also be suboptimal as a result of concomitant obesity, chest wall deformity, and pulmonary disease. In addition, further difficulties may relate to the acoustic shadowing produced by the metallic portion of the valve and its sewing ring, especially with valves in the mitral position. In such patients, cardiac catheterization may cause further decompensation and is associated with a recognized increase in morbidity and mortality. Angiography does not accurately site regurgitant jets in relation to the prosthetic valve concerned and will not detect the presence of vegetations. Transesophageal echocardiography circumvents many of these imaging difficulties and we evaluated its use in five patients with prosthetic heart valves who presented acutely ill, in severe pulmonary edema and suspected prosthetic heart valve failure. In each case, the diagnosis of valve dysfunction was established, and precise information regarding the site and cause of the failure was obtained. No complications or deterioration in patient condition resulted from the procedure and the findings were confirmed at surgery performed within 24 hours in all five patients. Transesophageal echocardiography should be included in the assessment of acute prosthetic heart valve failure.
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Affiliation(s)
- P J Scott
- Noninvasive Heart Unit, Killingbeck Hospital, Leeds, England
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Fulton JD, MacDonald E, Scott PJ. Television: fantastic reality or realistic fantasy? J Am Geriatr Soc 1990; 38:829. [PMID: 2370403 DOI: 10.1111/j.1532-5415.1990.tb01480.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Scott PJ. The immuno-suppressed patient--what are the implications? N Z Dent J 1990; 86:34-8. [PMID: 2371000] [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: 12/31/2022]
Abstract
Dentists, doctors, and other health professionals are increasingly involved in interacting with immunosuppressed and immuno-deficient patients. As the medico-legal and health-economic environments change, an increasing range of progressively more difficult problems is developing. Like other health professionals, dentists must accept their role as advocates for patients, despite the stresses that this will entail. The psychological and social stresses inherent in handling life-long management problems based upon immuno-suppression and immuno-deficiency exceeds the hazards to dentists and others which result from exposure to various viruses and bacteria. There are implications in terms of history taking, organisation of laboratory and organ-imaging investigations, for continuing education, and for intra-professional referral procedures.
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Affiliation(s)
- P J Scott
- Academic Unit, Middlemore Hospital, Auckland
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Scott PJ, Ettles DF, Rees MR, Williams GJ. The use of combined transoesophageal echocardiography and fluoroscopy in the biopsy of a right atrial mass. Br J Radiol 1990; 63:222-4. [PMID: 2334836 DOI: 10.1259/0007-1285-63-747-222] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- P J Scott
- Non-Invasive Cardiac Unit, Killingbeck Hospital, Leeds
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Scott PJ. Human nutrition--paradoxes of drugs and diet. N Z Dent J 1990; 86:9-14. [PMID: 2185445] [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: 12/30/2022]
Abstract
Complex historical and other reasons account for public confusion concerning optimal nutritional practice. The mass media are not alone in presenting results of scientific work in non-scientific form. Health professionals, scientists, and people from industry have all contributed to the confusion concerning diet and the public good. Extrapolation from one situation to another, simplification of issues, and biased presentation of data, have intensified the problems. The limited perspective of many experts is frequently coupled with over-enthusiastic promotion of what are really hypotheses rather than established truths. The public good is not being served by the present confusing pattern of paradoxes. There is an urgent need for health professionals to review their presentations to the public such that emerging scientific knowledge is presented effectively in terms of a broad perspective.
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Affiliation(s)
- P J Scott
- Academic Teaching Unit, Middlemore Hospital, Otahuhu, Auckland
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Scott PJ. The inheritance of microstructure variation in the song of four generations of Roller canaries. Behav Genet 1990; 20:97-102. [PMID: 2346473 DOI: 10.1007/bf01070745] [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: 12/31/2022]
Abstract
The microstructure of the calls and songs of four generations of Roller canaries was analyzed and compared. Many of the characteristics of the internal structure of the syllable show distributions in the progeny that suggest quantitative inheritance. The presence or absence of an underharmonic and the presence of a "block" underharmonic show a qualitative type of inheritance.
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Affiliation(s)
- P J Scott
- Department of Biology, Memorial University of Newfoundland, St. John's, Canada
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Herman TS, Jochelson MS, Teicher BA, Scott PJ, Hansen J, Clark JR, Pfeffer MR, Gelwan LE, Molnar-Griffin BJ, Fraser SM. A phase I-II trial of cisplatin, hyperthermia and radiation in patients with locally advanced malignancies. Int J Radiat Oncol Biol Phys 1989; 17:1273-9. [PMID: 2689396 DOI: 10.1016/0360-3016(89)90536-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A Phase I-II trial testing the addition of systemic cisplatin (CDDP) to local hyperthermia and radiation was conducted to determine the dose of cisplatin that is tolerable once weekly for 6 weeks and to estimate the therapeutic potential of this trimodality combination in patients with locally advanced malignancies. Cisplatin at 20 mg/m2 (4 patients), 30 mg/m2 (8 patients), and 40 mg/m2 (12 patients) was given rapidly (over 5-10 min) i.v. after prehydration with 1 liter of normal saline. After approximately two-thirds of the cisplatin dose had been delivered, microwave hyperthermia was begun and continued for 60 min; the target minimum tumor temperature was 43 degrees C. Following hyperthermia, a 400 cGy fraction of radiation was delivered to the tumor. On other days during the treatment weeks, additional 200 cGy fractions were given to total doses of 6,000-6600 cGy in patients with full radiation tolerance or 2400-3600 cGy in patients with limited radiation tolerance. The 24 patients in this trial had a median age of 57 years and the predominant sites/tumor types were head and neck/squamous cell carcinoma (9) and chest wall/breast adenocarcinoma (9). Seventeen of the 24 treated tumors (70%) had previously been irradiated. Eighteen patients (75%) had received prior chemotherapy and nine patients (38%) had previously been treated with cisplatin. Bone marrow suppression was dose limiting in patients heavily pretreated with chemotherapy and chest wall radiation. No significant toxicities were observed at the 20 and 30 mg/m2 dose levels, but 5 of the 12 patients (42%) treated at 40 mg/m2 required modification of the cisplatin dose because of blood count suppression in four patients and mild renal dysfunction in one patient. Each of the patients with bone marrow suppression, however, had been heavily pretreated except for one patient with thrombocytopenia due to hypersplenism. Nausea and vomiting were mild with use of a standard, multiagent antiemetic regimen. Twelve patients (50%) attained a complete regression (CR) and 12 patients (50%) a partial regression (PR). Complete regression appeared to correlate with small tumor volumes (115 cc for CR versus 199 cc for PR patients) and higher tumor temperatures (4.6 average minimum equivalent minutes at 43 degrees C in CR versus 2.0 min in PR patients). Local toxicities included second degree burns in 12 patients (50%) and third degree burns in 6 (25%), but all burns healed in 4-12 weeks without surgical intervention.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- T S Herman
- Joint Center for Radiation Therapy, Harvard Medical School, Boston, MA 02115
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