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Naumann DN, Sellon E, Mitchinson S, Tucker H, Marsden MER, Norris-Cervetto E, Bafitis V, Smith T, Bradley R, Alzarrad A, Naeem S, Smith G, Dillane S, Humphrys-Eveleigh A, Wordsworth M, Sanchez-Thompson N, Bootland D, Brown L. Occult tension pneumothorax discovered following imaging for adult trauma patients in the modern major trauma system: a multicentre observational study. BMJ Mil Health 2024; 170:123-129. [PMID: 35584853 DOI: 10.1136/bmjmilitary-2022-002126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Tension pneumothorax following trauma is a life-threatening emergency and radiological investigation is normally discouraged prior to treatment in traditional trauma doctrines such as ATLS. Some trauma patients may be physiologically stable enough for diagnostic imaging and occult tension pneumothorax is discovered radiologically. We assessed the outcomes of these patients and compared them with those with clinical diagnosis of tension pneumothorax prior to imaging. METHODS A multicentre civilian-military collaborative network of six major trauma centres in the UK collected observational data from adult patients who had a diagnosis of traumatic tension pneumothorax during a 33-month period. Patients were divided into 'radiological' (diagnosis following CT/CXR) or 'clinical' (no prior CT/CXR) groups. The effect of radiological diagnosis on survival was analysed using multivariable logistic regression that included the covariates of age, gender, comorbidities and Injury Severity Score. RESULTS There were 133 patients, with a median age of 41 (IQR 24-61); 108 (81%) were male. Survivors included 49 of 59 (83%) in the radiological group and 59 of 74 (80%) in the clinical group (p=0.487). Multivariable logistic regression showed no significant association between radiological diagnosis and survival (OR 2.40, 95% CI 0.80 to 7.95; p=0.130). There was no significant difference in mortality between the groups. CONCLUSION Radiological imaging may be appropriate for selected trauma patients at risk of tension pneumothorax if they are considered haemodynamically stable. Trauma patients may be physiologically stable enough for radiological imaging but have occult tension pneumothorax because they did not have the typical clinical presentation. The historical dogma of the 'forbidden scan' no longer applies to such patients.
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Affiliation(s)
- David N Naumann
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
- Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - E Sellon
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - S Mitchinson
- Emergency Department, Barts Health NHS Trust, London, UK
| | - H Tucker
- Emergency Department, St George's Healthcare NHS Trust, London, UK
| | - M E R Marsden
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
- Emergency Department, Barts Health NHS Trust, London, UK
| | - E Norris-Cervetto
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - V Bafitis
- Department of Radiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - T Smith
- Department of Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - R Bradley
- Emergency Department, Barts Health NHS Trust, London, UK
| | - A Alzarrad
- Emergency Department, Barts Health NHS Trust, London, UK
| | - S Naeem
- Emergency Department, Barts Health NHS Trust, London, UK
| | - G Smith
- Emergency Department, Barts Health NHS Trust, London, UK
| | - S Dillane
- Emergency Department, St George's Healthcare NHS Trust, London, UK
| | | | - M Wordsworth
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
- Department of Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - N Sanchez-Thompson
- Department of Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - D Bootland
- Emergency Department, Brighton and Sussex University Hospitals NHS Trust, Worthing, UK
| | - L Brown
- Emergency Department, Brighton and Sussex University Hospitals NHS Trust, Worthing, UK
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2
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Abeyta MA, Al-Qaisi M, Horst EA, Mayorga EJ, Rodriguez-Jimenez S, Goetz BM, Carta S, Tucker H, Baumgard LH. Effects of dietary antioxidant supplementation on metabolism and inflammatory biomarkers in heat-stressed dairy cows. J Dairy Sci 2023; 106:1441-1452. [PMID: 36543647 DOI: 10.3168/jds.2022-22338] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/20/2022] [Indexed: 12/24/2022]
Abstract
Heat-stress-induced inflammation may be ameliorated by antioxidant supplementation due to the purported effects of increased production of reactive oxygen species or oxidative stress on the gastrointestinal tract barrier. Thus, study objectives were to evaluate whether antioxidant supplementation [AGRADO Plus 2.0 (AP); EW Nutrition] affects metabolism and inflammatory biomarkers in heat-stressed lactating dairy cows. Thirty-two mid-lactation multiparous Holstein cows were assigned to 1 of 4 dietary-environmental treatments: (1) thermoneutral (TN) conditions and fed a control diet (TN-CON; n = 8), (2) TN and fed a diet with AP (10 g antioxidant; n = 8), (3) heat stress (HS) and fed a control diet (HS-CON; n = 8), or (4) HS and fed a diet with AP (HS-AP; n = 8). The trial consisted of a 23-d prefeeding phase and 2 experimental periods (P). Respective dietary treatments were top-dressed starting on d 1 of the prefeeding period and continued daily throughout the duration of the experiment. During P1 (4 d), baseline data were collected. During P2 (7 d), HS was artificially induced using an electric heat blanket (Thermotex Therapy Systems Ltd.). During P2, the effects of treatment, day, and treatment-by-day interaction were assessed using PROC MIXED of SAS (SAS Institute Inc.). Heat stress (treatments 3 and 4) increased rectal, vaginal, and skin temperatures (1.2°C, 1.1°C, and 2.0°C, respectively) and respiration rate (33 breaths per minute) relative to TN cows. As expected, HS decreased dry matter intake, milk yield, and energy-corrected milk yield (32%, 28%, and 28% from d 4 to 7, respectively) relative to TN. There were no effects of AP on body temperature indices or production. Milk fat, protein, and lactose concentrations remained unaltered by HS or AP; however, milk urea nitrogen was increased during HS regardless of AP supplementation (26% relative to TN). Circulating glucose remained unchanged by HS, AP, or time. Additionally, HS decreased circulating glucagon (29% from d 3 to 7 relative to TN), but there was no additional effect of AP. There was a tendency for nonesterified fatty acid concentrations to be increased in HS-AP cows throughout P2 (60% relative to TN-CON), whereas it remained similar in all other treatments. Blood urea nitrogen increased for both HS treatments from d 1 to 3 before steadily decreasing from d 5 to 7, with the overall increase being most pronounced in HS-CON cows (27% relative to TN-CON). Further, supplementing AP decreased blood urea nitrogen in HS-AP on d 3 relative to HS-CON (15%). Circulating serum amyloid A tended to be and lipopolysaccharide binding protein was increased by HS, but neither acute-phase protein was affected by AP. Overall, AP supplementation appeared to marginally alter metabolism but did not meaningfully alter inflammation during HS.
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Affiliation(s)
- M A Abeyta
- Department of Animal Science, Iowa State University, Ames 50011
| | - M Al-Qaisi
- Department of Animal Science, Iowa State University, Ames 50011
| | - E A Horst
- Department of Animal Science, Iowa State University, Ames 50011
| | - E J Mayorga
- Department of Animal Science, Iowa State University, Ames 50011
| | | | - B M Goetz
- Department of Animal Science, Iowa State University, Ames 50011
| | - S Carta
- Department of Animal Science, Iowa State University, Ames 50011
| | - H Tucker
- Novus International, St. Charles, MO 63304
| | - L H Baumgard
- Department of Animal Science, Iowa State University, Ames 50011.
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3
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Windsor WJ, Roell Y, Tucker H, Cheng CA, Suliman S, Peek LJ, Pestano GA, Lee WT, Zeichhardt H, Lamb MM, Kammel M, Wang H, Kedl R, Rester C, Morrison TE, Davenport BJ, Carson K, Yates J, Howard K, Kulas K, Walt DR, Dafni A, Taylor D, Chu M. Harmonization of Multiple SARS-CoV-2 Reference Materials Using the WHO IS (NIBSC 20/136): Results and Implications. Front Microbiol 2022; 13:893801. [PMID: 35707164 PMCID: PMC9190986 DOI: 10.3389/fmicb.2022.893801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background There is an urgent need for harmonization between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology platforms and assays prior to defining appropriate correlates of protection and as well inform the development of new rapid diagnostic tests that can be used for serosurveillance as new variants of concern (VOC) emerge. We compared multiple SARS-CoV-2 serology reference materials to the WHO International Standard (WHO IS) to determine their utility as secondary standards, using an international network of laboratories with high-throughput quantitative serology assays. This enabled the comparison of quantitative results between multiple serology platforms. Methods Between April and December 2020, 13 well-characterized and validated SARS-CoV-2 serology reference materials were recruited from six different providers to qualify as secondary standards to the WHO IS. All the samples were tested in parallel with the National Institute for Biological Standards and Control (NIBSC) 20/136 and parallel-line assays were used to calculate the relevant potency and binding antibody units. Results All the samples saw varying levels of concordance between diagnostic methods at specific antigen–antibody combinations. Seven of the 12 candidate materials had high concordance for the spike-immunoglobulin G (IgG) analyte [percent coefficient of variation (%CV) between 5 and 44%]. Conclusion Despite some concordance between laboratories, qualification of secondary materials to the WHO IS using arbitrary international units or binding antibody units per milliliter (BAU/ml) does not provide any benefit to the reference materials overall, due to the lack of consistent agreeable international unit (IU) or BAU/ml conversions between laboratories. Secondary standards should be qualified to well-characterized reference materials, such as the WHO IS, using serology assays that are similar to the ones used for the original characterization of the WHO IS.
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Affiliation(s)
| | - Yannik Roell
- Colorado School of Public Health, Center for Global Health, Aurora, CO, United States
| | - Heidi Tucker
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, NY, United States
| | - Chi-An Cheng
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, United States
| | - Sara Suliman
- Division of Rheumatology, Inflammation and Immunity, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, United States.,Division of Experimental Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, San Francisco, CA, United States
| | | | | | - William T Lee
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, NY, United States
| | - Heinz Zeichhardt
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, Germany.,IQVD GmbH, Institut fuer Qualitaetssicherung in der Virusdiagnostik, Berlin, Germany.,GBD Gesellschaft fuer Biotechnologische Diagnostik mbH, Berlin, Germany
| | - Molly M Lamb
- Colorado School of Public Health, Center for Global Health, Aurora, CO, United States
| | - Martin Kammel
- INSTAND e.V., Society for Promoting Quality Assurance in Medical Laboratories, Duesseldorf, Germany.,IQVD GmbH, Institut fuer Qualitaetssicherung in der Virusdiagnostik, Berlin, Germany.,GBD Gesellschaft fuer Biotechnologische Diagnostik mbH, Berlin, Germany
| | - Hui Wang
- Thermo Fisher Scientific, Waltham, MA, United States
| | - Ross Kedl
- Department of Immunology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Cody Rester
- Department of Immunology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Thomas E Morrison
- Department of Immunology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Bennet J Davenport
- Department of Immunology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Kyle Carson
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, NY, United States
| | - Jennifer Yates
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, NY, United States
| | - Kelly Howard
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, NY, United States
| | - Karen Kulas
- Division of Infectious Diseases, New York State Department of Health, Wadsworth Center, Albany, NY, United States
| | - David R Walt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, United States
| | - Aner Dafni
- Oneworld Accuracy, Vancouver, BC, Canada
| | | | - May Chu
- Colorado School of Public Health, Center for Global Health, Aurora, CO, United States
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4
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Coles-Black J, Tucker H, Ischia J, Lawrentschuk N, Woodruff M, Webb D, Bolton D. 3D printed models decentralise surgical skills training for retrograde intrarenal surgery and percutaneous nephrolithotomy in the COVID-19 era. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01104-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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5
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Schiff S, Pendley S, Baxter B, Starks M, Krikorian K, Tucker H, Cargal A, Kirchner K, Linnemann R. 120: A pediatric QI project to improve lung function and optimize treatment of CF pulmonary exacerbations. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01545-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Bao J, Maietta T, Hellman A, Byraju K, Ghoushal G, Neubauer P, Williams E, Burdette C, Mahoney E, Tucker H, Patel V, Shin D, Pilitsis JG. The Effects of Low Intensity Pulsed Focused Ultrasound on Somatosensory Cortex Neuronal Activity. Neurosurgery 2020. [DOI: 10.1093/neuros/nyaa447_531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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7
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Ter Avest E, Lambert E, de Coverly R, Tucker H, Griggs J, Wilson MH, Ghorbangholi A, Williams J, Lyon RM. Live video footage from scene to aid helicopter emergency medical service dispatch: a feasibility study. Scand J Trauma Resusc Emerg Med 2019; 27:55. [PMID: 31068199 PMCID: PMC6505217 DOI: 10.1186/s13049-019-0632-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/26/2019] [Indexed: 11/20/2022] Open
Abstract
Background Obtaining accurate information from a 112 caller is key to correct tasking of Helicopter Emergency Medical Services (HEMS). Being able to view the incident scene via video from a mobile phone may assist HEMS dispatch by providing more accurate information such as mechanism of injury and/or injuries sustained. The objective of this study is to describe the acceptability and feasibility of using live video footage from the mobile phone of a 112 caller as an HEMS dispatch aid. Methods Live footage is obtained via the 112 caller’s mobile phone camera through the secure GoodSAM app’s Instant-on-scene™ platform. Video footage is streamed directly to the dispatcher, and not stored. During the feasibility trial period, dispatchers noted the purpose for which they used the footage and rated ease of use and any technical- and operational issues they encountered. A subjective assessment of caller acceptance to use video was conducted. Results Video footage from scene was attempted for 21 emergency calls. The leading reasons listed by the dispatchers to use live footage were to directly assess the patient (18/21) and to obtain information about the mechanism of injury and the scene (11/21). HEMS dispatchers rated the ease of use with a 4.95 on a 5-point scale (range 4–5). All callers gave permission to stream from their telephone camera. Video footage from scene was successfully obtained in 19 calls, and was used by the dispatcher as an aid to send (5) or stand down (14) a Helicopter Emergency Medical Services team. Conclusion Live video footage from a 112 caller can be used to provide dispatchers with more information from the scene of an incident and the clinical condition of the patient(s). The use of mobile phone video was readily accepted by the 112 caller and the technology robust. Further research is warranted to assess the impact video from scene could have on HEMS dispatching.
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Affiliation(s)
- E Ter Avest
- Air Ambulance Kent, Surrey and Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK. .,Department of Emergency Medicine, University Hospital Groningen, Groningen, the Netherlands.
| | - E Lambert
- Air Ambulance Kent, Surrey and Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK
| | - R de Coverly
- Air Ambulance Kent, Surrey and Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK
| | - H Tucker
- Air Ambulance Kent, Surrey and Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK
| | - J Griggs
- Air Ambulance Kent, Surrey and Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK
| | - M H Wilson
- Air Ambulance Kent, Surrey and Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK.,Neurotrauma Centre, Imperial College, London, UK
| | | | - J Williams
- School of Health Sciences, University of Surrey, Guildford, UK.,South East Coast Ambulance Service NHS Foundation Trust, Crawley, UK
| | - R M Lyon
- Air Ambulance Kent, Surrey and Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK.,School of Health Sciences, University of Surrey, Guildford, UK
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8
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Stephenson E, Rathert A, Shoemake B, Nagy D, Messman R, Freitas T, Tucker H, Meyer A. 54 Effects of copper, zinc, and manganese source and concentration during late gestation on beef cow performance, fetal growth, and mineral status of cows and neonatal calves. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- E Stephenson
- Division of Animal Sciences, University of Missouri,Columbia, MO, United States
| | - A Rathert
- Division of Animal Sciences, University of Missouri,Columbia, MO, United States
| | - B Shoemake
- Division of Animal Sciences, University of Missouri,Columbia, MO, United States
| | - D Nagy
- Division of Animal Sciences, University of Missouri,Columbia, MO, United States
| | - R Messman
- Division of Animal Sciences, University of Missouri,Columbia, MO, United States
| | - T Freitas
- Novus International Inc, St. Charles, MO, United States
| | - H Tucker
- Novus International Inc, St. Charles, MO, United States
| | - A Meyer
- Division of Animal Sciences, University of Missouri,Columbia, MO, United States
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9
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Affiliation(s)
- C Redifer
- Department of Animal Science, Iowa State University,Ames, IA, United States
| | - H Tucker
- Novus International Inc,St. Charles, MO, United States
| | - D Loy
- Department of Animal Science, Iowa State University,Ames, IA, United States
| | - P Gunn
- Department of Animal Science, Iowa State University,Ames, IA, United States
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10
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Rathert A, Stephenson E, Kenny A, Freitas T, Tucker H, Meyer A. PSXII-1 Effects of copper, zinc, and manganese source and concentration during late gestation on beef cow colostrum yield and quality. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Rathert
- Division of Animal Sciences, University of Missouri,Columbia, Columbia, MO, United States
| | - E Stephenson
- Division of Animal Sciences, University of Missouri,Columbia, Columbia, MO, United States
| | - A Kenny
- Division of Animal Sciences, University of Missouri,Columbia, Columbia, MO, United States
| | - T Freitas
- Novus International Inc,St Charles, MO, United States
| | - H Tucker
- Novus International Inc,St Charles, MO, United States
| | - A Meyer
- Division of Animal Sciences, University of Missouri,Columbia, Columbia, MO, United States
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11
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Clements AR, Ireland FA, Freitas T, Tucker H, Shike DW. Effects of supplementing methionine hydroxy analog on beef cow performance, milk production, reproduction, and preweaning calf performance. J Anim Sci 2018; 95:5597-5605. [PMID: 29293801 DOI: 10.2527/jas2017.1828] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Mature Simmental × Angus cows (214 cows; 635 ± 7 kg) were utilized to determine the effects of late gestation and early postpartum supplementation of methionine hydroxy analog (MHA) on cow BW, BCS, milk production, milk composition, reproduction, and calf performance until weaning in a fall-calving, cool-season grazing system. Cows were stratified by BW, age, AI sire, and assigned to 1 of 12 pastures (17 or 18 cows·pasture). Pastures were randomly allotted to 1 of 2 treatments: control (0.45 kg·cow·d of wheat midd-based pellets, = 6) or supplement including MHA (0.45 kg·cow·d of wheat midd-based pellets including 10 g MHA supplied as MFP (Novus International, Inc., St. Charles, MO; = 6). Treatments were fed 23 ± 7 d prepartum through 73 ± 7 d postpartum. Cow BW was collected at postcalving (27 ± 7 d postpartum), end of supplementation (73 ± 7 d postpartum), AI, pregnancy check, and end of trial (192 and 193 ± 7 d postpartum). At 73 ± 7 d postpartum, a subset of cow-calf pairs was used in a weigh-suckle-weigh procedure to determine milk production, and milk samples were taken to determine milk composition ( = 45·treatment). Serum from blood was collected at 73 ± 7 and 83 ± 7 d postpartum to determine cow cyclicity and concentrations of 2-hydroxy4-(methylthio) butanoic acid (HMTBa) and L-Methionine. After supplementation, all cow-calf pairs were managed as a common group until weaning (193 ± 7 d of age). Cows were bred via AI at 97 ± 7 d postpartum and clean-up bulls were turned out 11 d post-AI for a 55-d breeding season. Cows fed MHA had greater ( < 0.01) serum concentrations of HMTBa. Cow BW and BCS were not different ( ≥ 0.10) at any time points between treatments. There was no treatment effect ( ≥ 0.17) on calf birth BW, calf weaning BW (193 ± 7 d of age), or calf ADG. Calculated 24-h milk production, milk composition and component production did not differ ( ≥ 0.21). There were no differences ( ≥ 0.50) in percentage of cows cycling, AI conception rate, and overall pregnancy rate between treatments. Post-trial nutritional modeling suggests cows experienced several nutritional deficiencies beyond methionine (Met) that limited the response to Met supplementation. Although supplementation of MHA during late gestation through estimated peak lactation increased serum HMTBa concentrations, it did not affect cow performance, cow milk production, or calf performance when fall-calving cows grazed cool-season forages.
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12
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Stokes RS, Tucker H, Shike DW. 434 Effect of Supplementation of Chelated Trace Minerals on Reproductive Performance of Beef Cattle. J Anim Sci 2018. [DOI: 10.1093/jas/sky073.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - H Tucker
- Novus International, Saint Charles, MO
| | - D W Shike
- Department of Animal Sciences, University of Illinois, Urbana, IL
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13
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Patel S, Tucker H, Jin L. The common human HAQ STING variant affects Pneumovax® 23 efficacy. The Journal of Immunology 2016. [DOI: 10.4049/jimmunol.196.supp.146.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Multiple polysaccharide vaccines have been licensed in U.S including the pneumococcal vaccine Pneumovax® 23, meningococcal vaccine Menomune, and Salmonella typhi vaccine Typhim Vi. Polysaccharides antigens activate the Stimulator of Interferon Gene (STING/MPYS) pathway in B cells. We previously found that ~3% of Caucasian and ~16% of Asian are homozygous for a STING variant containing three non-synonymous SNPs, R71H-G230A-R293Q (HAQ). Here, using human B cells derived from HAQ individuals and a knock-in mouse expressing mouse-equivalent of human HAQ variant, we investigated the impact of the HAQ variant on the effectiveness of Pneumovax® 23. Our results suggest that Pneumovax® 23 is likely less effective in HAQ individuals than the wt (R232) STING carriers. Our novel finding revealed, for the first time, the impact of the common HAQ human STING variant on Pneumovax® 23 efficacy and illustrated the need to develop personalized STING-targeting immunotherapy.
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14
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Barroso M, Tucker H, Drake L, Nichol K, Drake JR. Antigen-B Cell Receptor Complexes Associate with Intracellular major histocompatibility complex (MHC) Class II Molecules. J Biol Chem 2015; 290:27101-27112. [PMID: 26400081 DOI: 10.1074/jbc.m115.649582] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Indexed: 01/09/2023] Open
Abstract
Antigen processing and MHC class II-restricted antigen presentation by antigen-presenting cells such as dendritic cells and B cells allows the activation of naïve CD4+ T cells and cognate interactions between B cells and effector CD4+ T cells, respectively. B cells are unique among class II-restricted antigen-presenting cells in that they have a clonally restricted antigen-specific receptor, the B cell receptor (BCR), which allows the cell to recognize and respond to trace amounts of foreign antigen present in a sea of self-antigens. Moreover, engagement of peptide-class II complexes formed via BCR-mediated processing of cognate antigen has been shown to result in a unique pattern of B cell activation. Using a combined biochemical and imaging/FRET approach, we establish that internalized antigen-BCR complexes associate with intracellular class II molecules. We demonstrate that the M1-paired MHC class II conformer, shown previously to be critical for CD4 T cell activation, is incorporated selectively into these complexes and loaded selectively with peptide derived from BCR-internalized cognate antigen. These results demonstrate that, in B cells, internalized antigen-BCR complexes associate with intracellular MHC class II molecules, potentially defining a site of class II peptide acquisition, and reveal a selective role for the M1-paired class II conformer in the presentation of cognate antigen. These findings provide key insights into the molecular mechanisms used by B cells to control the source of peptides charged onto class II molecules, allowing the immune system to mount an antibody response focused on BCR-reactive cognate antigen.
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Affiliation(s)
- Margarida Barroso
- Center for Cardiovascular Sciences, Albany Medical College, Albany, New York 12208
| | - Heidi Tucker
- Center for Immunology and Microbial Disease, Albany Medical College, Albany, New York 12208
| | - Lisa Drake
- Center for Immunology and Microbial Disease, Albany Medical College, Albany, New York 12208
| | - Kathleen Nichol
- Center for Immunology and Microbial Disease, Albany Medical College, Albany, New York 12208
| | - James R Drake
- Center for Immunology and Microbial Disease, Albany Medical College, Albany, New York 12208.
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Abstract
Abstract
Background: Philadelphia chromosome, t(9;22), positive (Ph+) chronic myelogenous leukemia (CML) accounts for only 2-2.5% of childhood leukemia cases or about 60 cases per year in the US. Tyrosine kinase inhibitors (TKIs) have dramatically changed the prognosis and treatment of CML in adults and children. Failure of TKIs is often due to mutations. In adult CML, the F317i mutation has been implicated in resistance to first and second line TKIs (imatinib/dasatinib) without affecting sensitivity to the third line TKI, nilotinib. The F317i mutation has been documented a handful of times in adult CML and in childhood Ph+ALL cases. We describe what we believe to be a first report of F317i mutation in a child with Ph+ CML who, after initial major molecular responses, rapidly developed resistance to first, second and third line TKIs.
The current Childrens Oncology Group trial of oral nilotinib (COG AAML1321) does not recognize F317i as a mutation associated with nilotinib resistance.
Case: An 11-year old female with classic chronic phase (CP) CML was found to have the F317i mutation after initially achieving an MMR during the first 3 months of treatment while on dasatinib. After results of the F317i mutation were received, the patient was switched to nilotinib and again achieved an MMR in the first 2 months before rapidly decompensating with a pre B cell ALL blast crisis. The child was then treated with ALL induction and consolidation and allogeneic stem cell transplant and again achieved an MMR which has been sustained for 5 months.
Methods: Cases of the F317i mutation have been documented in adults, however, we did an extensive literature search of PubMed, Ovid, and Google Scholar using keywords “F317” as well as F317i, ” and we were unable to find another report of this mutation in a child.
Discussion: CML in children is rare and to our knowledge the F317i mutation in children has not been previously reported. In contrast to how the F317i mutation is expected to behave in adult Ph+ CML, our patient developed resistance to nilotinib.
Conclusion: Our CML patient failed nilotinib. The F317i mutation in a child may warrant closer molecular monitoring and the consideration of early stem cell transplantation.
Citation Format: Heidi Tucker, Paul Kent. F317i mutation-associated nilotinib resistance in a child with CML: A first report. [abstract]. In: Proceedings of the AACR Special Conference on Hematologic Malignancies: Translating Discoveries to Novel Therapies; Sep 20-23, 2014; Philadelphia, PA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(17 Suppl):Abstract nr B38.
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Affiliation(s)
| | - Paul Kent
- 2Rush University Medical Center, Chicago, IL
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VanderKooy T, Tucker H. The Safety of Discharge of Pediatric Patients With Peripheral IV Catheter in Place Until Time of Follow-Up. Ann Emerg Med 2013. [DOI: 10.1016/j.annemergmed.2013.07.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Davino-Ramaya C, Ramaya K, Tucker H. P348 Patient And Consumer Involvement In Guideline Interpretation And Patient Tool Development; A Comparison Of Two Focus Groups And Understanding Cultural Diversity. BMJ Qual Saf 2013. [DOI: 10.1136/bmjqs-2013-002293.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kimber I, Nookala S, Davis CC, Gerberick GF, Tucker H, Foertsch LM, Dearman RJ, Parsonnet J, Goering RV, Modern P, Donnellen M, Morel J, Kotb M. Toxic shock syndrome: characterization of human immune responses to TSST-1 and evidence for sensitivity thresholds. Toxicol Sci 2013; 134:49-63. [PMID: 23640863 DOI: 10.1093/toxsci/kft099] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Noninvasive vaginal infections by Staphylococcus aureus strains producing the superantigen TSST-1 can cause menstrual toxic shock syndrome (mTSS). With the objective of exploring the basis for differential susceptibility to mTSS, the relative responsiveness to TSST-1 of healthy women has been investigated. Peripheral blood mononuclear cells from healthy donors were incubated with purified TSST-1 or with the T-cell mitogen phytohemmaglutinin (PHA), and proliferation was measured. The concentrations of TSST-1 and PHA required to elicit a response equivalent to 15% of the maximal achievable response (EC15) were determined. Although with PHA, EC15 values were comparable between donors, subjects could be classified as being of high, medium, or low sensitivity based on responsiveness to TSST-1. Sensitivity to TSST-1-induced proliferation was associated with increased production of the cytokines interleukin-2 and interferon-γ. When the entire T lymphocyte population was considered, there were no differences between sensitivity groups with respect to the frequency of cells known to be responsive to TSST-1 (those bearing CD3(+) Vβ2(+)). However, there was an association between sensitivity to TSST-1 and certain HLA-class II haplotypes. Thus, the frequencies of DR7DQ2, DR14DQ5, DR4DQ8, and DR8DQ4 haplotypes were greater among those with high sensitivity, a finding confirmed by analysis of responses to immortalized homozygous B cell lines. Collectively, the results reveal that factors other than neutralizing antibody and the frequency of Vβ2(+) T lymphocytes determine immunological responsiveness to TSST-1. Differential responsiveness of lymphocytes to TSST-1 may form the basis of interindividual variations in susceptibility to mTSS.
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Affiliation(s)
- Ian Kimber
- Faculty of Life Sciences, University of Manchester, Manchester, M13 9PT, UK
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Farage MA, Wang B, Tucker H, Ogle J, Rodenberg C, Azuka CE, Klebba C, Wilhelm KP. Dermatological testing of an improved apertured film surface for feminine hygiene pads. Cutan Ocul Toxicol 2011; 31:198-203. [PMID: 22141375 DOI: 10.3109/15569527.2011.639040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Apertured polyethylene films (AF) have been used as a surface for sanitary pads for decades because they are compatible with the skin and keep the pad surface drier. A modified film (AF-plus) with improved fluid handling and a smoother, suppler texture has been developed. We hypothesized that these changes would improve both performance and skin compatibility. However, distinguishing the skin effects of materials that are inherently mild is a challenge. OBJECTIVES (i) To compare the skin irritation potential of pads with AF-plus modified film relative to the standard AF film and (ii) to assess the potential for the AF-plus film to induce delayed contact hypersensitivity. MATERIALS AND METHODS Pads bearing the AF-plus film were compared to pads with the standard AF film in a behind-the-knee (BTK) test, which assesses the combination of chemical irritation and frictional effects of materials applied to the popliteal fossa under a semi-occlusive bandage. Erythema on the skin surface was scored with the naked eye and subsurface tissue erythema was visualized and scored using cross-polarized illumination. Skin dryness was scored with the naked eye only. One-sided statistical evaluations were performed to test the hypothesis of AF-plus film superiority. The potential of the AF-plus film to induce delayed contact hypersensitivity was assessed by a human repeat insult patch test (HRIPT). RESULTS Pads with the AF-plus surface were significantly milder to skin in the BTK test, producing lower levels of both surface and subsurface tissue erythema. Moreover, subjects with preexisting erythema on the skin surface at study start developed comparatively less erythema over the course of the study overall with the AF-plus pad compared to the AF pad. No significant difference in skin dryness was observed between product groups. The AF-plus pad showed no evidence of inducing delayed contact hypersensitivity. CONCLUSIONS The AF-plus pad was superior to the AF pad in terms of skin mildness as discerned by objectively scored surface and subsurface tissue erythema. In subjects with preexisting erythema, the AF-plus pad appeared to contribute less to the further development of inflammation under the test conditions. Given the compositional similarities in the two films, the results could point to more limited contribution of the AF-plus film to skin friction, one of the factors simulated by the BTK test protocol.
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Affiliation(s)
- Miranda A Farage
- Feminine Clinical Sciences, The Procter & Gamble Company, Cincinnati, OH 45224, USA.
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Volleamere A, Tucker H, Ooi J. Rhomboid Rotational Flap use in Breast Fibromatosis. Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.08.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Baumgartner JN, Waszak Geary C, Tucker H, Wedderburn M. The influence of early sexual debut and sexual violence on adolescent pregnancy: a matched case-control study in Jamaica. Int Perspect Sex Reprod Health 2009; 35:21-8. [PMID: 19465345 DOI: 10.1363/ifpp.35.021.09] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
CONTEXT Contraceptive knowledge and use at first sex have increased over time among Jamaican adolescents, yet high unintended pregnancy rates persist. More information on risk factors for adolescent pregnancy is needed to inform programs. METHODS Structured interviews were conducted with 15-17-year-old females-250 who were currently pregnant and 500 sexually experienced, but never-pregnant, neighborhood-matched controls. Bivariate and multivariate analyses were used to examine associations between adolescent pregnancy and early sexual debut, sexual coercion or violence and sexual risk-taking behaviors. RESULTS Greater proportions of pregnant youth than of their never-pregnant peers reported having had first sex by age 14 (54% vs. 41%), a first sexual partner who was five or more years older (33% vs. 20%) or multiple partners (63% vs. 50%); a greater proportion of never-pregnant youth had used contraceptives at first sex (88% vs. 80%). Almost half (49%) of all young women reported ever having experienced sexual coercion or violence. Compared with controls, pregnant youth had greater odds of having had an older partner at first sex and believing contraception is a woman's responsibility (odds ratios, 1.3 and 2.1, respectively), and had lower odds of ever having experienced sexual violence and thinking that it is important to protect oneself against pregnancy (0.5 and 0.2, respectively). An interaction between early sexual debut and multiple partners was found. Having had multiple partners was associated with pregnancy only for youth with early sexual debut. CONCLUSIONS Encouraging adolescents to delay sexual debut and reduce their number of sexual partners may help prevent unintended pregnancies. Experiences of sexual coercion and violence were common among both groups, highlighting the need to address gender-based violence at the community level.
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Affiliation(s)
- Joy Noel Baumgartner
- Health Services Research, Family Health International, Research Triangle Park, NC, USA.
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Dhar KK, Foden-Shroff J, Ghoshal S, Tucker H, Millinship J, Redman CW. Local anaesthesia for large loop excision of the cervical transformation zone: has prilocaine/felypressin less side effects than lignocaine/adrenaline? J OBSTET GYNAECOL 2009; 18:373-4. [PMID: 15512113 DOI: 10.1080/01443619867164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- K K Dhar
- Colposcopy Clinic, North Staffordshire Hospital, Stoke on Trent, UK
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Chenoy R, Redman CWE, Tucker H, Gray J, Shafi MI, Luesley DM. Is there a significant association between Chlamydia trachomatis and mild cervical cytological abnormalities? J OBSTET GYNAECOL 2009. [DOI: 10.3109/01443619209025948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Baumgartner JN, Waszak Geary C, Tucker H, Wedderburn M. The Influence of Early Sexual Debut and Sexual Violence on Adolescent Pregnancy: A Matched Case-Control Study in Jamaica. IPSRH 2009. [DOI: 10.1363/3502109] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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McIntosh E, Wu D, Paradiso P, Tucker H, Burlington B, Brenner R, Clarke J, Cooke J, Puz P, Temple M, Papiernik D, Mallick R, Kuznik A, Barrett L, Woodrow A. P1048 Pandemicfiu preparedness - role of antibiotics. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70889-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Thomsen SC, Gallo MF, Ombidi W, Omungo Z, Janowitz B, Hawken M, Tucker H, Wong EL, Hobbs MM. Randomised controlled trial on whether advance knowledge of prostate-specific antigen testing improves participant reporting of unprotected sex. Sex Transm Infect 2006; 83:419-20. [PMID: 17135328 PMCID: PMC2659018 DOI: 10.1136/sti.2006.022772] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To determine whether the process of informing research participants that they would be tested for the presence of a biological marker of semen exposure would reduce bias in their reports of unprotected sex. METHODS A randomised trial of 210 female sex workers from Mombasa, Kenya, was conducted, where half the group had advance knowledge (via the request for informed consent) that they would be tested for prostate-specific antigen (PSA) in their vaginal fluid before they reported on sex and condom use for the past 48 h. The other half were invited to participate (via additional informed consent) in the test for PSA after they had already consented to be questioned and reported on these sexual behaviours. A trained nurse instructed participants to self-swab to collect vaginal fluid specimens, which were tested for PSA using ELISA. RESULTS Reporting of unprotected sex did not differ between those with advance knowledge of the test for PSA and those without this knowledge (14.3% v 11.4%, respectively; p = 0.27). Surprisingly, more women with advance knowledge (15.8%) had discrepant self reports and PSA results than women without advance knowledge (9.1%); however, the difference was not statistically significant (OR 1.9; 95% CI 0.8 to 4.5). CONCLUSIONS Knowing that one's answers to a questionnaire could be verified with a biological marker of semen exposure did not make respondents more likely to report unprotected sex.
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Affiliation(s)
- Sarah C Thomsen
- Centers for Disease Control and Prevention, Division of Reproductive Health, Atlanta, GA 30341, USA
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Abstract
CONTEXT Because of high levels of early childbearing in developing countries, pregnancy and childbirth are the leading causes of death among women aged 15-19. Use of skilled antenatal and delivery care improves maternal outcomes through the prevention, management and treatment of obstetric complications, and infant immunizations prevent many childhood diseases. METHODS Logistic regression analysis of Demographic and Health Survey data for 15 developing countries examined adolescents' use of antenatal care, delivery care and infant immunization services compared with use by older women. RESULTS In general, the use of maternal and child health care did not vary by mother's age. In five of the 15 countries, women aged 18 or younger were less likely than women aged 19-23 to use either antenatal care or delivery care, or both (odds ratios, 0.5-0.9). Younger mothers in six countries were less likely than older mothers to have their infants immunized, particularly for diphtheria, pertussis and tetanus and for measles (0.5-0.8). The association of age and health care use was largely limited to Bangladesh, India, Indonesia, Nicaragua, Peru and Uganda. In Latin America, controlling for parity allowed differences between adolescents and older women to emerge. Except in Uganda, there were no differences in health care use by mother's age in the African countries. CONCLUSION Country-specific investigations are needed in Asia to better understand the reasons for differences in service use by age. In general, further systematic evidence would help identify long-term interventions that will be most effective in increasing adolescents' use of maternal and child health services.
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Affiliation(s)
- Heidi W Reynolds
- Family Health International/Youth-Net, Research Triangle Park, NC, USA.
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Byrom J, Douce G, Jones PW, Tucker H, Millinship J, Dhar K, Redman CWE. Should punch biopsies be used when high-grade disease is suspected at initial colposcopic assessment? A prospective study. Int J Gynecol Cancer 2006; 16:253-6. [PMID: 16445640 DOI: 10.1111/j.1525-1438.2006.00344.x] [Citation(s) in RCA: 35] [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: 11/27/2022] Open
Abstract
The reliability and applicability of colposcopically directed cervical punch biopsy was assessed in a sample of 170 paired punch and large loop excision of cervical transformation zone (LLETZ) specimens obtained from previously untreated women who had been selected for treatment on the basis of cytology and/or colposcopic findings and in whom the entire cervical transformation zone was visible. A single punch biopsy was taken immediately before the LLETZ, and all the specimens were reviewed by a single pathologist. Nine (5.3%) punch biopsies were inadequate. In terms of whether or not there was cervical intraepithelial neoplasia (CIN), the chance-corrected kappa analysis rated overall agreement as poor (kappa = 0.21, 95% confidence limits 0.02-0.39), whereas in terms of histologic grade, it was fair to moderate (kappa = 0.32, 95% confidence limits 0.23-0.42). Punch biopsy tended to underestimate the disease. The sensitivity and specificity of colposcopically directed punch biopsy for the detection of high-grade CIN was 74% and 91%, respectively, with positive- and negative predictive values of 97% and 48%, respectively. Two microinvasive and two intraepithelial glandular lesions were missed on punch biopsy. Punch biopsy should be avoided when high-grade disease is suspected.
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Affiliation(s)
- J Byrom
- Colposcopy Clinic and Pathology Department, University Hospital of North Staffordshire, Stoke-on-Trent, Staffordshire ST4 6QG, United Kingdom
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Abstract
BACKGROUND AND OBJECTIVE This study evaluated patterns of long-term use of male condoms among partners of 966 Cameroonian women who received eight intensive, monthly counseling sessions about condoms and sexually transmitted infection testing and treatment. METHOD An interrupted time-series design was used with study participants reporting condom use and other covariates at enrollment, monthly for 6 months during the randomized, controlled trial, and at approximately 14 months after the trial. RESULTS Consistent condom use began decreasing while women were still receiving monthly condom use counseling, with every month in the trial associated with an odds ratio of 0.96 (95% confidence interval [CI], 0.94-0.99) of consistent condom use and dropped substantively after the trial with a 0.39 (95% CI, 0.26-0.59) odds ratio in a logistic regression analysis. The incidence of unprotected coital acts as each month passed increased by 3% (95% CI, 1-4%) with no statistically significant change during the condom use follow-up survey as indicated in a zero-inflated Poisson regression model for unprotected coital acts. Condom use in a coital act was 0.84 (95% CI, 0.78-0.92) less likely during the follow-up survey than during the trial. CONCLUSION Only a few women sustained consistent condom use throughout the study period and for more than 1 year after. It is important to continue documenting the impact of condom promotion in a rigorous manner and to identify content and delivery of counseling that will lead to sustained condom use beyond the intervention period.
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Affiliation(s)
- Emelita L Wong
- Family Health International, Durham, North Carolina 27713, USA.
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Powell GL, Postma FW, Cook C, Tucker H, Williamson AL. Mass-spectrographic determination of hydrogen thermally evolved from titanium. Anal Chem 2002. [DOI: 10.1021/ac60354a014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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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Seamark D, Moore B, Tucker H, Church J, Seamark C. Community hospitals for the new millennium. Br J Gen Pract 2001; 51:125-7. [PMID: 11217625 PMCID: PMC1313927] [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: 02/19/2023] Open
Abstract
There is a lack of basic information regarding the numbers of and facilities offered by community hospitals. This survey identified 471 community hospitals in the United Kingdom containing 18,579 beds with 20% of general practitioners having admitting rights. The majority of hospitals provide a comprehensive range of rehabilitation services and consultant outpatient clinics. Community hospitals are potentially an important resource in providing intermediate care in the community.
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Affiliation(s)
- D Seamark
- Surgery, Marlpits Road, Honiton, Devon, EX14 2NY.
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Abstract
From the dual progestin/antiandrogenic properties of certain synthetic steroids (e.g. cyproterone acetate), it was apparent that the progesterone (P) and androgen (A) receptors must have some common ligand binding features. The nonsteroidal antiandrogen (aA) hydroxyflutamide was therefore considered a possible starting point for medicinal chemistry aimed at antiprogestin (aP) activity. Various modifications to the side chain and aryl ring substituents of flutamide yielded both P and aP activity, but always coupled with varying degrees of A or aA activity. Mineralocorticoid activity was present in some structures, but glucocorticoid and antiglucorticoid activities were not detected. Species (rat, rabbit and monkey) and chiral differences presented formidable difficulties in developing simple structure activity patterns, and low ( < 1%) in vitro uterine receptor binding belied in vivo potency of some aPs. One of the most active aPs, ZM172406, the R enantiomer of ZM150271, N-(3-chloro-4-cyanophenyl)-3,3, 3-trifluoro-2-hydroxy-2-methylpropanamide, had comparable oral potency to mifepristone in rats and monkeys. The racemate ZM150271 was an effective abortifacient during early pregnancy in pigtailed monkeys (3 x 10 mg/kg) but less effective in cynomolgus monkeys. One of the most active progestins (Pn), ZM182345, N-(4-nitro-3-trifluoromethylphenyl)-4-phenyl-2-hydroxy-2-trifluoromet hyl-pentanamide, was at least as potent as P in rats and rabbits but also possessed A activity.
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Affiliation(s)
- M Dukes
- AstraZeneca, Alderley Park, Macclesfield, SK10 4TG, Cheshire, UK.
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Howells RE, O'Mahony F, Tucker H, Millinship J, Jones PW, Redman CW. How can the incidence of negative specimens resulting from large loop excision of the cervical transformation zone (LLETZ) be reduced? An analysis of negative LLETZ specimens and development of a predictive model. BJOG 2000; 107:1075-82. [PMID: 11002948 DOI: 10.1111/j.1471-0528.2000.tb11103.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyse biopsies of large loop excision of the transformation zone of the cervix; to identify factors associated with negative histology; and to develop predictive models in order to reduce the number of negative loop excisions. DESIGN Retrospective analysis of patient notes and audit database. SETTING Colposcopy clinic of a large district general hospital in North Staffordshire. POPULATION Four hundred and fifty-two women who underwent a large loop excision of the transformation zone (LLETZ) procedure for suspected cervical intraepithelial neoplasia. METHODS Women who underwent a LLETZ procedure were placed in two different groups, one positive for cervical intra epithelial neoplasia and the other negative for cervical intra epithelial neoplasia. Information was obtained on a number of clinical and colposcopic variables. Analysis was undertaken to determine if there were any differences between the two groups. These factors were then identified and three predictive models generated. Receiver-operator characteristic curves were used to assess and test these models. MAIN OUTCOMES MEASURES To identify factors associated with negative histology on a LLETZ specimen. To predict how to reduce the number of negative LLETZ specimens. RESULTS Four hundred and fifty-two women underwent a LLETZ procedure, 88 were negative (19%) and 364 were positive (81%). In women who were treated at their first visit, 56/316 (18%) had negative histology. There were significant associations between negative histology in the LLETZ and negative or low grade cytological atypia, negative colposcopic findings and years of age > 50 in both bivariate analysis and stepwise logistic regression. In the predictive models, the sensitivity ranged between 72% and 80%, the specificity 59%-72%, and the area under the receiver-operator characteristic was 0.75-0.77. If we had used the predictor models and managed women with negative or low grade cervical atypia and negative colposcopy findings conservatively, we would have reduced the negative biopsy rate from 19% to 14%, but five cases of high grade disease and 25 cases of low grade disease would have been missed. If we had also included women aged > 50 years in this model, the negative biopsy rate would have dropped from 19% to 15%, with only one case of high grade disease and 11 cases of low grade disease missed. All these women would require continued cytological and colposcopic surveillance. Importantly, no cases of invasion would have been missed. CONCLUSION Using a predictive model can reduce the number of negative LLETZ specimens, but at the expense of continued cytological and colposcopic surveillance and cannot be recommended in normal practice. This raises the question whether current standards for negative histology in LLETZ specimens are set unrealistically high.
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Affiliation(s)
- R E Howells
- Academic Department of Obstetrics and Gynaecology, North Staffordshire NHS Hospital Trust and The University of Keele, Stoke-on-Trent, UK
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Howells RE, Tucker H, Millinship J, Shroff JF, Dhar KK, Jones PW, Redman CW. A comparison of the side effects of prilocaine with felypressin and lignocaine with adrenaline in large loop excision of the transformation zone of the cervix: results of a randomised trial. BJOG 2000; 107:28-32. [PMID: 10645858 DOI: 10.1111/j.1471-0528.2000.tb11575.x] [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: 11/28/2022]
Abstract
OBJECTIVE To test the hypothesis that prilocaine with felypressin causes fewer side effects than lignocaine with adrenaline when performing large loop excision of the transformation zone of the cervix. DESIGN Randomised trial. SETTING Colposcopy clinic in a large district general hospital. PARTICIPANTS Two hundred consecutive women undergoing large loop excision of the transformation zone of the cervix. METHODS Two different local anaesthetic combinations (prilocaine with felypressin and lignocaine with adrenaline) were compared in women undergoing large loop excision of the transformation zone. Prospective collection of clinical and treatment data was undertaken with scoring using an ordinal scale of pain experienced by the women during the procedure. Peri-operative blood loss and any side effects were also recorded. MAIN OUTCOME MEASURES Side effects associated with the local anaesthetic agents. RESULTS Lignocaine with adrenaline resulted in less blood loss (P = 0.006) but was more likely to cause side effects, such as feeling faint (P = 0.017) and shaking (P < 0.001). CONCLUSION Prilocaine with felypressin causes fewer side effects than lignocaine with adrenaline and is therefore the preferred local anaesthetic combination for large loop excision of the transformation zone.
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Affiliation(s)
- R E Howells
- Academic Department of Obstetrics and Gynaecology, North Staffordshire Hospital Trust, Stoke-on-Trent, Staffordshire, UK
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Foden-Shroff J, Redman CW, Tucker H, Millinship J, Thomas E, Warwick A, Jones PW. Do routine antibiotics after loop diathermy excision reduce morbidity? Br J Obstet Gynaecol 1998; 105:1022-5. [PMID: 9763056 DOI: 10.1111/j.1471-0528.1998.tb10268.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate whether routinely giving an antibiotic after loop diathermy excision of the cervical transformation zone reduced post-operative vaginal loss. DESIGN Prospective, randomised, double-blind placebo controlled parallel study. PARTICIPANTS Five hundred women undergoing loop diathermy excision in a colposcopy clinic. INTERVENTION Administration of either ofloxacin 400 mg (2x200 mg) once daily for 5 days or an identical placebo. MAIN OUTCOME MEASURE Vaginal loss, assessed using a pictorial chart. RESULTS No significant difference in post-operative vaginal loss was found. CONCLUSION Routine antibiotic prophylaxis after loop diathermy excision is not justified.
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Affiliation(s)
- J Foden-Shroff
- Department of Obstetrics and Gynaecology, North Staffordshire Hospital NHS Trust, Harpfields, Stoke on Trent, UK
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36
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Abstract
Chlorambucil-induced apoptosis was assessed by three different flow cytometric methods in B-cell chronic lymphocytic leukaemia (B-CLL) cells cultured in vitro and the results were compared with those derived from the morphological assessment of the same samples. Spontaneous apoptosis was consistently observed in the control cultures in the absence of drug but this accounted for less than 12% of all cells in every case. The methods under investigation were the Annexin V labelling assay, the terminal deoxynucleotidyl transferase (TdT) end-labelling assay and the labelling of a 38 kDa mitochondrial membrane protein (7A6 antigen) which is exposed on cells undergoing apoptotic cell death (Apo2.7 assay). The Annexin V assay consistently stained a higher percentage of cells and with a greater separation between the positive and negative cell populations. We conclude that the phosphatidyl serine translocation to the outer leaflet of the cell membrane following an apoptotic signal, as labelled by Annexin V, probably occurs before the development of the DNA strand breaks or the exposure of 7A6 antigen in those cells triggered to die by apoptosis.
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Affiliation(s)
- C Pepper
- Department of Haematology, Llandough Hospital, Penarth, South Glamorgan, UK
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37
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Abstract
OBJECTIVES. To describe the preclinical development of bicalutamide and clarify its pharmacodynamics and mechanisms of action. Bicalutamide was developed from a series of nonsteroidal compounds related to flutamide that showed a range of pharmacologic activity from full androgen agonist to pure antiandrogen, including progestational and antiprogestational properties. METHODS AND RESULTS. Bicalutamide is a pure antiandrogen that binds to rat, dog, and human prostate; the affinity compared with the natural ligand 5 alpha-dihydrotestosterone is low, but bicalutamide has an affinity for the rat androgen receptor approximately four times higher than hydroxyflutamide, the active metabolite of flutamide. Bicalutamide also binds to androgen receptors found in the LNCaP human prostate tumor and the Shionogi S115 mouse mammary tumor cell line, as well as androgen receptors transfected into CV-1 and HeLa cells. In all cases, bicalutamide behaves as a pure antiandrogen and inhibits gene expression and cell growth stimulated by androgen. Studies with the LNCaP cell line are particularly interesting, as these cells contain a mutated androgen receptor (codon 868, Thr-->Ala), which behaves idiosyncratically with other antiandrogens (cyproterone acetate and flutamide): both these antiandrogens act as agonists in this cell line and stimulate proliferation. Studies in vivo show that bicalutamide is a potent antiandrogen in the rat. In immature, castrated male rats treated daily with testosterone propionate, bicalutamide produces a profound inhibition of accessory sex organ (ventral prostate and seminal vesicles) growth at oral doses as low as 0.25 mg/kg; it is more active in this test than flutamide or cyproterone acetate. In mature male rats, daily oral doses of bicalutamide produce a dose-related reduction in weights of the ventral prostate glands and seminal vesicles: in this test, bicalutamide is around five times as potent as flutamide. In contrast to flutamide, which produces dose-related, marked increases in serum luteinizing hormone (LH) and testosterone as a consequence of the central inhibition of the negative feedback effects of androgens on the hypothalamic-pituitary-tests axis, bicalutamide has little effect on serum LH and testosterone; i.e., it is peripherally selective. The peripheral selectivity of bicalutamide in the rat is not due to differences between the prostate versus hypothalamic or pituitary receptors, as bicalutamide reverses the suppressive effect of testosterone on luteinizing hormone-releasing hormone (LHRH) secretion from hypothalamic slices in vitro and is as effective as flutamide at sensitizing the pituitary gland to secrete LH in response to administered LHRH. The peripheral selectivity of bicalutamide has now been shown to be due to poor penetration across the blood-brain barrier: tissue distribution studies with [3H]bicalutamide show that although it is concentrated in the organs of metabolism and secretion as well as in the prostate, the pituitary glands, and the seminal vesicles, levels in the hypothalamus and the central nervous system (CNS) are much lower than in blood. Indeed, it is probable that levels found in the CNS reflect levels of blood contamination. In dogs, bicalutamide has exquisite potency and causes dose-related atrophy of the prostate gland and epididymides; with an oral ED50 of 0.1 mg/kg, it is around 50 times as potent as flutamide in this species and also more potent than the steroidal antiandrogen WIN49596 and the 5 alpha-reductase inhibitor MK-906. Even at substantial multiples of the active dose (up to 100 mg/kg orally), bicalutamide failed to increase serum testosterone, so it is also peripherally selective in the dog.
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Affiliation(s)
- B J Furr
- Vascular Inflammatory and Musculoskeletal Research Department, Zeneca Pharmaceutical, Alderly Park, Macclesfield, Cheshire, United Kingdom
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38
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Warwick AP, Tucker H, Jones JM, Redman CWE, Gray J. Is Chlamydia trachomatisassociated with dyskaryotic cervical cytology? Results of a prospective population-based study. J OBSTET GYNAECOL 1996. [DOI: 10.3109/01443619609030093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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39
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Abstract
A series of 5-[(arylcarbonyl)amino]- and 5-(arylcarbamoyl)pyridine-2-carboxylic acids has been prepared and tested for activity as inhibitors of the enzyme prolyl 4-hydroxylase (EC 1.14.11.2). All the analogues prepared were inhibitors of the enzyme in vitro, the best compounds being equipotent with the known inhibitor pyridine-2,5-dicarboxylic acid (9). Like 9 these amidic analogues were not active in a cultured embryonic chick tendon cell model, considered to be a predictor of in vivo activity. The activity of the amides is not consistent with the model described for the mode of action of 9 with the enzyme and aspects of this are discussed.
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Affiliation(s)
- H Tucker
- ICI Pharmaceuticals, Macclesfield, Cheshire, United Kingdom
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40
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Oka K, Tkalcevic GT, Nakano T, Tucker H, Ishimura-Oka K, Brown WV. Structure and polymorphic map of human lipoprotein lipase gene. Biochim Biophys Acta 1990; 1049:21-6. [PMID: 1972631 DOI: 10.1016/0167-4781(90)90079-h] [Citation(s) in RCA: 65] [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] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Lipoprotein lipase (LPL) catalyzes the key step for the removal of triacylglycerol-rich lipoproteins from the circulation. In this paper, we report the cloning and structure of the normal human LPL gene, which was isolated in three overlapping lambda phage clones that span about 35 kilo bases (kb) of the genetic locus. The peptide coding region of the gene is approx. 23 kb in length and contains nine exons with intron sizes ranging from 0.7 to 8.7 kb. The entire 3' untranslated region is in the tenth exon. Specific sequences in this region support the hypothesis that two mRNA species found for human LPL are generated by differential utilization of polyadenylation signals. The first exon occurs in the 5' untranslated region and the region coding for the signal peptide. The second exon includes the protein domain coding for the N-linked glycosylation site that is required for the expression of enzyme activity. The fourth exon contains the region that was proposed as a lipid binding domain, the sixth for one putative heparin binding domain, and the eighth codes for a domain containing another N-linked glycosylation site. These results suggest that the unique structural and functional domains are confined to specific exons. The PvuII polymorphic site was located within the intron between exon 6 and 7 and the HindIII polymorphic site to the 3' flanking region. The location of these polymorphic sites suggests that the PvuII restriction fragment length polymorphism (RFLP) associated with lipase deficiency in a few Japanese kindred may be a linkage marker for a functional defect of LPL, while the HindIII RFLP associated with hypertriglyceridemia may be important for gene regulation of LPL.
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Affiliation(s)
- K Oka
- Laboratory of Molecular Genetics, Medlantic Research Foundation, Washington, D.C. 20010
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41
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Nakano T, Tucker H, Oka K, Brown WV. A simple semi-dry capillary transfer of DNA. Biotechniques 1990; 8:173-4. [PMID: 1969286] [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: 12/29/2022] Open
Affiliation(s)
- T Nakano
- Medlantic Research Foundation, Washington, D.C. 20010
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42
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43
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Brewer D, Tucker H. Model for resettlement. Health Serv J 1989; 99:1011. [PMID: 10294643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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44
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Broniatowski M, Olsen E, Davies C, Benninger M, Jacobs G, Tucker H, Nosé Y. A canine model for global control of the reimplanted larynx. A potential avenue for human laryngeal transplantation. ASAIO Trans 1989; 35:487-9. [PMID: 2597514 DOI: 10.1097/00002480-198907000-00102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Previous attempts at laryngeal transplantation have failed because the grafted organ could not be dynamically rehabilitated. Nerve-muscle pedicles were used to reinnervate each of the principal intrinsic laryngeal muscles in 20 dogs after autotransplantation with conservation of the essential nutrient vessels. Afferent information obtained by sensors fixed to the chest (a strain gauge and transthoracic impedance electrode) was channeled to an electronic package for coordinated stimulation of pedicles reinnervating the posterior cricoartenoideus (opening), the cricothyroideus (elongation) and the thyroarytenoideus (closure of the vocal cords) by perineural electrodes. Corresponding vocal cord motion was videotaped on the same screen as sensor displacements and stimulating currents (approximately 2 V, 60 Hz, and 4 msec pulse width). Clear responses were recorded in all evaluable animals (n = 8), but contraction was stronger with longer reinnervation time (3-7 weeks). Based on this feasibility study, chronic experiments are planned that will set the ground work for possible future human laryngeal transplantation.
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Affiliation(s)
- M Broniatowski
- St. Vincent Charity Hospital and Health Center, Cleveland, Ohio 44115
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45
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Broniatowski M, Grundfest-Broniatowski S, Davies CR, Kasick JC, Jacobs GB, Nosé Y, Tucker H. Excitation thresholds for nerve pedicles: a preliminary report. Otolaryngol Head Neck Surg 1989; 100:578-82. [PMID: 2501733 DOI: 10.1177/019459988910000610] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Ongoing interest in the rehabilitation of paralyzed musculature in the head and neck has focused on the electronic stimulation of nerve-muscle pedicles that have been reimplanted into the incapacitated effector(s). Despite visual and histochemical evidence of reinnervation, it is still not known whether the excitability of a nerve-muscle pedicle (or for that matter a direct nerve implant) is equivalent to or better than that of reinnervated or normal muscle. Such information is necessary for the eventual construction of an implantable stimulator. Eighteen rabbits were anesthetized with intramuscular xylazine and ketamine and the ansa hypoglossi nerve was cut on one side. A crossover nerve-muscle pedicle was brought in from the opposite sternothyroid muscle to the sternohyoid in nine animals; the other nine received a direct nerve implant. After a minimum neurotization period of 3 months and reexploration, an electrical stimulator capable of delivering square wave pulses of variable amplitude and width was used to determine the thresholds of contraction of the nerve pedicles, an intact motor nerve of similar size, a normal muscle, and the reinnervated strap in 16 evaluable rabbits. Strength duration curves were established. The data indicate that thresholds for nerve pedicles are equivalent to those of normal nerves and are significantly lower than those of muscle.
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Affiliation(s)
- M Broniatowski
- Department of Artificial Organs Research, Cleveland Clinic Foundation, OH
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46
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Jones R, Tucker H. The role of community hospitals. Health Trends 1988; 20:45-8. [PMID: 10288507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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47
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Tucker H, Crook JW, Chesterson GJ. Nonsteroidal antiandrogens. Synthesis and structure-activity relationships of 3-substituted derivatives of 2-hydroxypropionanilides. J Med Chem 1988; 31:954-9. [PMID: 3361581 DOI: 10.1021/jm00400a011] [Citation(s) in RCA: 106] [Impact Index Per Article: 2.9] [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: 01/05/2023]
Abstract
A series of 3-(substituted thio)-2-hydroxypropionanilides and some corresponding sulfones and sulfoxides of general structure 7, in which R' is methyl or trifluoromethyl, were prepared and tested for antiandrogen activity. Members of the trifluoromethyl series (7, R' = CF3) generally exhibited partial androgen agonist activity whereas the members of the methyl series (7, R' = CH3) were pure antagonists. Lead optimization in the methyl series has led to the discovery of novel, potent antiandrogens, which are peripherally selective. One of these, (RS)-4'-cyano-3-[(4-fluorophenyl)sulfonyl]-2-hydroxy-2-methyl-3'- (trifluoromethyl)propionanilide, 40 (ICI 176334), is being developed currently for the treatment of androgen-responsive benign and malignant disease.
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Affiliation(s)
- H Tucker
- Imperial Chemical Industries PLC, Pharmaceuticals Division, Macclesfield, Cheshire, Great Britain
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48
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Tucker H, Chesterson GJ. Resolution of the nonsteroidal antiandrogen 4'-cyano-3-[(4-fluorophenyl)sulfonyl]-2-hydroxy-2-methyl-3'- (trifluoromethyl)-propionanilide and the determination of the absolute configuration of the active enantiomer. J Med Chem 1988; 31:885-7. [PMID: 3351865 DOI: 10.1021/jm00399a034] [Citation(s) in RCA: 62] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The nonsteroidal antiandrogen 4'-cyano-3-[(4-fluorophenyl)sulfonyl]-2- hydroxy-2-methyl-3'-(trifluoromethyl)-propionanilide (1) (ICI 176334) has been resolved by chromatographic separation of the diastereomeric (R)-camphanyl esters of the precursor thioether 2 followed by hydrolysis and oxidation of the isolated enantiomers. In addition, an asymmetric synthesis of (S)-3-bromo-2-hydroxy-2-methylpropanoic acid (11) and subsequent conversion into the (S)-sulfone 6a has established that the more potent enantiomer of 1 has the R absolute configuration.
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Affiliation(s)
- H Tucker
- Imperial Chemical Industries PLC, Pharmaceuticals Division, Macclesfield, Cheshire
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49
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Abstract
Pure antiandrogens, like flutamide, antagonize androgen action both peripherally and centrally at the hypothalamic-pituitary axis, which leads to an increase in LH and testosterone secretion. A new non-steroidal antiandrogen ICI 176,334 [2RS)-4'-cyano-3-(4-fluorophenylsulphonyl)-2-hydroxy-2-methyl-3'- trifluoromethyl)propion-anilide) has now been discovered which causes regression of the accessory sex organs but does not increase serum concentrations of LH and androgens. ICI 176,334 binds to rat prostate androgen receptors with an affinity around fourfold that of hydroxyflutamide. When administered s.c. concurrently with testosterone propionate (200 micrograms/kg) for 7 days to immature castrated rats, ICI 176,334 (10 mg/kg) significantly (P less than 0.001) inhibited growth of the seminal vesicles and ventral prostate gland. Oral administration of ICI 176,334 at doses of 1, 5 and 25 mg/kg for 14 days to adult rats caused a dose-related reduction in accessory sex organ weights but had no effect on the testes. None of these doses caused a significant increase in serum LH and testosterone. Flutamide was around fourfold less potent and significantly increased serum LH and testosterone at the higher doses. ICI 176,334 was well tolerated. ICI 176,334 should, therefore, prove useful for the treatment of androgen-responsive benign and malignant diseases.
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50
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Tucker H. Community hospitals. Progress of a concept of care. Health Serv J 1987; 97:244-5. [PMID: 10280898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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