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Simpkins C, Morris DS, Normando EM. Eyes in skies: ocular ultrasound performed by a low-experience operator at high altitude. BMJ Mil Health 2023:e002473. [PMID: 37336579 DOI: 10.1136/military-2023-002473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/05/2023] [Indexed: 06/21/2023]
Affiliation(s)
- Ciaran Simpkins
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - D S Morris
- Cardiff Eye Unit, University of Wales Hospital, Cardiff, UK
| | - E M Normando
- Western Eye Hospital, Imperial College Healthcare NHS Trust, London, UK
- Imperial College Ophthalmology Research Group (ICORG), Imperial College London, London, UK
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Perros P, Žarković MP, Panagiotou GC, Azzolini C, Ayvaz G, Baldeschi L, Bartalena L, Boschi AM, Nardi M, Brix TH, Covelli D, Daumerie C, Eckstein AK, Fichter N, Ćirić S, Hegedüs L, Kahaly GJ, Konuk O, Lareida JJ, Okosieme OE, Leo M, Mathiopoulou L, Clarke L, Menconi F, Morris DS, Orgiazzi J, Pitz S, Salvi M, Muller I, Knežević M, Wiersinga WM, Currò N, Dayan CM, Marcocci C, Marinò M, Möller L, Pearce SH, Törüner F, Bernard M. Asymmetry indicates more severe and active disease in Graves' orbitopathy: results from a prospective cross-sectional multicentre study. J Endocrinol Invest 2020; 43:1717-1722. [PMID: 32474767 PMCID: PMC7652741 DOI: 10.1007/s40618-020-01258-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 04/13/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE Patients with Graves' orbitopathy can present with asymmetric disease. The aim of this study was to identify clinical characteristics that distinguish asymmetric from unilateral and symmetric Graves' orbitopathy. METHODS This was a multi-centre study of new referrals to 13 European Group on Graves' Orbitopathy (EUGOGO) tertiary centres. New patients presenting over a 4 month period with a diagnosis of Graves' orbitopathy were included. Patient demographics were collected and a clinical examination was performed based on a previously published protocol. Patients were categorized as having asymmetric, symmetric, and unilateral Graves' orbitopathy. The distribution of clinical characteristics among the three groups was documented. RESULTS The asymmetric group (n = 83), was older than the symmetric (n = 157) group [mean age 50.9 years (SD 13.9) vs 45.8 (SD 13.5), p = 0.019], had a lower female to male ratio than the symmetric and unilateral (n = 29) groups (1.6 vs 5.0 vs 8.7, p < 0.001), had more active disease than the symmetric and unilateral groups [mean linical Activity Score 3.0 (SD 1.6) vs 1.7 (SD 1.7), p < 0.001 vs 1.3 (SD 1.4), p < 0.001] and significantly more severe disease than the symmetric and unilateral groups, as measured by the Total Eye Score [mean 8.8 (SD 6.6) vs 5.3 (SD 4.4), p < 0.001, vs 2.7 (SD 2.1), p < 0.001]. CONCLUSION Older age, lower female to male ratio, more severe, and more active disease cluster around asymmetric Graves' orbitopathy. Asymmetry appears to be a marker of more severe and more active disease than other presentations. This simple clinical parameter present at first presentation to tertiary centres may be valuable to clinicians who manage such patients.
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Affiliation(s)
- P Perros
- Department of Endocrinology, Level 6, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, Tyne, UK.
| | - M P Žarković
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, Belgrade, Serbia
| | - G C Panagiotou
- Department of Endocrinology, Level 6, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, Tyne, UK
| | - C Azzolini
- Department of Medicine and Surgery, Section of Ophthalmology, School of Medicine, University of Insubria, Via Guicciardini 9, 21100, Varese, Italy
| | - G Ayvaz
- Department of Endocrinology, Yüksek Ihtisas University Ankara Koru Hastanesi, 1450. Sk. No:13, Kızılırmak, 06510, Çankaya, Ankara, Turkey
| | - L Baldeschi
- Department of Ophthalmology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - L Bartalena
- Endocrine Unit, University of Insubria, Ospedale di Circolo, Viale Borri, 57 21100, Varese, Italy
| | - A M Boschi
- Department of Ophthalmology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - M Nardi
- Dipartimento di Patologia Chirurgica Medica, Molecolare e Dell'Area Critica, Università di Pisa, Pisa, Italy
| | - T H Brix
- Department of Endocrinology and Metabolism, Odense University Hospital, 5000, Odense, Denmark
| | - D Covelli
- Graves' Orbitopathy Center, Endocrinology, Fondazione IRCCS Cà Granda, University of Milan, via Sforza, 35 - I-20122, Milan, Italy
| | - C Daumerie
- Department of Endocrinology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - A K Eckstein
- Department of Ophthalmology, University of Duisburg-Essen, 45122, Essen, Germany
| | - N Fichter
- Interdisciplinary Centre for Graves' Orbitopathy, 4600, Olten, Switzerland
| | - S Ćirić
- Clinic of Endocrinology, Clinical Centre of Serbia, Belgrade, Serbia
| | - L Hegedüs
- Department of Endocrinology and Metabolism, Odense University Hospital, 5000, Odense, Denmark
| | - G J Kahaly
- Department of Medicine I, Johannes Gutenberg University Medical Center, 55101, Mainz, Germany
| | - O Konuk
- Department of Ophthalmology, Faculty of Medicine, Gazi University, Besevler, Ankara, 06500, Turkey
| | - J J Lareida
- Interdisciplinary Centre for Graves' Orbitopathy, 4600, Olten, Switzerland
| | - O E Okosieme
- Thyroid Research Group, Cardiff University School of Medicine, Cardiff, UK
| | - M Leo
- Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - L Mathiopoulou
- Department of Endocrinology, Level 6, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, Tyne, UK
| | - L Clarke
- Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - F Menconi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - D S Morris
- Cardiff Eye Unit, University Hospital of Wales, Cardiff, UK
| | - J Orgiazzi
- Department of Endocrinology, Centre Hospitalier Lyon-Sud, Lyon, France
| | - S Pitz
- Orbital Center, Ophthalmic Clinic, Bürger Hospital, Frankfurt, Germany
| | - M Salvi
- Graves' Orbitopathy Center, Endocrinology, Fondazione IRCCS Cà Granda, University of Milan, via Sforza, 35 - I-20122, Milan, Italy
| | - I Muller
- Graves' Orbitopathy Center, Endocrinology, Fondazione IRCCS Cà Granda, University of Milan, via Sforza, 35 - I-20122, Milan, Italy
| | - M Knežević
- Medical School, Clinic for Ophthalmology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - W M Wiersinga
- Department of Endocrinology, Academic Medical Center, Amsterdam, Netherlands
| | - N Currò
- Department of Surgery, Ophthalmology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - C M Dayan
- Thyroid Research Group, Cardiff University School of Medicine, Cardiff, UK
| | - C Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - M Marinò
- Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy
| | - L Möller
- Interdisciplinary Centre for Graves' Orbitopathy, 4600, Olten, Switzerland
| | - S H Pearce
- Department of Endocrinology, Level 6, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, Tyne, UK
| | - F Törüner
- Department of Endocrinology, Faculty of Medicine, Gazi University, Besevler, Ankara, 06500, Turkey
| | - M Bernard
- Neuro-Ophthalmology Outpatient Clinics, GHE-Hospices Civils de Lyon and Lyon 1 University, Lyon, France
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Morris DS, Willis S, Minassian D, Foot B, Desai P, MacEwen CJ. The incidence of serious eye injury in Scotland: a prospective study. Eye (Lond) 2013; 28:34-40. [PMID: 24097120 DOI: 10.1038/eye.2013.213] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 08/05/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Ocular trauma remains an important cause of visual morbidity worldwide. A previous population-based study in Scotland reported a 1-year cumulative incidence of 8.14 per 100 000 population. The purpose of this study was to identify any change in the incidence and pattern of serious ocular trauma in Scotland. METHODS This study was a 1-year prospective observational study using the British Ophthalmological Surveillance Unit reporting scheme among Scottish ophthalmologists. Serious ocular trauma was defined as requiring hospital admission. Data were collected using two questionnaires for each patient 1 year apart. RESULTS The response rate from ophthalmologists was 77.1%. There were 102 patients reported with complete data giving an incidence of 1.96 per 100 000 population, four times less than in 1992. In patients younger than 65 years, the age-adjusted incidence ratio (males/females) indicated a ninefold higher risk of trauma in males. In 25 patients (27.2%), the injured eye was blind (final visual acuities (FVA) <6/60), 24 being attributable to the eye injury. Standardised morbidity ratios suggested a threefold decrease in risk of poor visual outcome in 2009 compared with 1992. CONCLUSIONS The incidence of serious ocular trauma has fallen; this study has shown hospital admission for serious eye injury in Scotland has decreased fourfold in 17 years. Young adult males continue to be at highest risk, which needs to be specifically addressed in future health-prevention strategies. This study also observed a reduction in visual loss from serious ocular injuries, although the reasons for this require further exploration.
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Affiliation(s)
- D S Morris
- Cardiff Eye Unit, University Hospital of Wales, Cardiff, UK
| | - S Willis
- University of Cardiff Medical School, Cardiff, UK
| | - D Minassian
- The Institute of Ophthalmology, University College of London, London, UK
| | - B Foot
- British Ophthalmic Surveillance Unit, The Royal College of Ophthalmologists, London, UK
| | - P Desai
- Moorfields Eye Hospital, London, UK
| | - C J MacEwen
- University Department of Ophthalmology, Ninewells Hospital, Dundee, UK
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Affiliation(s)
- D S Morris
- Health Promotion and Chronic Disease Prevention, Oregon Public Health Division, 800 NE Oregon St, Suite 730, Portland, OR 97232, USA.
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Barnes BR, Morris DS. Revising quality awareness through internal marketing: An exploratory study among French and English medium-sized enterprises. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/09544120050007788] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Carannante T, Haigh RH, Morris DS. Implementing total productive maintenance: A comparative study of the UK and Japanese foundry industries. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/09544129610513] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Morris DS, Elzaridi E, Clarke L, Dickinson AJ, Lawrence CM. Periocular basal cell carcinoma: 5-year outcome following Slow Mohs surgery with formalin-fixed paraffin-embedded sections and delayed closure. Br J Ophthalmol 2008; 93:474-6. [PMID: 19060015 DOI: 10.1136/bjo.2008.141325] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM The aim of the study was to determine the 5-year outcome of periocular basal cell carcinoma (BCC) managed by Mohs surgery using formalin-fixed, paraffin-embedded sections (Slow Mohs). METHODS This was a prospective, non-comparative, interventional case series of all patients with periocular BCC treated by Slow Mohs in Newcastle upon Tyne, UK, between 1985 and 1999. Data collected included demographic information, indication for Slow Mohs, tumour site, histology, recurrence rate after 5 years and cosmetic outcome. RESULTS Of 287 BCCs in 278 patients, 5-year follow-up data were available for 173 (60.2%). Recurrence following Slow Mohs occurred in one patient: 0.34% of total and 0.58% of those with 5-year follow-up. The main indication for Slow Mohs was most frequently due to the tumour site. Cosmetic outcome was deemed excellent in 56%, good in 18%, adequate in 8%, unknown in 14% and revision advised in only 4%. CONCLUSION The low 5-year recurrence rate (0.58%) reported in this prospective series confirms the importance of margin-controlled removal of recurrent, poorly defined or critically sited BCCs, and illustrates that Slow Mohs is equivalent to standard Mohs. While delayed closure does not appear to compromise cosmetic outcome, this technique offers a histologically superior and cheaper alternative to frozen-section Mohs surgery.
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Affiliation(s)
- D S Morris
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
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Sutherland AI, Morris DS, Owen CG, Bron AJ, Roach RC. Optic nerve sheath diameter, intracranial pressure and acute mountain sickness on Mount Everest: a longitudinal cohort study. Br J Sports Med 2008; 42:183-8. [DOI: 10.1136/bjsm.2007.045286] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
A case of ocular blunt trauma is described in which a 17 year old male ice hockey player collided with an opponent during a game. The opponent's stick travelled under the patient's half face visor and struck his left eye causing hyphema, angle recession, lens subluxation, and choroidal rupture over the macula, permanently reducing his vision to counting fingers. Sequelae of ocular blunt trauma are discussed along with methods of injury prevention by addressing players' behaviour and safety equipment. This injury is unlikely to have occurred with properly used full face protection.
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Affiliation(s)
- D S Morris
- Department of Ophthalmology, James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK.
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Girgis R, Morris DS, Kotagiri A, Ramaesh K. Bilateral corneal scarring after LASIK and PRK in a patient with propensity to keloid scar formation. Eye (Lond) 2005; 21:96-7. [PMID: 16327796 DOI: 10.1038/sj.eye.6702180] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Barnes BR, Sheys T, Morris DS. Analysing service quality: The case of a US military club. Total Quality Management & Business Excellence 2005. [DOI: 10.1080/14783360500163102] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Barnes BR, Fox MT, Morris DS. Exploring the Linkage between Internal Marketing, Relationship Marketing and Service Quality: a Case Study of a Consulting Organization. Total Quality Management & Business Excellence 2004. [DOI: 10.1080/14783360410001680080] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Bergquist PL, Gibbs MD, Saul DJ, Reeves RA, Morris DS, Te'o VSJ. Families and Functions of Novel Thermophilic Xylanases in the Facilitated Bleaching of Pulp. ACS Symposium Series 1996. [DOI: 10.1021/bk-1996-0655.ch007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- P. L. Bergquist
- School of Biological Sciences, Macquarie University, North Ryde, Sydney, New South Wales 2109, Australia
- Centre for Gene Technology, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - M. D. Gibbs
- School of Biological Sciences, Macquarie University, North Ryde, Sydney, New South Wales 2109, Australia
- Centre for Gene Technology, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - D. J. Saul
- Centre for Gene Technology, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - R. A. Reeves
- School of Biological Sciences, Macquarie University, North Ryde, Sydney, New South Wales 2109, Australia
- Centre for Gene Technology, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - D. S. Morris
- Centre for Gene Technology, University of Auckland, Private Bag 92019, Auckland, New Zealand
| | - V. S. J. Te'o
- School of Biological Sciences, Macquarie University, North Ryde, Sydney, New South Wales 2109, Australia
- Centre for Gene Technology, University of Auckland, Private Bag 92019, Auckland, New Zealand
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Abstract
Normal and pathological formation of blood vessels is of considerable interest both in terms of basic scientific processes and clinical applications. Angiogenic events in the adult are likely to represent persistence of developmental mechanisms, and embryos are therefore a suitable experimental model for these processes. Among embryonic tissues, muscle is particularly appropriate for investigation, since it is highly vascularised from early stages. There are a number of competing explanations of how this process is controlled. Bioassays offer advantages over conventional molecular localisation techniques, in that they reveal the presence of active processed forms of the molecules under study, rather than non-processed forms, or non-translated messages. Using these techniques, we report here that embryonic chick muscle, taken from the stages at which blood vessels are forming, produces an angiogenic activity on the chick chorioallantoic membrane (CAM), and transforms NR6 cells in soft agar. Basic fibroblast growth factor (bFGF) is shown to be angiogenic on the CAM in the same way, and also transforms NR6 cells (NR6 cells lack functional epidermal growth factor/transforming growth factor-a receptors, and are believed to respond only to bFGF in this way). Anti-bFGF removes the transforming activity of the embryonic muscle. We conclude that this represents evidence that embryonic chick muscle is producing an FGF-like molecule which is capable of acting as an angiogenic agent at the appropriate times in development.
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Affiliation(s)
- D S Morris
- School of Biological and Medical Sciences, University of St. Andrews, Scotland United Kingdom
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Abstract
The International Committee of the Red Cross (ICRC) is at the forefront in the provision of surgical care to the victims of war. In 1990 twenty-two surgical teams were deployed in 14 hospitals in eight countries and 18,450 patients were treated. This article reviews the contribution made by ICRC, and the experience that can be gained by New Zealand and Australian surgeons and anaesthetists.
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Affiliation(s)
- D S Morris
- Green Lane Hospital, Auckland, New Zealand
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Morris DS, Sugrue WJ. Abdominal injuries in the war wounded of Afghanistan: a report from the International Committee of the Red Cross Hospital in Kabul. Br J Surg 1991; 78:1301-4. [PMID: 1760686 DOI: 10.1002/bjs.1800781108] [Citation(s) in RCA: 24] [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: 12/28/2022]
Abstract
This report is from the hospital opened by the International Committee of the Red Cross, in Kabul, which receives acute war-wounded patients from the Afghanistan conflict. Of more than 1000 operations carried out by the New Zealand team in a 6-month period, there were 70 laparotomies for penetrating wounds. These injuries were dealt with by established surgical techniques. The main area of controversy was the management of colonic wounds where the recent trend away from mandatory colostomy was followed by good results. Selective primary repair was achieved in 16 of 27 patients with colonic injury with no mortality and minimal morbidity. The right colon was considered particularly favourable for primary anastomosis. The overall mortality rate for all laparotomies was 13 per cent, with injuries to the liver, major veins and rectum particularly being fatal. There were eight negative laparotomies.
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Affiliation(s)
- D S Morris
- International Red Cross Hospital, Kabul, Afghanistan
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Bell AS, Campbell SF, Morris DS, Roberts DA, Stefaniak MH. 2(1H)-quinolinones with cardiac stimulant activity. 3. Synthesis and biological properties of 6-imidazol-1-yl derivatives. J Med Chem 1989; 32:1552-8. [PMID: 2544726 DOI: 10.1021/jm00127a025] [Citation(s) in RCA: 12] [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: 01/01/2023]
Abstract
A series of 6-imidazol-1-yl-8-methyl-2(1H)-quinolinones was synthesized and evaluated for cardiac stimulant activity in dogs. The majority of compounds were prepared from an appropriate 6-imidazol-1-yl-2(1H)-quinolinone precursor or by sulfuric acid catalyzed cyclization of an N-(4-heteroarylphenyl)-3-ethoxypropenamide. Introduction of a range of 5-substituents into 6-(2,4-dimethylimidazol-1-yl)-8-methyl-2(1H)-quinolinone (1) reduced inotropic activity in anesthetized dogs (percentage increase in dP/dtmax) although replacement of the 2-methyl group by iodo (10) or cyano (11) substituents was well tolerated. The 2-methyl-4-chloro (15) and 2-methyl-4-(methylthio) (22) derivatives displayed similar potency to 1 (40-50% increase in dP/dtmax, 10-12.5 micrograms/kg) and these compounds were 3-5 times more potent than milrinone. Introduction of iodo (14), cyano (16), or acetyl (17) substituents into the 4-position approximately halved inotropic activity. In conscious dogs, 11 (0.25 mg/kg) and 16 and 17 (0.125 mg/kg) produced similar increases in cardiac contractility (decrease in the QA interval) to 1 (0.125 mg/kg) and maximum responses were maintained for at least 3 h. Dose-related (25, 125, 250 micrograms/kg) cardiac stimulant activity was demonstrated by 17 and after the higher doses a marked response (approximately 30% increase in dP/dtmax) was still observed after 7 h, in contrast to milrinone. The substantial increases in cardiac contractility observed with 16 and 17 in the conscious dog were not accompanied by any tachycardia. These compounds also displayed an overwhelming selectivity for increasing the force of cardiac contraction (greater than 120% increase in dP/dtmax) rather than heart rate (5-10 beats/min decrease) in the Starling heart-lung preparation. As a result of this beneficial pharmacological profile, 6-(4-acetyl-2-methylimidazol-1-yl)-8-methyl-2(1H)-quinolinone (17, UK-66,838) was selected for preclinical development studies.
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Affiliation(s)
- A S Bell
- Department of Discovery Chemistry, Pfizer Central Research, Sandwich, Kent, United Kingdom
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Alabaster CT, Bell AS, Campbell SF, Ellis P, Henderson CG, Morris DS, Roberts DA, Ruddock KS, Samuels GM, Stefaniak MH. 2(1H)-quinolinones with cardiac stimulant activity. 2. Synthesis and biological activities of 6-(N-linked, five-membered heteroaryl) derivatives. J Med Chem 1989; 32:575-83. [PMID: 2537423 DOI: 10.1021/jm00123a011] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
A series of 6-(N-linked, five-membered heteroaryl)-2(1H)-quinolinone derivatives was synthesized and evaluated for cardiotonic activity. Most compounds were prepared by sulfuric acid catalyzed cyclization of an N-(4-heteroarylphenyl)-3-ethoxypropenamide or by condensation of a 2-amino-5-heteroarylbenzaldehyde or -acetophenone derivative with the ylide derived from triethyl phosphonoacetate. In anesthetized dogs, 6-imidazol-1-yl-8-methyl-2(1H)-quinolinone (3; 25 micrograms/kg) produced a greater increase in cardiac contractility (percentage increase in dP/dt max) than alternative 6-(five-membered heteroaryl)-substituted analogues (4-8). Introduction of 4-methyl (10) or 2,4-dimethyl (13) substituents into the imidazole ring of 3 produced a marked increase in inotropic activity, and these compounds were some 10 and 5 times more potent than milrinone. Most of these quinolinones also displayed positive inotropic effects (decrease in QA interval) in conscious dogs after oral administration (0.0625-1 mg/kg) and in many cases (3, 5-7, 9, 11, 13, 16) there was little difference in activities at both the 1- and 3-h time points. Compound 13 (62.5, 125, 250 micrograms/kg po) demonstrated dose-related cardiac stimulant activity which, in contrast to milrinone, was maintained over the whole 7-h test period. No changes in heart rate were detected at any dose level and compounds 3, 9, 10, and 13 also displayed high selectivity for the stimulation of cardiac contractile force rather than heart rate in the Starling dog heart-lung preparation. Increases in dP/dt max of approximately 50% were accompanied by heart rate changes of less than 10 beats/minute. Physicochemical measurements gave a log P of 1.64 for 13 with pKa values of 7.13 +/- 0.04 and 11.5 +/- 0.2 for the imidazole and quinolinone moieties, respectively. X-ray structural analysis of 13 showed the imidazole and quinolinone rings at 52 degrees to one another in close agreement with the minimum-energy conformation (30 degrees) suggested by PCILO calculations. 6-(2,4-Dimethylimidazol-1-yl)-8-methyl-2-(1H)-quinolinone (13, UK-61,260) is currently undergoing phase II clinical evaluation in congestive heart failure patients.
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Affiliation(s)
- C T Alabaster
- Department of Discovery Biology, Pfizer Central Research, Sandwich, Kent, United Kingdom
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Morris DS, Ewen KM, Selderbeek H. Colonoscopy and the followup of colorectal carcinoma. N Z Med J 1985; 98:1009-10. [PMID: 3866187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The colonoscopy findings in 100 patients who had had a previous resection for colorectal carcinoma are reviewed. This postoperative surveillance was aimed at discovering benign or malignant neoplastic growth within the remaining large bowel. Six patients had further carcinoma discovered at colonoscopy followup, five of these were symptomless. Twenty-eight patients had one or more adenomas. A special risk group was confirmed: patients with multiple neoplasia in the original resected specimen have over a 50% chance of further adenomas being present. This represents a worthwhile yield and colonoscopy surveillance of the remaining colon should be part of the followup programme in these patients.
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Abstract
The recurrence of multiple inflammatory fibroid polyps is reported in three generations of a Devon family. Only one female in each has been affected in a direct line of descent. The grandmother has had nine polyps resected over 11 years, the mother seven over 18 years, and the daughter six over six years. None of the patients or their relatives are known to have any allergies, dietary fads, or gastrointestinal infections. Chromosome studies have been normal in two patients. No cancer risk has been identified. Conventional histology, electron microscopy, and immunohistology suggest that the lesion is a self-limiting proliferation of histiocytes; the initiating event or stimulus remains unknown. A genetic factor is likely to operate in this unique family which is probably polygenic and multifactorial in nature.
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Mee AD, McNickle WG, Morris DS. Renal tuberculosis in a multi-racial community. N Z Med J 1978; 88:183-5. [PMID: 280797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
There were 44 new cases of renal tuberculosis at the Waikato Hospital, 1961-1975. Thirty-three patients were Maoris or Polynesians and 10 Europeans. Most patients were adults. Culture of the urine and intravenous urography were the most useful diagnostic tests. The patients were treated with antituberculous chemotherapy. Seventeen had surgical procedures including 10 nephrectomies. In all there was one death. Factors concerned with prevention in high risk groups are discussed.
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Clemo GR, Daglish AF, Keneford JR, Simpson JCE, Hey DH, Morris DS, Childs AF, Goldswokthy LJ, Harding GF, Plant SGP, Weeks GA, Batt RF, Woodcock D. Notes. ACTA ACUST UNITED AC 1948. [DOI: 10.1039/jr9480002318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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