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Frainey BT, Majerus SJA, Derisavifard S, Lewis KC, Williams AR, Balog BM, Butler RS, Goldman HB, Damaser MS. First in Human Subjects Testing of the UroMonitor: A Catheter-free Wireless Ambulatory Bladder Pressure Monitor. J Urol 2023; 210:186-195. [PMID: 37293725 DOI: 10.1097/ju.0000000000003451] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/28/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Urodynamics is the standard method of diagnosing bladder dysfunction, but involves catheters and retrograde bladder filling. With these artificial conditions, urodynamics cannot always reproduce patient complaints. We have developed a wireless, catheter-free intravesical pressure sensor, the UroMonitor, which enables catheter-free telemetric ambulatory bladder monitoring. The purpose of this study was twofold: to evaluate accuracy of UroMonitor pressure data, and assess safety and feasibility of use in humans. MATERIALS AND METHODS Eleven adult female patients undergoing urodynamics for overactive bladder symptoms were enrolled. After baseline urodynamics, the UroMonitor was transurethrally inserted into the bladder and position was confirmed cystoscopically. A second urodynamics was then performed with the UroMonitor simultaneously transmitting bladder pressure. Following removal of urodynamics catheters, the UroMonitor transmitted bladder pressure during ambulation and voiding in private. Visual analogue pain scales (0-5) were used to assess patient discomfort. RESULTS The UroMonitor did not significantly alter capacity, sensation, or flow during urodynamics. The UroMonitor was also easily inserted and removed in all subjects. The UroMonitor reproduced bladder pressure, capturing 98% (85/87) of voiding and nonvoiding urodynamic events. All subjects voided with only the UroMonitor in place with low post-void residual volume. Median ambulatory pain score with the UroMonitor was rated 0 (0-2). There were no post-procedural infections or changes to voiding behavior. CONCLUSIONS The UroMonitor is the first device to enable catheter-free telemetric ambulatory bladder pressure monitoring in humans. The UroMonitor appears safe and well tolerated, does not impede lower urinary tract function, and can reliably identify bladder events compared to urodynamics.
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Affiliation(s)
- Brendan T Frainey
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Steve J A Majerus
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samir Derisavifard
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kevin C Lewis
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Anna R Williams
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Brian M Balog
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Robert S Butler
- Quantitative Health Sciences Department, Cleveland Clinic, Cleveland, Ohio
| | - Howard B Goldman
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Margot S Damaser
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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Frainey BT, Majerus SJA, Derisavifard S, Lewis KC, Williams AR, Balog BM, Butler RS, Goldman HB, Damaser MS. Reply by Authors. J Urol 2023; 210:195. [PMID: 37293724 DOI: 10.1097/ju.0000000000003451.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Brendan T Frainey
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Steve J A Majerus
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samir Derisavifard
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kevin C Lewis
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Anna R Williams
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Brian M Balog
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Robert S Butler
- Quantitative Health Sciences Department, Cleveland Clinic, Cleveland, Ohio
| | - Howard B Goldman
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Margot S Damaser
- Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
- Advanced Platform Technology Center, Louis Stokes VA Medical Center, Cleveland, Ohio
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
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Qu C, Rozsa JL, Jung HJ, Williams AR, Markin EK, Running MP, McNamara S, Walsh KM. Bio-inspired antimicrobial surfaces fabricated by glancing angle deposition. Sci Rep 2023; 13:207. [PMID: 36604529 PMCID: PMC9814675 DOI: 10.1038/s41598-022-27225-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
This paper describes the fabrication of cicada-wing-inspired antimicrobial surfaces using Glancing Angle Deposition (GLAD). From the study of an annual cicada (Neotibicen Canicularis, also known as dog-day cicada) in North America, it is found that the cicada wing surfaces are composed of unique three-dimensional (3D) nanofeature arrays, which grant them extraordinary properties including antimicrobial (antifouling) and antireflective. However, the morphology of these 3D nanostructures imposes challenges in artificially synthesizing the structures by utilizing and scaling up the template area from nature. From the perspective of circumventing the difficulties of creating 3D nanofeature arrays with top-down nanofabrication techniques, this paper introduces a nanofabrication process that combines bottom-up steps: self-assembled nanospheres are used as the bases of the features, while sub-100 nm pillars are grown on top of the bases by GLAD. Scanning electron micrographs show the resemblance of the synthesized cicada wing mimicry samples to the actual cicada wings, both quantitatively and qualitatively. The synthetic mimicry samples are hydrophobic with a water contact angle of 125˚. Finally, the antimicrobial properties of the mimicries are validated by showing flat growth curves of Escherichia coli (E. coli) and by direct observation under scanning electron microscopy (SEM). The process is potentially suitable for large-area antimicrobial applications in food and biomedical industries.
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Affiliation(s)
- Chuang Qu
- Department of Electrical and Computer Engineering, University of Louisville, 2210 S Brook St, Louisville, KY, 40292, USA.
| | - Jesse L. Rozsa
- grid.266623.50000 0001 2113 1622Department of Biology, University of Louisville, 139 Life Sciences Bldg., Louisville, KY 40292 USA
| | - Hyun-Jin Jung
- grid.266623.50000 0001 2113 1622Department of Biology, University of Louisville, 139 Life Sciences Bldg., Louisville, KY 40292 USA
| | - Anna R. Williams
- grid.266623.50000 0001 2113 1622Department of Biology, University of Louisville, 139 Life Sciences Bldg., Louisville, KY 40292 USA
| | - Emmanuel K. Markin
- grid.266623.50000 0001 2113 1622Department of Biology, University of Louisville, 139 Life Sciences Bldg., Louisville, KY 40292 USA
| | - Mark P. Running
- grid.266623.50000 0001 2113 1622Department of Biology, University of Louisville, 139 Life Sciences Bldg., Louisville, KY 40292 USA
| | - Shamus McNamara
- grid.266623.50000 0001 2113 1622Department of Electrical and Computer Engineering, University of Louisville, 2210 S Brook St, Louisville, KY 40292 USA
| | - Kevin M. Walsh
- grid.266623.50000 0001 2113 1622Department of Electrical and Computer Engineering, University of Louisville, 2210 S Brook St, Louisville, KY 40292 USA
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Summan A, Nejsum P, Williams AR. Modulation of human dendritic cell activity by Giardia and helminth antigens. Parasite Immunol 2018; 40:e12525. [PMID: 29574798 DOI: 10.1111/pim.12525] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 12/18/2017] [Accepted: 03/12/2018] [Indexed: 12/13/2022]
Abstract
Giardia duodenalis is a common intestinal protozoan parasite known to modulate host immune responses, including dendritic cell (DC) function. Coinfections of intestinal pathogens are common, and thus, DCs may be concurrently exposed to antigens from multiple parasites. Here, we investigated the effects of G. duodenalis products on human monocyte-derived DC function independently and in combination with helminth antigens (Ascaris suum and Trichuris suis). All antigens individually induced an anti-inflammatory phenotype in DCs, reducing lipopolysaccharide (LPS)-induced interleukin (IL)-6, IL-12p70 and tumour necrosis factor (TNF)-α secretion. G. duodenalis and T. suis products also consistently upregulated IL-10 production. Despite a similar modulation of cytokine secretion, additive effects between Giardia and helminth products were not observed, indicating a dominant effect of a single parasite stimulus and limited interactive effects on DC function. G. duodenalis trophozoites induced rapid apoptosis in DCs, which was not observed with the helminth antigens suggesting that the modulatory effects of G. duodenalis may override that of A. suum and T. suis. Thus, G. duodenalis modulates DC activity by modulating cytokine secretion and/or inducing apoptosis, which may be a parasite-driven mechanism to dampen host immunity and establish chronic infections. The differential mechanisms of DC modulation by intestinal parasites warrant further attention.
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Affiliation(s)
- A Summan
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - P Nejsum
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - A R Williams
- Department of Veterinary and Animal Sciences, University of Copenhagen, Frederiksberg, Denmark
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Charlier J, Thamsborg SM, Bartley DJ, Skuce PJ, Kenyon F, Geurden T, Hoste H, Williams AR, Sotiraki S, Höglund J, Chartier C, Geldhof P, van Dijk J, Rinaldi L, Morgan ER, von Samson-Himmelstjerna G, Vercruysse J, Claerebout E. Mind the gaps in research on the control of gastrointestinal nematodes of farmed ruminants and pigs. Transbound Emerg Dis 2017; 65 Suppl 1:217-234. [PMID: 29124904 DOI: 10.1111/tbed.12707] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [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: 02/11/2017] [Indexed: 12/31/2022]
Abstract
Gastrointestinal (GI) nematode control has an important role to play in increasing livestock production from a limited natural resource base and to improve animal health and welfare. In this synthetic review, we identify key research priorities for GI nematode control in farmed ruminants and pigs, to support the development of roadmaps and strategic research agendas by governments, industry and policymakers. These priorities were derived from the DISCONTOOLS gap analysis for nematodes and follow-up discussions within the recently formed Livestock Helminth Research Alliance (LiHRA). In the face of ongoing spread of anthelmintic resistance (AR), we are increasingly faced with a failure of existing control methods against GI nematodes. Effective vaccines against GI nematodes are generally not available, and anthelmintic treatment will therefore remain a cornerstone for their effective control. At the same time, consumers and producers are increasingly concerned with environmental issues associated with chemical parasite control. To address current challenges in GI nematode control, it is crucial to deepen our insights into diverse aspects of epidemiology, AR, host immune mechanisms and the socio-psychological aspects of nematode control. This will enhance the development, and subsequent uptake, of the new diagnostics, vaccines, pharma-/nutraceuticals, control methods and decision support tools required to respond to the spread of AR and the shifting epidemiology of GI nematodes in response to climatic, land-use and farm husbandry changes. More emphasis needs to be placed on the upfront evaluation of the economic value of these innovations as well as the socio-psychological aspects to prioritize research and facilitate uptake of innovations in practice. Finally, targeted regulatory guidance is needed to create an innovation-supportive environment for industries and to accelerate the access to market of new control tools.
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Affiliation(s)
- J Charlier
- Kreavet, Kruibeke, Belgium.,Avia-GIS, Zoersel, Belgium
| | - S M Thamsborg
- Department of Veterinary Disease Biology, University of Copenhagen, Frederiksberg C, Denmark
| | | | - P J Skuce
- Moredun Research Institute, Edinburgh, UK
| | - F Kenyon
- Moredun Research Institute, Edinburgh, UK
| | | | - H Hoste
- UMR IHAP 1225, INRA, ENVT, Université de Toulouse, Toulouse, France
| | - A R Williams
- Department of Veterinary Disease Biology, University of Copenhagen, Frederiksberg C, Denmark
| | - S Sotiraki
- VetResInst, HAO-DEMETER, Thessaloniki, Greece
| | - J Höglund
- BVF, Section for Parasitology, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - P Geldhof
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - J van Dijk
- Institute of Infection and Global Health, University of Liverpool, Neston, Cheshire, UK
| | - L Rinaldi
- Department of Veterinary Medicine and Animal Productions, University of Naples Federico II, Napoli, Italy
| | - E R Morgan
- Institute for Global Food Security, Queen's University Belfast, Belfast, UK.,School of Veterinary Science, University of Bristol, North Somerset, UK
| | | | - J Vercruysse
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - E Claerebout
- Laboratory of Parasitology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Dige A, Rasmussen TK, Nejsum P, Hagemann-Madsen R, Williams AR, Agnholt J, Dahlerup JF, Hvas CL. Mucosal and systemic immune modulation by Trichuris trichiura in a self-infected individual. Parasite Immunol 2016; 39. [PMID: 27743501 DOI: 10.1111/pim.12394] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 10/07/2016] [Indexed: 12/26/2022]
Abstract
Helminthic therapy of immune-mediated diseases has gained attention in recent years, but we know little of how helminths modulate human immunity. In this study, we investigated how self-infection with Trichuris (T.) trichiura in an adult man without intestinal disease affected mucosal and systemic immunity. Colonic mucosal biopsies were obtained at baseline, during T. trichiura infection, and after its clearance following mebendazole treatment. Unexpectedly, the volunteer experienced a Campylobacter colitis following T. trichiura clearance, and this served as a positive infectious control. Trichuris trichiura colonization induced equally increased expressions of T-helper (h)1-, Th2-, Th17- and Treg-associated cytokines and transcription factors, measured by quantitative polymerase chain reaction. We observed several indicators of modulation of systemic immunity during the T. trichiura infection. Plasma eosinophils and anti-Trichuris antibodies rose markedly during the inoculation phase, and a shift towards a Th2-dominated T cell response at the expense of the Th1-response was observed in circulating T cells. Taken together, our findings corroborate that helminths modulate regional and systemic human immunity.
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Affiliation(s)
- A Dige
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark
| | - T K Rasmussen
- Department of Biomedicine, Aarhus University, Aarhus C, Denmark.,Department of Rheumatology, Aarhus University Hospital, Aarhus C, Denmark
| | - P Nejsum
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | | | - A R Williams
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
| | - J Agnholt
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark
| | - J F Dahlerup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark
| | - C L Hvas
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus C, Denmark
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Abstract
INTRODUCTION Transitional care is an NHS priority with newly published NICE guidance. Many paediatric surgical patients need quality care to continue into adulthood. We undertook an evaluation of our departmental activity to assess the magnitude of this issue. METHODS We identified all outpatients ≥ 15 years (potentially requiring imminent transition) seen over a 12 month period for all five general paediatric surgery consultants in our tertiary centre. Those patients requiring transition were highlighted and the appropriate adult team for referral recorded. RESULTS There were 2989 general paediatric surgery clinic appointments within the year; 289 (9.7%) were for young people aged 15 years or older; 62 patients (28% of those ≥ 15years) were deemed to require transition into adult care. Significantly more patients having colorectal surgery required follow-up (P = 0.0009 Chi-square test) compared with patients in other subspecialties. CONCLUSIONS More patients than expected required transition. This may be the case in other units. Current best practice includes time intensive preclinic planning, careful preparation of patient and family, followed by joint clinics. A joint clinic appointment takes 30 minutes, allowing for comprehensive handover and forging new relationships. In our department, we need at least ten transition clinics across 2 years. Coalition with adult colleagues is vital. These data enable us to plan services to provide quality care for our adolescent patients and highlights colorectal surgery as a priority.
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Affiliation(s)
- A R Jones
- Department of Paediatric Surgery, Nottingham Children's Hospital, Queen's Medical Centre , Nottingham , UK
| | - M John
- Department of Paediatric Surgery and Urology, Nottingham Children's Hospital, Queen's Medical Centre , Nottingham , UK
| | - S J Singh
- Department of Paediatric Surgery and Urology, Nottingham Children's Hospital, Queen's Medical Centre , Nottingham , UK
| | - A R Williams
- Department of Paediatric Surgery and Urology, Nottingham Children's Hospital, Queen's Medical Centre , Nottingham , UK
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8
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Ramsay A, Williams AR, Thamsborg SM, Mueller-Harvey I. Galloylated proanthocyanidins from shea (Vitellaria paradoxa) meal have potent anthelmintic activity against Ascaris suum. Phytochemistry 2016; 122:146-153. [PMID: 26708339 DOI: 10.1016/j.phytochem.2015.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 12/08/2015] [Accepted: 12/11/2015] [Indexed: 06/05/2023]
Abstract
Proanthocyanidins (PA) from shea (Vitellaria paradoxa) meal were investigated by thiolytic degradation with benzyl mercaptan and the reaction products were analysed by high performance liquid chromatography-mass spectrometry. These PA were galloylated (≈40%), contained only B-type linkages and had a high proportion of prodelphinidins (>70%). The mean degree of polymerisation was 8 (i.e. average molecular size was 2384Da) and epigallocatechin gallate (EGCg) was the major flavan-3-ol subunit in PA. Shea meal also proved to be a potentially valuable source for extracting free flavan-3-ol-O-gallates, especially EGCg (575mg/kg meal), which is known for its health and anti-parasitic benefits. Proanthocyanidins were isolated and tested for bioactivity against Ascaris suum, which is an important parasite of pigs. Migration and motility tests revealed that these PA have potent activity against this parasitic nematode.
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Affiliation(s)
- A Ramsay
- Chemistry and Biochemistry Laboratory, School of Agriculture, Policy and Development, University of Reading, 1 Earley Gate, PO Box 236, Reading RG6 6AT, UK.
| | - A R Williams
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - S M Thamsborg
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark
| | - I Mueller-Harvey
- Chemistry and Biochemistry Laboratory, School of Agriculture, Policy and Development, University of Reading, 1 Earley Gate, PO Box 236, Reading RG6 6AT, UK
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Rollins KE, Aggarwal S, Fletcher A, Knight A, Rigg K, Williams AR, Bhattacharjya S. Impact of early incentive spirometry in an enhanced recovery program after laparoscopic donor nephrectomy. Transplant Proc 2013; 45:1351-3. [PMID: 23726570 DOI: 10.1016/j.transproceed.2013.01.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/15/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to assess the impact of early incentive spirometry on the incidence of chest infection in patients undergoing laparoscopic donor nephrectomy. METHODS A retrospective review on all consecutive laparoscopic donor nephrectomies (LDN) performed at a single institution from January 2008 to August 2012 was performed. We performed 84 LDN. Seventy patients had epidural analgesia continued for 48 hours postoperatively and 14 had a combination of spinal followed by oral analgesia. Incentive spirometry was introduced from July 2010 and 45 of the 84 donors used the spirometer as taught, both pre- and postoperatively. RESULTS We performed 84 LDN; 39 patients did not receive incentive spirometers and had postoperative chest physiotherapy started on postoperative day 1. Of the 45 patients given incentive spirometers, 44 started using their spirometers as taught, after recovery once they were settled in the ward, 1 patient started the exercises the following day. In the group who received no spirometer, 5 patients had a chest infection. In the group of patients who started using their spirometers in the early perioperative period (44/45), no patient developed a chest infection. One patient in this group was excluded from the analysis because he started spirometer exercises on postoperative day 1. This patient did develop a chest infection. CONCLUSIONS Our results suggest that early introduction of incentive spirometry after LDN significantly reduces the incidence of chest infection (P < .05); however, this benefit may be lost if the introduction of spirometry is delayed.
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Affiliation(s)
- K E Rollins
- Transplant Unit, Nottingham City Hospital, Nottingham, UK.
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Fraser N, Lyon PC, Williams AR, Christian MT, Shenoy MU. Native nephrectomy in pediatric transplantation--less is more! J Pediatr Urol 2013; 9:84-9. [PMID: 22227459 DOI: 10.1016/j.jpurol.2011.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 12/16/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVE Indications for pre-transplantation native nephrectomy (PTNN) include chronic renal parenchymal infection, proteinuria, intractable hypertension, polycystic kidneys and malignancy. Our aim was to establish the frequency and reasons for PTNN in children undergoing renal transplant at our center. MATERIALS AND METHODS Children listed for renal transplant between 1998 and 2010 who underwent PTNN were analyzed. Etiology of established renal failure, indication for nephrectomy, stage of chronic kidney disease, laterality, complications, and timing of subsequent transplant were determined. Outcome of children, and that of preserved native kidneys following transplant, was reviewed. RESULTS 21/203 children listed for transplant (10.3%) underwent PTNN (32 nephrectomies). Indications were drug-resistant proteinuria (6 children), recurrent upper tract urosepsis (6), refractory hypertension (4), malignancy/malignant predisposition (4), concomitant procedure during ureterocystoplasty (1). Median age at nephrectomy was 3.3 years; 86% had impaired renal function at time of (first) nephrectomy. Median time until transplantation following bilateral nephrectomy was 1.7 years. 19/21 children have been transplanted; 17 reached stable graft function. Only 2 children who did not undergo PTNN required nephrectomy post-transplant. CONCLUSION When malignancies were excluded, PTNN was performed in a minority (8.4%) of children, mainly for proteinuria. This adds great advantage by reducing morbidity. Resulting graft function seems favorable.
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Affiliation(s)
- Nia Fraser
- Department of Paediatric Urology, Kidney Transplant Unit, Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Rd, Nottingham NG7 2UH, UK.
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11
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Lindley RM, Williams AR, Fraser N, Shenoy MU. Synchronous laparoscopic-assisted percutaneous endoscopic gastrostomy and peritoneal dialysis catheter placement is a valid alternative to open surgery. J Pediatr Urol 2012; 8:527-30. [PMID: 22023847 DOI: 10.1016/j.jpurol.2011.09.011] [Citation(s) in RCA: 10] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Accepted: 09/28/2011] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Gastrostomy feeding is frequently necessary in children receiving chronic peritoneal dialysis (PD). Synchronous laparoscopic-assisted placement of percutaneous endoscopic gastrostomy (PEG) and PD catheter has many potential advantages. This study investigates whether this technique is comparable to open placement. METHODS The notes of all patients over a 16-year time period were reviewed retrospectively. Peritonitis was defined as the presence of a white blood cell count > 100/mm(3) with at least 50% being polymorphonuclear leukocytes, and infection was defined as the presence of positive peritoneal cultures with peritonitis. RESULTS Ten patients received primary laparoscopic-assisted PEG and PD catheter insertion (LAP) and 23 patients open gastrostomy and PD catheter (OPEN). PD catheter survival was median 12 months in the LAP group and 17 months in the OPEN group. Peritonitis and infection rates per catheter-year were 0.89 and 0.7 LAP and 0.59 and 0.5 OPEN. The risk of peritonitis and infection was not related to method of placement. CONCLUSIONS There were no statistically significant differences in outcomes between the two groups. We conclude that laparoscopic-assisted synchronous PD and PEG catheter insertion is safe and effective.
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Affiliation(s)
- R M Lindley
- Department of Paediatric Surgery, Sheffield Children's NHS Trust, Western Bank, Sheffield S10 2TH, UK.
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12
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Abstract
The available evidence suggests that drug treatment can lead to modest, but real, reductions in criminal offending for drug-using criminal offenders. Considering the scope of the problem of drug-related crime and the expense of dealing with these issues, even marginal improvements can lead to important aggregate savings in both economic and humanitarian terms. More randomized, controlled trials of drug treatment in criminal justice programs will lead to a more sophisticated understanding of what kind of treatment works best for this group.
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13
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Sharp T, Fraser N, Shenoy MU, Randell T, Denvir L, Williams AR. 46XY girls: the importance of careful newborn examination. J Pediatr Adolesc Gynecol 2012; 25:103-104. [PMID: 22130386 DOI: 10.1016/j.jpag.2011.09.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 09/19/2011] [Accepted: 09/21/2011] [Indexed: 10/15/2022]
Abstract
STUDY OBJECTIVE To understand the timing and factors affecting diagnosis of phenotypically female 46XY children. DESIGN, SETTING, AND PARTICIPANTS We studied all phenotypically female 46XY children who attended our multidisciplinary disorders of sexual differentiation (DSD) clinic in Nottingham England in a 3-year period since its inception. Case notes from a prospectively maintained database were reviewed and data were analyzed on the age at presentation, family history, findings on genital examination, and underlying endocrine abnormality. RESULTS Eleven children were studied, all of whom were being raised as girls. The median age of presentation was 18 months (range birth-15 years). Although the newborn examination detected the possibility of DSD in only 3 cases; 10 of 11 children had at least one significant abnormality in their external genitalia at presentation. CONCLUSION Careful neonatal genital examination can identify children with DSD. However, not all children with these conditions are identified early. Early diagnosis, when possible, is important, as it has the potential to make the management of this difficult condition more straightforward.
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Affiliation(s)
- T Sharp
- Department of Pediatric Urology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.
| | - N Fraser
- Department of Pediatric Urology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - M U Shenoy
- Department of Pediatric Urology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - T Randell
- Department of Pediatric Endocrinology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - L Denvir
- Department of Pediatric Endocrinology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - A R Williams
- Department of Pediatric Urology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
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Turner S, Williams AR, Rees JMH. A Pharmacological Method of Extending the Useful Storage Life of Blood. J Pharm Pharmacol 2011. [DOI: 10.1111/j.2042-7158.1985.tb14178.x] [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: 11/28/2022]
Affiliation(s)
- S Turner
- Departments of Medical Biophysics, University of Manchester, M13 9PT UK
| | - A R Williams
- Departments of Medical Biophysics, University of Manchester, M13 9PT UK
| | - J M H Rees
- Pharmacology, University of Manchester, M13 9PT UK
- Departments of Medical Biophysics, University of Manchester, M13 9PT UK
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Williams AR, Karlsson LJE, Palmer DG, Vercoe PE, Williams IH, Greeff JC, Emery DL. Relationships between faecal dry matter, worm burdens and inflammatory mediators and cells in parasite-resistant Merino rams. Vet Parasitol 2010; 171:263-72. [PMID: 20430531 DOI: 10.1016/j.vetpar.2010.03.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Revised: 03/16/2010] [Accepted: 03/24/2010] [Indexed: 11/25/2022]
Abstract
Immune-mediated scouring due to ingested parasite larvae is a major concern for sheep producers in Mediterranean climates. We investigated immune-mediated scouring in parasite-resistant Merino sheep in Australia. Forty-adult, parasite-resistant Merino rams were judged to be either susceptible or non-susceptible to immune-mediated scouring on the basis of dag scores taken under field conditions. We hypothesised that the susceptible rams would have lower faecal dry matter during larval challenge than non-susceptible rams and that, at post-mortem examination, inflammatory mediators and granulocytes would be negatively correlated with both faecal dry matter and worm numbers. In pens, the rams received a dose of 500 Teladorsagia circumcincta L(3) and 500 Trichostrongylus colubriformis L(3) each day for 6 weeks before euthanasia. Ten rams acted as unchallenged controls. Challenging sheep with larvae reduced faecal dry matter at 2, 3 and 4 weeks after challenge began and the greatest reductions were with the sheep susceptible to scouring. The sheep showed good resistance to the parasite challenge as evidenced by low faecal worm egg counts and low total worm counts at post-mortem, with the numbers of T. colubriformis particularly low. Sheep with low faecal dry matter had significantly higher numbers of eosinophils in small intestine tissue. Sheep with low total worm counts had significantly higher levels of bradykinin in abomasum mucus. Sheep with more granulocytes in tissue and inflammatory mediators in mucus tended to have fewer numbers of T. circumcincta but there was little relationship with numbers of T. colubriformis. Our results show that dag scores are correlated to a reduction in faecal dry matter, which can be attributed to the challenge with infective parasite larvae. Inflammation during worm infection is associated with rejection of the worm challenge and may result in more fluid faeces and consequently diarrhoea. Therefore, sheep breeders should focus on breeding for both low worm egg counts and also low dag scores.
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Affiliation(s)
- A R Williams
- School of Animal Biology, University of Western Australia, Crawley, WA 6009, Australia.
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Fraser N, Paul A, Williams AR, Broderick N, Shenoy MU. Dysplastic kidneys in children - do they grow? J Pediatr Urol 2010; 6:40-4. [PMID: 19570721 DOI: 10.1016/j.jpurol.2009.05.014] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Accepted: 05/11/2009] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Dysplastic kidneys (DK) are a common cause of chronic kidney disease (CKD). Little is known about their growth or how their sonographic appearance changes. This study aimed to test the hypothesis that DK gain little length, and to identify radiologic trends predictive of CKD. METHODS Ultrasound scans of children with DK born in 1980-2005 and referred to a single tertiary centre were analysed by a pediatric radiologist. Renal lengths were plotted on standard nomograms and the degree of dysplastic appearance noted. Factors related to DK - bladder outlet obstruction, vesico-ureteric reflux and renal impairment - were noted. RESULTS Fifty-three children were studied (83 kidneys), of whom 41 were boys; 289 scans were analysed. In 33 children there was associated bladder outlet obstruction or vesico-ureteric reflux. Forty-four DK were noted to fall off their renal length 'centile'. This correlated well with the development of CKD and is statistically significant. Deterioration occurred in 53% of DK; primarily progressive reduction in corticomedullary differentiation. This also correlated well with development of CKD. CONCLUSION More than half of the DK showed poor growth velocity. This, together with the degree of sonographic abnormality, carries a high predictive value for development of CKD. We recommend diligent serial sonography to follow renal growth and dysplastic appearance in children with DK.
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Affiliation(s)
- Nia Fraser
- Department of Paediatric Urology, Nottingham University Hospitals NHS Trust, Queens Medical Centre Campus, Level E, East Block, Nottingham, UK.
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17
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Lees CW, Critchley J, Chee N, Beez T, Gailer RE, Williams AR, Shand AG, Arnott IDR, Satsangi J. Lack of association between cervical dysplasia and IBD: a large case-control study. Inflamm Bowel Dis 2009; 15:1621-9. [PMID: 19618462 DOI: 10.1002/ibd.20959] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND It has been variously reported that women with inflammatory bowel disease (IBD) have an increased risk of cervical dysplasia. We aimed to assess in a large, accurately phenotyped, case-controlled population whether women with IBD had increased rates of abnormal cervical smears and if this was affected by immunosuppressant therapy or disease phenotype. METHODS Women with IBD diagnosed prior to the age of 60 were studied at a single tertiary referral center in Scotland. Full cervical smear histories were available on 411 women (204 Crohn's disease, 207 ulcerative colitis, median age at diagnosis 28.4 years, median current age 44.1 years). All the cases were matched 1:4 to healthy controls (n = 1644) from the same geographical location. RESULTS There was no difference in rates of abnormal smears between patients with IBD (80.5% negative, 10.5% low-grade, and 9.0% high-grade dysplasia) and controls (85.4%, 7.7%, and 6.9%, P = 0.37). The use of immunosuppressant therapy had no impact on rates of cervical dysplasia or neoplasia. Furthermore, there was no effect of disease location, behavior, or oral contraceptive use. However, there were significantly more abnormal cervical smears in IBD patients who were current smokers compared with exsmokers and those who had never smoked (27.4% versus 11.4%, P = 0.001, odds ratio = 2.95, 95% confidence interval = 1.55-5.50). CONCLUSIONS Women with IBD are not at increased risk of abnormal cervical smears unless they smoke. These data suggest that young women with IBD should be managed as per the background population; attending for regular smear testing, and undergoing vaccination against cervical cancer when available.
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Affiliation(s)
- C W Lees
- Gastrointestinal Unit, Western General Hospital, Edinburgh, UK.
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18
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Horne AW, Duncan WC, King AE, Burgess S, Lourenco PC, Cornes P, Ghazal P, Williams AR, Udby L, Critchley HOD. Endometrial cysteine-rich secretory protein 3 is inhibited by human chorionic gonadotrophin, and is increased in the decidua of tubal ectopic pregnancy. Mol Hum Reprod 2009; 15:287-94. [PMID: 19282327 PMCID: PMC2666224 DOI: 10.1093/molehr/gap019] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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] [Received: 11/25/2008] [Revised: 02/25/2009] [Accepted: 02/27/2009] [Indexed: 12/20/2022] Open
Abstract
Ectopic pregnancy (EP) remains a considerable cause of morbidity and occasional mortality. Currently, there is no reliable test to differentiate ectopic from intrauterine gestation. We have previously used array technology to demonstrate that differences in gene expression in decidualized endometrium from women with ectopic and intrauterine gestations could be used to identify candidate diagnostic biomarkers for EP. The aim of this study was to further investigate the decidual gene with the highest fold increase in EP, cysteine-rich secretory protein-3 (CRISP-3). Decidualized endometrium from gestation-matched women undergoing surgical termination of pregnancy (n = 8), evacuation of uterus for miscarriage (n = 6) and surgery for EP (n = 11) was subjected to quantitative RT-PCR, morphological assessment, immunohistochemistry and western blot analysis. Sera were analysed for progesterone and human chorionic gonadotrophin (hCG) levels. Immortalized endometrial epithelial cells were cultured with physiological concentrations of hCG. CRISP-3 mRNA and protein expression were greater in endometrium from ectopic when compared with intrauterine pregnancies (P < 0.05). CRISP-3 protein was localized to epithelium and granulocytes of endometrium. CRISP-3 serum concentrations were not different in women with ectopic compared with intrauterine pregnancies. CRISP-3 expression in endometrium was not related to the degree of decidualization or to serum progesterone levels. Endometrial CRISP-3 expression was inversely proportional to serum hCG concentrations (P < 0.001). Stimulation of endometrial epithelial cells with hCG in vitro caused a reduction in CRISP-3 expression (P < 0.01). The measurement of CRISP-3 in endometrium could provide an additional tool in the diagnosis of failing early pregnancy of unknown location. The absence of a local reduction in expression of CRISP-3 in decidualized endometrium of women with EP may be due to reduced exposure to hCG due to the ectopic location of the trophoblast.
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Affiliation(s)
- A W Horne
- Division of Reproductive and Developmental Sciences, The University of Edinburgh, Edinburgh, UK.
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Horne AW, van den Driesche S, King AE, Burgess S, Myers M, Ludlow H, Lourenco P, Ghazal P, Williams AR, Critchley HOD, Duncan WC. Endometrial inhibin/activin beta-B subunit expression is related to decidualization and is reduced in tubal ectopic pregnancy. J Clin Endocrinol Metab 2008; 93:2375-82. [PMID: 18381568 DOI: 10.1210/jc.2008-0136] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
CONTEXT Ectopic pregnancy is common but remains difficult to diagnose accurately. There is no serum test to differentiate ectopic from intrauterine gestation. OBJECTIVE Our objective was to investigate differential gene expression in decidualized endometrium of ectopic pregnancy. DESIGN Tissue and serum analysis informed by microarray study was performed. SETTING The study was performed at a large United Kingdom teaching hospital. PATIENTS OR OTHER PARTICIPANTS Women undergoing surgical termination of pregnancy (n = 8), evacuation of uterus for miscarriage (n = 6), and surgery for tubal ectopic pregnancy (n = 11) were included in the study. Endometrium was collected from normally cycling women undergoing hysterectomy. INTERVENTIONS Decidualized endometrium was subjected to microarray analysis, morphological assessment, and immunohistochemistry. Endometrial stromal fibroblasts were cultured in the presence of decidualizing stimuli. MAIN OUTCOME MEASURES Differential expression of potentially secreted molecules was calculated. RESULTS Inhibin/activin beta-B expression was lower in decidualized endometrium from ectopic pregnancies when compared with that of ongoing pregnancies (P < 0.01) or miscarriages (P < 0.01). The localization of the beta-B subunit was more marked in decidualized than nondecidualized stroma. Decidualization of stromal fibroblasts in vitro was associated with increased beta-B expression (P < 0.05). Endometrial stroma of ectopic pregnancies was less decidualized morphologically (P < 0.05), with lower prolactin (P < 0.01) and IGF binding protein-1 (P < 0.005) expression. Serum activin B was lower in ectopic pregnancies (P < 0.005) than in intrauterine pregnancies, whereas there was no difference in progesterone concentrations. CONCLUSIONS Despite similar concentrations of progesterone, the endometrium of ectopic pregnancies is less decidualized than intrauterine pregnancies. Expression of the beta-B subunit is related to decidualization and can be detected in the circulation as activin B. Serum activin B concentrations are lower in ectopic pregnancy.
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Affiliation(s)
- A W Horne
- Obstetrics and Gynaecology, University of Edinburgh, Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, United Kingdom.
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Abstract
Roux-en-Y jejunostomy (RYJ) permits enteral feeding in children unable to tolerate oral or intragastric feeds. It avoids many of the complications of nasojejunal and gastrojejunal tubes. Here we report our experience of intubated RYJ. By retrospective review of patient notes from 1998 - 2003, thirty-five children were identified. The median age was seven months (1 month - 16 years) and median follow-up was twenty-five months (1 - 55 months). There were no early postoperative complications or deaths. There were eighteen (51 %) late complications: peristomal leak (6), peristomal infection (2), bilious vomiting (5), tube displacement (3), abscess (1) and jejuno-colic fistula (1). Five children progressed to full oral feeds and had the RYJ resected. Fourteen of the twenty-eight children still alive remain fed by RYJ. Nine infants subsequently underwent fundoplication and gastrostomy with RYJ resection. Seven children died during the study period. RYJ is a straightforward procedure which can be performed safely in the face of poor nutrition and significant comorbidity. We recommend RYJ as a medium-term measure for enteral feeding.
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Affiliation(s)
- A R Williams
- Department of Paediatric Surgery, Nottingham City Hospital, Nottingham, UK
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22
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Creedon DJ, Hopkins MR, Williams AR, Cabanela RL, Wagie AE. Comparative cost-analysis of Essure hysteroscopic sterilization and laparoscopic bilateral fulguration. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/s1074-3804(04)80380-3] [Citation(s) in RCA: 2] [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: 11/15/2022]
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Abstract
BACKGROUND Mifepristone in low daily doses has contraceptive potential by inhibiting ovulation and menstruation. Because follicular development is maintained, the endometrium is exposed to estrogen for prolonged periods unopposed by progesterone. METHODS Endometrial biopsies were collected from 90 women in Edinburgh and Shanghai before (late proliferative) and 60 and 120 days after taking 2 or 5 mg mifepristone per day for 120 days. RESULTS Ovulation and menstruation were inhibited in >90% of cycles and estrogen production was similar to that observed during the follicular phase of the control cycle. By 120 days, endometrial thickness increased significantly in women in Edinburgh but decreased in Shanghai. Endometrial histology showed inactive proliferative or cystic changes with dense stroma. There was a significant decrease in markers of proliferation, i.e. mitotic index and Ki67 staining. There were no pregnancies in a total of 200 women-months in 50 sexually active women who used no other method of contraception. CONCLUSIONS We confirm that ovulation and menstruation were suppressed in the majority of cycles and there was asynchrony between ovarian activity and endometrial histology, which showed no signs of hyperplasia or atypia. These preliminary data suggest that daily low-dose mifepristone is potentially a safe estrogen-free contraceptive pill which has the added health benefit of amenorrhoea.
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Affiliation(s)
- D T Baird
- Contraceptive Development Network, Centre for Reproductive Biology, University of Edinburgh, Academic Centre, 49 Little France Crescent, Old Dalkeith Road, Edinburgh EH16 4SB,UK.
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Opperman LA, Galanis V, Williams AR, Adab K. Transforming growth factor-beta3 (Tgf-beta3) down-regulates Tgf-beta3 receptor type I (Tbetar-I) during rescue of cranial sutures from osseous obliteration. Orthod Craniofac Res 2002; 5:5-16. [PMID: 12071374 DOI: 10.1034/j.1600-0544.2002.01179.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Appropriate biochemical regulation of intramembranous bone growth from sutures is necessary to achieve correct craniofacial morphology. Failure to form sutures (agenesis) or to maintain sutures in their unossified state (craniosynostosis) can result in severe facial dysmorphology. Several factors such as Twist, Msx2, fibroblast growth factors (Fgfs), bone morphogenetic proteins (Bmps) and transforming growth factors-beta (Tgf-betas) regulate suture patency, likely by interacting with one another. Tgf-beta2 and Tgf-beta3 use the same cell surface receptors, yet have opposite effects on suture patency, cellular proliferation and apoptosis within the suture. One possible mechanism by which Tgf-beta3 rescues sutures from obliteration is by regulating the ability of suture cells to respond to Tgf-beta2. As Tgf-beta3 does not regulate protein levels of Tgf-beta2 in sutures, Tgf-beta3 could regulate tissue responsiveness to Tgf-beta2 by regulating Tgf-beta2 access to receptors. Tgf-beta3 is a more potent competitor than Tgf-beta2 for cell surface receptors, so it is proposed that Tgf-beta3 binds to and down-regulates Tgf-beta receptor type I (Tbetar-I) expression by suture cells. This down-regulation would limit the ability of cells to respond to all Tgf-betas, including Tgf-beta2. To test this hypothesis, an in vitro culture model was used in which fetal rat sutures either remain patent or are induced to fuse when cultured in the presence or absence of dura mater, respectively. Tgf-beta3 was added to cultured calvaria and changes in the number of receptor positive cells within the suture were established. Data were compared with that seen in control sutures and in normal sutures in vivo. It was found that the numbers of cells expressing Tbetar-I within the suture matrix increased over time in sutures remaining patent. Osteoblastic cells lining the bone fronts on either side of sutures were Tbetar-I positive during early morphogenesis, but these numbers declined as sutures fused, both in vivo and in vitro. Addition of Tgf-beta3 to calvaria in culture decreased the number of Tbetar-I expressing cells in both fusing and non-fusing sutures, with dramatic decreases in the numbers of osteoblasts expressing Tbetar-I.
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Affiliation(s)
- L A Opperman
- Department of Biomedical Sciences and Center for Craniofacial Research and Diagnosis, Baylor College of Dentistry, Texas A & M University System Health Science Center, Dallas 75266-0677, USA.
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Shaw D, Chicchi GG, Elliott JM, Kurtz M, Morrison D, Ridgill MP, Szeto N, Watt AP, Williams AR, Swain CJ. 2-Aryl indole NK(1) antagonists: optimisation of the amide substituent. Bioorg Med Chem Lett 2001; 11:3031-4. [PMID: 11714604 DOI: 10.1016/s0960-894x(01)00616-3] [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: 10/27/2022]
Abstract
The in vivo properties of a series of 2-arylindole NK(1) antagonists have been improved, by modification of the amide substituent. The 1-(2-methoxyphenyl)piperazine amide was identified as a major area of metabolism in the lead compound 1. Replacement of this amine moiety by a 4-benzyl-4-hydroxypiperidine resulted in a compound 18 with reduced clearance and improved central duration of action.
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Affiliation(s)
- D Shaw
- Department of Medicinal Chemistry, Merck Sharp & Dohme Research Laboratories, Neuroscience Research Centre, Terlings Park, Eastwick Road, Harlow, Essex CM20 2QR, UK.
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26
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Cheeta S, Tucci S, Sandhu J, Williams AR, Rupniak NM, File SE. Anxiolytic actions of the substance P (NK1) receptor antagonist L-760735 and the 5-HT1A agonist 8-OH-DPAT in the social interaction test in gerbils. Brain Res 2001; 915:170-5. [PMID: 11595206 DOI: 10.1016/s0006-8993(01)02846-3] [Citation(s) in RCA: 62] [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: 11/29/2022]
Abstract
The gerbil social interaction test has previously detected anxiolytic effects of nicotine and diazepam. In the present study, the high affinity substance P (NK(1)) receptor antagonist L-760735 (3 mg/kg) significantly increased the time spent in social interaction, whereas its low affinity analogue L-781773 (3 mg/kg) was without effect. Diazepam (0.1 mg/kg) and the 5-HT(1A) receptor agonist 8-OH-DPAT (0.003 and 0.01 mg/kg) also increased social interaction, whereas an acute dose of the selective serotonin re-uptake inhibitor fluoxetine (10 mg/kg) decreased the time spent in social interaction. Diazepam (0.1 mg/kg) significantly increased locomotor activity, but this effect was independent of the increase in social interaction. The other drugs tested were without effect on locomotor activity. The present findings suggest that the gerbil social interaction may well provide a useful assay for detecting both anxiolytic and anxiogenic compounds, and suggests that the high affinity NK(1) receptor antagonist L-760735 may prove to be useful as an anxiolytic therapy.
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Affiliation(s)
- S Cheeta
- Psychopharmacology Research Unit, Centre for Neuroscience, King's College London, SE1 1UL, London, UK
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27
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Cooper LC, Chicchi GG, Dinnell K, Elliott JM, Hollingworth GJ, Kurtz MM, Locker KL, Morrison D, Shaw DE, Tsao KL, Watt AP, Williams AR, Swain CJ. 2-Aryl indole NK1 receptor antagonists: optimisation of indole substitution. Bioorg Med Chem Lett 2001; 11:1233-6. [PMID: 11354384 DOI: 10.1016/s0960-894x(01)00182-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The synthesis and biological evaluation of a series of 2-aryl indoles with high affinity for the human neurokinin-1 (hNK1) receptor are reported, concentrating on optimisation of the indole substitution.
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Affiliation(s)
- L C Cooper
- Department of Medicinal Chemistry, The Neuroscience Research Centre, Harlow, Essex, UK.
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28
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Dinnell K, Chicchi GG, Dhar MJ, Elliott JM, Hollingworth GJ, Kurtz MM, Ridgill MP, Rycroft W, Tsao KL, Williams AR, Swain CJ. 2-Aryl indole NK1 receptor antagonists: optimisation of the 2-aryl ring and the indole nitrogen substituent. Bioorg Med Chem Lett 2001; 11:1237-40. [PMID: 11354385 DOI: 10.1016/s0960-894x(01)00183-4] [Citation(s) in RCA: 44] [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: 11/17/2022]
Abstract
Novel 2-aryl indole hNK1 receptor ligands were prepared utilising palladium cross-coupling chemistry of a late intermediate as a key step. Compounds with high hNK1 receptor binding affinity and good brain penetration (e.g., 9d) were synthesised.
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Affiliation(s)
- K Dinnell
- Department of Medicinal Chemistry, Merck, Sharp and Dohme Research Laboratories, The Neuroscience Research Centre, Harlow, Essex, UK.
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29
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Jabbour HN, Milne SA, Williams AR, Anderson RA, Boddy SC. Expression of COX-2 and PGE synthase and synthesis of PGE(2)in endometrial adenocarcinoma: a possible autocrine/paracrine regulation of neoplastic cell function via EP2/EP4 receptors. Br J Cancer 2001; 85:1023-31. [PMID: 11592775 DOI: 10.1054/bjoc.2001.2033] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.3] [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] [Received: 03/14/2001] [Revised: 06/18/2001] [Accepted: 07/02/2001] [Indexed: 11/18/2022] Open
Abstract
This study was designed to investigate the possible role of cyclo-oxygenase-2 (COX-2) and prostaglandin E(2)(PGE(2)) in endometrial adenocarcinoma. COX-2 RNA expression was confirmed in various grades of adenocarcinoma by ribonuclease protection assay. COX-2 and microsomal glutathione-dependent prostaglandin E synthase (mPGES) expression and PGE(2)synthesis were localised to the neoplastic epithelial cells and endothelial cells. In order to establish whether PGE(2)has an autocrine/paracrine effect in adenocarcinomas, we investigated the expression of 2 subtypes of PGE(2)receptors, namely EP2 and EP4, by real time quantitative PCR. Expression of EP2 and EP4 receptors was detected in adenocarcinomas from all grades of differentiation and was significantly higher than that detected in normal secretory phase endometrium (P< 0.01). The fold induction of expression in adenocarcinoma compared with normal secretory phase endometrium was 28.0 +/- 7.4 and 52.5 +/- 10.1 for EP2 and EP4 receptors respectively. Immunohistochemistry localised the site of expression of EP4 receptor in neoplastic epithelial cells and in the endothelium of carcinomas of all grades of differentiation. Finally, the functionality of the EP2/EP4 receptors was assessed by investigating cAMP generation following in vitro culture of adenocarcinoma tissue in the presence or absence of 300 nM PGE(2). cAMP production in response to PGE(2)was significantly higher in carcinoma tissue than that detected in normal secretory phase endometrium (3.42 +/- 0.46 vs 1.15 +/- 0.05 respectively; P< 0.001). In conclusion, these data suggest that PGE(2)may regulate neoplastic cell function in an autocrine/paracrine manner via the EP2/EP4 receptors.
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Affiliation(s)
- H N Jabbour
- MRC Human Reproductive Sciences Unit, Centre for Reproductive Biology, 37 Chalmers Street, Edinburgh, EH3 9ET, United Kingdom
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Abstract
Incidental memory for three types of cartoons was compared: original cartoons, literal translations of the originals, and weird cartoons created by inserting incongruous material into the literal translations. In Experiment 1, the three types of cartoons were mixed together in lists. In Experiment 2, each list contained only two cartoon types. In both experiments, original cartoons were remembered better than the literal and the weird cartoons, whereas the literal and the weird cartoons were equally well remembered. The detection of incongruities, or attempts to resolve those incongruities, cannot adequately explain the observed humor effects. The results were also inconsistent with both rehearsal and distinctiveness interpretations. Rather, humor per se appears to support good memory performance. Perhaps participants elaborated or gave sustained attention to humorous material at the expense of less humorous material.
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Affiliation(s)
- S R Schmidt
- Psychology Department, Middle Tennessee State University, Murfreesboro 37132, USA.
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Miller DL, Spooner GJ, Williams AR. Photodisruptive laser nucleation of ultrasonic cavitation for biomedical applications. J Biomed Opt 2001; 6:351-358. [PMID: 11516327 DOI: 10.1117/1.1380669] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2000] [Revised: 10/27/2000] [Accepted: 02/26/2001] [Indexed: 05/23/2023]
Abstract
Pulses of high intensity laser light, when focused into transparent materials, may produce localized electron-ion plasmas through optical breakdown. By simultaneously incorporating the resulting volume of vaporized material within the focal volume of a high intensity ultrasound source, the photodisruption (1.05 microm wavelength) void served as a nucleation site for ultrasonic cavitation. Dilute suspensions of canine erythrocytes in phosphate buffered saline were exposed in a flow-through exposure chamber and the percentage of lysed cells was used as a measure of the biologically effective cavitation activity produced in the chamber. Brief (about 30 micros) acoustic emissions were detected from the photodisruption alone (indicating laser nucleation of bubbles), but the cell lysis produced was undetectable against the background. However, combined exposure greatly increased both the duration of the acoustic emissions (up to 1.5 ms) and the amount of cell lysis above an ultrasonic pressure amplitude threshold of about 4.3 MPa at 2.5 MHz. The amount of cell lysis (sometimes approaching 100%) increased with increasing ultrasonic intensity, laser pulse energy and laser PRF. Addition of 5% serum albumin enhanced the effect, apparently by stabilizing bubbles and nuclei. Photodisruptive laser nucleation of ultrasonic cavitation can provide controlled and synergistic enhancement of bioeffects.
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Affiliation(s)
- D L Miller
- University of Michigan Medical Center, Department of Radiology, 3315 Kresge III, 200 Zina Pitcher Place, Ann Arbor, Michigan 48109, USA.
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Franke DE, Habet O, Tawah LC, Williams AR, DeRouen SM. Direct and maternal genetic effects on birth and weaning traits in multibreed cattle data and predicted performance of breed crosses. J Anim Sci 2001; 79:1713-22. [PMID: 11465358 DOI: 10.2527/2001.7971713x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [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: 11/13/2022] Open
Abstract
Direct and maternal additive effects and heterosis were estimated using data from straightbred Angus, Brahman, Charolais, Hereford, and four generations of rotational crosses among these breeds. Traits of interest were birth weight, Julian day of birth, average daily gain from birth to weaning, 205-d weight, and weaning weight per cow exposed. Complete data were available on 3,445 calves produced from 4,733 matings. Discrete generations of 4-yr duration were produced from 1970 through 1988. Brahman was included in each rotational crossbreeding system. Genetic effects were estimated by regression. Direct and maternal additive effects of Brahman, Charolais, and Hereford were estimated as deviations from Angus. Direct and maternal heterosis effects were assumed proportional to expected heterozygosity. The Brahman direct additive effect resulted in later-born calves (P < 0.01). Brahman, Charolais, and Hereford direct additive effects increased birth weight, and the Brahman maternal additive effect decreased birth weight compared with Angus (P < 0.05). Charolais direct and maternal additive effects were greater than Angus for average daily gain and 205-d weight (P < 0.01). The Hereford maternal additive effects on average daily gain and 205-d weight were less than those of the other breeds (P < 0.01). Breed combinations including Brahman had greater direct heterosis for birth weight, average daily gain, and 205-d weight than other combinations (P < 0.01). Angus, Charolais, and Hereford direct additive effects on weaning weight per cow exposed were greater than Brahman (P < 0.05). Predicted average daily gain, 205-d weight, and weaning weight per cow exposed were, on average, greater in four-breed rotation systems than in three- and two-breed systems. Among two-breed rotation systems, predicted average daily gain and 205-d weaning weight were greatest for Charolais-Brahman and least for Angus-Hereford. Calves from the Angus-Charolais-Hereford system weighed less at weaning than any other three-breed combination. However, weaning weight per cow exposed from the Angus-Charolais-Hereford system was greatest among three-breed systems. Within three- and four-breed rotation systems, ranges in predicted birth and weaning weights among generations varied by up to 10.0 and 25.2 kg, respectively. The choice of breeds affects performance, and the sequence of their use may affect intergenerational variation in performance.
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Affiliation(s)
- D E Franke
- Department of Animal Science, Louisiana State University Agricultural Center, Baton Rouge 70803, USA.
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Williams AR. More than poor care can lead to legal liability. Air Med J 2001; 20:8-9. [PMID: 11438802] [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: 02/20/2023]
Affiliation(s)
- A R Williams
- Abigail Williams & Associates, PC, Worcester, Mass., USA
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Williams PD, Ducey KA, Sears AM, Williams AR, Tobin-Rumelhart SE, Bunde P. Treatment type and symptom severity among oncology patients by self-report. Int J Nurs Stud 2001; 38:359-67. [PMID: 11245872 DOI: 10.1016/s0020-7489(00)00067-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Oncology patients receiving chemotherapy (n=109) and radiation therapy RT (n=161) reported symptom concerns and severity on the 25-item therapy-related symptom checklist (TRSC). Secondary analysis of the self-reports of the two treatment groups was done using the Mann-Whitney U Test. Thirteen symptoms differed significantly between the two groups. RT patients reported significantly greater severity of five symptoms (p<0.05) during therapy. Chemotherapy patients reported significantly greater severity of eight different symptoms. The other 14 items showed a heterogeneous pattern of self-reported patient symptom concerns. The TRSC appears to be a clinically useful self-report checklist that captures the more important symptom concerns of both RT and chemotherapy patients. Earlier efforts to develop this checklist are reviewed briefly.
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Affiliation(s)
- P D Williams
- University of Kansas School of Nursing, 3901 Rainbow Blvd., Kansas City, KS 66160-7052, USA.
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Williams AR. Who pays when air medical personnel are injured? Air Med J 2001; 20:6-7. [PMID: 11331817] [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: 02/19/2023]
Affiliation(s)
- A R Williams
- Abigail Williams & Associates, PC, Worcester, Mass
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Williams AR. Some comments on the importance of third order contributions to the screening of the ionic potential and to the structural energy of metals. ACTA ACUST UNITED AC 2001. [DOI: 10.1088/0305-4608/3/4/020] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Affiliation(s)
- G Roblin
- Department of Otolaryngology, Singleton Hospital, Swansea, Wales, UK
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Blackburn TP, Edge DA, Williams AR, Adams CB. Head protection in England before the first World War. Neurosurgery 2000; 47:1261-85; discussion 1285-6. [PMID: 11126898] [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: 02/18/2023] Open
Abstract
Man has sought to protect himself from physical injury resulting either from the vicissitudes of an arbitrary natural environment or from the calculated activity of his fellow creatures since at least the beginning of recorded time. The earliest substantial British evidence of this activity dates from shortly after the Roman invasion of 55 BC. The head has always been seen by both assailant and defender as a region of particular vulnerability, where an incapacitating blow might most effectively be landed. We present an overview of the evolution and development of English military head protection through the ages, with particular reference to the advances made in metallurgical technology at Greenwich through the course of the 16th century. Much of this represents original research by the authors (particularly ARW), published here for the first time. We include the first metallographic data on armor excavated from the Wisby grave-pits (1361), the first scientific analysis of the textile composition of medieval helmet linings from the Wallace Collection, and the first metallurgical study of the Windsor Castle suit, the personal armor of King Henry VIII, perhaps England's most famous monarch. We combine this with our own experimental data, also previously unpublished, relating to the attack energy available from ancient weaponry (whose technology determines the design of defenses, then as now) in an attempt to assess the effectiveness of helmets. Finally, we set this in the context of contemporary medical technology. The latter is found to be woefully inadequate when presented with serious head injuries. Nevertheless, mortality from battlefield injury has been reduced from ancient times to the present day, despite advances in weapons technology.
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Affiliation(s)
- T P Blackburn
- Department of Neurosciences, Cromwell Hospital, London, England.
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Williams AR, Alleyne BD, Hall LA, White AJ, Williams DJ, Thompson LK. Synthesis and structures of polymeric Mn, Co, Cu, and Zn complexes of 3-diphenylamino-4-hydroxycyclobut-3-ene-1,2-dione (diphenylaminosquarate) and of the salt [Ni(H2O)6][(C6H5)2NC4O3]2.2H2O. Inorg Chem 2000; 39:5265-70. [PMID: 11187469 DOI: 10.1021/ic000390q] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Reaction of M(NO3)2.xH2O (M = Mn, Co, Ni, Cu, Zn) with 3-diphenylamino-4-hydroxycyclobut-3-ene-1,2-dione (diphenylaminosquarate) produces the neutral polymeric species (M[mu-(C6H5)2NC4O3]2[H2O]2)n [M = Mn (1), Cu (2)]; (M[mu-(C6H5)2NC4O3][(C6H5)2NC4O3][H2O]3)n [M = Co (3), Zn (4)]; and in the case of Ni, the salt [Ni(H2O)6][(C6H5)2NC4O3]2.2H2O (5). Complexes 1 and 2 are isomorphous and crystallize in the monoclinic space group P2(1)/c with, for 1, a = 13.138(1) A, b = 10.900(2) A, c = 9.269(2) A, beta = 96.07(1) degrees, and Z = 2. Complexes 3 and 4 are also isomorphous and crystallize in the space group P2(1)/c with, for 3, a = 13.211(1) A, b = 11.038(1) A, c = 18.748(1) A, beta = 97.75(1) degrees, and Z = 4. The nickel salt, 5, crystallizes in the triclinic space group P1 with a = 6.181(1) A, b = 9.417(1) A, c = 15.486(1) A, alpha = 101.37(1) degrees, beta = 95.51(1) degrees, gamma = 107.57(1) degrees, and Z = 1. In 1 and 2, the metal coordination is octahedral, comprising four mu-1,3-bridging diphenylaminosquarate ligands and two trans aqua ligands. In 3 and 4, the metal coordination is again octahedral, comprising two mu-1,3-bridging and one pendant diphenylaminosquarate ligands, the octahedron being completed by three aqua ligands in a meridional configuration. In 5, the hexaaquanickel(II) ion is linked by O-H...O hydrogen bonds to a pair of diphenylaminosquarate anions. These anion-cation units are linked via included water molecules to form hydrogen-bonded chains. The diphenylaminosquarate ligands in the polymeric complexes 1-4 display multiple-bond localization, a feature which is absent in 5. Complex 1 exhibits weak antiferromagnetic coupling, whereas 2 shows no significant magnetic interactions.
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Affiliation(s)
- A R Williams
- Department of Chemistry, University of the West Indies, St. Augustine, Trinidad, West Indies
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