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Bergiers S, Henckel J, Hothi H, Di Laura A, Goddard C, Raymont D, Ullah F, Cotton R, Bryan R, Hart A. Statistical Shape Modelling the In Vivo Location of Acetabular Wear in Retrieved Hip Implants. Bioengineering (Basel) 2022; 10:bioengineering10010046. [PMID: 36671617 PMCID: PMC9854783 DOI: 10.3390/bioengineering10010046] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/19/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022]
Abstract
Edge-wear in acetabular cups is known to be correlated with greater volumes of material loss; the location of this wear pattern in vivo is less understood. Statistical shape modelling (SSM) may provide further insight into this. This study aimed to identify the most common locations of wear in vivo, by combining CT imaging, retrieval analysis and SMM. Shape variance was described in 20 retrieved metal-on-metal acetabular surfaces. These were revised after a mean of 90 months, from 13 female and seven male patients. They were positioned with a mean inclination and anteversion of 53° and 30°, respectively. Their orientation, in vivo, was established using their stabilising fins, visible in pre-revision CT imaging. The impact of wear volume, positioning, time, gender and size on the in vivo location of wear was investigated. These surfaces had a mean wear volume of 49.63 mm3. The mean acetabular surface displayed superior edge-wear centred 7° within the posterosuperior quadrant, while more of the volumetric wear occurred in the anterosuperior quadrant. Components with higher inclination had greater superior edge-wear scars, while a relationship was observed between greater anteversion angles and more posterosuperior edge-wear. This SSM method can further our understanding of hip implant function, informing future design and may help to refine the safe zone for implant positioning.
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Affiliation(s)
- Sean Bergiers
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London WC1E 6BT, UK
| | - Johann Henckel
- Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK
| | - Harry Hothi
- Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK
| | - Anna Di Laura
- Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK
| | | | | | - Furqan Ullah
- Synopsys Northern Europe Ltd., Exeter EX4 3PL, UK
| | - Ross Cotton
- Synopsys Northern Europe Ltd., Exeter EX4 3PL, UK
| | | | - Alister Hart
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London WC1E 6BT, UK
- Royal National Orthopaedic Hospital, Stanmore HA7 4LP, UK
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Goddard C, Collopy KT, Powers Iv WF. Prehospital Hypertonic Saline Administration After Severe Traumatic Brain Injury. Air Med J 2022; 41:498-502. [PMID: 36153150 DOI: 10.1016/j.amj.2022.04.004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/29/2022] [Accepted: 04/07/2022] [Indexed: 06/16/2023]
Abstract
A 25-year old male paient was critically injuried in a high speed motor vehicle collision over an hour from the nearest trauma center. Paramedics diagnosed the patient with a traumatic brain injury and increasing intracranial pressure and transported the patient to a predesignated landing zone for helicopter intercept. During transport paramedics initiated a severe traumatic brain injury protocol which included the adminisration of 3% hypertonic saline. The flight crew continued 3% hypertonic saline managment which was later transferred to the receiving trauma team. Upon trauma center arrival the patient was diagnosed with a skull fracture and subdural hematoma. The patient was transitioned to a 3% hypertonic saline infusion for the next 24 h. The need for integrating systems of care is particularly important when managing patients with severe traumatic brain injury. This case report describes a patient with a severe TBI who received prehospital 3% hypertonic saline based on an integrated protocol developed between multiple prehosptial systems and a tertiary care trauma center. Severe traumatic brain injuries (TBIs) are a potentially catastrophic event, and morbidity can rise precipitously without early interventions to prevent hypoxia and hypotension and control for rising intracranial pressure. In recent years, hypertonic saline (HTS) has shown efficacy in lowering intracranial pressures for patients experiencing TBIs, the leading cause of death and disability among children and young adults in the United States.1 Integrating care between health care providers across the acute care continuum, from prehospital systems to discharge, is paramount in providing the best patient outcomes possible, especially in health care system expansions such as air medical transport. The need for integrating systems of care is particularly important when managing patients with severe TBI. Statewide prehospital care protocols vary greatly; 78% provide ventilation guidance, 77.3% have targeted end-tidal carbon dioxide levels below < 35 mm Hg, and only 1 (of 38 reviewed) includes HTS (3%).2 One barrier to consistency in protocol development is the available literature. One trial demonstrated that a prehospital bolus of 7.5% HTS in severe TBI did not improve mortality.3 However, the Brain Foundation guidelines continue to recommend the prehospital use of hyperosmolar therapy for patients with severe TBI and evidence of impending herniation.4 Hyperosmolar therapy is also recommended as an inpatient strategy for lowering increased intracranial pressure (ICP).4 One reason for this apparent disconnect is because the ideal timing of HTS administration and its concentration have not been determined.4 A meta-analysis previously determined no one prehospital fluid is superior to another in improving the outcomes of patients with severe TBI.5 However, none of the reviewed research investigated the continued use of HTS across an integrated system of care. This case report describes a patient with a severe TBI who received 3% HTS initiated in the prehospital setting with the infusion continued upon arrival at the trauma center using a system-wide integrated protocol.
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Affiliation(s)
- Chris Goddard
- Edward Via College of Osteopathic Medicine, Blacksburg, VA, United States
| | - Kevin T Collopy
- Novant Health New Hanover Regional Medical Center, AirLink/VitaLink Critical Care Transport, 2131 South 17th Street, Wilmington, NC 28401, United States.
| | - William F Powers Iv
- Novant Health New Hanover Regional Medical Center, AirLink/VitaLink Critical Care Transport, 2131 South 17th Street, Wilmington, NC 28401, United States; Novant Health New Hanover Regional Medical Center, Division of Acute Care Surgery, Wilmington, NC, United States
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Clare K, Ojo A, Teke J, Willis M, Akhtar G, Clegg B, Goddard C, Freeman C, Drew KJ, Radley D, Homer C, Ells L. ' Valued and listened to': the collective experience of patient and public involvement in a national evaluation. Perspect Public Health 2022; 142:199-201. [PMID: 35833551 PMCID: PMC9284077 DOI: 10.1177/17579139221103184] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- K Clare
- Obesity Institute, Leeds Beckett University, School of Health, Leeds Beckett University, Leeds, UK.,Re:Mission Patient and Public Involvement Group, Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK.,Obesity U, Southport, UK
| | - A Ojo
- Re:Mission Patient and Public Involvement Group, Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - J Teke
- Re:Mission Patient and Public Involvement Group, Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - M Willis
- Re:Mission Patient and Public Involvement Group, Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - G Akhtar
- Re:Mission Patient and Public Involvement Group, Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK
| | - B Clegg
- Re:Mission Patient and Public Involvement Group, Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK.,Obesity UK, Southport, UK
| | - C Goddard
- Re:Mission Patient and Public Involvement Group, Obesity Institute, School of Health, Leeds Beckett University, Leeds, UK.,Obesity UK, Southport, UK
| | - C Freeman
- Obesity Institute, Leeds Beckett University, School of Health, Leeds Beckett University, Leeds, UK
| | - K J Drew
- Obesity Institute, Leeds Beckett University, School of Health, Leeds Beckett University, Leeds, UK
| | - D Radley
- Obesity Institute, Leeds Beckett University, School of Health, Leeds Beckett University, Leeds, UK
| | - C Homer
- Sport and Physical Activity Research Centre, Sheffield Hallam University, Olympic Legacy Park, 2 Old Hall Road, Sheffield S9 3TU, UK
| | - L Ells
- Obesity Institute, Leeds Beckett University, School of Health, Leeds Beckett University, Leeds, UK
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Higgs A, McGrath BA, Goddard C, Rangasami J, Suntharalingam G, Gale R, Cook TM. DAS guidelines on the airway management of critically ill patients. Anaesthesia 2019; 73:1035-1036. [PMID: 30117585 DOI: 10.1111/anae.14352] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Higgs A, McGrath B, Goddard C, Rangasami J, Suntharalingam G, Gale R, Cook T. Response to: ‘A team approach to the difficult airway’. Br J Anaesth 2018; 121:100. [DOI: 10.1016/j.bja.2018.04.007] [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] [Received: 04/06/2018] [Accepted: 04/09/2018] [Indexed: 11/29/2022] Open
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Higgs A, McGrath B, Goddard C, Rangasami J, Suntharalingam G, Gale R, Cook T. Response to ‘Surgical cricothyroidotomy—the tracheal tube dilemma’. Br J Anaesth 2018; 120:1138-1139. [DOI: 10.1016/j.bja.2018.02.009] [Citation(s) in RCA: 1] [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] [Received: 02/09/2018] [Accepted: 02/12/2018] [Indexed: 12/20/2022] Open
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Higgs A, McGrath BA, Goddard C, Rangasami J, Suntharalingam G, Gale R, Cook TM. Guidelines for the management of tracheal intubation in critically ill adults. Br J Anaesth 2017; 120:323-352. [PMID: 29406182 DOI: 10.1016/j.bja.2017.10.021] [Citation(s) in RCA: 437] [Impact Index Per Article: 62.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/23/2017] [Accepted: 10/25/2017] [Indexed: 12/17/2022] Open
Abstract
These guidelines describe a comprehensive strategy to optimize oxygenation, airway management, and tracheal intubation in critically ill patients, in all hospital locations. They are a direct response to the 4th National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society, which highlighted deficient management of these extremely vulnerable patients leading to major complications and avoidable deaths. They are founded on robust evidence where available, supplemented by expert consensus opinion where it is not. These guidelines recognize that improved outcomes of emergency airway management require closer attention to human factors, rather than simply introduction of new devices or improved technical proficiency. They stress the role of the airway team, a shared mental model, planning, and communication throughout airway management. The primacy of oxygenation including pre- and peroxygenation is emphasized. A modified rapid sequence approach is recommended. Optimal management is presented in an algorithm that combines Plans B and C, incorporating elements of the Vortex approach. To avoid delays and task fixation, the importance of limiting procedural attempts, promptly recognizing failure, and transitioning to the next algorithm step are emphasized. The guidelines recommend early use of a videolaryngoscope, with a screen visible to all, and second generation supraglottic airways for airway rescue. Recommendations for emergency front of neck airway are for a scalpel-bougie-tube technique while acknowledging the value of other techniques performed by trained experts. As most critical care airway catastrophes occur after intubation, from dislodged or blocked tubes, essential methods to avoid these complications are also emphasized.
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Affiliation(s)
- A Higgs
- Anaesthesia and Intensive Care Medicine, Warrington and Halton Hospitals NHS Foundation Trust, Cheshire, UK(8).
| | - B A McGrath
- Anaesthesia and Intensive Care Medicine, University Hospital South Manchester, Manchester, UK(9)
| | - C Goddard
- Anaesthesia & Intensive Care Medicine, Southport and Ormskirk Hospitals NHS Trust, Southport, UK(8)
| | - J Rangasami
- Anaesthesia & Intensive Care Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK(8)
| | - G Suntharalingam
- Intensive Care Medicine and Anaesthesia, London North West Healthcare NHS Trust, London, UK(10)
| | - R Gale
- Anaesthesia & Intensive Care Medicine, Countess of Chester Hospital NHS Foundation Trust, Chester, UK(11)
| | - T M Cook
- Anaesthesia and Intensive Care Medicine, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK(12)
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9
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Othman S, Goddard C, Piterman L. Victims' barriers to discussing domestic violence in clinical consultations: a qualitative enquiry. J Interpers Violence 2014; 29:1497-1513. [PMID: 24323695 DOI: 10.1177/0886260513507136] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Victims of domestic violence frequently attend health care facilities. In many cases, their abusive experience is neither disclosed nor discussed during clinical consultations. This study examined the barriers faced by women when discussing abuse with health care providers, specifically in cases involving Malaysian women with a history of domestic violence. A qualitative study using in-depth interviews was conducted with 10 women with a history of domestic violence residing at a shelter. Purposive sampling was conducted until data saturation. Using the grounded theory approach of analysis, themes that emerged from these interviews were then further analyzed to examine the barriers faced by these women. Women who experienced domestic violence faced multiple barriers while discussing their accounts of abuse with others. Values placed on the privacy of domestic violence; upholding the traditional gender roles; preserving the family unity; minimizing the abuse, the feeling of shame, self-blame; and fearing their abuser generally create internal barriers when discussing their encounters of abuse with health care providers. The perceived unknown role of health care professionals when dealing with patients experiencing domestic violence as well as the previous negative experiences in clinical consultations acted as external barriers for discussing abuse with health care providers. Women with domestic violence experiences faced internal and external barriers to discussing their abuse during clinical consultations. Physicians and health care providers must consider domestic violence in consultations with female patients. A good doctor-patient relationship that encompasses empathy, confidence, trust, support, assurance, confidentiality, and guidance can help patients with abusive backgrounds overcome these barriers, leading to the disclosure and discussion of their abusive encounters. Proper education, guidelines, and support for health care providers are required to help them assist women with histories of domestic violence.
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Mudaly N, Goddard C. The urgent need for ethical guidelines to protect children in the dissemination of research findings. Child Abuse Negl 2012; 36:798-799. [PMID: 23146581 DOI: 10.1016/j.chiabu.2012.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 07/30/2012] [Accepted: 08/02/2012] [Indexed: 06/01/2023]
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Abstract
Child injury, regardless of intent, is a major public health issue in Australia and elsewhere. Child protection and injury prevention policies and practices are implemented in most countries in an attempt to manage and reduce the incidence of both intentional and unintentional injuries. While these systems are thought to assist in improving protection from violence, injury and neglect, one of the major limitations in understanding the effectiveness of child protection policy in Australia is a lack of reliable national data on child abuse and neglect. As a result there is a lack of an appropriate evidence base on which to guide the development of effective policies. A particular area where official figures may under-represent the true prevalence of child deaths is those which result from homicide. This article provides a review of the recent literature on child homicide, abuse and neglect, with the overall aim of understanding more fully the reasons for the possible under-representation of child homicides and provides recommendations to address this problem in Australia. Improvements in methods of identifying at risk children in addition to systematic investigations of child deaths to understand the risk factors and underlying contributing factors are required.
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Affiliation(s)
- John Frederick
- a Monash Injury Research Institute, Building 70, Monash University , Clayton , 3800 , Australia
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Campbell R, Hofmann D, Hatch S, Gordon P, Lempp H, Das L, Blumbergs P, Limaye V, Vermaak E, McHugh N, Edwards MH, Jameson K, Sayer AA, Dennison E, Cooper C, Salvador FB, Huertas C, Isenberg D, Jackson EJ, Middleton A, Churchill D, Walker-Bone K, Worsley PR, Mottram S, Warner M, Morrissey D, Gadola S, Carr A, Cooper C, Stokes M, Srivastava RN, Sanghi D, Srivastava RN, Sanghi D, Elbaz A, Mor A, Segal G, Drexler M, Norman D, Peled E, Rozen N, Goryachev Y, Debbi EM, Haim A, Rozen N, Wolf A, Debi R, Mor A, Segal G, Debbi EM, Cohen MS, Igolnikov I, Bar Ziv Y, Benkovich V, Bernfeld B, Rozen N, Elbaz A, Collins J, Moots RJ, Clegg PD, Milner PI, Ejtehadi HD, Nelson PN, Wenham C, Balamoody S, Hodgson R, Conaghan P, Wilkie R, Blagojevic M, Jordan KP, Mcbeth J, Peffers MJ, Beynon RJ, Thornton DJ, Clegg PD, Chapman R, Chapman V, Walsh D, Kelly S, Hui M, Zhang W, Doherty S, Rees F, Muir K, Maciewicz R, Doherty M, Snelling S, Davidson RK, Swingler T, Price A, Clark I, Stockley E, Hathway G, Faas H, Auer D, Chapman V, Hirsch G, Hale E, Kitas G, Klocke R, Abraham A, Pearce MS, Mann KD, Francis RM, Birrell F, Tucker M, Mellon SJ, Jones L, Price AJ, Dieppe PA, Gill HS, Ashraf S, Chapman V, Walsh DA, McCollum D, McCabe C, Grieve S, Shipley J, Gorodkin R, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Rajak R, Bennett C, Williams A, Martin JC, Abdulkader R, MacNicol C, Brixey K, Stephenson S, Clunie G, Andrews RN, Oldroyd AG, Evans B, Greenbank C, Bukhari M, Clark EM, Gould VC, Carter L, Morrison L, Tobias JH, Pye SR, Vanderschueren D, O'Neill TW, Lee DM, Jans I, Billen J, Gielen E, Laurent M, Claessens F, Adams JE, Ward KA, Bartfai G, Casanueva F, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi I, Kula K, Lean ME, Pendleton N, Punab M, Wu FC, Boonen S, Mercieca C, Webb J, Shipley J, Bhalla A, Fairbanks S, Moss KE, Collins C, Sedgwick P, Clark EM, Gould VC, Morrison L, Tobias JH, Parker J, Greenbank C, Evans B, Oldroyd AG, Bukhari M, Harvey NC, Cole ZA, Crozier SR, Ntani G, Mahon PA, Robinson SM, Inskip HM, Godfrey KM, Dennison EM, Cooper C, Bridges M, Ruddick S, Holroyd CR, Mahon P, Crozier SR, Godfrey K, Inskip HM, Cooper C, Harvey NC, Bridges M, Ruddick S, McNeilly T, McNally C, Beringer T, Finch M, Coda A, Davidson J, Walsh J, Fowlie P, Carline T, Santos D, Patil P, Rawcliffe C, Olaleye A, Moore S, Fox A, Sen D, Ioannou Y, Nisar S, Rankin K, Birch M, Finnegan S, Rooney M, Gibson DS, Malviya A, Ferris CM, Rushton SP, Foster HE, Hanson H, Muthumayandi K, Deehan DJ, Birt L, Poland F, MacGregor A, Armon K, Pfeil M, McErlane F, Beresford MW, Baildam EM, Thomson W, Hyrich K, Chieng A, Davidson J, Foster HE, Gardner-Medwin J, Lunt M, Wedderburn L, Gibson DS, Finnegan S, Newell K, Evans A, Manning G, Scaife C, McAllister C, Pennington SR, Duncan M, Moore T, Rooney M, Pericleous C, Croca SC, Giles I, Alber K, Yong H, Isenberg D, Midgely A, Beresford MW, Rahman A, Ioannou Y, Rzewuska M, Mallen C, Strauss VY, Belcher J, Peat G, Byng-Maddick R, Wijendra M, Penn H, Roddy E, Muller S, Hayward R, Mallen C, Kamlow F, Pakozdi A, Jawad A, Green DJ, Muller S, Mallen C, Hider SL, Singh Bawa S, Bawa S, Turton A, Palmer M, Grieve S, Lewis J, Moss T, McCabe C, Goodchild CE, Tang N, Scott D, Salkovskis P, Selvan S, Williamson L, Selvan S, Williamson L, Thalayasingam N, Higgins M, Saravanan V, Rynne M, Hamilton JD, Heycock C, Kelly C, Norton S, Sacker A, Done J, Young A, Smolen JS, Fleischmann RM, Emery P, van Vollenhoven RF, Guerette B, Santra S, Kupper H, Redden L, Kavanaugh A, Keystone EC, van der Heijde D, Weinblatt ME, Mozaffarian N, Guerette B, Kupper H, Liu S, Kavanaugh A, Zhang N, Wilkinson S, Riaz M, Ostor AJ, Nisar MK, Burmester G, Mariette X, Navarro-Blasco F, Oezer U, Kary S, Unnebrink K, Kupper H, Jobanputra P, Maggs F, Deeming A, Carruthers D, Rankin E, Jordan A, Faizal A, Goddard C, Pugh M, Bowman S, Brailsford S, Nightingale P, Tugnet N, Cooper SC, Douglas KM, Edwin Lim CS, Bee Lian Low S, Joy C, Hill L, Davies P, Mukherjee S, Cornell P, Westlake SL, Richards S, Rahmeh F, Thompson PW, Breedveld F, Keystone E, van der Heijde D, Landewe R, Smolen JS, Guerette B, McIlraith M, Kupper H, Liu S, Kavanaugh A, Byng-Maddick R, Penn H, Abdulkader R, Dharmapalaiah C, Shand L, Rose G, Clunie G, Watts R, Eldashan A, Dasgupta B, Borg FA, Bell GM, Anderson AE, Harry RA, Stoop JN, Hilkens CM, Isaacs J, Dickinson A, McColl E, Banik S, Smith L, France J, Bawa S, Rutherford A, Scott Russell A, Smith J, Jassim I, Withrington R, Bacon P, De Lord D, McGregor L, Morrison I, Stirling A, Porter DR, Saunders SA, Else S, Semenova O, Thompson H, Ogunbambi O, Kallankara S, Baguley E, Patel Y, Alzabin S, Abraham S, Taher TE, Palfeeman A, Hull D, McNamee K, Jawad A, Pathan E, Kinderlerer A, Taylor P, Williams RO, Mageed RA, Iaremenko O, Mikitenko G, Ferrari M, Kamalati T, Pitzalis C, Tugnet N, Pearce F, Tosounidou S, Obrenovic K, Erb N, Packham J, Sandhu R, White C, Cardy CM, Justice E, Frank M, Li L, Lloyd M, Ahmed A, Readhead S, Ala A, Fittall M, Manson J, Ioannou Y, Sibilia J, Marc Flipo R, Combe B, Gaillez C, Le Bars M, Poncet C, Elegbe A, Westhovens R, Hassanzadeh R, Mangan C, France J, Bawa S, Weinblatt ME, Fleischmann R, van Vollenhoven R, Emery P, Huizinga TWJ, Goldermann R, Duncan B, Timoshanko J, Luijtens K, Davies O, Dougados M, Hewitt J, Owlia M, Dougados M, Gaillez C, Le Bars M, Poncet C, Elegbe A, Schiff M, Alten R, Kaine JL, Keystone E, Nash PT, Delaet I, Qi K, Genovese MC, Clark J, Kardash S, Wong E, Hull R, McCrae F, Shaban R, Thomas L, Young-Min S, Ledingham J, Genovese MC, Covarrubias Cobos A, Leon G, Mysler EF, Keiserman MW, Valente RM, Nash PT, Abraham Simon Campos J, Porawska W, Box JH, Legerton CW, Nasonov EL, Durez P, Pappu R, Delaet I, Teng J, Alten R, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Edwards CJ, Arden N, Campbell J, van Staa T, Housden C, Sargeant I, Choy E, McAuliffe S, Roberts K, Sargeant I, Emery P, Sarzi-Puttini P, Moots RJ, Andrianakos A, Sheeran TP, Choquette D, Finckh A, Desjuzeur ML, Gemmen EK, Mpofu C, Gottenberg JE, Bukhari M, Shah P, Kitas G, Cox M, Nye A, O'Brien A, Jones P, Sargeant I, Jones GT, Paudyal P, MacPherson H, Sim J, Doherty M, Ernst E, Fisken M, Lewith G, Tadman J, Macfarlane GJ, Mariette X, Bertin P, Arendt C, Terpstra I, VanLunen B, de Longueville M, Zhou H, Cai A, Lacy E, Kay J, Keystone E, Matteson E, Hu C, Hsia E, Doyle M, Rahman M, Shealy D, Scott DL, Ibrahim F, Abozaid H, Choy E, Hassell A, Plant M, Richards S, Walker D, Simpson G, Kowalczyk A, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Nash PT, Ludivico CL, Delaet I, Qi K, Murthy B, Corbo M, Kaine JL, Emery P, Smolen JS, Samborski W, Berenbaum F, Davies O, Ambrugeat J, Bennett B, Burkhardt H, Prouse P, Brown A, George M, Kumar N, Mackay K, Marshall S, Bykerk V, Ostor AJ, Roman Ivorra J, Wollenhaupt J, Stancati A, Bernasconi C, Sibilia J, Scott DGI, Claydon P, Ellis C, Buchan S, Pope J, Fleischmann R, Dougados M, Bingham CO, Massarotti EM, Wollenhaupt J, Duncan B, Coteur G, Weinblatt M, Hull D, Ball C, Abraham S, Ainsworth T, Kermik J, Woodham J, Haq I, Quesada-Masachs E, Carolina Diaz A, Avila G, Acosta I, Sans X, Alegre C, Marsal S, McWilliams D, Kiely PD, Young A, Walsh DA, Fleischmann R, Bolce R, Wang J, Ingham M, Dehoratius R, Decktor D, Rao V, Pavlov A, Klearman M, Musselman D, Giles J, Bathon J, Sattar N, Lee J, Baxter D, McLaren JS, Gordon MM, Thant KZ, Williams EL, Earl S, White P, Williams J, Westlake SL, Ledingham J, Jan AK, Bhatti AI, Stafford C, Carolan M, Ramakrishnan SA. Muscle disorders * 111. The impact of fatigue in patients with idiopathic inflammatory myopathy: a mixed method study. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes109] [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] Open
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Stewart F, Goddard C, Schiff R, Hall S. Advanced care planning in care homes for older people: a qualitative study of the views of care staff and families. Age Ageing 2011; 40:330-5. [PMID: 21345840 DOI: 10.1093/ageing/afr006] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE to explore views on advance care planning in care homes for older people. DESIGN qualitative exploration of views from care home staff and the family of residents in care homes for older people. SETTING all care homes for the elderly in two London Boroughs. PARTICIPANTS staff (care managers, nurses and care assistants), community nurses and families. METHODS individual semi-structured interviews. RESULTS themes of the analysis: (i) BENEFITS staff and family revealed positive opinions towards advance care planning. Staff felt it provided choice for residents and encouraged better planning. (ii) Barriers: staff and families perceived residents as reluctant to discuss advance care planning. Some care assistants were reluctant to be involved. Furthermore, families and staff reported prevalence of dementia among residents as another barrier. Nurses and care managers identified both family involvement and unforeseen medical circumstances as problematic. (iii) Facilitators: (a) early initiation of discussions (b) family involvement to establish preferences (c) residents and staff being well-known to each other and (d) staff training, were perceived to facilitate ACP. CONCLUSIONS overall, staff and families support the concept of ACP. Methods to overcome the identified barriers are required to embed ACP within end of life care in care homes.
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Affiliation(s)
- F Stewart
- Department of Palliative Care, Policy and Rehabilitation, King's College London, Cicely Saunders Institute, London SE5 9PJ, UK.
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Affiliation(s)
- J A Slack
- CRC Experimental Chemotherapy Group, Pharmaceutical Sciences Institute, Aston University Birmingham B4 7ET
| | - C Goddard
- CRC Experimental Chemotherapy Group, Pharmaceutical Sciences Institute, Aston University Birmingham B4 7ET
| | - M F G Stevens
- CRC Experimental Chemotherapy Group, Pharmaceutical Sciences Institute, Aston University Birmingham B4 7ET
| | - G U Baig
- CRC Experimental Chemotherapy Group, Pharmaceutical Sciences Institute, Aston University Birmingham B4 7ET
| | - M J Griffin
- CRC Experimental Chemotherapy Group, Pharmaceutical Sciences Institute, Aston University Birmingham B4 7ET
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Hall S, Goddard C, Speck P, Opio D, Chochinov HM, Higginson IJ. Fostering hope and enhancing end of life experiences: two Phase II RCTs of dignity therapy. BMJ Support Palliat Care 2011. [DOI: 10.1136/bmjspcare-2011-000020.24] [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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16
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Finlayson CE, Goddard C, Papachristodoulou E, Snoswell DRE, Kontogeorgos A, Spahn P, Hellmann GP, Hess O, Baumberg JJ. Ordering in stretch-tunable polymeric opal fibers. Opt Express 2011; 19:3144-3154. [PMID: 21369136 DOI: 10.1364/oe.19.003144] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We demonstrate the production of high-quality polymer opal fibers in an industrially-scalable process. These fibers exhibit structural color, based on the self-assembly of sub-micron core-shell particles, with a spectrum which is stretch-tunable across the visible region. The internal substructure and ordering of fibers, as inferred from variations in spectral bandwidth, is studied using dark-field microscopy. We employ a granular model to examine flow and shear forces during the extrusion process, and the effects on particle ordering. In both theory and experiment, a concentric zone of the fiber near the exposed surface develops particularly strong structural color. Such elastically-tuned structurally colored fibers are of interest for many applications.
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Affiliation(s)
- Chris E Finlayson
- NanoPhotonics Centre, University of Cambridge, Cambridge CB3 0HE, UK
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Travers B, Henderson S, Vasireddy S, SeQueira EJ, Cornell PJ, Richards S, Khan A, Hasan S, Withrington R, Leak A, Sandhu J, Joseph A, Packham JC, Lyle S, Martin JC, Goodfellow RM, Rhys-Dillon C, Morgan JT, Mogford S, Rowan-Phillips J, Moss D, Wilson H, McEntegart A, Morgan JT, Martin JC, Rhys Dillon C, Goodfellow R, Gould L, Bukhari M, Hassan S, Butt S, Deighton C, Gadsby K, Love V, Kara N, Gohery M, Keat A, Lewis A, Robinson R, Bastawrous S, Roychowdhury B, Roskell S, Douglas B, Keating H, Giles S, McPeake J, Molloy C, Chalam V, Mulherin D, Price T, Sheeran T, Benjamin SR, Thompson PW, Cornell P, Siddle HJ, Backhouse MR, Monkhouse RA, Harris NJ, Helliwell PS, Azzopardi L, Hudson S, Mallia C, Cassar K, Coleiro B, Cassar PJ, Aquilina D, Camilleri F, Serracino Inglott A, Azzopardi LM, Robinson S, Peta H, Margot L, David W, Mann C, Gooberman-Hill R, Jagannath D, Healey E, Goddard C, Pugh MT, Gilham L, Bawa S, Barlow JH, MacFarland L, Tindall L, Leddington Wright S, Tooby J, Ravindran J, Perkins P, McGregor L, Mabon E, Bawa S, Bond U, Swan J, O'Connor MB, Rathi J, Regan MJ, Phelan MJ, Doherty T, Martin K, Ruth C, Panthakalam S, Bondin D, Castelino M, Evin S, Gooden A, Peacock C, Teh LS, Ryan SJ, Bryant E, Carter A, Cox S, Moore AP, Jackson A, Kuisma R, Pattman J, Juarez M, Quilter A, Williamson L, Collins D, Price E, Chao Y, Mooney J, Watts R, Graham K, Birrell F, Reed M, Croyle S, Stell J, Vasireddy S, Storrs P, McLoughlin YM, Scott G, McKenna F, Papou A, Rahmeh FH, Richards SC, Westlake SL, Birrell F, Morgan L, Baqir W, Walsh NE, Ward L, Caine R, Williams M, Breslin A, Owen C, Ahmad Y, Morgan L, Blair A, Birrell F, Ramachandran Nair J, Zia A, Mewar D, Peffers GM, Larder R, Dockrell D, Wilson S, Cummings J, Bansal J, Barlow J. BHPR: Audit/Service Delivery [239-277]: 239. Arma-Based Audit of Rheumatology Service Delivered Predominantly Outside the Traditional Hospital Setting. Rheumatology (Oxford) 2010. [DOI: 10.1093/rheumatology/keq730] [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: 11/14/2022] Open
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Goddard C, Hess O, Hess S. Low Reynolds number turbulence in nonlinear Maxwell-model fluids. Phys Rev E Stat Nonlin Soft Matter Phys 2010; 81:036310. [PMID: 20365857 DOI: 10.1103/physreve.81.036310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2008] [Revised: 11/11/2009] [Indexed: 05/29/2023]
Abstract
A generalized nonlinear Maxwell model which had previously been analyzed for plane Couette geometry is here applied to a lid-driven cavity flow. The full three-dimensional hydrodynamical problem is treated numerically. Depending on the relevant model parameters, both smooth laminar and low Reynolds number turbulent flows are found, strikingly similar to the experimentally observed elastic turbulence phenomena in polymer solutions. Representative results of the calculated flow patterns, as well as measures for the turbulent nature of the flow are presented graphically.
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Affiliation(s)
- Chris Goddard
- Department of Physics, Faculty of Engineering and Physical Sciences, University of Surrey, Advanced Technology Institute, Guildford GU2 7XH, United Kingdom.
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20
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Frederick J, Goddard C. 'It's been really, really hard': a qualitative study of the health problems of people receiving emergency relief in Australia. Health Soc Care Community 2009; 17:581-589. [PMID: 19469916 DOI: 10.1111/j.1365-2524.2009.00860.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The aim of the research reported in this paper was to explore the perspectives and insights of emergency relief recipients in relation to their complex health problems, which had contributed to their position of needing to seek emergency relief. The sample consisted of 20 adults aged between 19 and 51 years who had received emergency relief in a regional city in Victoria, Australia. Non-probability sampling was used, employing the convenience sampling procedure. A qualitative, exploratory research approach utilising in-depth interviews was selected to obtain data from the respondents. The method of data analysis used involved open, axial and selective coding. The main findings were that the participants experienced abuse and neglect in childhood, the effects of mental health problems, going without food, lack of access to and the high cost of health care, and the interactive aspects of health problems and poverty. Implications for policy and service delivery are outlined.
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Affiliation(s)
- John Frederick
- Child Abuse Prevention Research Australia, Monash University, Notting Hill, Vic., Australia.
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Goddard C, Hess O, Balanov AG, Hess S. Shear-induced chaos in nonlinear Maxwell-model fluids. Phys Rev E Stat Nonlin Soft Matter Phys 2008; 77:026311. [PMID: 18352126 DOI: 10.1103/physreve.77.026311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Indexed: 05/26/2023]
Abstract
A generalized model for the behavior of the stress tensor in non-Newtonian fluids is investigated for spatially homogeneous plane Couette flow, showing a variety of nonlinear responses and deterministic chaos. Mapping of chaotic solutions is achieved through the largest Lyapunov exponent for the two main parameters: The shear rate and the temperature and/or density. Bifurcation diagrams and stability analysis are used to reveal some of the rich dynamics that can be found. Suggested mechanisms for stability loss in these complex fluids include Hopf, saddle-node, and period-doubling bifurcations.
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Affiliation(s)
- Chris Goddard
- Advanced Technology Institute, School of Electronics and Physical Sciences, University of Surrey, Guildford, GU2 7XH, United Kingdom.
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Thorp BH, Jakowlew SB, Goddard C. Avian dyschondroplasia: Local deficiencies in growth factors are integral to the aetiopathogenesis. Avian Pathol 2007; 24:135-48. [DOI: 10.1080/03079459508419054] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Affiliation(s)
- Gillinder Bedi
- National Research Centre for the Prevention of Child Abuse,
- Department of Psychology, Monash University
- Department of Social Work, Monash University , Melbourne, Victoria, Australia
| | - Chris Goddard
- National Research Centre for the Prevention of Child Abuse,
- Department of Social Work, Monash University , Melbourne, Victoria, Australia
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Abstract
The mid-gestation fetus is able to heal skin wounds rapidly and without scarring, an ability that is lost as development proceeds. The aim of this study was to identify novel genes involved in this process. We established an ex vivo wound model from embryonic rats and showed that over 72 hours, embryonic day 17 wounds reepithelialized and closed whereas day 19 wounds did not. To investigate the molecular basis of this phenomenon we analyzed changes in gene expression using differential display polymerase chain reaction. We characterized one transcript that was strongly up-regulated in the healing response of wounded, day 17 skin. It encodes a protein of 249 amino acids with striking similarity to the human low-affinity receptor for the Fc portion of IgG (FcgammaRIII), suggesting that it is a novel member of the FcgammaR family, which we named FcgammaRIII-X. A wound-healing timecourse shows that FcgammaRIII-X was up-regulated in healing, wounded day 17 skin but not in nonhealing, wounded day 19 skin and that its up-regulation was accelerated in skin with multiple wounds. We suggest that up-regulation of FcgammaRIII-X may contribute to scarless healing of fetal skin.
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Affiliation(s)
- Jacqueline T Teusner
- Child Health Research Institute, Women's and Children's Hospital, North Adelaide, Australia
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28
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Shavlakadze T, Boswell JM, Burt DW, Asante EA, Tomas FM, Davies MJ, White JD, Grounds MD, Goddard C. Rskalpha-actin/hIGF-1 transgenic mice with increased IGF-I in skeletal muscle and blood: impact on regeneration, denervation and muscular dystrophy. Growth Horm IGF Res 2006; 16:157-173. [PMID: 16716629 DOI: 10.1016/j.ghir.2005.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2005] [Revised: 11/08/2005] [Accepted: 11/09/2005] [Indexed: 10/24/2022]
Abstract
Human IGF-I was over-expressed in skeletal muscles of C57/BL6xCBA mice under the control of the rat skeletal alpha-actin gene promoter. RT-PCR verified expression of the transgene in skeletal muscle but not in the liver of 1- and 21-day old heterozygote transgenic mice. The concentration of endogenous mouse IGF-I, measured by an immunoassay which does not detect human IGF-I, was not significantly different between transgenic mice and wild-type littermates (9.5 +/- 0.8 and 13.3 +/- 1.9 ng/g in muscle; 158.3 +/- 18.6 and 132.9 +/- 33.1 ng/ml in plasma, respectively). In contrast, quantitation with antibodies to human IGF-I showed an increase in IGF-I of about 100 ng/ml in plasma and 150 ng/g in muscle of transgenic mice at 6 months of age. Transgenic males, compared to their age matched wild-type littermates, had a significantly higher body weight (38.6 +/- 0.53 g vs. 35.8 +/- 0.64 g at 6 months of age; P < 0.001), dry fat-free carcass mass (5.51 +/- 0.085 vs. 5.08 +/- 0.092 g; P < 0.001) and myofibrillar protein mass (1.62 +/- 0.045 vs. 1.49 +/- 0.048 g; P < 0.05), although the fractional content of fat in the carcass was lower (167 +/- 7.0 vs. 197 +/- 7.7 g/kg wet weight) in transgenic animals. There was no evidence of muscle hypertrophy and no change in the proportion of slow type I myofibres in the limb muscles of Rskalpha-actin/hIGF-I transgenic mice at 3 or 6 months of age. Phenotypic changes in Rskalpha-actin/hIGF-I mice are likely to be due to systemic as well as autocrine/paracrine effects of overproduction of IGF-I due to expression of the human IGF-I transgene. The effect of muscle specific over-expression of Rskalpha-actin/hIGF-I transgene was tested on: (i) muscle regeneration in auto-transplanted whole muscle grafts; (ii) myofibre atrophy following sciatic nerve transection; and (iii) sarolemmal damage and myofibre necrosis in dystrophic mdx muscle. No beneficial effect of muscle specific over-expression of Rskalpha-actin/hIGF-I transgene was seen in these three experimental models.
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Affiliation(s)
- T Shavlakadze
- School of Anatomy and Human Biology, The University of Western Australia, Crawley, Perth.
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29
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Dean N, Haynes J, Brennan J, Neild T, Goddard C, Dearman B, Cooter R. Nipple-areolar pigmentation: histology and potential for reconstitution in breast reconstruction. ACTA ACUST UNITED AC 2005; 58:202-8. [PMID: 15710115 DOI: 10.1016/j.bjps.2004.10.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2003] [Accepted: 10/21/2004] [Indexed: 11/29/2022]
Abstract
The makeup of nipple-areolar skin, in terms of its melanin and melanocyte content has not previously been established. This histological information is required if pigmentation of the reconstructed nipple-areola is to be successful in post-mastectomy breast reconstruction. We describe examination of 200 parallel sections of nipple-areolar skin of 20 women using histochemical (Masson-Fontana) and immunohistochemical (Mel-5) techniques, evaluated using quantitative image analysis. The amount of melanin present per length of basement membrane was 2.14 times higher in areolar skin than breast skin. The ratio of melanocytes to keratinocytes was 1:9.7 in areolar skin vs. 1:14.7 in breast skin. We also describe a cell culture and skin construct method using autologous human serum without toxic growth promoting additives, which could be used in the clinical setting of nipple-areolar reconstruction.
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Affiliation(s)
- Nicola Dean
- Department of Anatomical Sciences, University of Adelaide, Adelaide, SA, Australia.
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Suresh E, Doherty V, Schofield O, Goddard C, Dhillon V. Eosinophilic fasciitis and eosinophilic colitis: a rare association. Rheumatology (Oxford) 2005; 44:411-3. [PMID: 15728413 DOI: 10.1093/rheumatology/keh510] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
Betacellulin is a relatively new member of the epidermal growth factor peptide family, however, its function remains poorly defined. We investigated its physiological effects in rats implanted with pumps to deliver vehicle or recombinant rat betacellulin [46 microg/day] for 7 days. At kill, blood and gastrointestinal tissues were collected for determinations of betacellulin levels, proliferation (bromodeoxyuridine-BrdU incorporation) and growth. Plasma betacellulin levels were increased 8-fold compared to vehicle, whilst serum insulin, body weight and food intake were decreased by 32, 15 and 9%, respectively. Water intake, urine and faecal output and small intestinal weight were respectively increased by 36, 78, 47 and 24%. Ileal and proximal colonic crypt depths were increased by 25 and 51% although the BrdU labelling index was unaffected. Betacellulin stimulated gastrointestinal growth, the increased responsiveness of the terminal ileum and colon suggesting therapeutic potential in disease conditions in which ileal or colonic re-growth is desirable. Betacellulin further stimulated a diuresis suggesting an additional role in fluid homeostasis.
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Affiliation(s)
- Gordon S Howarth
- Cooperative Research Centre for Tissue Growth and Repair, University of Adelaide, Adelaide, Australia.
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Bratton D, Goddard C, Kailey J, Frasch S, Henson P. Localization of plasma membrane phospholipid (PL) scrambling in relationship to PL scramblase 1 in neutrophils, jurkat and rat basophil leukemic cells. J Allergy Clin Immunol 2003. [DOI: 10.1016/s0091-6749(03)80624-3] [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: 10/24/2022]
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Dean NR, Neild T, Haynes J, Goddard C, Cooter RD. Fading of nipple-areolar reconstructions: the last hurdle in breast reconstruction? Br J Plast Surg 2002; 55:574-81. [PMID: 12528997 DOI: 10.1054/bjps.2002.3920] [Citation(s) in RCA: 11] [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: 11/18/2022]
Abstract
Fading of nipple-areolar reconstructions is commonly reported, but there are few formal studies of this phenomenon. The purpose of this study was to determine whether deficiencies in nipple-areolar reconstruction and pigmentation were perceived by patients, their partners and independent observers, and whether a technique could be developed to measure nipple-areolar colour reliably. A total of 57 patients, 32 partners and four independent observers completed questionnaires about the appearance of the patients' breast reconstructions in general and specifically about their nipple-areolar reconstructions. Scores for the general attributes of the breast reconstruction were used as internal controls for the scores of the nipple-areolar reconstruction. A computer software package was developed to analyse colour in photographs of the reconstructions. Independent observers thought that nipple-areolar reconstruction improved the appearance of a breast reconstruction 81% of the time. Considerably fewer patients were happy with their nipple-areolar colour than were happy with the more general attributes of the breast reconstruction (P < 0.005). Colour analysis objectively demonstrated measurable mismatch between normal and reconstructed nipple-areolar skin, which was positively correlated with time since surgery due to fading of the nipple-areolar reconstruction. In our patients, the quality of nipple-areolar reconstruction, in particular its pigmentation, is seen as inferior to that of the rest of the breast reconstruction in the eyes of patients, their partners and independent observers. The poor colour match and fading of reconstructed nipple-areolar skin are phenomena that can be measured using colour analysis.
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Affiliation(s)
- N R Dean
- Department of Plastic and Reconstructive Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia
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Dunaiski V, Dunshea FR, Walton PE, Goddard C. Short-term infusion of LongR(3) insulin-like growth factor (IGF)-I decreases hepatic IGF-I mRNA but not IGF binding protein-3 mRNA expression in pigs. Gen Comp Endocrinol 2002; 126:221-8. [PMID: 12030778 DOI: 10.1006/gcen.2002.7796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Infusion of pigs with an insulin-like growth factor-I (IGF-I) analogue (LongR(3)IGF-I) that does not bind to IGF-binding proteins decreases growth rate and the plasma concentration of growth hormone (GH), IGF-I, IGFBP-3, and insulin. This study was designed to determine whether the decrease is due to changes in IGF-I and IGFBP-3 gene expression. IGF-I or LongR(3)IGF-I (180 microg/kg/day) was infused into 55-kg finisher pigs for 4 days using Travenol infuser pumps. Plasma IGF-I concentration was measured by radioimmunoassay and plasma IGFBP-3 and IGFBP-2 were estimated by Western ligand blotting. Steady-state levels of IGF-I and IGFBP-3 mRNA were measured by RNase protection assay. Neither IGF-I nor LongR(3)IGF-I had a significant effect on hepatic IGF-I class 1 mRNA expression, whereas hepatic IGF-I class 2 mRNA expression was significantly reduced by both peptides. Plasma IGFBP-3 levels were unaffected by IGF-I treatment but were reduced by LongR(3)IGF-I treatment. The decrease in IGFBP-3 was not due to decreased gene expression in porcine liver or kidney, since neither IGF-I nor LongR(3)IGF-I treatment altered IGFBP-3 mRNA. This study infers a direct effect of the IGF analogue LongR(3)IGF-I on GH through its inhibition of plasma IGF-I concentration and class 2 IGF-I mRNA. The decrease in plasma IGFBP-3 was not accompanied by a decrease in hepatic or renal IGFBP-3 mRNA, suggesting that in this case, plasma IGFBP-3 protein levels are posttranslationally regulated or are derived from tissues other than liver or kidney.
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Affiliation(s)
- V Dunaiski
- Cooperative Research Centre for Tissue Growth and Repair, Child Health Research Institute, 72 King William Road, North Adelaide, South Australia 5006, Australia
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Haq A, Morris J, Goddard C, Mahmud S, Nassar AHM. Delayed cholangitis resulting from a retained T-tube fragment encased within a stone: a rare complication. Surg Endosc 2002; 16:714. [PMID: 11972223 DOI: 10.1007/s00464-001-4235-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2001] [Accepted: 10/17/2001] [Indexed: 01/27/2023]
Abstract
Inserting a T-tube after choledochotomy for the removal of bile duct stones remains a time-honored practice. Biliary drainage after bile duct exploration has some advantages. It minimizes bile leakage, provides access for cholangiography, and removes occasional retained stones. The use of T-tubes also has been associated with significant complications. Biliary sepsis, bile duct trauma during removal, bile leakage leading to peritonitis, retention of a fragment, stricture formation after removal have been reported. We report an unusual case of cholangitis caused by a T-tube fragment within a large stone, occurring 11 years after bile duct exploration. A 39-year-old woman underwent common bile duct exploration with insertion of a T-tube. Cholangiography was normal, but as the T-tube was removed, its horizontal limb was missing. The patient failed to present for endoscopic removal a few weeks after surgery Five years later, she presented with recurrent biliary pains and a mild episode of cholangitis. This last episode was associated with severe pain and jaundice. After initial conservative treatment, endoscopic retrograde cholangiopancreatography was performed, and endoscopic removal of the fragment and stone material was successful. Despite the declining numbers of bile duct explorations in the laparoscopic era and the tendency to use transcystic drainage or primary closure of a choledochotomy, the T-tube will continue to be a useful tool in biliary surgery, subject to consideration of the indications and the available alternatives. The reported case highlights the importance of careful tube preparation to prevent partial separation at removal, and early removal of a missing fragment to avoid potential serious complications.
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Affiliation(s)
- A Haq
- Department of Surgery, Vale of Leven District General Hospital, Alexandria, Dunbartonshire, G83 0UA, United Kingdom
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Abstract
A method for the large scale expression and purification of rat betacellulin (BTC) from Escherichia coli has been developed using a cleavable fusion protein strategy. Insoluble fusion protein collected as inclusion bodies was dissolved in urea under reducing conditions, re-folded, and purified by gel filtration chromatography and C(4) RP-HPLC. Authentic rat BTC was obtained after proteolytic cleavage of the fusion protein with Factor Xa. Factor Xa cleaved an additional site within the BTC protein, generating a truncated isoform separable from full-length BTC by heparin-affinity chromatography. Recombinant rat BTC stimulated the proliferation of mouse Balb/c 3T3 fibroblasts and competed for binding to the ErbB1 receptor in a dose-dependent manner analogous to that of BTC purified from natural sources.
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Affiliation(s)
- A J Dunbar
- Cooperative Research Centre for Tissue Growth and Repair, CSIRO Health Sciences and Nutrition, PO Box 10065 Adelaide BC, South Australia 5000, Australia.
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Taylor VL, Goddard C, Read LC. A milk growth factor extract reduces chemotherapeutic drug toxicity in epithelial cells in vitro. In Vitro Cell Dev Biol Anim 2001; 37:310-8. [PMID: 11513086 DOI: 10.1007/bf02577547] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Transforming growth factor-beta (TGF-beta) and insulin-like growth factor (IGF-I) can attenuate drug-induced cell death in epithelial cells. Since milk whey contains a mixture of these and other growth factors, we evaluated mitogenic bovine whey extract (MBWE) for protective activity against chemotherapy drug damage in cultured epithelial cells (mink lung, MvlLu). Etoposide and vinblastine reduced cell survival by up to 90%. This was attenuated by the addition of MBWE before and during drug exposure, but not following drug removal. MBWE was compared with individual growth factors known to be present in the mixture. IGF-I and platelet-derived growth factor were ineffective, whereas TGF-beta2 induced growth inhibition and cell survival, with a maximum response at 3 ng/ml. TGF-beta2 bioactivity was also demonstrated by showing that acidification of MBWE (A-MBWE), to activate TGF-beta2, enhanced its growth inhibitory and chemoprotective activities 60- and 12-fold, respectively. However, MBWE contained additional protective factors. When TGF-beta2 and the MBWE preparations were compared, on the basis of growth inhibition equivalents, MBWE protected cells against drug toxicity at concentrations an order of magnitude lower than with TGF-beta2 or A-MBWE. Immunoneutralization of the TGF-beta present in MBWE and A-MBWE eliminated all growth inhibitory activity but not all cell survival activity. We conclude that the MBWE preparations are cytoprotective against two chemotherapy drugs when added before and during drug exposure. TGF-beta contributes to this activity, but the extracts contain other factors that promote the survival of epithelial cells after chemotherapy drug exposure.
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Affiliation(s)
- V L Taylor
- Cooperative Research Center for Tissue Growth and Repair, Adelaide BC, Australia.
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39
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Abstract
Betacellulin, a member of the epidermal growth factor (EGF) family, was originally isolated and identified from the conditioned medium from a murine pancreatic beta-cell carcinoma cell line. Recently, we isolated bovine betacellulin from a growth factor enriched cheese whey extract, but there is no information on the presence of betacellulin in other biological fluids. We have cloned the cDNA for bovine betacellulin, produced recombinant betacellulin and shown that it has a similar potency to the purified native molecule in stimulating the proliferation of Balb/c3T3 fibroblasts. We have produced a polyclonal antiserum to bovine betacellulin which did not cross-react with EGF or transforming growth factor-alpha (TGF-alpha). The antibody was used in a homologous RIA that was able to detect betacellulin in pooled bovine colostrum sampled during the first 3 days after calving (2.30+/-0.11 ng/ml mean+/-s.e.m.; n=6), in bovine milk soluble fraction (1.93+/-0.64 ng/ml mean+/-s.e.m.; n=5) and in bovine cheese whey (2.59+/-0.16 ng/ml mean+/-s.e.m.; n=3). The betacellulin concentration in foetal bovine serum (FBS) (3.68+/-0.59 ng/ml mean+/-s.e.m.; n=6) greatly exceeded that of betacellulin in serum from male calves 1 and 5 weeks of age (0.53+/-0.15 ng/ml and 0.70+/- 0.09 ng/ml respectively; mean+/-s.e.m.; n=9). Betacellulin measured in the serum of these same animals when aged between 27 and 43 weeks was below the detection limits of the RIA. Sera from 10 out of 36 unmated heifers contained betacellulin levels within the detection limits of the assay (0.433+/-0.06 ng/ml mean+/-s.e.m.; n=10). The presence of betacellulin in bovine colostrum and milk suggests that it plays a role in the growth and development of the neonate and/or mammary gland function. The results also show that betacellulin is undetectable in the castrated adult male circulation. Additionally, although present in very low amounts, serum betacellulin could be under hormonal regulation in the female, since betacellulin was detected in sera from 27% of the unmated heifers examined in this study. The high levels of betacellulin detected in FBS relative to newborn and adult serum suggests a possible endocrine role for this growth factor in the bovine foetus.
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Affiliation(s)
- S E Bastian
- Cooperative Research Centre for Tissue Growth and Repair, CSIRO Health Sciences and Nutrition, PO Box 10041, Adelaide BC, SA 5000, Australia.
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40
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Abstract
Betacellulin (BTC) belongs to the epidermal growth factor (EGF) family of peptide ligands that are characterised by a six-cysteine consensus motif that forms three intra-molecular disulfide bonds crucial for binding the ErbB receptor family. BTC was initially described, purified and cloned from a mouse insulinoma cell line. BTC is proteolytically processed from a larger membrane-anchored precursor and is a potent mitogen for a wide variety of cell types. BTC binds and activates ErbB-1 and ErbB-4 homodimers and is further characterised by its unique ability to activate all possible heterodimeric ErbB receptors. BTC is widely expressed in most tissues and various body fluids, including milk. Expression is particularly high in the pancreas where it is thought to play a role in the differentiation of pancreatic beta cells. While much is known about the ErbB receptor binding characteristics of BTC and its effect on a variety of cultured cells under different conditions, the challenge that lies ahead is to determine the role of BTC in vivo. This review will focus on the structure of BTC and the various biological effects ascribed to this member of the EGF family.
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Affiliation(s)
- A J Dunbar
- Cooperative Research Centre for Tissue Growth and Repair, CSIRO Health Sciences and Nutrition, Adelaide, Australia.
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41
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Rayner TE, Cowin AJ, Robertson JG, Cooter RD, Harries RC, Regester GO, Smithers GW, Goddard C, Belford DA. Mitogenic whey extract stimulates wound repair activity in vitro and promotes healing of rat incisional wounds. Am J Physiol Regul Integr Comp Physiol 2000; 278:R1651-60. [PMID: 10848535 DOI: 10.1152/ajpregu.2000.278.6.r1651] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The ability of single growth factors to promote healing of normal and compromised wounds has been well described, but wound healing is a process requiring the coordinated action of multiple growth factors. Only the synergistic effect on wound healing of combinations containing at most two individual growth factors has been reported. We sought to assess the ability of a novel milk-derived growth factor-enriched preparation ¿mitogenic bovine whey extract (MBWE), which contains six known growth factors, to promote repair processes in organotypic in vitro models and incisional wounds in vivo. MBWE stimulated the contraction of fibroblast-populated collagen lattices in a dose-dependent fashion and promoted the closure of excisional wounds in embryonic day 17 fetal rat skin. Application of MBWE increased incisional wound strength in normal animals on days 3, 5, 7, and 10 and reversed the decrease in wound strength observed following steroid treatment. Wound histology showed increased fibroblast numbers in wounds from normal and steroid-compromised animals. These data suggest the mixture of factors present in bovine milk exerts a direct action on the cells of cutaneous wound repair to enhance both normal and compromised healing.
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Affiliation(s)
- T E Rayner
- Cooperative Research Centre for Tissue Growth and Repair, Child Health Research Institute, Women's and Children's Hospital, North Adelaide 5006, Australia.
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42
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Dunbar AJ, Goddard C. Identification of an alternatively spliced mRNA transcript of human betacellulin lacking the C-loop of the EGF motif and the transmembrane domain. Growth Factors 2000; 18:169-75. [PMID: 11334053 DOI: 10.3109/08977190009003242] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper describes the cloning and characterization of a novel cDNA encoding a short form of betacellulin (BTC-beta), and reports the expression of this mRNA in a variety of human tissues and cell types. BTC-beta is likely the result of alternative splicing. This splicing event leads to the generation of an mRNA encoding an unusual BTC precursor in which the C-loop of the EGF domain and the transmembrane domain are deleted while the remainder of the mature molecule is fused in-frame to the C-terminal cytoplasmic tail.
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Affiliation(s)
- A J Dunbar
- Cooperative Research Centre for Tissue Growth and Repair, CSIRO Health Sciences and Nutrition, Adelaide, South Australia.
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43
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Dunbar AJ, Priebe IK, Belford DA, Goddard C. Identification of betacellulin as a major peptide growth factor in milk: purification, characterization and molecular cloning of bovine betacellulin. Biochem J 1999; 344 Pt 3:713-21. [PMID: 10585857 PMCID: PMC1220692] [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: 02/14/2023]
Abstract
Betacellulin (BTC), a member of the epidermal growth factor (EGF) family of peptide growth factors, was purified from a growth-factor-enriched whey fraction of bovine milk by a combination of ion-exchange chromatography, gel-filtration chromatography, affinity chromatography and reverse-phase HPLC. Bovine BTC (bBTC) had an apparent molecular mass of 21-22 kDa on SDS/PAGE and exists in a glycosylated form. The cDNA encoding bBTC was obtained by a combination of 5' and 3' rapid amplification of cDNA ends ('RACE'). The primary translation product consists of 178 amino acid residues containing a putative signal sequence, a transmembrane domain, the mature BTC domain and a cytoplasmic domain containing a highly hydrophilic Arg-Lys-rich region similar to that of mouse BTC and human BTC. The amino acid sequence of the bBTC precursor was 88% identical with human BTC and 79% identical with mouse BTC. The bBTC gene was found to be expressed in a wide range of tissues, including the mammary gland. The identification of BTC in milk raises the possibility that it has a major role in the growth and development of the neonatal gastrointestinal tract.
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Affiliation(s)
- A J Dunbar
- Cooperative Research Centre for Tissue Growth and Repair, CSIRO Health Sciences and Nutrition, Adelaide BC, SA 5000, Australia.
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44
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Abstract
The effect of short-term GH treatment on steady-state insulin-like growth factor binding protein-3 (IGFBP-3) mRNA levels in liver, kidney, longissimus dorsi muscle, stomach and jejunum was examined in pigs. Ten female crossbred pigs were allocated to either saline or GH (70 microg/kg/day) treatment by subcutaneous injection for 4 days. They were allowed to feed ad libitum, and were weighed daily. At the end of the treatment period, the pigs were slaughtered and samples of liver, kidney, skeletal muscle, stomach and jejunum were collected and total RNA was extracted. Steady-state levels of IGFBP-3 mRNA were quantified by RNase protection assay and were compared with the level of IGF-I class 1 and class 2 transcripts. IGFBP-3 mRNA increased in response to GH in both liver and kidney, but not in the other tissues sampled. Hepatic IGF-I mRNA responded to short-term GH treatment with a fourfold increase in IGF-I class 1 mRNA and an eightfold increase in IGF-I class 2 mRNA, which was liver specific. IGF-I class 1 mRNA was not responsive to GH treatment in other tissues. The short-term nature of this treatment suggests that the increase in hepatic IGFBP-3 and IGF-I transcripts is a relatively early response to treatment with GH, and that the increase in plasma concentrations of IGFBP-3 in response to GH are derived from the liver, the kidney, or both.
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Affiliation(s)
- V Dunaiski
- Co-operative Research Centre for Tissue Growth and Repair, Child Health Research Institute, 72 King William Road, North Adelaide, South Australia 5006, Australia
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45
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Abstract
An underground system of tanks was installed to delay the discharge of 131I waste from the thyroid therapy unit to the on-site sewage treatment plant. As a consequence, the level of radioactivity discharged to sewage has fallen by a factor of 530, reducing the radiation dose to hospital and auxiliary service staff. Cancer patients are no longer required to collect their urine, hence increasing the hygiene for all concerned. A model was developed of iodine waste which estimates the dose rate above the delay tanks and the activity of iodine discharged. The maximum effective dose to a member of the public due to the holding tanks is 40 microSv.year-1. There is now better management of the radioactive waste from the iodine therapy ward.
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Affiliation(s)
- C Goddard
- Department of Clinical and Biomedical Physics, College of Medicine, Sultan Qaboos University, Sultanate of Oman. or
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46
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Dunaiski V, Dunshea FR, Walton PE, Goddard C. Long [R3] insulin-like growth factor-I reduces growth, plasma growth hormone, IGF binding protein-3 and endogenous IGF-I concentrations in pigs. J Endocrinol 1997; 155:559-65. [PMID: 9488001 DOI: 10.1677/joe.0.1550559] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Growth hormone (GH) improves growth performance in the pig. Analogues of insulin-like growth factor-I (IGF-I) that bind poorly to IGF binding proteins (IGFBP) stimulate growth in the rat but, in contrast, inhibit growth in the pig. This study was designed to determine the effect of IGF peptides alone or in combination with porcine GH (pGH) on growth characteristics and plasma hormone concentrations in finisher pigs. A four-day infusion of Long [R3] IGF-I (LR3IGF-I; 180 micrograms/kg/day) decreased the average daily gain, food intake, and plasma IGFBP-3, IGF-I and insulin concentrations. The mean plasma GH concentration was decreased by 23% and the area under the GH peaks was reduced by 60%. Co-administration of pGH (30 micrograms/kg/day) with LR3IGF-I had no interactive effect on growth performance, and plasma insulin, IGFBP-3 and IGF-I concentrations remained suppressed. The area under the GH peaks was not restored with this combination treatment although mean plasma GH concentrations were elevated in all animals receiving pGH. Infusion of IGF-I (180 micrograms/kg/day) decreased plasma insulin and mean GH concentrations but had no significant effect on IGFBP-3 concentrations. Average daily gain and feed intake were not changed by IGF-I treatment. A combination of IGF-I and pGH injection (30 micrograms/kg/day) increased plasma IGFBP-3 concentrations but plasma insulin levels remained suppressed. Plasma glucose levels were unaffected by any treatment. The study demonstrates that both IGF-I and LR3IGF-I suppress plasma GH concentrations in finisher pigs. This, in turn, may be responsible for the reduction in the plasma concentration of IGF-I, IGFBP-3 and insulin seen in LR3IGF-I-treated animals. The decrease in these parameters may contribute to the inhibitory effect of LR3IGF-I on growth performance in the pig.
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Affiliation(s)
- V Dunaiski
- Cooperative Research Centre for Tissue Growth and Repair, Adelaide, South Australia, Australia
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47
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MacVinish LJ, Goddard C, Colledge WH, Higgins CF, Evans MJ, Cuthbert AW. Normalization of ion transport in murine cystic fibrosis nasal epithelium using gene transfer. Am J Physiol 1997; 273:C734-40. [PMID: 9277371 DOI: 10.1152/ajpcell.1997.273.2.c734] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The murine nasal epithelium was investigated by the short-circuit current (SCC) technique. Electrogenic sodium absorption was revealed by addition of amiloride and calcium-dependent chloride secretion by the addition of amiloride and calcium-dependent chloride secretion by the addition of 2,5-di-(tert-butyl)-1,4-benzohydroquinone (TBHQ)/ionomycin. In the presence of these agents a further increase in SCC was obtained by addition of forskolin. Epithelia from both cystic fibrosis (CF) null (Cftrtm1Cam) and CF delta F508 (Cftrtm2Cam) mice had enhanced sodium absorption compared with controls, whereas only delta F508 epithelia had increased calcium-dependent chloride secretion. Both strains gave nasal epithelia that showed significantly reduced responses to forskolin, due to the absence of CF transmembrane conductance regulator (CFTR) chloride channels. In Cftrtm2Cam nasal epithelia the forskolin responses were not significantly different from zero. Transfection of these mice with the plasmid pTRIAL10-CFTR2 complexed with cationic liposomes normalized the transporting activity in the nasal epithelium. Basal SCC and calcium-dependent chloride secretion were significantly reduced, whereas CFTR-dependent chloride secretion was increased to normal values. Amiloride-sensitive SCC was reduced by transfection but failed to reach significance. The similarity of murine CF nasal epithelium to that in human CF airways makes the model valuable for gene therapy studies.
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Affiliation(s)
- L J MacVinish
- Department of Pharmacology, University of Cambridge, United Kingdom
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48
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Belford DA, Rogers ML, Francis GL, Payne C, Ballard FJ, Goddard C. Platelet-derived growth factor, insulin-like growth factors, fibroblast growth factors and transforming growth factor beta do not account for the cell growth activity present in bovine milk. J Endocrinol 1997; 154:45-55. [PMID: 9246937 DOI: 10.1677/joe.0.1540045] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cation-exchange chromatography effectively concentrates the cell growth activity present in whey and we have used this process as a basis to characterise further the growth factors present in bovine milk. Under neutral conditions, total bioactivity in the growth factor-enriched cation-exchange fraction chromatographed with an apparent molecular mass of 80-100 kDa. In contrast, acid gel-filtration chromatography resolved two peaks of cell growth activity. A peak at 15-25 kDa contained the bulk of growth activity for Balb/c 3T3 fibroblasts while bio-activity for L6 myoblasts and skin fibroblasts eluted with a molecular mass of 6 kDa. A peak of inhibitory activity for Mv1Lu and MDCK cells also eluted at 15-25 kDa. Both IGF-I and IGF-II were purified from fractions that eluted at 6 kDa, although the IGF peptides alone did not account for the total bioactivity recovered. Platelet-derived growth factor (PDGF), identified by radioreceptor assay, eluted at a slightly higher molecular mass than the peak of growth activity for Balb/c 3T3 cells, and an anti-PDGF antibody was without effect on the growth of Balb/c 3T3 cells in response to the whey-derived factors. Further purification of the inhibitory activity for epithelial cells yielded a sequence for transforming growth factor beta (TGF-beta), and all inhibitory activity for Mv1Lu cells was immunoneutralised by an antibody against TGF-beta. In contrast, this antibody decreased the growth of Balb/c 3T3 fibroblasts in the whey-derived extract by only 10%. Finally, a cocktail of recombinant growth factors containing IGF-I, IGF-II, PDGF, TGF-beta and fibroblast growth factor 2 stimulated growth of Balb/c 3T3 cells to a level equivalent to only 51% of that observed in the milk-derived growth factor preparation. We conclude that: (i) cell growth activity recovered from bovine whey is present in acid-labile high molecular weight complexes; (ii) all cell growth inhibitory activity for epithelial cells can be accounted for by TGF-beta; (iii) IGF-I and IGF-II co-elute with the major peak of activity for L6 myoblasts and skin fibroblasts, although the IGF peptides alone do not explain the growth of these cells in the whey-derived extract; and (iv) neither PDGF nor TGF-beta account for the 15-25 kDa peak of Balb/c 3T3 growth activity. These data suggest the presence of additional mitogenic factors in bovine milk.
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Affiliation(s)
- D A Belford
- Cooperative Research Centre for Tissue Growth and Repair, Women's and Children's Hospital, North Adelaide, Australia
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49
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Abstract
Transforming growth factor beta (TGF-beta) is one of the predominant growth factors present in milk. The concentration, molecular mass forms and stability of TGF-beta in bovine milk were investigated using a standard bioassay measuring the growth inhibition of a milk lung epithelial cell line. Most of the TGF-beta bioactivity in milk was found to be in a latent form, which was also retained in the whey fraction. After acid activation, the total TGF-beta concentration was 4.3 +/- 0.8 ng and 3.7 +/- 0.7 ng TGF-beta per ml of milk and cheese whey respectively. Cation-exchange chromatography at pH 6.5 was used to concentrate latent whey-derived TGF-beta, which could be activated by transient exposure to extremes of pH, urea or heat. Heparin did not significantly activate milk-derived TGF-beta. Neutral gel filtration of the cationic whey fraction revealed a major peak of latent TGF-beta with a molecular mass of 80 kDa and a smaller peak at 600 kDa. Transient acidification of the cationic whey fraction prior to neutral gel filtration, or gel filtration under acidic conditions, released low molecular mass TGF-beta from both high molecular mass peaks. Whey-derived TGF-beta was purified using a five-step chromatographic procedure. An N-terminal sequence was obtained for TGF-beta 2, which accounted for over 85% of the TGF-beta bioactivity in whey. All TGF-beta activity in whey could be neutralised by a monoclonal antibody directed against TGF-beta 1, -beta 2 and -beta 3. The results suggest that the majority of TGF-beta in bovine milk is present in a small latent complex.
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Affiliation(s)
- M L Rogers
- Cooperative Research Centre for Tissue Growth and Repair, Adelaide, Australia
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50
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Duclos MJ, Chevalier B, Remignon H, Ricard FH, Goddard C, Simon J. Divergent selection for high or low growth rate modifies the response of muscle cells to serum or insulin-like growth factor-I in vitro. Growth Regul 1996; 6:176-184. [PMID: 8894651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Genetic differences in growth potential could result from changes in the levels of growth stimulatory factors or in the response of target tissues. The latter possibility was tested in adult myoblasts prepared from chickens selected for high (HG) or low growth rate (LG). Stimulation of [3H]-thymidine incorporation into DNA by serum was of higher amplitude in HG than LG muscle cells irrespective of whether the cell preparations were enriched in myoblasts or fibroblasts. HG myoblasts were also more responsive to insulin-like growth factor-I (IGF-I) in terms of [3H]-thymidine incorporation. IGF analogues with a reduced affinity for IGF binding proteins gave similar results suggesting that activity of binding proteins could not explain the difference between cells from the HG and LG lines. This difference was restricted to the proliferative stage because in myotubes, basal or IGF-I stimulated glucose and amino acid transports, tyrosine incorporation and protein degradation were not different.
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Affiliation(s)
- M J Duclos
- Station de Recherches Avicoles, INRA, Nouzilly, France
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