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Woort F, Reef V, Stefanovski D, Slack J. Cardiac pre‐purchase examination in horses – evaluation, outcome and athletic follow‐up. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- F. Woort
- Equine Sports Medicine Practice Waterloo Belgium
| | - V. Reef
- New Bolton Center University of Pennsylvania Kennett Square Pennsylvania USA
| | - D. Stefanovski
- New Bolton Center University of Pennsylvania Kennett Square Pennsylvania USA
| | - J. Slack
- New Bolton Center University of Pennsylvania Kennett Square Pennsylvania USA
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Slack J, Stefanovski D, Madsen TF, Fjordbakk CT, Strand E, Fintl C. Cardiac arrhythmias in poorly performing Standardbred and Norwegian-Swedish Coldblooded trotters undergoing high-speed treadmill testing. Vet J 2020; 267:105574. [PMID: 33375960 DOI: 10.1016/j.tvjl.2020.105574] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 10/22/2020] [Accepted: 10/30/2020] [Indexed: 11/28/2022]
Abstract
The significance of cardiac arrhythmias and their possible association with upper airway obstruction are frequently considered in the clinical investigation of poor performance. The specific aims of this retrospective study of a group of poorly performing Standardbred and Norwegian-Swedish Coldblooded trotters were to: (1) describe the overall frequency and frequency distributions of arrhythmias; (2) describe arrhythmia characteristics including percent prematurity, relative recovery cycle lengths and QRS morphology; (3) describe variability of normal RR intervals; and (4) explore possible associations between upper airway abnormalities and arrhythmia categories during peak exercise and recovery. The records of 103 trotters presented to the Norwegian University of Life Sciences for high-speed treadmill testing were reviewed. The occurrence of at least one arrhythmic event was high (77-78%) when considering all exercise periods and 6-10% prematurity criteria. Triplets, salvos, and/or paroxysmal tachyarrhythmias occurred in 8% of horses during peak exercise. Complex ventricular arrhythmias occurred in 15% of horses in the first 2 min of recovery. Evaluation of QRS morphology and return cycle lengths demonstrated areas of overlap in characteristics typically attributed to either supraventricular or ventricular arrhythmias. There was no association between airway diagnosis and arrhythmias during any exercise period. The maximum average HR during peak exercise was an excellent predicter for complex ventricular arrhythmias during recovery. Because perfect categorization of arrhythmias is not possible, future studies should report descriptive arrhythmia information. Prospective studies that evaluate various degrees of upper airway obstruction and the effect on known initiators of arrhythmogenesis are needed.
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Affiliation(s)
- J Slack
- University of Pennsylvania, New Bolton Center, Department of Clinical Studies, 382 West Street Rd Kennett Square, PA 19348, USA.
| | - D Stefanovski
- University of Pennsylvania, New Bolton Center, Department of Clinical Studies, 382 West Street Rd Kennett Square, PA 19348, USA
| | - T F Madsen
- Norwegian University of Life Sciences, Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, P.O. Box 369 Sentrum, N-0102 Oslo, Norway
| | - C T Fjordbakk
- Norwegian University of Life Sciences, Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, P.O. Box 369 Sentrum, N-0102 Oslo, Norway
| | - E Strand
- Norwegian University of Life Sciences, Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, P.O. Box 369 Sentrum, N-0102 Oslo, Norway
| | - C Fintl
- Norwegian University of Life Sciences, Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, P.O. Box 369 Sentrum, N-0102 Oslo, Norway
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Reef VB, Davidson EJ, Slack J, Stefanovski D. Hypercapnia and hyperlactatemia were positively associated with higher-grade arrhythmias during peak exercise in horses during poor performance evaluation on a high-speed treadmill. Vet J 2020; 266:105572. [PMID: 33323171 DOI: 10.1016/j.tvjl.2020.105572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 10/09/2020] [Accepted: 11/02/2020] [Indexed: 01/21/2023]
Abstract
Cardiac arrhythmias are common in horses during exercise, especially immediately post-exercise. The objectives of this study were to: (1) describe the frequency and type of cardiac arrhythmias detected in horses during incremental high-speed treadmill exercise testing (ITET); (2) determine if arterial blood gas (ABG) changes at peak and immediately post-exercise were associated with arrhythmias; and (3) determine whether upper or lower airway disease was associated with exercising cardiac arrhythmias. Horses (n = 368) presenting for an ITET underwent resting and exercising upper airway endoscopy, resting, exercising and post-exercise electrocardiography, resting and post-exercise echocardiography and exercising ABG. Arrhythmias were graded by the most severe arrhythmia present. Grade 1 arrhythmias were defined as one or two atrial (APCs) or ventricular premature complexes (VPCs), or one APC and one VPC, detected in 6.9% at peak and 16% at 0-2 min post exercise.. Grade 2 arrhythmias were >2 APCs or VPCs, or both, detected in 5.8% at peak and 16.6% at 0-2 min post exercise. Grade 3 included complex arrhythmias (couplets, triplets, R on T, multiform complexes or paroxysmal atrial or ventricular tachycardia), detected in 4.4% at peak and 7.3% at 0-2 min post exercise. Both partial pressure of arterial CO2 (PaCO2; P = 0.008) and lactate (P = 0.031) were significantly associated with arrhythmias occurring at peak exercise, but not immediately post-exercise. As PaCO2 and lactate increased, arrhythmia severity increased. Blood pH was significantly associated with grades 2 and 3 arrhythmias at 0-2 min post ITET (OR = 0.0002; P < 0.001). There was no significant association between grades 2 and 3 cardiac arrhythmias, inflammatory airway disease (IAD), or exercise-induced pulmonary hemorrhage (EIPH). When adjusted for lactate concentration (P = 0.06), higher PaCO2 concentrations in horses with and without exercising upper respiratory tract (URT) obstruction were associated with higher likelihood of grades 2 and 3 arrhythmias (P < 0.01). This study demonstrated that at peak exercise, with severe hypercapnia and hyperlactatemia, there was increased risk for grades 2 or 3 cardiac arrhythmias and, as the PaCO2 and lactate values increased further, the severity of those arrhythmias increased.
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Affiliation(s)
- V B Reef
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA.
| | - E J Davidson
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA
| | - J Slack
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA
| | - D Stefanovski
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA
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Affiliation(s)
- T Hilal
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, USA.
| | - P Bansal
- Division of Hematology/Oncology, University of New Mexico, Albuquerque, USA
| | - K Kelemen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, USA
| | - J Slack
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, USA
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Decook L, Chang YH, Slack J, Gastineau D, Leis J, Noel P, Palmer J, Sproat L, Sorror M, Khera N. Association of hematopoietic cell transplantation-specific comorbidity index with resource utilization after allogeneic transplantation. Bone Marrow Transplant 2017; 52:998-1002. [DOI: 10.1038/bmt.2017.70] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/02/2017] [Accepted: 03/06/2017] [Indexed: 11/09/2022]
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Luethy D, Slack J, Kraus MS, Gelzer AR, Habecker P, Johnson AL. Third-Degree Atrioventricular Block and Collapse Associated with Eosinophilic Myocarditis in a Horse. J Vet Intern Med 2017; 31:884-889. [PMID: 28295606 PMCID: PMC5435066 DOI: 10.1111/jvim.14682] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 01/10/2017] [Accepted: 01/31/2017] [Indexed: 12/01/2022] Open
Abstract
Third‐degree atrioventricular block (AVB) and primary inflammatory myocarditis are uncommon findings in horses. The horse of this report presented for collapse at rest and was found to have multiple cardiac arrhythmias, most notably 3rd‐degree AVB. The horse was subsequently diagnosed with eosinophilic myocarditis on necropsy, a rare form of myocarditis not previously reported in horses. Despite extensive testing, an etiologic agent could not be identified, illustrating the difficulty in identifying a specific cause of myocarditis in horses.
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Affiliation(s)
- D Luethy
- Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA
| | - J Slack
- Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA
| | - M S Kraus
- Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - A R Gelzer
- Ryan Veterinary Hospital, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - P Habecker
- Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA
| | - A L Johnson
- Department of Clinical Studies-New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA
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Slack J, Boston RC, Soma LR, Reef VB. Occurrence of cardiac arrhythmias in Standardbred racehorses. Equine Vet J 2014; 47:398-404. [DOI: 10.1111/evj.12299] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 05/01/2014] [Indexed: 12/22/2022]
Affiliation(s)
- J. Slack
- Department of Clinical Studies; New Bolton Center; University of Pennsylvania; USA
| | - R. C. Boston
- Department of Clinical Studies; New Bolton Center; University of Pennsylvania; USA
| | - L. R. Soma
- Department of Clinical Studies; New Bolton Center; University of Pennsylvania; USA
| | - V. B. Reef
- Department of Clinical Studies; New Bolton Center; University of Pennsylvania; USA
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Slack J, Boston R, Soma L, Reef V. Cardiac Troponin I in Racing Standardbreds. J Vet Intern Med 2012; 26:1202-8. [PMID: 22827474 DOI: 10.1111/j.1939-1676.2012.00969.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2011] [Revised: 04/05/2012] [Accepted: 06/04/2012] [Indexed: 11/28/2022] Open
Affiliation(s)
- J. Slack
- Department of Clinical Studies; New Bolton Center; University of Pennsylvania; 382 West Street Road; Kennett Square; PA
| | - R.C. Boston
- Department of Clinical Studies; New Bolton Center; University of Pennsylvania; 382 West Street Road; Kennett Square; PA
| | - L. Soma
- Department of Clinical Studies; New Bolton Center; University of Pennsylvania; 382 West Street Road; Kennett Square; PA
| | - V.B. Reef
- Department of Clinical Studies; New Bolton Center; University of Pennsylvania; 382 West Street Road; Kennett Square; PA
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Prall S, Slack J, Siekmann I, Martinez N, Heidenreich O. Focal adhesion kinase (FAK) in t(8;21) rearranged acute myeloid leukaemia (AML). Klin Padiatr 2012. [DOI: 10.1055/s-0032-1310483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Norton J, Nolen-Walston R, Underwood C, Boston R, Slack J, Dallap B. Repeatability, Reproducibility, and Effect of Head Position on Central Venous Pressure Measurement in Standing Adult Horses. J Vet Intern Med 2011; 25:575-8. [DOI: 10.1111/j.1939-1676.2011.0701.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Norton JL, Nolen-Walston RD, Underwood C, Slack J, Boston R, Dallap BL. Comparison of water manometry to 2 commercial electronic pressure monitors for central venous pressure measurement in horses. J Vet Intern Med 2011; 25:303-6. [PMID: 21281354 DOI: 10.1111/j.1939-1676.2010.0670.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Central venous pressure (CVP) customarily has been measured in veterinary patients with water manometry. However, many institutions are now using stallside electronic monitors in both anesthesia and intensive care units for many aspects of patient monitoring. HYPOTHESIS Electronic stall side monitoring devices will agree with water manometry for measurement of CVP in horses. ANIMALS Ten healthy adult horses from the university research herd. METHODS Central venous catheters were placed routinely, and measurements were obtained in triplicate with each of the 3 methods every 12 hours for 3 days. Data were analyzed by a Lin concordance correlation coefficient and modified Bland-Altman limits of agreement, with all devices compared pairwise. RESULTS Compared with water manometry, agreement (bias) of the Passport was -1.94 cmH₂O (95% limits of agreement, -8.54 to 4.66 cmH₂O) and of the Medtronic was -1.83 cmH₂O (95% limits of agreement, -8.60 to 4.94 cmH₂O). When compared with the Passport, agreement of the data obtained with the Medtronic was 0.27 cmH₂O (95% limits of agreement, -4.39 to 4.93 cmH₂O). CONCLUSIONS AND CLINICAL IMPORTANCE These data show that both electronic monitors systematically provide measurements that are approximately 2 cmH₂O lower than water manometry, but differences between the 2 electronic devices are small enough (< 0.5 cmH₂O) to be considered clinically unimportant. This discrepancy should be taken into account when interpreting data obtained with these monitoring devices.
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Affiliation(s)
- J L Norton
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, USA
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Nolen-Walston RD, Norton JL, Navas de Solis C, Underwood C, Boston R, Slack J, Dallap BL. The effects of hypohydration on central venous pressure and splenic volume in adult horses. J Vet Intern Med 2010; 25:570-4. [PMID: 21092009 DOI: 10.1111/j.1939-1676.2010.0641.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Central venous pressure (CVP) is used in many species to monitor right-sided intravascular volume status, especially in critical care medicine. HYPOTHESIS That hypohydration in adult horses is associated with a proportional reduction in CVP. ANIMALS Ten healthy adult horses from the university teaching herd. METHODS In this experimental study, horses underwent central venous catheter placement and CVP readings were obtained by water manometry. The horses were then deprived of water and administered furosemide (1 mg/kg IV q6h) for up to 36 hours. Weight, CVP, vital signs, PCV, total protein (TP), and serum lactate were monitored at baseline and every 6 hours until a target of 5% decrease in body weight loss was achieved. The spleen volume was estimated sonographically at baseline and peak volume depletion. Linear regression analysis was used to assess the association of CVP and other clinical parameters with degree of body weight loss over time. RESULTS There was a significant association between CVP and decline in body weight (P < .001), with a decrease in CVP of 2.2 cmH(2)O for every percentage point decrease in body weight. Other significant associations between volume depletion and parameters measured included increased TP (P = .007), increased serum lactate concentration (P = .048), and decreased splenic volume (P = .046). There was no significant association between CVP and vital signs or PCV. CONCLUSIONS AND CLINICAL IMPORTANCE These findings suggest that CVP monitoring might be a useful addition to the clinical evaluation of hydration status in adult horses.
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Affiliation(s)
- R D Nolen-Walston
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA 19348, USA.
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Underwood C, Norton J, Nolen-Walston R, Dallap-Schaer B, Boston R, Slack J. Echocardiographic Changes in Heart Size in Hypohydrated Horses. J Vet Intern Med 2010; 25:563-9. [DOI: 10.1111/j.1939-1676.2010.0612.x] [Citation(s) in RCA: 17] [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: 11/28/2022] Open
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Abstract
REASONS FOR PERFORMING STUDY There is interest in using pharmacological stress testing (PST) as a substitute for exercise stress testing (EST) to evaluate cardiac function in horses. OBJECTIVES To compare the effect of PST and EST on right ventricular pressure dynamics and stress echocardiography. METHODS Five horses completed a PST and EST in a randomised crossover design. High fidelity pressure transducers were placed in the right ventricle. Continuous pressure signals were digitally collected and stored, and dP/dtmax, dP/dtmin and tau calculated from these measurements. ECGs were recorded continuously for 20 h. Echocardiography was performed prior to EST and PST, during and after PST, and immediately post EST. Plasma cardiac troponin I concentrations were measured pre- and 3-4 h post stress testing. For PST, 5 microg/kg bwt glycopyrrolate i.v. followed after 10 min by 5 microg/kg bwt/min dobutamine infusion over 10 min was given. EST consisted of a 2 min gallop at 110% speed required to elicit VO2max. RESULTS Both EST and PST resulted in a significant increase in right-ventricular dP/dtmax and dP/dtmin over baseline (P<0.05) and a significant decrease in tau compared with baseline (P<0.05). EST dP/dtmax and dP/dtmin were significantly greater than PST dP/dtmax and dP/dtmin (P<0.05) and EST tau was significantly less than PST tau (P<0.05). Two minutes post EST and 5 min post PST dP/dtmax were not significantly different, but were significantly less than end-EST and during PST. Tau was also not significantly different between post EST and post PST, but was significantly decreased end-EST compared with during PST. FS were not significantly different between PST and post EST, but during PST and post EST all FS were significantly higher than baseline. Cardiac troponin I concentrations were significantly elevated post PST and were greater than post EST. The clinical relevance of this is unknown. CONCLUSIONS PST had a similar, although less marked effect on the cardiac parameters related to right-ventricular pressure dynamics and a similar effect on echocardiography as exercise stress testing. POTENTIAL RELEVANCE PST deserves further evaluation in normal horses and those with cardiac disease, and may be complementary to EST to better identify exercise-induced cardiac dysfunction.
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Affiliation(s)
- M M Durando
- Department of Clinical Studies, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, 382 W Street Road, Kennett Square, Pennsylvania 19348, USA
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Fushan A, Mckluskey S, Simons C, Slack J, Drayna D. Genetic dissection of human taste perception. Appetite 2008. [DOI: 10.1016/j.appet.2008.04.085] [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: 11/29/2022]
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Paripati H, Stewart AK, Cabou S, Dueck A, Zepeda VJ, Pirooz N, Ehlenbeck C, Reeder C, Slack J, Leis JF, Boesiger J, Torloni AS, Fonseca R, Bergsagel PL. Compromised stem cell mobilization following induction therapy with lenalidomide in myeloma. Leukemia 2008; 22:1282-4. [PMID: 18216870 DOI: 10.1038/sj.leu.2405100] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Slack J, Evans KA. The increased risk of death from ischaemic heart disease in first degree relatives of 121 men and 96 women with ischaemic heart disease. J Med Genet 2005; 3:239-57. [PMID: 16175706 PMCID: PMC1013779 DOI: 10.1136/jmg.3.4.239] [Citation(s) in RCA: 201] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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List A, Beran M, DiPersio J, Slack J, Vey N, Rosenfeld CS, Greenberg P. Opportunities for Trisenox (arsenic trioxide) in the treatment of myelodysplastic syndromes. Leukemia 2003; 17:1499-507. [PMID: 12886236 DOI: 10.1038/sj.leu.2403021] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Arsenic trioxide (ATO) has a long history of efficacy as an antileukemic agent. However, with the advent of modern therapy, it had been relegated to a historical footnote. In the 1990s, investigators in China reported that ATO was safe and had dramatic efficacy in patients with acute promyelocytic leukemia (APL). Preclinical investigations indicate that the biological targets of this novel drug extend to a variety of malignancies other than APL and include induction of apoptosis, nonterminal differentiation, and suppression of proliferation and angiogenesis. The myelodysplastic syndromes (MDSs) present a particular therapeutic challenge. Ineffective hematopoiesis predominates in patients with low-grade prognostic scores. The survival of those patients with high-grade disease is compromised by a high risk of leukemia transformation. Although a number of therapeutic options have been investigated, none has emerged as being broadly efficacious and having an acceptable toxicity profile. No drug has yet received approval by the Food and Drug Administration for this indication. Biologic features of MDS, which include accelerated apoptotic potential, limited maturation capacity, and medullary neovascularity, create a strong scientific rationale for the investigation of ATO in MDS. This report describes the history and scientific basis for ATO treatment of hematologic malignancies, enumerates the potential benefits of ATO in MDS, and discusses the direction of ongoing trials of this novel antineoplastic agent.
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Affiliation(s)
- A List
- Arizona Cancer Centre 3945, University of Arizona, Tucson 85724, USA
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Hahn T, Rondeau C, Shaukat A, Jupudy V, Miller A, Alam AR, Baer MR, Bambach B, Bernstein Z, Chanan-Khan AA, Czuczman MS, Slack J, Wetzler M, Mookerjee BK, Silva J, McCarthy PL. Acute renal failure requiring dialysis after allogeneic blood and marrow transplantation identifies very poor prognosis patients. Bone Marrow Transplant 2003; 32:405-10. [PMID: 12900777 DOI: 10.1038/sj.bmt.1704144] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We examined the incidence, risk factors and associated mortality of acute renal failure requiring dialysis (Renal Bearman Grade [BG] 3) in a 3-year cohort of 97 consecutive allogeneic blood and marrow transplantation (alloBMT) patients. In all, 20 (21%) developed Renal BG3 (all died by day +132) and 77 (79%) developed renal insufficiency (Renal BG1-2). Renal BG3 was a contributing or primary cause of death in 18 (90%) patients who continued to require dialysis at time of death. The two Renal BG3 patients whose deaths were not related to renal failure died on day +103 of hemorrhage and day +132 of underlying disease. By univariate analysis, age, unrelated donor, veno-occlusive disease (VOD) and grade III-IV acute graft-versus-host disease with hepatic involvement were significantly associated with Renal BG3. The multivariate model of time to Renal BG3 determined only a prior diagnosis of severe acute GVHD (RR=4.1, 95% CI 1.6-10.3, P=0.003) and VOD (RR=9.1, 95% CI 3.5-23.7, P<0.001) as significant independent predictors. Renal BG3 is generally considered a conditioning regimen-related toxicity. This study demonstrates that Renal BG3 is most commonly a complication of hepatic co-morbidities after allogeneic blood and marrow transplantation and identifies patients with a very poor prognosis.
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Affiliation(s)
- T Hahn
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
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Slack J. Zero-sum politics, the Herbert thesis, and the Ryan White CARE Act: lessons learned from the local side of AIDS. J Health Hum Serv Adm 2002; 24:80-102. [PMID: 12134564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
This study examines the dynamics of grass-roots decision-making processes involved in the implementation of the Ryan White CARE Act. Providing social services to persons with HIV/AIDS, the CARE act requires participation of all relevant groups, including representatives of the HIV/AIDS and gay communities. Decision-making behavior is explored by applying a political (zero-sum) model and a bureaucratic (the Herbert Thesis) model. Using qualitative research techniques, the Kern County (California) Consortium is used as a case study. Findings shed light on the decision-making behavior of social service organizations characterized by intense advocacy and structured on the basis of volunteerism and non-hierarchical relationships. Findings affirm bureaucratic behavior predicted by the Herbert Thesis and also discern factors which seem to trigger more conflictual zero-sum behavior.
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Affiliation(s)
- J Slack
- University of Alabama at Birmingham, USA
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Abstract
Stem cells have been big news for the past couple of years and yet they remain remarkably inscrutable in terms of declaring their true nature and identity. On pages 778-784 of this issue, Toma et al. describe the identification of a new type of stem cell from the dermis of ths skin, called skin-derived precursor (SKP) cells. These can be converted into several differentiated cell types in vitro, including neurons, and might become a source of cells for therapeutic tissue repair.
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Affiliation(s)
- J Slack
- Department of Biology and Biochemistry, University of Bath, Bath BA2 7AY, UK.
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Slack J, Risdahl JM, Valberg SJ, Murphy MJ, Schram BR, Lunn DP. Effects of dexamethasone on development of immunoglobulin G subclass responses following vaccination of horses. Am J Vet Res 2000; 61:1530-3. [PMID: 11131594 DOI: 10.2460/ajvr.2000.61.1530] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of dexamethasone on development of IgG subclass responses following vaccination of healthy horses. ANIMALS 11 mature Thoroughbreds. PROCEDURE Horses received 2 IM injections at 2-week intervals of a vaccine containing inactivated infectious bovine rhinotracheitis, bovine viral diarrhea, and parainfluenza-3 viral antigens and were then randomly assigned to 2 groups. Six horses received dexamethasone (0.2 mg/kg of body weight, IM) twice weekly for 8 weeks starting the day of the first vaccination. Five control horses received an equivalent volume of saline (0.9% NaCl) solution. Antigen-specific serum IgG subclass titers were determined weekly after vaccination by use of an ELISA. RESULTS Vaccination resulted in similar antigen-specific serum IgG(T) titers in dexamethasone-treated and control horses. In contrast, although control horses developed IgGa and IgGb responses after vaccination, corticosteroid administration completely inhibited these responses in treated horses. CONCLUSIONS AND CLINICAL RELEVANCE Cortico steroids can have profound effects on primary immune responses in horses and can significantly affect IgG responses to inactivated vaccines. Corticosteroid treatment regimens commonly used to treat diseases in horses may result induction of a nonprotective IgG subclass response, leaving treated horses susceptible to disease. Additionally, mechanisms regulating IgGa and IgGb responses appear to differ from those regulating IgG(T) responses. Further defining these mechanisms is a critical step in designing effective vaccines, and corticosteroid-induced immunomodulation may be a valuable tool for studying immune responses in horses.
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Affiliation(s)
- J Slack
- Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison 53706, USA
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Schriber J, Milk B, Shaw D, Christiansen N, Baer M, Slack J, Tezcan H, Wetzler M, Herzig G. Tissue plasminogen activator (tPA) as therapy for hepatotoxicity following bone marrow transplantation. Bone Marrow Transplant 1999; 24:1311-4. [PMID: 10627640 DOI: 10.1038/sj.bmt.1702069] [Citation(s) in RCA: 28] [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: 01/03/2023]
Abstract
The treatment of established veno-occlusive disease (VOD) of the liver with tissue plasminogen activator (tPA) has been disappointing. In attempts to improve upon these results we identified a subgroup of patients with consistently elevated bilirubin levels who did not meet conventional criteria for VOD (Susp VOD) but who had a significant risk of later developing clinical VOD. In January 1994 we began to treat patients who developed Susp VOD with tPA rather than waiting until they developed clinical VOD. We now report on the results of the first 37 patients who ultimately developed clinical VOD and received tPA therapy prior to Susp VOD, or at the time they had established VOD. Significant bleeding complications occurred in 13 (35%) patients but resolved with discontinuation of therapy in all but one. We found that patients treated early in the course of hepatotoxicity prior to the development of overt VOD had a significantly higher response rate and 100 day survival than patients treated at the time of established VOD. Given the poor results seen in treating late VOD, we suggest that early treatment with tPA may improve the outcome in patients who develop signs of hepatotoxicity following marrow transplantation.
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Affiliation(s)
- J Schriber
- Division of Medicine, Departments of Hematologic Oncology and Bone Marrow Transplantation, Roswell Park Cancer Institute, Buffalo, NY, USA
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25
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Michalak F, von Rottkay K, Richardson T, Slack J, Rubin M. Electrochromic lithium nickel oxide thin films by RF-sputtering from a LiNiO2 target. Electrochim Acta 1999. [DOI: 10.1016/s0013-4686(99)00024-9] [Citation(s) in RCA: 31] [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: 10/16/2022]
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26
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von Rottkay K, Rubin M, Michalak F, Armitage R, Richardson T, Slack J, Duine P. Effect of hydrogen insertion on the optical properties of Pd-coated magnesium lanthanides. Electrochim Acta 1999. [DOI: 10.1016/s0013-4686(99)00025-0] [Citation(s) in RCA: 30] [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: 11/30/2022]
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Abstract
The objective of this study was to assess the effects of two brief training interventions to improve obstetricians' and midwives' explanations to patients of a routine prenatal screening test. Health professionals were randomly allocated to one of two intervention groups or a control group. Information-giving about the test and communication skills were assessed at baseline, post-training and 3-month follow-up from audiotaped consultations. Both intervention groups received a 1-h training session involving small group discussions focused around a video. In addition, one group received individual feedback on their baseline and post-training consultations. Twenty-six midwives and nine obstetricians completed the study according to the protocol. Changes between baseline and post-training, and between baseline and follow-up, were computed. Information-giving and communication skills improved significantly in subjects receiving training and feedback on their performance, with the greatest improvements occurring before feedback was given. Those receiving training without feedback significantly improved their communication skills and showed some improvement in information-giving. These results show that modest improvements in communication can be made with relatively brief training. Greater and more sustained improvements may be found if all staff were trained, and trained on a regular basis.
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Affiliation(s)
- D K Smith
- Psychology and Genetics Research Group, UMDS, London, U.K
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29
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Slack J. Rather a daunting exercise in the care of elderly people. Elder Care 1995; 7:40. [PMID: 7627166 DOI: 10.7748/eldc.7.2.40.s18] [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] [Indexed: 01/26/2023]
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30
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Giri JG, Wells J, Dower SK, McCall CE, Guzman RN, Slack J, Bird TA, Shanebeck K, Grabstein KH, Sims JE. Elevated levels of shed type II IL-1 receptor in sepsis. Potential role for type II receptor in regulation of IL-1 responses. J Immunol 1994; 153:5802-9. [PMID: 7989776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Two types of cellular IL-1Rs have been characterized and cloned from both human and murine sources. The type II IL-1R has a very short cytoplasmic domain and does not seem to participate in IL-1 signaling. We demonstrate that type II IL-1Rs are released from the surface of neutrophils in response to treatment with TNF or endotoxin. In addition, serum from patients with sepsis syndrome contains elevated levels of soluble type II IL-1Rs. Neutrophils isolated from patients with sepsis have greatly enhanced expression of type II IL-1R mRNA and cell surface receptors and are therefore a likely source for the shed receptors in serum. Of the three forms of IL-1, soluble type II IL-1R binds IL-1 beta with highest affinity and also selectively inhibits IL-1 beta activity. We propose that increased cell surface expression and rapid release of preformed type II IL-1R from neutrophils, as a soluble IL-1 beta binding protein, represents a mechanism that has evolved for regulating IL-1 activity in sepsis.
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Affiliation(s)
- J G Giri
- Immunex Research and Development Corporation, Seattle, WA 98101
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31
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Giri JG, Wells J, Dower SK, McCall CE, Guzman RN, Slack J, Bird TA, Shanebeck K, Grabstein KH, Sims JE. Elevated levels of shed type II IL-1 receptor in sepsis. Potential role for type II receptor in regulation of IL-1 responses. The Journal of Immunology 1994. [DOI: 10.4049/jimmunol.153.12.5802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Two types of cellular IL-1Rs have been characterized and cloned from both human and murine sources. The type II IL-1R has a very short cytoplasmic domain and does not seem to participate in IL-1 signaling. We demonstrate that type II IL-1Rs are released from the surface of neutrophils in response to treatment with TNF or endotoxin. In addition, serum from patients with sepsis syndrome contains elevated levels of soluble type II IL-1Rs. Neutrophils isolated from patients with sepsis have greatly enhanced expression of type II IL-1R mRNA and cell surface receptors and are therefore a likely source for the shed receptors in serum. Of the three forms of IL-1, soluble type II IL-1R binds IL-1 beta with highest affinity and also selectively inhibits IL-1 beta activity. We propose that increased cell surface expression and rapid release of preformed type II IL-1R from neutrophils, as a soluble IL-1 beta binding protein, represents a mechanism that has evolved for regulating IL-1 activity in sepsis.
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Affiliation(s)
- J G Giri
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - J Wells
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - S K Dower
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - C E McCall
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - R N Guzman
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - J Slack
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - T A Bird
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - K Shanebeck
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - K H Grabstein
- Immunex Research and Development Corporation, Seattle, WA 98101
| | - J E Sims
- Immunex Research and Development Corporation, Seattle, WA 98101
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32
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Jurell KR, O'Connor KW, Slack J, Fraiz J, Shaar CJ, Kent L, Callon R. Effect of supplemental oxygen on cardiopulmonary changes during gastrointestinal endoscopy. Gastrointest Endosc 1994; 40:665-70. [PMID: 7859961] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
This prospective study evaluated supplemental oxygen as an effective means of preventing hypoxemia and electrocardiographic changes in sedated patients undergoing endoscopic procedures. Ninety-five patients with documented ischemic heart disease and 106 patients without heart or lung disease were studied. Patients within each group received either supplemental oxygen (2 L/minute) via nasal cannula or room air. Hypoxemia (oxygen saturation below 90%) and ST-segment deviations occurred in cardiac and control groups. The combination of midazolam and meperidine significantly increased the risk for hypoxemia as compared to midazolam alone (44% versus 8%). Supplemental oxygen significantly decreased, but did not entirely prevent, hypoxemia in cardiac and control groups. The incidence of ST-segment deviation in cardiac patients who were hypoxic was significantly lower in the group receiving oxygen (p = .0015). Supplemental oxygen did not affect the incidence of arrhythmias. Prophylactic supplemental oxygen should be administered to patients with ischemic heart disease who undergo conscious sedation for upper and lower gastrointestinal endoscopic procedures.
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Affiliation(s)
- K R Jurell
- St. Vincent Hospital and Health Care Center, Inc., Indianapolis, Indiana
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Abstract
To assess the potential role of a molecule in development we need to know three things: 1) what are the biological activities of the molecule, 2) what is its expression pattern, and 3) what are the consequences of removing it from the embryo? In the case of the FGF family in Xenopus embryos we have quite a lot of information about all three questions. Most members of the family can induce mesoderm from isolated animal caps, thus mimicking the natural "ventral vegetal" inducing signal operative in the blastula. This activity can be exerted on isolated, disaggregated cells and does not involve a change in division rate. When overexpressed from injected mRNA, the activity of FGFs depends largely on whether or not they possess a signal sequence, showing the importance of secretion in the inductive process. In addition to the mesoderm-inducing activity, there are effects of overexpression on whole embryos which lead to a suppression of anterior structures. Three types of FGF have so far been cloned from Xenopus: direct homologs of each of the mammalian types FGF-2 and FGF-3, and eFGF ("embryonic FGF"), which is equidistant in sequence from mammalian FGF-4 and FGF-6. Attempts to find homologs of mammalian FGF-5 and FGF-7 in Xenopus have proved unsuccessful. All three types of Xenopus FGF are expressed in early development. FGF-2 and eFGF are present in the oocyte and fertilized egg, and are thus both available at the time of mesoderm induction.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J Slack
- Developmental Biology Unit, Department of Zoology, Oxford, United Kingdom
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34
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Nagoya S, Greenberg PD, Yee C, Weisser KE, Sugawara H, Widmer MB, Slack J, Dower SK, Lupton SD, Overell RW. Helper T cell-independent proliferation of CD8+ cytotoxic T lymphocytes transduced with an IL-1 receptor retrovirus. The Journal of Immunology 1994. [DOI: 10.4049/jimmunol.153.4.1527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Although the proliferation of CD8+ CTL typically requires cytokine support provided by helper T cells, a subset of naturally occurring CD8+ CTL are capable of proliferating independently of T cell help. Such helper-independent CTL have previously been shown to possess IL-1 receptors (IL-1R) and to proliferate in response to IL-1 through endogenous production of IL-2. In this study, we have transduced conventional helper-dependent CTL clones with a retroviral vector encoding the murine type I IL-1R. Transduced CTL selected in G418 expressed vector-derived transcripts encoding IL-1R and displayed approximately 1000 cell surface receptors with an IL-1 affinity typical for the type I IL-1R. In contrast to parental cells, transduced CTL proliferated in response to IL-1 in the presence of Ag, without a requirement for helper T cells, IL-2, or other cytokine support. Stimulation with both IL-1 and Ag was necessary for the proliferative response. No endogenous synthesis of IL-2 could be detected in the IL-1R transduced cells in response to IL-1 stimulation, in the presence or absence of Ag. The IL-1R-induced phenotype was demonstrated in two independent T cell clones, both of which retained Ag-specific cytolytic activity. No such conversion to a helper-independent phenotype was induced by a retroviral vector encoding only the neo gene. The behavior of the IL-1R-transduced CTL in proliferation assays thus resembled that of the naturally occurring helper-independent CTL.
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Affiliation(s)
- S Nagoya
- Department of Medicine, University of Washington, Seattle 98101
| | - P D Greenberg
- Department of Medicine, University of Washington, Seattle 98101
| | - C Yee
- Department of Medicine, University of Washington, Seattle 98101
| | - K E Weisser
- Department of Medicine, University of Washington, Seattle 98101
| | - H Sugawara
- Department of Medicine, University of Washington, Seattle 98101
| | - M B Widmer
- Department of Medicine, University of Washington, Seattle 98101
| | - J Slack
- Department of Medicine, University of Washington, Seattle 98101
| | - S K Dower
- Department of Medicine, University of Washington, Seattle 98101
| | - S D Lupton
- Department of Medicine, University of Washington, Seattle 98101
| | - R W Overell
- Department of Medicine, University of Washington, Seattle 98101
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35
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Nagoya S, Greenberg PD, Yee C, Weisser KE, Sugawara H, Widmer MB, Slack J, Dower SK, Lupton SD, Overell RW. Helper T cell-independent proliferation of CD8+ cytotoxic T lymphocytes transduced with an IL-1 receptor retrovirus. J Immunol 1994; 153:1527-35. [PMID: 8046231] [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: 01/28/2023]
Abstract
Although the proliferation of CD8+ CTL typically requires cytokine support provided by helper T cells, a subset of naturally occurring CD8+ CTL are capable of proliferating independently of T cell help. Such helper-independent CTL have previously been shown to possess IL-1 receptors (IL-1R) and to proliferate in response to IL-1 through endogenous production of IL-2. In this study, we have transduced conventional helper-dependent CTL clones with a retroviral vector encoding the murine type I IL-1R. Transduced CTL selected in G418 expressed vector-derived transcripts encoding IL-1R and displayed approximately 1000 cell surface receptors with an IL-1 affinity typical for the type I IL-1R. In contrast to parental cells, transduced CTL proliferated in response to IL-1 in the presence of Ag, without a requirement for helper T cells, IL-2, or other cytokine support. Stimulation with both IL-1 and Ag was necessary for the proliferative response. No endogenous synthesis of IL-2 could be detected in the IL-1R transduced cells in response to IL-1 stimulation, in the presence or absence of Ag. The IL-1R-induced phenotype was demonstrated in two independent T cell clones, both of which retained Ag-specific cytolytic activity. No such conversion to a helper-independent phenotype was induced by a retroviral vector encoding only the neo gene. The behavior of the IL-1R-transduced CTL in proliferation assays thus resembled that of the naturally occurring helper-independent CTL.
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Affiliation(s)
- S Nagoya
- Department of Medicine, University of Washington, Seattle 98101
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36
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Abstract
OBJECTIVE To assess obstetricians' and midwives' knowledge of routine prenatal screening tests for fetal abnormality and factors associated with such knowledge. DESIGN Questionnaire assessment of antenatal clinic staff. SETTING Six hospitals within the United Kingdom (four district general hospitals in London, one district general hospital in Wales, and one teaching hospital in Wales), offering routine prenatal screening tests. SUBJECTS 29 obstetricians and 97 midwives were invited to participate, of whom 21 and 70 respectively responded to the questionnaire. MAIN MEASURES Knowledge of prenatal tests, according to 19 item multiple choice questionnaire, reluctance to disclose uncertainty, and clinical experience. RESULTS The overall response rate was 72% (91/126). In all, 43% of midwives and 14% of obstetricians obtained correct responses on fewer than half the items. Reluctance to disclose uncertainty to patients was associated in obstetricians with having less knowledge about prenatal testing (r = -0.50; p < 0.025, Pearson product moment correlation) and in midwives with more clinical experience (r = 0.43; p < 0.001). CONCLUSIONS Lack of knowledge and greater clinical experience seem to be important barriers to providing patients with information about prenatal screening tests.
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Affiliation(s)
- D K Smith
- United Medical and Dental Schools (UMDS), Guy's Campus, London
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37
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McKean DJ, Podzorski RP, Bell MP, Nilson AE, Huntoon CJ, Slack J, Dower SK, Sims J. Murine T helper cell-2 lymphocytes express type I and type II IL-1 receptors, but only the type I receptor mediates costimulatory activity. The Journal of Immunology 1993. [DOI: 10.4049/jimmunol.151.7.3500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
The role of IL-1 in augmenting the Ag receptor-initiated activation program was evaluated in IL-4-producing (Th2) CD4+ murine T lymphocytes. Northern blot and 125I-labeled IL-1 alpha cross-linking analyses demonstrated that Th2 lymphocytes express both type I and type II IL-1R. The expression of both IL-1R isoforms on the surface of the Th2 cells is coordinately up-regulated in response to anti-CD3 cross-linking in the absence of detectable accessory cells. Analyses of the kinetics of IL-1R acquisition demonstrated that the peak level of type I and type II IL-1R mRNA expression occurs after the peak expression of mRNA encoding IL-2R alpha and IL-4, which are two IL-1-responsive events in the Th2 activation program. Type I IL-1R ligand-binding antagonists, IL-1R antagonist and anti-type I mAb, were used to evaluate the functional significance of Th2 cell expression of two IL-1R isoforms. The addition of either IL-1R antagonist or anti-type I mAb completely inhibited the IL-1 alpha-augmented component of the proliferative response stimulated by anti-CD3 plus exogenous IL-1 alpha. Together, these studies indicate that, although Th2 clones express inducible levels of both type I and type II IL-1R isoforms, the IL-1-induced intracellular signals involved in augmenting an anti-CD3-stimulated proliferative response are mediated solely through the type I IL-1R.
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Affiliation(s)
- D J McKean
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
| | - R P Podzorski
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
| | - M P Bell
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
| | - A E Nilson
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
| | - C J Huntoon
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
| | - J Slack
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
| | - S K Dower
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
| | - J Sims
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
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McKean DJ, Podzorski RP, Bell MP, Nilson AE, Huntoon CJ, Slack J, Dower SK, Sims J. Murine T helper cell-2 lymphocytes express type I and type II IL-1 receptors, but only the type I receptor mediates costimulatory activity. J Immunol 1993; 151:3500-10. [PMID: 8376789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The role of IL-1 in augmenting the Ag receptor-initiated activation program was evaluated in IL-4-producing (Th2) CD4+ murine T lymphocytes. Northern blot and 125I-labeled IL-1 alpha cross-linking analyses demonstrated that Th2 lymphocytes express both type I and type II IL-1R. The expression of both IL-1R isoforms on the surface of the Th2 cells is coordinately up-regulated in response to anti-CD3 cross-linking in the absence of detectable accessory cells. Analyses of the kinetics of IL-1R acquisition demonstrated that the peak level of type I and type II IL-1R mRNA expression occurs after the peak expression of mRNA encoding IL-2R alpha and IL-4, which are two IL-1-responsive events in the Th2 activation program. Type I IL-1R ligand-binding antagonists, IL-1R antagonist and anti-type I mAb, were used to evaluate the functional significance of Th2 cell expression of two IL-1R isoforms. The addition of either IL-1R antagonist or anti-type I mAb completely inhibited the IL-1 alpha-augmented component of the proliferative response stimulated by anti-CD3 plus exogenous IL-1 alpha. Together, these studies indicate that, although Th2 clones express inducible levels of both type I and type II IL-1R isoforms, the IL-1-induced intracellular signals involved in augmenting an anti-CD3-stimulated proliferative response are mediated solely through the type I IL-1R.
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Affiliation(s)
- D J McKean
- Department of Immunology, Mayo Clinic, Rochester, MN 55905
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Houlston R, Bourne T, Davies A, Whitehead M, Campbell S, Collins W, Slack J. Use of family history in a screening clinic for familial ovarian cancer. Int J Gynaecol Obstet 1993. [DOI: 10.1016/0020-7292(93)90689-t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Houlston RS, Bourne TH, Collins WP, Whitehead MI, Campbell S, Slack J. Risk of ovarian cancer and genetic relationship to other cancers in families. Hum Hered 1993; 43:111-5. [PMID: 8359812 DOI: 10.1159/000154126] [Citation(s) in RCA: 21] [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: 01/30/2023] Open
Abstract
The risk of ovarian and other cancers was assessed in first-degree relatives of patients with ovarian cancer from an analysis of 391 pedigrees. Overall there was a significant increase in the risk of ovarian cancer (4.5-fold; p < 0.001). The risks were 14.2- (p < 0.001), 5.2- (p < 0.001) and 3.7-fold (p < 0.001) for relatives of patients diagnosed before 45, between 45 and 54 and after the age of 55, respectively. There was no significant increase in the risk of cancers of the uterus, stomach, lung, colorectum or prostate. There was, however, an overall increase in the risk of breast cancer (1.3-fold; p < 0.05). The risk was highest for those relatives of patients diagnosed with ovarian cancer before the age of 55 (2.2-fold; p < 0.01). These results support the role of genetic factors in the aetiology of ovarian cancer and provide further evidence for the existence of a breast-ovarian family cancer syndrome, which may result from the pleiotropic effects of the same gene in some families.
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Affiliation(s)
- R S Houlston
- Department of Clinical Genetics, Royal Free Hospital and School of Medicine, London, UK
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Slack J, McMahan CJ, Waugh S, Schooley K, Spriggs MK, Sims JE, Dower SK. Independent binding of interleukin-1 alpha and interleukin-1 beta to type I and type II interleukin-1 receptors. J Biol Chem 1993; 268:2513-24. [PMID: 8428929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Interleukin (IL)-1 refers to a group of three polypeptide hormones with a wide range of cellular targets. Two types of IL-1 receptor have been identified and characterized by cDNA cloning. Both human type I and type II IL-1 receptors contain extracellular domains of approximately 310 residues and a single membrane-spanning region. The type I receptor contains a cytoplasmic domain of 213 residues. The cytoplasmic region of the type II receptor is 29 residues in length. It has been found recently that a number of cells express both forms of receptor. By analogy with other cytokine receptor systems, the two IL-1 receptors might be expected to form a heterodimeric complex, the type II receptor being an alpha-chain-like structure, functioning only to bind ligand, and associating with the type I receptor (a beta-chain-like structure) which would transduce signals. In this report we show that this is not the case, but rather that IL-1, when complexed to type II receptor, cannot bind type I receptors, and vice versa. These data show that the complex patterns often observed for IL-1 binding to cells cannot be accounted for by the same type of mechanism that underlies the behavior of, for example, the IL-2 system.
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Affiliation(s)
- J Slack
- Department of Biochemistry, Immunex Research and Development Corporation, Seattle, Washington 98101
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42
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Houlston R, Bourne TH, Davies A, Whitehead MI, Campbell S, Collins WP, Slack J. Use of family history in a screening clinic for familial ovarian cancer. Gynecol Oncol 1992; 47:247-52. [PMID: 1468703 DOI: 10.1016/0090-8258(92)90114-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We have estimated the risks of ovarian and other types of cancer in first-degree relatives of women who have developed the disease (the index patients). The number of deaths from each type of cancer was determined from pedigrees taken from 391 self-referred, asymptomatic women attending a screening clinic for familial ovarian cancer. These values were compared with the expected number of deaths for women in the general population (calculated from life tables), and the relative risks were used to estimate lifetime risks. The overall relative risk were 4.5, 1.4, 1.3, and 1.1 for ovarian, stomach, breast, and endometrial cancers, respectively. The risks were invariably higher if the index patient was < 55 years old. Ovarian cancer appeared to have no clear inheritance pattern in 290 pedigrees and there was no increased risk for the first-degree relatives. Eighty-two pedigrees were compatible with a diagnosis of a multiple-site cancer family syndrome and the relative risks were 6.1, 2.8, 3.7, and 2.7 for ovarian, breast, stomach, and colorectal cancer, respectively. There was evidence of site-specific ovarian cancer in 19 families; the relative risk for the first-degree relatives was 39.1 and the lifetime risk 1 in 2. We believe that family history can be used to identify women who are at a high risk of developing ovarian and certain other types of cancer. This information can be used to counsel women attending ovarian cancer screening clinics and to maximize the usefulness of current resources.
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Affiliation(s)
- R Houlston
- Department of Clinical Genetics, Royal Free Hospital, London, United Kingdom
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Abstract
The analysis of pedigrees taken from 97 of 1466 women attending a screening clinic for early familial ovarian cancer showed that there was a strong correlation in the ages at death from the disease among sisters (r = 0.68, confidence limits 0.51-0.82, P < 0.001), but not between mothers and daughters. This information can be used to help counsel women who are considering the appropriate time for more intensive screening or prophylactic oophorectomy.
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Affiliation(s)
- R S Houlston
- Department of Clinical Genetics, Royal Free Hospital School of Medicine, London, United Kingdom
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Houlston RS, Lemoine L, McCarter E, Harrington S, MacDermot K, Hinton J, Berger L, Slack J. Screening and genetic counselling for relatives of patients with breast cancer in a family cancer clinic. J Med Genet 1992; 29:691-4. [PMID: 1433227 PMCID: PMC1016124 DOI: 10.1136/jmg.29.10.691] [Citation(s) in RCA: 10] [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: 12/27/2022]
Abstract
Family history is the major risk factor in the aetiology of breast cancer. Breast screening is currently available to women from the age of 50 to 64 through the National Breast Screening Programme. There is, however, an equivalent risk of developing breast cancer below 50 for first degree relatives of women diagnosed with breast cancer premenopausally. We have estimated the risk of breast cancer for relatives of women affected at different ages and used these to establish a family cancer clinic offering breast screening based on individual risk. In three years we have seen 851 patients. Compliance for annual radiology was in excess of 83% over this period and of five cancers detected one had a lump at presentation, two developed interval breast lumps, and two were asymptomatic.
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Affiliation(s)
- R S Houlston
- Department of Clinical Genetics, Royal Free Hospital, School of Medicine, London
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45
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Houlston RS, Fallon T, Harocopos C, Williams CB, Davey C, Slack J. Congenital hypertrophy of retinal pigment epithelium in patients with colonic polyps associated with cancer family syndrome. Clin Genet 1992; 42:16-8. [PMID: 1325301 DOI: 10.1111/j.1399-0004.1992.tb03128.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Congenital hypertrophy of retinal pigment epithelium (CHRPE) has been shown to be a frequent extracolonic manifestation of adenomatous polyposis coli (APC). The presence of CHRPE in patients with adenomatous polyps from families with cancer family syndrome suggests possible involvement of the APC gene locus in syndromes associated with less florid polyp formation than seen in APC. It also emphasises that caution must be exercised in using the presence of CHRPE clinically as a marker for APC in isolated at-risk individuals.
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Affiliation(s)
- R S Houlston
- Department of Clinical Genetics, Royal Free Hospital and School of Medicine, London, UK
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46
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Grabstein KH, Baker PE, Hess B, Clark L, Slack J, Sims JE, Alpert AR, Dower S, Weisser KE, Overell RW. Regulation of murine B-cell growth in vitro by infection with a retroviral vector containing the murine IL-1R. Ann N Y Acad Sci 1992; 651:474-6. [PMID: 1534648 DOI: 10.1111/j.1749-6632.1992.tb24649.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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48
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Marteau TM, Kidd J, Cook R, Michie S, Johnston M, Slack J, Shaw RW. Psychological effects of having amniocentesis: are these due to the procedure, the risk or the behaviour? J Psychosom Res 1992; 36:395-402. [PMID: 1534372 DOI: 10.1016/0022-3999(92)90076-e] [Citation(s) in RCA: 29] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The purpose of the study was to examine the impact of amniocentesis on women at risk for having a baby with Down's syndrome because of raised maternal age. Fifty-four of the study participants had amniocentesis and nine did not. At the time of the procedure, those having amniocentesis were significantly more anxious, less certain about the baby's health, and held more negative attitudes towards the baby than women who did not undergo amniocentesis. For women undergoing amniocentesis there was a positive association between perceived risk of having an abnormal baby and anxiety. After the baby's birth, women who had undergone amniocentesis held less positive attitudes to the baby and were significantly more worried about the baby's health. These results suggest that the anxiety surrounding amniocentesis is related both to the procedure and to the perceived likelihood of an abnormal result. The differences between the groups after the birth seem more likely to reflect pre-existing attitudinal differences between the two groups, than the effects of amniocentesis.
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Affiliation(s)
- T M Marteau
- Health Psychology Unit, Royal Free Hospital School of Medicine, London, U.K
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49
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Abstract
The genetic basis for colorectal cancer was investigated by complex segregation analysis of a published series of consecutive pedigrees ascertained through patients undergoing treatment for colorectal cancer. Analysis favoured a dominant gene or genes with a frequency of 0.006 with a lifetime penetrance of 0.63. These genes account for 81% of colorectal cancer in patients under 35, however, by 65 about 85% are phenocopies.
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Affiliation(s)
- R S Houlston
- Department of Community Medicine, Southampton General Hospital
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50
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Houlston RS, Iraggori S, Murday V, Scrine M, Macdermot K, Slack J, Rees L. Microcephaly, focal segmental glomerulonephritis and marfanoid habitus in two sibs. Clin Dysmorphol 1992; 1:111-3. [PMID: 1345513] [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: 03/25/2023]
Abstract
Two female sibs aged 15 and 18 years with microcephaly, mental retardation and marfanoid habitus who developed focal segmental glomerulonephritis leading to renal failure are described. This combination of features appears to represent a unique syndrome distinct from previous reports of microcephaly in association with the nephrotic syndrome. The mode of inheritance is likely to be autosomal recessive.
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Affiliation(s)
- R S Houlston
- Department of Clinical Genetics, Royal Free Hospital School of Medicine, Hampstead, London, UK
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