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Wiggins EB, Anderson BE, Brown MD, Campuzano‐Jost P, Chen G, Crawford J, Crosbie EC, Dibb J, DiGangi JP, Diskin GS, Fenn M, Gallo F, Gargulinski EM, Guo H, Hair JW, Halliday HS, Ichoku C, Jimenez JL, Jordan CE, Katich JM, Nowak JB, Perring AE, Robinson CE, Sanchez KJ, Schueneman M, Schwarz JP, Shingler TJ, Shook MA, Soja AJ, Stockwell CE, Thornhill KL, Travis KR, Warneke C, Winstead EL, Ziemba LD, Moore RH. Reconciling Assumptions in Bottom-Up and Top-Down Approaches for Estimating Aerosol Emission Rates From Wildland Fires Using Observations From FIREX-AQ. J Geophys Res Atmos 2021; 126:e2021JD035692. [PMID: 35865864 PMCID: PMC9286562 DOI: 10.1029/2021jd035692] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/22/2021] [Accepted: 11/24/2021] [Indexed: 06/15/2023]
Abstract
Accurate fire emissions inventories are crucial to predict the impacts of wildland fires on air quality and atmospheric composition. Two traditional approaches are widely used to calculate fire emissions: a satellite-based top-down approach and a fuels-based bottom-up approach. However, these methods often considerably disagree on the amount of particulate mass emitted from fires. Previously available observational datasets tended to be sparse, and lacked the statistics needed to resolve these methodological discrepancies. Here, we leverage the extensive and comprehensive airborne in situ and remote sensing measurements of smoke plumes from the recent Fire Influence on Regional to Global Environments and Air Quality (FIREX-AQ) campaign to statistically assess the skill of the two traditional approaches. We use detailed campaign observations to calculate and compare emission rates at an exceptionally high-resolution using three separate approaches: top-down, bottom-up, and a novel approach based entirely on integrated airborne in situ measurements. We then compute the daily average of these high-resolution estimates and compare with estimates from lower resolution, global top-down and bottom-up inventories. We uncover strong, linear relationships between all of the high-resolution emission rate estimates in aggregate, however no single approach is capable of capturing the emission characteristics of every fire. Global inventory emission rate estimates exhibited weaker correlations with the high-resolution approaches and displayed evidence of systematic bias. The disparity between the low-resolution global inventories and the high-resolution approaches is likely caused by high levels of uncertainty in essential variables used in bottom-up inventories and imperfect assumptions in top-down inventories.
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Affiliation(s)
- E. B. Wiggins
- NASA Postdoctoral ProgramUniversities Space Research AssociationColumbiaMDUSA
- NASA Langley Research CenterHamptonVAUSA
| | | | - M. D. Brown
- NASA Langley Research CenterHamptonVAUSA
- Science Systems and Applications, Inc.HamptonVAUSA
| | | | - G. Chen
- NASA Langley Research CenterHamptonVAUSA
| | | | - E. C. Crosbie
- NASA Langley Research CenterHamptonVAUSA
- Science Systems and Applications, Inc.HamptonVAUSA
| | - J. Dibb
- Earth Systems Research CenterUniversity of New HampshireDurhamNHUSA
| | | | | | - M. Fenn
- NASA Langley Research CenterHamptonVAUSA
- Science Systems and Applications, Inc.HamptonVAUSA
| | - F. Gallo
- NASA Postdoctoral ProgramUniversities Space Research AssociationColumbiaMDUSA
- NASA Langley Research CenterHamptonVAUSA
| | | | - H. Guo
- CIRESUniversity of Colorado BoulderBoulderCOUSA
| | - J. W. Hair
- NASA Langley Research CenterHamptonVAUSA
| | - H. S. Halliday
- Environmental Protection AgencyResearch TriangleDurhamNCUSA
| | - C. Ichoku
- College of Arts and SciencesHoward UniversityWashingtonDCUSA
| | | | - C. E. Jordan
- NASA Langley Research CenterHamptonVAUSA
- National Institute of AerospaceHamptonVAUSA
| | - J. M. Katich
- CIRESUniversity of Colorado BoulderBoulderCOUSA
- NOAA Chemical Science LaboratoryBoulderCOUSA
| | | | - A. E. Perring
- Department of ChemistryColgate UniversityHamiltonNYUSA
| | - C. E. Robinson
- NASA Langley Research CenterHamptonVAUSA
- Science Systems and Applications, Inc.HamptonVAUSA
| | - K. J. Sanchez
- NASA Postdoctoral ProgramUniversities Space Research AssociationColumbiaMDUSA
- NASA Langley Research CenterHamptonVAUSA
| | | | | | | | | | - A. J. Soja
- NASA Langley Research CenterHamptonVAUSA
- National Institute of AerospaceHamptonVAUSA
| | - C. E. Stockwell
- CIRESUniversity of Colorado BoulderBoulderCOUSA
- NOAA Chemical Science LaboratoryBoulderCOUSA
| | - K. L. Thornhill
- NASA Langley Research CenterHamptonVAUSA
- Science Systems and Applications, Inc.HamptonVAUSA
| | | | - C. Warneke
- NOAA Chemical Science LaboratoryBoulderCOUSA
| | - E. L. Winstead
- NASA Langley Research CenterHamptonVAUSA
- Science Systems and Applications, Inc.HamptonVAUSA
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Benn E, Tabb LP, Exum P, Moore RH, Morales KH, Simpson F, Lawrence SA, Bellamy SL. Creating and sustaining effective pipeline initiatives to increase diversity in biostatistics: the ENAR Fostering Diversity in Biostatistics Workshop. J Stat Educ 2020; 28:295-303. [PMID: 33776396 PMCID: PMC7993064 DOI: 10.1080/10691898.2020.1820409] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Biostatisticians with advanced degrees are highly sought after. Employment opportunities in the fields of mathematics and statistics are expected to increase dramatically by 2028. Underrepresentation of minorities in biostatistics has been a persistent problem, yielding a demographic landscape that differs substantially from the general US population. In some instances, students may have the appropriate quantitative skills, but are unaware of biostatistics and in other instances, students may not yet have the appropriate quantitative background, but are intellectually capable and willing to shore up those skills once they learn about biostatistics as a viable, exciting career option. Therefore, in order to ensure robust scientific advancement, there must be a concerted effort to increase the pipeline of intellectually talented persons available with exposure to the appropriate quantitative skills who are interested in careers in biostatistics. The overarching goal of this paper is to discuss the development, implementation, and impact of a federally funded pipeline initiative aimed at increasing the number of underrepresented minorities successful in graduate training and professional careers in biostatistics as well as establishing effective mentoring and networking relationships. Our findings provide a roadmap for the development of sustainable initiatives to promote diversity in biostatistics and STEM fields more broadly.
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Affiliation(s)
- Ekt Benn
- Center for Scientific Diversity, Center for Biostatistics, and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - L P Tabb
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | | | - R H Moore
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University
| | - K H Morales
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - F Simpson
- Department of Mathematics, Winston-Salem State University, Winston Salem, NC
| | - S A Lawrence
- Center for Scientific Diversity, Center for Biostatistics, and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - S L Bellamy
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
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Ambrus JL, Ambrus CM, Taheri SA, Gastpar H, Reddington MM, Taheri P, Kahn EA, Schattman GL, Dean LS, Moore RH. Red Cell Flexibility and Platelet Aggregation in Patients with Chronic Obstructive Vascular Disease (COAD) and Study of Therapeutic Approaches. Angiology 2016; 35:418-26. [PMID: 6540538 DOI: 10.1177/000331978403500704] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The red blood cell flexibility was studied in the blood of twenty patients with severe peripheral vascular disease and twenty matched controls. Patients exhibited significantly less red cell flexibility than controls. In both groups there was an inverse relationship between age and red cell flexibility. No correlation was found between red cell flexibility and sex or smoking history. Pentoxifylline, a xanthine derivative which inhibits phosphodiesterases and platelet aggregation, was found to increase red cell flexibility. This effect of the drug was greater on red cells with impaired flexibility than on normal cells. Various prostaglandins by contrast were found to decrease red cell flexibility, this could be compensated for by pentoxifylline. Forty patients with COAD were treated intravenously with PgE1. Significant inhibition of platelet aggregation and clinical improvement was noticed. It is suggested that combinations of PgE1 and pentoxifylline should be explored in clinical studies.
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Reiser I, Nishikawa RM, Giger ML, Wu T, Rafferty E, Moore RH, Kopans DB. Computerized Detection of Mass Lesions in Digital Breast Tomosynthesis Images Using Two- and Three Dimensional Radial Gradient Index Segmentation. Technol Cancer Res Treat 2016; 3:437-41. [PMID: 15453808 DOI: 10.1177/153303460400300504] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Initial results for a computerized mass lesion detection scheme for digital breast tomosynthesis (DBT) images are presented. The algorithm uses a radial gradient index feature for the initial lesion detection and for segmentation of lesion candidates. A set of features is extracted for each segmented partition. Performance of two- and three dimensional features was compared. For gradient features, the additional dimension provided no improvement in classification performance. For shape features, classification using 3D features was improved compared to the 2D equivalent features. The preliminary overall performance was 76% sensitivity at 11 false positives per exam, estimated based on DBT image data of 21 masses. A larger database will allow for further development and improvement in our computer aided detection scheme.
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Affiliation(s)
- I Reiser
- Department of Radiology, The University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
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Volger S, Wadden TA, Sarwer DB, Moore RH, Chittams J, Diewald LK, Panigrahi E, Berkowitz RI, Schmitz K, Vetter ML. Changes in eating, physical activity and related behaviors in a primary care-based weight loss intervention. Int J Obes (Lond) 2013; 37 Suppl 1:S12-8. [PMID: 23921776 PMCID: PMC3786775 DOI: 10.1038/ijo.2013.91] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine changes in eating behaviors and physical activity, as well as predictors of weight loss success, in obese adults who participated in a 2-year behavioral weight loss intervention conducted in a primary care setting. DESIGN A longitudinal, randomized controlled, multisite trial. SUBJECTS Three hundred ninety obese (body mass index, 30-50 kg m(-2)) adults, ≥ 21 years, in the Philadelphia region. METHODS Participants were assigned to one of three interventions: (1) Usual Care (quarterly primary care provider (PCP) visits that included education on diet and exercise); (2) Brief Lifestyle Counseling (quarterly PCP visits plus monthly lifestyle counseling (LC) sessions about behavioral weight control); or (3) Enhanced Brief LC (the previous intervention with a choice of meal replacements or weight loss medication). RESULTS At month 24, participants in both Brief LC and Enhanced Brief LC reported significantly greater improvements in mean (± s.e.) dietary restraint than those in Usual Care (4.4 ± 0.5, 4.8 ± 0.5 and 2.8 ± 0.5, respectively; both P-values ≤ 0.016). The percentage of calories from fat, along with fruit and vegetable consumption, did not differ significantly among the three groups. At month 24, both the Brief LC and Enhanced Brief LC groups reported significantly greater increases than usual care in energy expenditure (kcal per week) from moderately vigorous activity (+593.4 ± 175.9, +415.4 ± 179.6 and -70.4 ± 185.5 kcal per week, respectively; both P-values ≤ 0.037). The strongest predictor of weight loss at month 6 (partial R(2)=33.4%, P<0.0001) and at month 24 (partial R(2)=19.3%, P<0.001) was food records completed during the first 6 months. Participants who achieved a 5% weight loss at month 6 had 4.7 times greater odds of maintaining a ≥ 5% weight loss at month 24. CONCLUSIONS A behavioral weight loss intervention delivered in a primary care setting can result in significant weight loss, with corresponding improvements in eating restraint and energy expenditure. Moreover, completion of food records, along with weight loss at month 6, is a strong predictor of long-term weight loss.
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Affiliation(s)
- S Volger
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA 19104, USA.
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Moore RH, Cerully K, Bahreini R, Brock CA, Middlebrook AM, Nenes A. Hygroscopicity and composition of California CCN during summer 2010. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/2011jd017352] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Wheeler AJ, Zhang AY, Drohan B, Lawrence C, Roche C, Kopans DB, Moore RH, Smith BL, Sharko J, Kevin HS. Predicting risk of developing invasive breast cancer in the African American female population. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.11080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11080 Background: African Americans (AA) have a lower incidence of breast cancer with a poorer prognosis than Caucasians. It is unclear whether AA women have fewer known risk factors for breast cancer or that risk factors have a lesser effect in AA. We evaluated the accuracy of the race-based modification Gail Model in predicting the risk of developing invasive breast cancer in the AA population. Methods: With IRB approval, we performed a retrospective analysis of data obtained from women (n=15,973) ages 40–79 presenting to our Breast Center(5/2003 to 7/2005) for a screening mammogram. The five-year probability of breast cancer for AA (n=702) versus Caucasians (n=15,721) was calculated for each individual using 3 methods: 1) the race specific Gail model, 2) the Gail model ignoring race (AA using the Caucasian model), and 3) age and race matched SEER projection using DevCan (v6.1.1) software. Results: There was no significant difference between the 5-year probability of breast cancer for Caucasians as calculated by the Gail model vs. the SEER prediction (p=NS), suggesting our population was representative of the larger study population from which SEER data was derived. As compared to SEER prediction, the modified Gail model underestimated the breast cancer risk for all age groups of AA (p<0.0001). When the Gail Model without the race-based modification was applied to the AA population, the projected risk was not significantly different from the SEER prediction (p=0.1049). Conclusions: This study suggests that the race-based modification of the Gail Model underestimate the risk of breast cancer in AA women. When the model is applied to AA women without incorporating the modification for race, the Gail model accurately reflects SEER 5-year projections of risk of invasive cancer in AA women. Differences in risk factor distribution among race, rather than a differential effect of those factors on risk, may have a substantial role in explaining the lower incidence in AA women as compared to Caucasian women over 40. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
| | | | - B. Drohan
- Massachusetts General Hospital, Boston, MA
| | | | - C. Roche
- Massachusetts General Hospital, Boston, MA
| | | | | | | | - J. Sharko
- Massachusetts General Hospital, Boston, MA
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Fabricatore AN, Wadden TA, Moore RH, Butryn ML, Gravallese EA, Erondu NE, Heymsfield SB, Nguyen AM. Attrition from randomized controlled trials of pharmacological weight loss agents: a systematic review and analysis. Obes Rev 2009; 10:333-41. [PMID: 19389060 PMCID: PMC2682632 DOI: 10.1111/j.1467-789x.2009.00567.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Clinical trials of obesity treatments have been limited by substantial dropout. Participant-level variables do not reliably predict attrition, and study-level variables have not yet been examined. We searched MEDLINE and identified 24 large randomized controlled trials of weight loss medications. These trials were comprised of 23 placebo and 32 drug groups. Two authors independently extracted the following for each treatment group: (i) treatment received; (ii) design characteristics (inclusion of a lead-in period, selection of participants with weight-related comorbidities, study location and number of study visits); (iii) sample characteristics (sample size, % female, and mean baseline age and body mass index); and (iv) attrition (total, adverse event [AE]-related and non-AE-related) at 1 year. The primary outcome was total attrition, which was significantly related to treatment (i.e. 34.9%, 28.6%, 28.3% and 35.1% in placebo, orlistat, sibutramine and rimonabant groups, respectively, P < 0.0001). In adjusted multivariable models, total attrition was significantly lower in groups that completed a pre-randomization lead-in period than in those that did not (29.1% vs. 39.9%, P < 0.01). Gender also was significantly related to total attrition; groups with more women had higher dropout (P < 0.01). The pattern was similar for predicting non-AE-related attrition. Findings suggest ways to design studies that maximize retention.
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Affiliation(s)
- A N Fabricatore
- Center for Weight and Eating Disorders, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
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Reiser I, Nishikawa RM, Edwards AV, Kopans DB, Schmidt RA, Papaioannou J, Moore RH. Automated detection of microcalcification clusters for digital breast tomosynthesis using projection data only: a preliminary study. Med Phys 2008; 35:1486-93. [PMID: 18491543 DOI: 10.1118/1.2885366] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Digital breast tomosynthesis (DBT) is a promising modality for breast imaging in which an anisotropic volume image of the breast is obtained. We present an algorithm for computerized detection of microcalcification clusters (MCCs) for DBT. This algorithm operates on the projection views only. Therefore it does not depend on reconstruction, and is computationally efficient. The algorithm was developed using a database of 30 image sets with microcalcifications, and a control group of 30 image sets without visible findings. The patient data were acquired on the first DBT prototype at Massachusetts General Hospital. Algorithm sensitivity was estimated to be 0.86 at 1.3 false positive clusters, which is below that of current MCC detection algorithms for full-field digital mammography. Because of the small number of patient cases, algorithm parameters were not optimized and one linear classifier was used. An actual limitation of our approach may be that the signal-to-noise ratio in the projection images is too low for microcalcification detection. Furthermore, the database consisted of predominantly small MCC. This may be related to the image quality obtained with this first prototype.
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Affiliation(s)
- I Reiser
- Department of Radiology, The University of Chicago, Chicago, Illinois 60637, USA.
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Chan HP, Wu Y, Sahiner B, Zhang Y, Moore RH, Kopans DB, Hadjiiski L, Helvie MA. TH-E-L100J-03: Digital Breast Tomosynthesis Mammography: Computerized Classification of Malignant and Benign Masses. Med Phys 2007. [DOI: 10.1118/1.2761739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Shrestha BM, Darby CR, Moore RH. Ureteric complications following renal transplantation: an eight years experience. Kathmandu Univ Med J (KUMJ) 2006; 4:409-14. [PMID: 18603945 DOI: pmid/18603945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Ureteric complications (UCs) following renal transplantation (RT) cause significant morbidity and ureteric stents are employed to bridge the vesico-ureteric anastomosis with a view to preventing these complications. The purpose of this study was to examine the incidence of UCs and outcomes following RT in both stented (STG) and non-stented groups (NSTG) of RT patients. METHODS This is a retrospective study of a cohort of 650 consecutive RTs [STG (N=267; 41%) and NSTG (N=383; 59%)] performed over a period of 8 years, where the data were retrieved from a prospectively maintained computerised database and case-notes. RESULTS The overall incidence of UCs was 6.5% (42/650), which consisted of ureteric obstruction (UO) in 4.3% (28) and ureteric leak (UL) in 2.2%(14) of patients. The incidence of UO was significantly high in the NSTG compared to the STG (6.3% vs.1.5%; P=0.002). However, the incidence of UL (3.4% vs.1.3%; P=0.1) and post-transplant urinary tract infection (UTI) (44% vs.41%; P=0.57) were not significantly different between the STG and NSTG groups. UO and UL were associated with significantly high incidence of UTI (P=0.001 and 0.01, respectively). All UCs were managed successfully without allograft loss. CONCLUSIONS Routine stenting of ureteric anastomosis resulted in reduced incidence of UO without concomitant increased risk of UTI.
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Affiliation(s)
- B M Shrestha
- Renal Transplant Unit, University Hospital of Wales, Heath Park, Cardiff, UK.
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Rabideau SW, Moore RH. THE APPLICATION OF HIGH-SPEED COMPUTERS TO THE LEAST SQUARES DETERMINATION OF THE FORMATION CONSTANTS OF THE CHLORO-COMPLEXES OF TIN(II)1. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100820a505] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Moore RH, Morrey JR, Voiland EE. THE EQUILIBRIUM CONTROLLED REDUCTION OF URANIUM CHLORIDE BY MOLTEN ALUMINUM IN A FUSED SALT SOLVENT. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100798a005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rosenfeld JL, Moore RH, Zimmer KP, Alpizar-Foster E, Dai W, Zarka MN, Knoll BJ. Lysosome proteins are redistributed during expression of a GTP-hydrolysis-defective rab5a. J Cell Sci 2001; 114:4499-508. [PMID: 11792815 DOI: 10.1242/jcs.114.24.4499] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The functioning of the endocytic pathway is influenced by a distinct set of rab GTPases, including rab5a, which regulates homotypic fusion of early endosomes. Expression of a dominant active, GTPase-defective rab5a accelerates endosome fusion, causing the formation of a greatly enlarged endocytic compartment. Here we present evidence that rab5a also regulates trafficking between endosomes and lysosomes and may play a role in lysosome biogenesis. The GTPase defective rab5aQ79L mutant was inducibly expressed as an EGFP fusion in HEK293 cells, and the distribution of lysosome proteins and endocytic markers then assessed by deconvolution fluorescence microscopy. During expression of EGFP-rab5aQ79L, the lysosome proteins LAMP-1, LAMP-2 and cathepsin D were found in dilated EGFP-rab5aQ79L-positive vesicles, which also rapidly labeled with transferrin Texas Red. Exogenous tracers that normally traffic to lysosomes after prolonged chase (dextran Texas Red and DiI-LDL) also accumulated in these vesicles. Dextran Texas Red preloaded into lysosomes localized with subsequently expressed EGFP-rab5a Q79L, suggesting the existence of lysosome to endosome traffic. Cells expressing EGFP-rab5a wt or the dominant negative EGFP-rab5aS34N did not exhibit these abnormalities. Despite the dramatic alterations in lysosome protein distribution caused by expression of EGFP-rab5a Q79L, there was little change in the endocytosis or recycling of a cell-surface receptor (β2-adrenergic receptor). However, there was a deficiency of dense β-hexosaminidase-containing lysosomes in cells expressing EGFP-rab5aQ79L, as assessed by Percoll gradient fractionation. These results suggest that expression of a GTPase-defective rab5a affects lysosome biogenesis by alteration of traffic between lysosomes and endosomes.
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Affiliation(s)
- J L Rosenfeld
- Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX 77030, USA
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Slanetz PJ, Giardino AA, Oyama T, Koerner FC, Halpern EF, Moore RH, Kopans DB. Mammographic appearance of ductal carcinoma in situ does not reliably predict histologic subtype. Breast J 2001; 7:417-21. [PMID: 11843854 DOI: 10.1046/j.1524-4741.2001.07607.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Histologic subtypes of ductal carcinoma in situ (DCIS) have been correlated with disease prognosis. There are conflicting reports on whether the grade of DCIS can be predicted by the morphology of calcifications seen on mammography. We undertook this study to determine whether the grade of DCIS can be reliably and accurately determined by mammography prior to excisional biopsy. Ninety consecutive cases of DCIS from 1993 to 1996 were identified, of which 75 cases had mammograms available for review. Any lesion with invasion was excluded. The mammogram showed only a mass in 10 of 75 cases, a mass and calcifications in 3 of 75 cases, and calcifications alone in 62 of 75 cases. Three board-certified radiologists with special expertise in mammography reviewed and categorized the mammographic findings as well, intermediate or poorly differentiated DCIS without knowledge of the histologic diagnosis. Histologic grading was performed without knowledge of the mammographic finding. Receiver operating curves (ROCs) were computed for each of the radiologists. For microcalcifications, the ROC comparisons of the radiologists' opinions of tumor grade and random chance were not significantly different. In those cases with available magnification views, the grade assessment did not change significantly. If only a mass was present on mammography, well-differentiated DCIS was the predominant histologic subtype. A histologic grade of DCIS cannot accurately be determined prospectively based on the mammographic appearance of microcalcifications. However, if only a mass is present, this is more likely to represent well-differentiated DCIS.
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Affiliation(s)
- P J Slanetz
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA
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Abstract
PURPOSE The purpose of this work was to determine whether cross-sectional area and coronal and sagittal diameter measurements of the trachea between inspiration and end-expiration on CT are significantly different between patients with acquired tracheomalacia and those without this condition. METHOD Inspiratory and end-expiratory CT scans of the trachea of 23 normal patients and 10 patients with acquired tracheomalacia were analyzed. Percent changes in cross-sectional area, coronal, and sagittal diameters were calculated. RESULTS For patients with tracheomalacia, mean percent changes in the upper and middle trachea between inspiration and expiration were 49 and 44%; mean changes in the coronal and sagittal diameters in the upper and middle tracheal were 4 and 10% and 39 and 54%, respectively. Control group mean percent changes in the upper and middle tracheal area were 12 and 14%, respectively, and mean changes in the coronal and sagittal diameters in the upper and middle trachea were 4 and 4% and 11 and 13%, respectively. Significant differences were calculated for changes in cross-sectional area and sagittal diameter between groups (p < 10-5). Based on receiver operator curve analysis, a > 18% change in the upper trachea and 28% change in the midtrachea between inspiration and expiration were observed; the probability of tracheomalacia was 89-100%. The probability of tracheomalacia was > 89%, especially if the change in sagittal diameter was > 28%. CONCLUSION By measuring changes in tracheal cross-sectional area and sagittal diameters between inspiratory and end-expiratory CT, a significant difference can be identified between normal patients and those with acquired tracheomalacia.
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Affiliation(s)
- S L Aquino
- Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.
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Seibold A, Williams B, Huang ZF, Friedman J, Moore RH, Knoll BJ, Clark RB. Localization of the sites mediating desensitization of the beta(2)-adrenergic receptor by the GRK pathway. Mol Pharmacol 2000; 58:1162-73. [PMID: 11040066 DOI: 10.1124/mol.58.5.1162] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The human beta(2)-adrenergic receptor (betaAR) is rapidly desensitized in response to saturating concentrations of agonist by G protein-coupled receptor kinases (GRKs) and cAMP-dependent protein kinase A (PKA) phosphorylation of the betaAR, followed by beta-arrestin binding and receptor internalization. betaAR sites phosphorylated by GRK in vivo have not yet been identified. In this study, we examined the role of the carboxyl terminal serines, 355, 356, and 364, in the GRK-mediated desensitization of the betaAR. Substitution mutants of these serine residues were constructed in which either all three (S355,356,364A), two (S355,356A and S356, 364A), or one of the serines (S356A and S364A) were modified. These mutants were constructed in a betaAR in which the serines of the PKA consensus site were substituted with alanines (designated PKA(-)) to eliminate any PKA contribution to desensitization, and they were stably transfected into human embryonic kidney 293 cells. Treatment of the PKA(-) mutant with 10 microM epinephrine for 5 min caused a 3. 5-fold increase in the EC(50) value and a 42% decrease in the V(max) value for epinephrine stimulation of adenylyl cyclase. Substitution of all three serines completely inhibited the epinephrine-induced shift in the EC(50). Both double mutants, S355,356A and S356,364A, showed a nearly complete loss of the EC(50) shift, whereas the single substitutions, S356A and S364A, caused only a slight decrease in desensitization. None of the mutations altered the epinephrine-induced decrease in V(max,) which seems to be downstream of the receptor. The triple mutation caused a 45% decrease in epinephrine-induced internalization and a 90 to 95% reduction in phosphorylation of the betaAR relative to the PKA(-) (1.9+/- 0.2- and 16.6+/-3.8-fold phosphorylation over basal, respectively). The double mutants caused an intermediate reduction in internalization (20-21%) and phosphorylation (43-52%). None of the serine mutations altered the rate of betaAR recycling. Our data demonstrate that the cluster of serines within the 355 to 364 betaAR domain confer the rapid, GRK-mediated, receptor-level desensitization of the betaAR.
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Affiliation(s)
- A Seibold
- Department of Integrative Biology and Pharmacology, University of Texas-Houston Medical School, Houston, Texas, USA
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Pollard SG, Lear PA, Ready AR, Moore RH, Johnson RW. Comparison of microemulsion and conventional formulations of cyclosporine A in preventing acute rejection in de novo kidney transplant patients. The U.K. Neoral Renal Study Group. Transplantation 1999; 68:1325-31. [PMID: 10573071 DOI: 10.1097/00007890-199911150-00018] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [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: 11/26/2022]
Abstract
BACKGROUND The microemulsion preconcentrate formulation of cyclosporine A (CsA) (Neoral) exhibits more uniform pharmacokinetics than the conventional formulation (Sandimmun; SIM). This randomized, open-label, U.K. multicenter study compared the efficacy, safety, and tolerability of Neoral and SIM in preventing acute rejection in de novo renal transplant recipients. METHODS Adult cadaveric kidney recipients (n=293) received Neoral or SIM twice daily for 12 months. Initially identical Neoral and SIM doses were titrated, maintaining trough CsA levels within locally defined therapeutic limits. RESULTS In the year after transplantation, acute rejection occurred in 34% of the Neoral and 47% of the SIM recipients (P=0.037). In the intent-to-treat population, fewer treatment failures (defined as acute rejection, graft loss, withdrawal, or death) occurred in the Neoral (45%) than the SIM recipients (58%) (P=0.015) and therapeutic CsA levels (> or =250 microg/L) were reached faster with Neoral than SIM (P=0.0017). Antibody treatment of refractory rejection was used slightly less in the Neoral group (Neoral: 10%; SIM: 12%). One-year patient and graft survival rates (excluding deaths with functioning grafts) were 95% and 88%, respectively, for Neoral and 96% and 89% for SIM. Both formulations were well tolerated. No differences were observed between therapies in the nature, frequency, or severity of adverse events. Neoral use was not associated with increased nephrotoxicity or excessive immunosuppression. CONCLUSIONS Neoral reduced the incidence of acute rejection compared with SIM, without significant increases in adverse events. This was achieved without altering existing SIM protocols and was attributed to improved absorption of CsA from Neoral and less variability in whole blood CsA concentrations.
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Affiliation(s)
- S G Pollard
- Department of Organ Transplantation, St. James's University Hospital, Leeds, UK
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22
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Moore RH, Hall HS, Rosenfeld JL, Dai W, Knoll BJ. Specific changes in beta2-adrenoceptor trafficking kinetics and intracellular sorting during downregulation. Eur J Pharmacol 1999; 369:113-23. [PMID: 10204689 DOI: 10.1016/s0014-2999(99)00055-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Agonist-activated beta2-adrenoceptors rapidly internalize and then recycle to the cell surface, however chronic agonist eventually causes receptor downregulation. To characterize beta2-adrenoceptor trafficking kinetics and intracellular sorting during downregulation, human embryonic kidney cells expressing epitope-tagged receptors were examined by radioligand binding with (+/-)-[3H]4-(3-tertiarybutylamino-2-hydroxypropoxy)-benzimidazole- 2-on hydrochloride ([3H]CGP12177) and immunofluorescence microscopy. The first-order receptor recycling rate constant declined after 18 h of agonist compared with 15 min (0.05 min(-1) vs. 0.12 min(-1)), thus increasing the intracellular transit time (20.0 min vs. 8.3 min). There was also a reduction in the rate of receptor endocytosis and a decline in the total number of receptors. Although the intracellular receptor fraction did not increase between 15 min and 18 h of agonist, some receptors moved irreversibly into a protease-containing compartment while retaining radioligand binding activity. Our results indicate that beta2-adrenoceptor downregulation is associated principally with an increased intracellular transit time during recycling. This could promote the diversion of receptors into protease-containing compartments, where there is an irreversible commitment to downregulation prior to loss of radioligand binding activity.
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Affiliation(s)
- R H Moore
- Department of Pediatrics (Pulmonary), Baylor College of Medicine, Houston, TX 77030, USA
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Moore RH, Tuffaha A, Millman EE, Dai W, Hall HS, Dickey BF, Knoll BJ. Agonist-induced sorting of human beta2-adrenergic receptors to lysosomes during downregulation. J Cell Sci 1999; 112 ( Pt 3):329-38. [PMID: 9885286 DOI: 10.1242/jcs.112.3.329] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
During prolonged exposure to agonist, beta2-adrenergic receptors undergo downregulation, defined by the loss of radioligand binding sites. To determine the cellular basis for beta2-adrenergic receptor downregulation, we examined HEK293 cells stably expressing beta2-adrenergic receptors with an N-terminal epitope tag. Downregulation was blocked by leupeptin, a cysteine protease inhibitor, but not by pepstatin, an inhibitor of aspartate proteases. Immunofluorescence microscopy of cells treated with agonist for 3–6 hours in the presence of leupeptin showed beta2-adrenergic receptors, but not transferrin receptors, localizing with the lysosomal protease cathepsin D, and with lysosomes labeled by uptake of a fluorescent fluid-phase marker. No localization of beta2-adrenergic receptors with lysosomal markers was observed in the absence of leupeptin, most likely due to proteolysis of the epitope. The proton pump inhibitor, bafilomycin A1, significantly inhibited this agonist-induced redistribution of beta2-adrenergic receptors into lysosomes, causing receptors to accumulate in the rab11-positive perinuclear recycling compartment and slowing the rate of beta2-adrenergic receptor recycling. Control experiments showed that leupeptin had no nonspecific effects on the cellular trafficking of either beta2-adrenergic receptors or transferrin receptors. Although cAMP alone caused a small decline in receptor levels without redistributing beta2-adrenergic receptors from the plasma membrane, this effect was additive to that seen with agonist alone, suggesting that agonist-induced beta2-adrenergic receptor downregulation resulted largely from cAMP-independent mechanisms. These results indicate that during agonist-induced downregulation, a significant fraction of beta2-adrenergic receptors are specifically sorted to lysosomes via the endosomal pathway, where receptor degradation by cysteine proteases occurs. These results provide a cellular explanation for the loss of radioligand binding sites that occurs during prolonged exposure to agonist.
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Affiliation(s)
- R H Moore
- Departments of Pediatrics (Pulmonary), Molecular Physiology & Biophysics, Medicine (Pulmonary) and Cell Biology, Baylor College of Medicine, Houston VA Medical Center, Houston, TX 77030, USA
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Tuvim MJ, Adachi R, Chocano JF, Moore RH, Lampert RM, Zera E, Romero E, Knoll BJ, Dickey BF. Rab3D, a small GTPase, is localized on mast cell secretory granules and translocates to the plasma membrane upon exocytosis. Am J Respir Cell Mol Biol 1999; 20:79-89. [PMID: 9870920 DOI: 10.1165/ajrcmb.20.1.3279] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.9] [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: 11/24/2022] Open
Abstract
Although mast cell secretion has been intensively studied because of its pivotal role in allergic reactions and its advantages as a physiologic model, the molecular composition of the secretory machine is virtually unknown. In view of the guanine-nucleotide dependency of mast cell exocytosis and the participation of Rab3 proteins in synaptic vesicle release, we hypothesized that a Rab3 isoform regulates mast cell secretion. Fragments of Rab3A, 3B, and 3D were cloned from RBL-2H3 mast cells by reverse transcription- polymerase chain reaction (RT-PCR). Northern blot analysis revealed Rab3D transcripts to be relatively abundant, Rab3B substantially less so, and Rab3A and 3C undetectable. By ribonuclease (RNase) protection assay, Rab3D transcripts were at least 10-fold more abundant than those of other isoforms, and by immunoblot analysis, Rab3D protein was at least 60-fold more abundant than that of Rab3B. Rab3D was more abundant in RBL cells than in brain, but the total mass of Rab3 proteins in RBL cells was 10-fold less than in brain. Rab3D only partly colocalized with secretory granules in RBL cells, but fully colocalized in mature peritoneal mast cells. There was a descending concentration gradient of Rab3D from peripheral to central granules, and no cytoplasmic pool was detectable in resting mast cells. Following exocytotic degranulation, Rab3D translocated to the plasma membrane and remained there for at least 15 min. These studies suggest that Rab3D is a component of the regulated exocytotic machine of mast cells, and identify differences between mast cells and neurons in Rab3 expression and trafficking.
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Affiliation(s)
- M J Tuvim
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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Loehlin JH, Franz KJ, Gist L, Moore RH. Supramolecular Alcohol–Amine Crystals and Their Hydrogen-Bond Patterns. Acta Crystallogr B Struct Sci 1998. [DOI: 10.1107/s0108768198003231] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
An analysis of the structures of five new cocrystals with saturated hydrogen bonding between amines and alcohols is presented. These five are all cocrystals with p-phenylenediamine (PDA) and a mono- or diol. The cocrystals are p-phenylenediamine–phenol (1/2) [PDA·2 phenol, (I)], p-phenylenediamine–p-phenylphenol (1/2) [PDA·2 p-phenylphenol (II)], p-phenylenediamine–2,6-dihydroxynaphthalene (1/1) [PDA·2,6-dihydroxynaphthalene (III)], p-phenylenediamine–1,6-hexanediol (1/1) [PDA·1,6-hexanediol (IV)] and p-phenylenediamine–p-chlorophenol (1/2) [PDA·2 p-chlorophenol (V)]. These crystals have two distinctly different supramolecular hydrogen-bond patterns, when considering only the hydroxyl and amine groups. There are, in addition, variations in the ways covalently bonded crosslinks connect these hydrogen-bond networks. The graph sets of the hydrogen-bond networks of these and other published saturated amine–alcohol crystals are compared and suggestions made on how to present the graph-set descriptions, especially those involving infinite two- and three-dimensional networks of intersecting chains which are characteristic of most of these materials.
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Baboolal K, Evans C, Moore RH. Incidence of end-stage renal disease in medically treated patients with severe bilateral atherosclerotic renovascular disease. Am J Kidney Dis 1998; 31:971-7. [PMID: 9631841 DOI: 10.1053/ajkd.1998.v31.pm9631841] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Incidence of end-stage renal disease in medically treated patients with severe bilateral atherosclerotic renovascular disease. Atherosclerotic renovascular disease is an important cause of end-stage renal disease (ESRD). The exact incidence of ESRD and the rate of decline in glomerular filtration rate (GFR) in patients with this condition is unknown. We report the mortality, the rate of decline in renal function, and incidence of ESRD in 51 patients with bilateral atherosclerotic renovascular disease followed-up for a median period of 52 months. None of these patients had undergone any surgical or radiological intervention. Renal function was determined by serial measurements of serum creatinine. Bilateral atherosclerotic renovascular disease was associated with a high mortality rate; the crude mortality rate at 60 months was 45%. Assessment of renal function showed impaired renal function at time of angiography and a nonuniform and variable decline in renal function during the period of observation. The median GFR decreased from 39 mL/min (range, 15 to 80 mL/min) at time of angiography to 31 mL/min (range, 10 to 70 mL/min) and 24 mL/min (range, 10 to 40 mL/min) at 24 and 60 months, respectively (P < 0.05). The calculated mean rate of decline in GFR for all patients was 4 mL/min/yr (range, 1 to 16 mL/min/yr). Over the 5 years, there was a progressive increase in the incidence of ESRD. Of the original 51 patients who underwent angiography, six patients reached ESRD. The crude incidence of ESRD was, therefore, 12%. Patients who reached ESRD were characterized by advanced azotemia at the time of angiography (median GFR, 25 mL/min) and a rapid decline in GFR (8 mL/min) compared with patients who did not reach ESRD during the observation period (median GFR, 43 mL/min and an average rate of decline GFR of 3 mL/min).
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Affiliation(s)
- K Baboolal
- Institute of Nephrology, Cardiff Royal Infirmary, United Kingdom.
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Slanetz PJ, Giardino AA, McCarthy KA, Hall DA, Halpern EF, Moore RH, Kopans DB. Previous breast biopsy for benign disease rarely complicates or alters interpretation on screening mammography. AJR Am J Roentgenol 1998; 170:1539-41. [PMID: 9609170 DOI: 10.2214/ajr.170.6.9609170] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 02/07/2023]
Abstract
OBJECTIVE It has been suggested that breast screening leads to too many biopsies for benign disease that permanently scar the breast and confuse the interpretation of subsequent mammograms. We undertook retrospective and prospective studies to determine how often an excisional biopsy for benign breast disease complicates or alters interpretation of screening mammograms. MATERIALS AND METHODS Retrospective review of our screening center database yielded 31,025 asymptomatic patients who had routine mammographic screening studies between 1993 and 1996. Of the 58,538 examinations of these patients, 53,510 were of patients who had no history of breast biopsy and 5028 were of patients who had a history of breast biopsy for benign disease. Recall rates were compared between the two groups. In the prospective study, radiologists reviewed the mammograms of 1997 consecutive patients presenting to the screening center, 173 of whom reported a prior breast biopsy for benign disease. The radiologist interpreting the images determined how often evidence of the biopsy site was apparent on the mammogram and how often such changes necessitated additional imaging. RESULTS In the retrospective study, 3296 (6%) of the 53,510 studies done in patients who did not have a biopsy for benign disease and 360 (7%) of the 5028 studies done in women who had a biopsy for benign disease led to additional imaging. Eight recalls for further imaging (0.16%) among the 5028 studies in women with a prior biopsy for benign disease were related to the biopsy site. In the prospective study, 24 (14%) of the 173 women who had a biopsy for benign disease had mammographic evidence of the biopsy site. Nine (5%) of the 173 women who had previously had a biopsy for benign disease and 86 (5%) of the 1824 patients without a prior biopsy were recalled for additional imaging. No women were recalled because a previous breast biopsy for benign disease led to confusion or diagnostic concern. CONCLUSION Changes in patients' breasts due to previous excisional biopsies for benign breast disease rarely pose a diagnostic dilemma in the interpretation of routine screening mammograms.
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Affiliation(s)
- P J Slanetz
- Department of Radiology (ACC 219), Massachusetts General Hospital and the Harvard Medical School, Boston 02114, USA
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Abstract
OBJECTIVE To review the pharmacology of the long-acting inhaled beta2-agonists, salmeterol and formoterol, summarize results of their clinical trials, evaluate their safety records, and discuss their roles in the treatment of asthma. DATA SOURCES Preclinical and clinical studies involving salmeterol or formoterol were identified by a MEDLINE search, weekly computerized literature updates, and manual searches. Studies of satisfactory quality were chosen for review. DATA SYNTHESIS Salmeterol and formoterol are potent and selective beta2-adrenoceptor agonists with durations of action >12 h. Their major differences are that formoterol has a rapid onset of action and is a partial agonist of high intrinsic efficacy, whereas salmeterol has a delayed onset and is a partial agonist of low intrinsic efficacy. Twice daily use of either drug results in improved lung function, reduced symptoms, and a better quality of life. These agents protect against exercise-induced asthma for 12 h and eliminate nighttime awakening in most patients. Limited tolerance develops, especially to their bronchoprotective effects, but their improvement of lung function is sustained. CONCLUSIONS Regular use of salmeterol or formoterol provides subjective and objective amelioration of asthma in patients experiencing excessive symptoms or physiologic impairment despite the regular administration of low doses of inhaled corticosteroids (equivalent to approximately 500 microg/d of beclomethasone). Intermittent use of either long-acting beta2-agonist can provide prolonged protection against exercise-induced asthma or nighttime symptoms. Patients should be instructed to continue taking inhaled steroids when long-acting beta2-agonists are administered on a regular schedule and to not take long-acting beta2-agonists between regularly scheduled doses. Used properly, they are effective and safe adjunctive agents in the treatment of asthma.
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Affiliation(s)
- R H Moore
- Baylor College of Medicine and the Houston Veterans Affairs Medical Center, Tex 77030, USA
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January B, Seibold A, Allal C, Whaley BS, Knoll BJ, Moore RH, Dickey BF, Barber R, Clark RB. Salmeterol-induced desensitization, internalization and phosphorylation of the human beta2-adrenoceptor. Br J Pharmacol 1998; 123:701-11. [PMID: 9517390 PMCID: PMC1565216 DOI: 10.1038/sj.bjp.0701658] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
1. Partial agonists of the beta2-adrenoceptor which activate adenylyl cyclase are widely used as bronchodilators for the relief of bronchoconstriction accompanying many disease conditions, including bronchial asthma. The bronchodilator salmeterol has both a prolonged duration of action in bronchial tissue and the ability to reassert this activity following the temporary blockade of human beta2-adrenoceptors with antagonist. 2. We have compared the activation and desensitization of human beta2-adrenoceptor stimulation of adenylyl cyclase induced by salmeterol, adrenaline and salbutamol in a human lung epithelial line, BEAS-2B, expressing beta2-adrenoceptor levels of 40-70 fmol mg(-1), and in human embryonic kidney (HEK) 293 cell lines expressing 2-10 pmol mg(-1). The efficacy observed for the stimulation of adenylyl cyclase by salmeterol was only approximately 10% of that observed for adrenaline in BEAS-2B cells expressing low levels of beta2-adrenoceptor, but similar to adrenaline in HEK 293 cells expressing very high levels of receptors. Salmeterol pretreatment of these cells induced a rapid and stable activation of adenylyl cyclase activity which resisted extensive washing and beta2-adrenoceptor antagonist blockade, consistent with binding to a receptor exosite and/or to partitioning into membrane lipid. 3. The desensitization and internalization of beta2-adrenoceptors induced by the partial agonists salmeterol and salbutamol were considerably reduced relative to the action of adrenaline. Consistent with these observations, the initial rate of phosphorylation of the receptor induced by salmeterol and salbutamol was much reduced in comparison to adrenaline. 4. Our data suggest that the reduction in the rapid phase of desensitization of beta2-adrenoceptors after treatment with salmeterol or salbutamol is caused by a decrease in the rate of beta2-adrenoceptor kinase (betaARK) phosphorylation and internalization. In contrast, the rate of cyclic AMP-dependent protein kinase (PKA)-mediated phosphorylation by these partial agonists appears to be similar to adrenaline.
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Affiliation(s)
- B January
- The University of Texas-Houston Health Science Center, Department of Integrative Biology, Pharmacology and Physiology, 77225-0708, USA
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Slanetz PJ, Moore RH, Hulka CA, Halpern EF, Habunek DA, Whitman GJ, McCarthy KA, Hall DA, Kopans DB. Screening mammography: effect of national guidelines on current physician practice. Radiology 1997; 203:335-8. [PMID: 9114084 DOI: 10.1148/radiology.203.2.9114084] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE To evaluate the effect of national breast cancer screening guidelines on current physician attitudes toward and practice of screening mammography. MATERIALS AND METHODS Questionnaire responses from 278 physicians were analyzed. The questionnaire had four sections: general information on physician practice and experience, current use of breast cancer screening, perceptions of screening mammography, and physician awareness of and response to the controversy in breast cancer screening. RESULTS In women aged 40-49 years, 144 (52%) of 278 physicians performed annual clinical breast examination and screening mammography every 2 years; 57 (21%) favored annual mammography and clinical breast examination. In women aged 50 years and older, 232 (83%) physicians screened patients annually with clinical breast examination and mammography. Two hundred seventeen (78%) physicians were aware of the recommended changes in screening guidelines; 54 (19%) were not aware of the changes. Of those aware of the changes, 56 (26%) changed to the new guidelines, 150 (69%) did not change, and six (3%) modified their practice somewhat. CONCLUSION Physician practice as regards screening mammography is influenced by national guidelines.
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Affiliation(s)
- P J Slanetz
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
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Griffin PJ, Moore RH, Jurewicz WA, Lord RH, Webley Y, Jenkins J. Conversion from cyclosporine Sandimmune to cyclosporine Neoral in the stable renal transplant population. Transplant Proc 1997; 29:303. [PMID: 9123007 DOI: 10.1016/s0041-1345(96)00118-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- P J Griffin
- Transplant Unit, Cardiff Royal Infirmary, United Kingdom
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Kopans DB, Moore RH, McCarthy KA, Hall DA, Hulka CA, Whitman GJ, Slanetz PJ, Halpern EF. Should women with implants or a history of treatment for breast cancer be excluded from mammography screening programs? AJR Am J Roentgenol 1997; 168:29-31. [PMID: 8976914 DOI: 10.2214/ajr.168.1.8976914] [Citation(s) in RCA: 10] [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: 02/03/2023]
Abstract
OBJECTIVE Our objective was to determine whether it is scientifically justified to require that women with implants or a history of treatment for breast cancer be screened in a diagnostic mammography setting and that they be excluded from mammography screening programs. MATERIALS AND METHODS The recall rates for women with breast implants or a history of treatment for breast cancer who were screened in a dedicated mammography screening program were compared with those of other women in the screening program. The computerized records for the breast screening program of the Department of Radiology at our institution for January 1, 1990, through December 31, 1995, were reviewed. The recall rates for women who had breast implants and those for women with a history of treatment for breast cancer were compared with the recall rates for the other women who underwent screening. Each recall rate included women who were called back for additional evaluation in addition to those for whom a biopsy was recommended on the basis of the screening study. RESULTS Of 45,134 screening examinations done during the review period, 43,454 (96%) were for women who had no history of breast cancer or of breast implants; 590 (1%) were for women who had undergone mastectomy; 991 (2%) were for women who had been treated with lumpectomy and irradiation for breast cancer; and 99 (0.2%) were for women with breast implants. Among the 43,454 examinations of women with no history of breast cancer or implants, 3081 examinations (7%) led to interpretations that produced requests for the patient to return for additional evaluation. Thirty-six women who had been treated for breast cancer by mastectomy were recalled (6%). Seventy-five women who had undergone lumpectomy and irradiation for breast cancer were recalled (8%). Five women with breast implants were recalled (5%). Statistically, these rates were not significantly different. CONCLUSION We find no scientific reason to exclude women who have been treated for breast cancer or who have breast implants from dedicated screening programs.
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Affiliation(s)
- D B Kopans
- Department of Radiology, Massachusetts General Hospital, Boston, USA
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Abstract
Prophylactic use of the monoclonal antibody OKT3 has been studied for the prevention of rejection in sensitised renal transplant recipients. Patients receiving a full dose (FD) regimen were compared to a subsequent consecutive group of patients receiving a reduced dose (RD) regimen. The characteristics of the two groups were not significantly different with regard to age, HLA mismatch and panel-reactive antibody (PRA) status. The number of days that OKT3 was given was 12.9 +/- 1.8 for the FD regimen and 11.3 +/- 2.8 for the RD regimen. The total dose of OKT3 given was 64.4 +/- 9 mg (FD) and 38.3 +/- 8.5 mg (RD). Patient survival at 12 months was 8/8 for FD and 17/17 for RD. Graft survival at 12 months was 7/8 for FD and 17/17 for RD. Creatinine at 24 months was 185 +/- 68 and 201 +/- 81 mumol/l for FD and RD, respectively. A reduced dose regimen of OKT3 produced excellent and comparable results to the standard recommended full-dose regimen. The cost per patient was reduced 40% from 5676 pounds for FD to 3344 pounds for RD.
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Affiliation(s)
- C R Darby
- Department of Transplantation, Cardiff Royal Infirmary, UK
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Affiliation(s)
- P T Ender
- Department of Infectious Diseases, Wilford Hall Medical Center, Lackland AFB, TX, USA.
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35
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Oermann CM, Moore RH. Foolers: things that look like pneumonia in children. Semin Respir Infect 1996; 11:204-13. [PMID: 8883178] [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: 02/02/2023]
Abstract
Pulmonary infiltrates on chest radiographs are common findings in the pediatric age group and are generally associated with acute infectious pneumonias. Occasionally, however, these "pneumonias" fail to respond to appropriate antibiotic therapy. Under these circumstances, noninfectious conditions that may be associated with pulmonary infiltrates should be considered. Thus, it is important that physicians who care for children have some knowledge of these potential "mimickers" of childhood pneumonia.
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Affiliation(s)
- C M Oermann
- Pulmonary Medicine Service, Baylor College of Medicine, Texas Children's Hospital, Houston 77030, USA
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36
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Morrison KJ, Moore RH, Carsrud ND, Trial J, Millman EE, Tuvim M, Clark RB, Barber R, Dickey BF, Knoll BJ. Repetitive endocytosis and recycling of the beta 2-adrenergic receptor during agonist-induced steady state redistribution. Mol Pharmacol 1996; 50:692-9. [PMID: 8794912] [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: 02/02/2023] Open
Abstract
The human beta 2-adrenergic receptor (beta 2AR) rapidly internalizes after binding agonist, resulting in a dramatic redistribution of receptors from the plasma membrane and into endocytic vesicles. We sought to determine whether intracellular receptors constitute a static pool or represent a fraction of dynamically internalizing and recycling receptors. Using cells expressing a beta 2AR with an epitope tag at its amino-terminal ectodomain, changes in surface receptor levels were measured by flow cytometry and radioligand binding assays. The addition of a saturating level of a strong agonist (isoproterenol) caused the endocytosis of receptors with first-order kinetics (ke for naive cells, 0.222 min-1). After 10 min, the level of surface receptors remained stable at approximately 20% that of untreated cells, even though endocytosis continued with similar kinetics (ke for pretreated cells, 0.258 min-1), suggesting that internalized receptors were cycling in steady state with surface receptors. This prediction was confirmed directly by showing that internalized beta 2ARs recycled to the cell surface in the continued presence of agonist. The calculated transit times (1/k) in the presence of isoproterenol were 3.9 min for endocytosis and 11.2 min for recycling. The endocytic rate constant and the steady state redistribution to the internal pool were much lower after treatment with the partial agonist albuterol, suggesting a correlation between the efficiency of endocytosis and that of receptor coupling to the downstream signal transduction pathway. These findings indicate that in the presence of agonist, beta 2ARs are in a dynamic steady state between the plasma membrane and endosomes that is regulated principally by agonist efficacy.
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Affiliation(s)
- K J Morrison
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
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37
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Kopans DB, Moore RH, McCarthy KA, Hall DA, Hulka CA, Whitman GJ, Slanetz PJ, Halpern EF. Positive predictive value of breast biopsy performed as a result of mammography: there is no abrupt change at age 50 years. Radiology 1996; 200:357-60. [PMID: 8685325 DOI: 10.1148/radiology.200.2.8685325] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE To determine if the positive predictive value (PPV) of a biopsy initiated because of an abnormal mammogram changes abruptly at age 50 years. MATERIALS AND METHODS The PPV and its variation with age was analyzed for 4,778 women who underwent biopsy for a clinically occult abnormality detected at mammography. The relationship of the results to the patient's age was analyzed with age represented as a continuous and two-categorized (< 50, > 50) measure. The latter measure represented an abrupt change, which distinguished those aged 49 years and younger from those aged 50 years and over. With this measure, the patients in each of the two age groups were statistically indistinguishable. RESULTS The results were consistent with a steady increase in PPV and the yield of cancers with age, and there was no abrupt change at age 50 years. The modeled PPV for all cancers for these 4,778 patients was approximately 12% for women aged 40 years and increased to 46% by age 79 years. CONCLUSION The PPV did not change abruptly at any age for women aged 40-79 years but increased steadily, which reflects the prior probability of breast cancer at each age. Inappropriate grouping of data can lead to misinterpretation of results. Screening guidelines should not be predicated on the false assumption that this variable changes at age 50 years.
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Affiliation(s)
- D B Kopans
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
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39
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Moore RH. UK multicentre study to assess the safety and tolerability of Neoral in stable renal transplant patients. U.K. Neoral Study Group. Transplant Proc 1996; 28:2202-3. [PMID: 8769200] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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40
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Slanetz PJ, Moore RH, Hulka CA, Halpern EF, Habunek D, Whitman GJ, McCarthy KA, Hall DA, Kopans DB. Physicians' opinions on the delivery of mammographic screening services: immediate interpretation versus double reading. AJR Am J Roentgenol 1996; 167:377-9. [PMID: 8686608 DOI: 10.2214/ajr.167.2.8686608] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE Mammographic services are delivered in many ways. Emphasis has been placed on providing women with immediate reports of their screening mammograms. We believe that double reading of mammograms is more important than an immediate report. We sought to determine physicians' attitudes toward this issue and if education affects their opinions. MATERIALS AND METHODS Questionnaires were mailed to 1000 physicians in Massachusetts who were randomly selected from 16,000 members of the state medical society. The questionnaire had four sections, of which two were pertinent to this subject. The first section collected general information on the physician's practice and experience. The second section described two common delivery systems for mammographic screening services and asked physicians to choose the delivery system that would most benefit their patients. RESULTS Of the 1000 physicians, 294 returned the questionnaire, giving a response rate of 29%. Of these, 16 physicians returned blank surveys, leaving 278 for analysis. Two hundred forty-nine (90%) valued off-site, delayed interpretation of mammographic screening for their patients over on-site reading by a single radiologist if an off-site, delayed reading made double reading possible. CONCLUSION An off-site, double-reading delivery system for mammographic screening services is preferred by many physicians for their patients once they are educated as to the benefits of double reading.
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Affiliation(s)
- P J Slanetz
- Department of Radiology, Massachusetts General Hospital, Boston 02114, USA
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41
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Shrestha BM, Darby C, Fergusson C, Lord R, Salaman JR, Moore RH. Cytomegalovirus causing acute colonic pseudo-obstruction in a renal transplant recipient. Postgrad Med J 1996; 72:429-30. [PMID: 8935605 PMCID: PMC2398516 DOI: 10.1136/pgmj.72.849.429] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A female patient presented with pyrexia and features of large intestinal obstruction, 10 weeks posttransplantation, with biopsy-proven colitis caused by cytomegalovirus (CMV) and positive CMV antigenaemia and IgM tests. The symptoms resolved after treatment with ganciclovir, nasogastric aspiration and intravenous fluid replacement.
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Affiliation(s)
- B M Shrestha
- Renal Transplant Unit, Cardiff Royal Infirmary, UK
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42
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Wheeler DC, Morgan R, Thomas DM, Seed M, Rees A, Moore RH. Factors influencing plasma lipid profiles including lipoprotein (a) concentrations in renal transplant recipients. Transpl Int 1996; 9:221-6. [PMID: 8723190 DOI: 10.1007/bf00335389] [Citation(s) in RCA: 5] [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: 02/01/2023]
Abstract
Fasting plasma cholesterol, triglycerides, high-density lipoprotein (HDL) and apoprotein (apo) B were elevated in 214 nondiabetic renal transplant recipients when compared to a reference group. Apo (a) was slightly but not significantly lower in transplant recipients (median 118 mg/dl, range 16-1680 vs 130 mg/dl, 10-1176) and this difference could be predicted from Lp (a) isoform analysis. Cholesterol, triglyceride, apo B and apo (a) concentrations correlated negatively with creatinine clearance but none of these parameters showed a significant association with proteinuria. Patients treated with steroids had higher plasma HDL concentrations than those receiving cyclosporin monotherapy (P < 0.01). The use of diuretics was associated with raised triglycerides (P < 0.001) and cholesterol (P < 0.01) and with reduced HDL (P < 0.01) whilst patients receiving beta-blockers had significantly higher triglycerides (P < 0.01) and lower HDL levels (P < 0.02). In multiple regression analysis, age (P < 0.01), creatinine clearance (P < 0.05) and diuretic therapy (P < 0.005) were independent risk factors for increased cholesterol whilst apo (a) levels correlated negatively with creatinine clearance (P < 0.005). These results suggest that impaired renal function, steroids and non-immunosuppressive drugs contribute to lipid abnormalites in renal transplant recipients.
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Affiliation(s)
- D C Wheeler
- Renal Transplant Unit, Cardiff Royal Infirmary, Wales, UK
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Shrestha BM, Parton D, Gray A, Shephard D, Griffith D, Westmoreland D, Griffin P, Lord R, Salaman JR, Moore RH. Cytomegalovirus involving gastrointestinal tract in renal transplant recipients. Clin Transplant 1996; 10:170-5. [PMID: 8664513 DOI: pmid/8664513] [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: 02/08/2023]
Abstract
Infection due to cytomegalovirus (CMV) is a substantial cause of mortality and morbidity among renal transplant recipients but the prognosis of the disease has changed dramatically since the introduction of ganciclovir (GAN). During a period of 5 years we treated 54 patients who developed CMV disease. From this group of patients we identified 7 patients with primary gastrointestinal tract (GIT) CMV disease who received treatment with GAN. Tissue diagnosis was made by endoscopy of the upper GIT (6 patients) or sigmoidoscopy (one patient) and histological examination. All patients improved after treatment with GAN; three patients required additional treatment for recurrent CMV disease and recovered, and 1 patient relapsed without GIT involvement (P = 0.014). Recurrent CMV disease was more severe (mean score of 15 in relapse compared to 7 in the first episode). We believe relapse to be more common and the disease to be more severe in the presence of GIT involvement suggesting that a longer duration of treatment with GAN may be required in this clinical manifestation of CMV disease.
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Affiliation(s)
- B M Shrestha
- Renal Transplant Unit of Cardiff Royal Infirmary, University of Glamorgan, Wales
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Abstract
BACKGROUND Reticulocytes are important in the phenotyping of transfused patients. Reticulocytes can persist in blood units for the shelf life of the unit. STUDY DESIGN AND METHODS Temperature dependence of reticulocyte persistence was examined in vitro at 4, 24, and 37 degrees C by using thiazole orange staining and flow cytometric analysis. Two-color flow cytometric analysis was used to evaluate the persistence of donor reticulocytes in transfused patients. RESULTS Flow cytometric analysis using thiazole orange demonstrated that persistence of reticulocytes in units of stored CPDA-1 blood was temperature-dependent. Reticulocytes disappeared over 13 and 6 days at 24 degrees C and 37 degrees C, respectively, but at 4 degrees C the reticulocyte count changed little over 35 days. Two-color flow cytometric analysis of reticulocyte antigens was used to follow donor reticulocytes in 14 transfusion events in nine different patients. Donor reticulocytes persisted through 24 hours in 75 percent of the patients and were detectable at 48 hours in three patients. CONCLUSION This study demonstrates that reticulocytes persist during refrigerated storage; they are detectable in the circulation of most recipients for the first 24 hours after transfusion and in the circulation of a few recipients after 48 hours. These findings may have relevance for separation techniques based on reticulocyte density in samples drawn shortly after transfusion and for evaluation of reticulocyte counts in patients with hematologic abnormalities.
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Affiliation(s)
- E S Perry
- Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA
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Fennessy M, Hitman GA, Moore RH, Metcalfe K, Medcraft J, Sinico RA, Mustonen JT, D'Amico G. HLA-DQ gene polymorphism in primary IgA nephropathy in three European populations. Kidney Int 1996; 49:477-80. [PMID: 8821832 DOI: 10.1038/ki.1996.67] [Citation(s) in RCA: 34] [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: 02/02/2023]
Abstract
MHC Class II genes may contribute to susceptibility to IgA nephropathy (IgAN). We have previously identified a restriction fragment length polymorphism (RFLP) of the DQB1 region that associated with IgAN in British Caucasoids. However, another group, while demonstrating a DQB1 association, was unable to confirm our finding. MHC molecules are heterodimers consisting of an alpha and beta chain, and thus polymorphism of the DQA1 alpha chain may also be important to disease pathogenesis in IgAN. Therefore, we have determined DQA1 alleles and re-examined DQB1 alleles in British Caucasoids with IgAN using an approach that can differentiate between the common DQ alleles; we have also extended our studies to Caucasoid populations from Northern and Southern Europe, thereby addressing the possibility of variation in genetic susceptibility between populations. DNA was prepared from IgAN patients (British, N = 105; Italian, N = 71; Finnish, N = 48) and healthy controls (British, N = 111; Italian, N = 63; Finnish, N = 41). DQA1 alleles were identified by TaqI RFLP and Southern blotting; alleles that could not be fully resolved by Taq Southern blotting were identified by PCR-RFLP. DQB1 alleles were identified by polymerase chain reaction (PCR) based technique (PCR-RFLP). No consistent association of DQ alleles were found between the populations studied. In British patients a decreased frequency of DQB1*0201 was observed (P = 0.008), in Finnish patients a decreased frequency of DQB1*0602 was observed (P = 0.01), and in Italian patients no association between DQ markers and IgAn was found. These data demonstrate population variation in disease association, but no strong or consistent association in the DQ region.
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Affiliation(s)
- M Fennessy
- Medical Unit, Royal London Hospital, England, United Kingdom
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Abstract
The safety and tolerability of transferring maintained renal transplant patients from Sandimmun to Neoral is being assessed in a multicentre, open-label, single-arm study. A total of 250 patients has been enrolled and results are available from 75 patients up to 12 months post-transfer. A slight trend to higher mean cyclosporin trough levels was seen in this cohort, but trough levels were unchanged in the sub-group receiving > or = 1 dose changes. The mean dose fell by 13%. Creatinine levels showed a slight overall upward trend. Blood pressure and uric acid were unchanged and adverse events were typical of those seen with Sandimmun. Neoral was well-tolerated. Data from the full cohort of 250 patients up to 3 months post-transfer support these findings. These results indicate that transfer from Sandimmun to Neoral is safe and well-tolerated and provides appropriate immunosuppression at a lower average dose than Sandimmun. The Neoral dose should be adjusted promptly, as required, to maintain the target trough level.
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Moore RH, Sadovnikoff N, Hoffenberg S, Liu S, Woodford P, Angelides K, Trial JA, Carsrud ND, Dickey BF, Knoll BJ. Ligand-stimulated beta 2-adrenergic receptor internalization via the constitutive endocytic pathway into rab5-containing endosomes. J Cell Sci 1995; 108 ( Pt 9):2983-91. [PMID: 8537438 DOI: 10.1242/jcs.108.9.2983] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The small GTPase rab5 appears to be rate-limiting for the constitutive internalization of transferrin receptor and for fluid-phase endocytosis. However, it is unknown whether rab5 regulates receptors whose internalization is stimulated by the binding of ligand, and whether such receptors change the underlying rate of the endocytic pathways they utilize. As a model for ligand-stimulated endocytosis, we used transfected HEK293 cells expressing high levels of an epitope-tagged human beta 2-adrenergic receptor. Nearly all receptors were on the cell surface in the absence of agonist, but within ten minutes of agonist addition > 50% of receptors internalized and colocalized extensively with rab5. Hypertonic sucrose blocked beta 2-adrenergic receptor internalization, as well as that of transferrin receptor, suggesting a clathrin-mediated process. In contrast, an inhibitor of potocytosis had little effect upon beta 2-adrenergic receptor internalization, suggesting that this process did not require active caveolae. Consistent with this finding, caveolin was not detectable in the 12 beta 6 line, as assessed by western blotting with a polyclonal anti-caveolin antibody. Stimulated receptor internalization did not affect the rate or capacity of the constitutive endocytic pathway since there was no detectable increase in fluid-phase endocytosis after addition of beta-agonist, nor was there a significant change in the amount of surface transferrin receptor. Altogether, these data suggest that beta 2-adrenergic receptors internalize by a clathrin-mediated and rab5-regulated constitutive endocytic pathway. Further, agonist-stimulated receptor internalization has no detectable effect upon the function of this pathway.
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Affiliation(s)
- R H Moore
- Department of Pediatrics, Baylor College of Medicine, Houston VA Medical Center, TX 77030, USA
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Haug CE, Lopez IA, Moore RH, Rubin RH, Tolkoff-Rubin N, Palacios de Caretta N, Colvin RB, Cosimi AB, Rabito CA. Real-time monitoring of renal function during ischemic injury in the rhesus monkey. Ren Fail 1995; 17:489-502. [PMID: 8570862 DOI: 10.3109/08860229509037614] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [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: 01/31/2023] Open
Abstract
The presence of delayed graft function (DGF) following cadaver donor renal transplantation is associated with inferior graft survival as well as decreased patient survival. Delay in onset of function eliminates a valuable indicator of allograft viability, which is not easily replaced by standard diagnostic procedures. The purpose of this study was to demonstrate that a new clearance technique could be used to measure renal function minute to minute and under conditions similar to those observed in humans in the immediate posttransplantation period. A monkey model was used to provide controlled conditions. Increasing levels of ischemic injury were produced in 12 Rhesus monkeys by renal hilum cross-clamping. Real-time measurements of glomerular filtration rate (GFR) were obtained from the rate of clearance of the extracellular fluid of the GFR agent 99mTc-DTPA, as measured with a specially designed external radioactivity counting device called the ambulatory renal monitor, or ARM. GRF was measured every 2-5 min as the slope (k) of the log of activity measured minute to minute versus time. GFR measurements were correlated with blood urea nitrogen (BUN), plasma creatinine (Cr), routine light microscopy, and measurement of proliferating cell nuclear antigen (PCNA), a marker of cell proliferation. Large changes in renal function due to ischemia or ureteral obstruction were observed within minutes. In addition, the rate constant on Day 1 was predictive of peak serum Cr(R =--0.86, R2=.74, p = .0001). Acute tubular necrosis (ATN) resolution was reflected more quickly when using the rate constant (Day 1) than when using either BUN or plasma Cr (Day 3-4). Because of renal functional reserve, BUN and plasma Cr were relatively insensitive indicators of mild to moderate reductions in GFR as compared with the rate constant. We conclude that ARM is a simple method which provide an accurate, near real-time GFR readout with potential applications not only for the clinical management of patients with DGF, but also as a research tool in acute renal failure (ARF).
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Affiliation(s)
- C E Haug
- Department of Surgery, Massachusetts General Hospital, Boston 02114, USA
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49
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Abstract
In former mining communities tailings containing up to 2% (20,000 ppm) lead (Pb), frequently as galena (lead sulfide), may be present in large piles near residences, as landfill under homes, or mixed with residential soils. The impact of tailings on blood lead was assessed by comparing blood lead values obtained from residents and environmental lead measured in soils and tailings piles. Data from 13 communities were compiled. Approximately 2995 blood lead measurements were available from persons residing on or near tailings, with the majority of samples from children. Blood lead levels were compared to 1806 controls from nearby communities, national norms, and communities with active smelters. Data comparisons indicated that blood lead values in tailings residents were usually comparable to controls. These data suggest that lead present in mill tailings is not readily bioavailable, even to children who played in dirt or tailings piles. Consequently, the hazard of lead in soils appears to be site-specific and influenced by bioavailability; the bioavailability of galena tailings to humans is low. When health risks of lead soils are predicted, factors affecting the bioavailability of lead present in tailings need to be taken into account.
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Affiliation(s)
- I H Danse
- ENVIROMED Health Services, Inc., San Rafael, CA 94901, USA
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50
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Moore RH. Use of a palmtop pocket computer to produce a customised logbook of surgical experience. Ann R Coll Surg Engl 1995; 77:74-6. [PMID: 7574301] [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: 01/26/2023] Open
Abstract
The use of a pocket palmtop computer for the prospective audit of a basic surgical trainee's operative experience is described. A powerful yet portable system of information storage is shown, which can be used to compile a logbook suitable for examinations and career interviews in clinical surgery.
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Affiliation(s)
- R H Moore
- Department of Surgery, Hinchingbrooke Hospital, Cambridgeshire
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