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Oluwarotimi AC, Ogundana OM, Gbotolorun OM, James O, Adebule O. Odontogenic Tumours: A Clinicopathologic Appraisal of Cases seen in a Nigerian Tertiary Hospital using 2017 WHO Classification. West Afr J Med 2023; 40:914-919. [PMID: 37767673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
BACKGROUND Odontogenic tumours (OT) are a group of diverse lesions seen in the maxillofacial region. They are categorized according to their tissues of origin as; epithelial, mesenchymal or mixed tumours. OBJECTIVES The aim of this study is to present the proportion of odontogenic tumours seen in Lagos University Teaching Hospital using the 2017 WHO classification. METHODS Data from cases of OT histologically diagnosed from January 2006 to December 2016 were collected from records of the Oral and Maxillofacial Surgery and Oral and Maxillofacial Pathology Departments. Information on age, sex, site of occurrence and histologic diagnosis were recorded. After reconfirmation of diagnosis, cases were categorized according to the latest World Health Organization (WHO) classification for OT. Ethical approval was obtained and data was analyzed using SPSS software for Windows (version 22: SPSS, Chicago IL). RESULTS A total of 232 odontogenic tumours were diagnosed during the period of study, 227(97.8%) cases were benign OT and 82.8% occurred in the mandible. The mean age ± SD of patients was 32.1±13.8 years and the age range from 2-73 years. OT was slightly more common in females (119) with an almost equal male-to-female ratio of 1:1.1. Most of the patients were in the 21-30 year age group and ameloblastoma 148(63.8%) was the most common OT. The histological types of odontogenic tumours and the age group of patients were significantly associated with the site of occurrence of tumours (P=0.000* and P=0.037* respectively). CONCLUSION Epithelial odontogenic tumours are still by far the most common odontogenic tumours.
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Affiliation(s)
- A C Oluwarotimi
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria, P.M.B. 12003, Lagos State, Nigeria
| | - O M Ogundana
- Department of Oral and Maxillofacial Pathology/Biology, College of Medicine, University of Lagos, Lagos, Nigeria, P.M.B. 12003, Lagos State, Nigeria.
| | - O M Gbotolorun
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria, P.M.B. 12003, Lagos State, Nigeria
| | - O James
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos, Nigeria, P.M.B. 12003, Lagos State, Nigeria
| | - O Adebule
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos, Nigeria, P.M.B. 12003, Lagos State, Nigeria
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James O, Sabo VY, Adamson OO, Otoghile B, Adekunle AA, Adeyemo WL, Ladeinde AL, Ogunlewe MO. Presentation and Management of Atypical Orofacial Clefts: A Single-Institution Experience for 13 Year Period. Cleft Palate Craniofac J 2023; 60:133-141. [PMID: 34787018 DOI: 10.1177/10556656211055012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
This study reviews the craniofacial clefts that presented at a Nigerian tertiary health facility, highlighting our experience with the pattern of presentation and surgical care of these patients. A retrospective review of the smile train database and medical records of all individuals who had been diagnosed with any of the Tessier craniofacial clefts and managed between 1st January 2007 and 31st December 2020 was done. The data were presented as numbers and percentages of cases. The cleft clinic of a tertiary health facility and a major cleft referral center in South-West Nigeria. Forty-five patients with craniofacial clefts were managed over the study period. 15.6% had associated syndromes, 2.2% had a family history of similar craniofacial cleft and 11% had a history of a possible teratogen. There were 21 (46.7%) middle clefts, 14(31.1%) lateral clefts and 10(22.2%) oblique clefts. The most common type of cleft was Tessier 0 while the Tessier 6 was the least common type. The median age at surgery was 10 months for male and 5months for female subjects, 15.3% complication rate was found in this study. Four patients had revision surgeries to correct residual deformities in this study. The diverse presentations and occurrence of the rare craniofacial clefts present complex aesthetic and functional problems that require individualized often multidisciplinary care. The execution of a properly planned treatment will reduce complications and the need for revision surgeries.
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Affiliation(s)
- O James
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
| | - V Y Sabo
- Department of Surgery, 291366University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
| | - O O Adamson
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
| | - B Otoghile
- Department of Otorhinolaryngology-Head and Neck Surgery, Federal Medical Centre Yenegoa, Yenegoa, Nigeria
| | - A A Adekunle
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
| | - W L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
| | - A L Ladeinde
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
| | - M O Ogunlewe
- Department of Oral and Maxillofacial Surgery, College of Medicine, 98002University of Lagos, Lagos, Nigeria
- Department of Oral and Maxillofacial Surgery, 291389Lagos University Teaching Hospital, Lagos, Nigeria
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Gowans LJJ, Comnick CL, Mossey PA, Eshete MA, Adeyemo WL, Naicker T, Awotoye WA, Petrin A, Adeleke C, Donkor P, Busch TD, James O, Ogunlewe MO, Li M, Olotu J, Hassan M, Adeniyan OA, Obiri-Yeboah S, Arthur FKN, Agbenorku P, Oti AA, Olatosi O, Adamson OO, Fashina AA, Zeng E, Marazita ML, Adeyemo AA, Murray JC, Butali A. Genome-Wide Scan for Parent-of-Origin Effects in a sub-Saharan African Cohort With Nonsyndromic Cleft Lip and/or Cleft Palate (CL/P). Cleft Palate Craniofac J 2022; 59:841-851. [PMID: 34382870 PMCID: PMC9884465 DOI: 10.1177/10556656211036316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Nonsyndromic cleft lip and/or cleft palate (NSCL/P) have multifactorial etiology where genetic factors, gene-environment interactions, stochastic factors, gene-gene interactions, and parent-of-origin effects (POEs) play cardinal roles. POEs arise when the parental origin of alleles differentially impacts the phenotype of the offspring. The aim of this study was to identify POEs that can increase risk for NSCL/P in humans using a genome-wide dataset. METHODS The samples (174 case-parent trios from Ghana, Ethiopia, and Nigeria) included in this study were from the African only genome wide association studies (GWAS) that was published in 2019. Genotyping of individual DNA using over 2 million multiethnic and African ancestry-specific single-nucleotide polymorphisms from the Illumina Multi-Ethnic Genotyping Array v2 15070954 A2 (genome build GRCh37/hg19) was done at the Center for Inherited Diseases Research. After quality control checks, PLINK was employed to carry out POE analysis employing the pooled subphenotypes of NSCL/P. RESULTS We observed possible hints of POEs at a cluster of genes at a 1 mega base pair window at the major histocompatibility complex class 1 locus on chromosome 6, as well as at other loci encompassing candidate genes such as ASB18, ANKEF1, AGAP1, GABRD, HHAT, CCT7, DNMT3A, EPHA7, FOXO3, lncRNAs, microRNA, antisense RNAs, ZNRD1, ZFAT, and ZBTB16. CONCLUSION Findings from our study suggest that some loci may increase the risk for NSCL/P through POEs. Additional studies are required to confirm these suggestive loci in NSCL/P etiology.
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Affiliation(s)
- LJJ Gowans
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana,Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa, IA, USA
| | - CL Comnick
- Division of Biostatistics and Computational Biology, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - PA Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | - MA Eshete
- Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - WL Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Akoka, Lagos, Nigeria
| | - T Naicker
- Department of Pediatrics, University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, South Africa
| | - WA Awotoye
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa, IA, USA
| | - A Petrin
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa, IA, USA
| | - C Adeleke
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa, IA, USA
| | - P Donkor
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - TD Busch
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa, IA, USA
| | - O James
- Department of Oral and Maxillofacial Surgery, University of Lagos, Akoka, Lagos, Nigeria
| | - MO Ogunlewe
- Department of Oral and Maxillofacial Surgery, University of Lagos, Akoka, Lagos, Nigeria
| | - M Li
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa, IA, USA
| | - J Olotu
- Department of Anatomy, University of Port Harcourt, Nigeria
| | - M Hassan
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa, IA, USA
| | - OA Adeniyan
- NHS Foundation Trust (Queens Hospital, Belvedere Road, Burton-On-Trent), Staffordshire, UK
| | - S Obiri-Yeboah
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - FKN Arthur
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - P Agbenorku
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - AA Oti
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - O Olatosi
- Center for Craniofacial and Dental Genetics, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - OO Adamson
- Department of Oral and Maxillofacial Surgery, University of Lagos, Akoka, Lagos, Nigeria
| | - AA Fashina
- Department of Oral and Maxillofacial Surgery, University of Lagos, Akoka, Lagos, Nigeria
| | - E Zeng
- Division of Biostatistics and Computational Biology, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - ML Marazita
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA,Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - AA Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, Bethesda, MD, USA
| | - JC Murray
- Department of Pediatrics, University of Iowa, Iowa, IA, USA
| | - A Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa, IA, USA
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Daubert MA, Tailor T, James O, Shaw LJ, Douglas PS, Koweek L. Multimodality cardiac imaging in the 21st century: evolution, advances and future opportunities for innovation. Br J Radiol 2020; 94:20200780. [PMID: 33237824 DOI: 10.1259/bjr.20200780] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular imaging has significantly evolved since the turn of the century. Progress in the last two decades has been marked by advances in every modality used to image the heart, including echocardiography, cardiac magnetic resonance, cardiac CT and nuclear cardiology. There has also been a dramatic increase in hybrid and fusion modalities that leverage the unique capabilities of two imaging techniques simultaneously, as well as the incorporation of artificial intelligence and machine learning into the clinical workflow. These advances in non-invasive cardiac imaging have guided patient management and improved clinical outcomes. The technological developments of the past 20 years have also given rise to new imaging subspecialities and increased the demand for dedicated cardiac imagers who are cross-trained in multiple modalities. This state-of-the-art review summarizes the evolution of multimodality cardiac imaging in the 21st century and highlights opportunities for future innovation.
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Affiliation(s)
- Melissa A Daubert
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Tina Tailor
- Division of Cardiothoracic Imaging, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Olga James
- Division of Cardiothoracic Imaging, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Leslee J Shaw
- Department of Radiology, Cornell Medical Center, New York, New York, USA
| | - Pamela S Douglas
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Lynne Koweek
- Division of Cardiothoracic Imaging, Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA
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James O, Erinoso OA, Adamson OO, Sokunbi OJ, Agbogidi FO, Adekunle AA, Ogunlewe AO, Ekure EN, Adeyemo WL, Ladeinde AL, Ogunlewe MO. Risk of congenital cardiovascular anomalies in patients with non-syndromic orofacial cleft: A preliminary case-control study. Niger J Clin Pract 2020; 23:1561-1565. [PMID: 33221782 DOI: 10.4103/njcp.njcp_176_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Orofacial clefts (OCs) are one of the most common craniofacial anomalies and are reported to be associated with congenital cardiovascular anomalies (CCAs). However, there is paucity of data in African populations on the risk of CCAs in OC patients compared to the general population. Aims This study aims to determine the odds of congenital cardiovascular anomalies in patients with OC compared to the general population. Subjects and Methods A case-control study design was used. Case subjects were non-syndromic OC subjects, while controls were non-syndromic subjects without OC. All subjects were thoroughly assessed by a pediatric cardiologist for CCAs; and grouped by OC phenotypic type (cleft lip and/or alveolus, cleft lip and palate, cleft palate only and Tessier cleft). Statistical analysis was done using STATA version 14 (College Station, Texas), and significance was placed at P value ≤0.05. Results A total of 120 subjects (60 cases and 60 controls) were enrolled in the study. In total, 23.3% of the subjects had CCAs. Among the case group, 40% had CCAs compared to 6.7% in the control group. Patent foramen ovale (18.3%) and atrial septal defects (10.0%) were the most common type of CCAs in cases, respectively. Further, cases had significantly higher odds of CCAs compared to controls (OR: 9.3; CI: 2.8, 39.4). Conclusions Our finding reveals that the odds of CCAs are significantly higher in patients with OC than the general population. Future studies could assess the effect of CCAs on surgical outcome.
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Affiliation(s)
- O James
- Department of Oral and Maxillofacial Surgery, University of Lagos; Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - O A Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - O O Adamson
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - O J Sokunbi
- Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - F O Agbogidi
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - A A Adekunle
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - A O Ogunlewe
- Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - E N Ekure
- Department of Paediatrics, Lagos University Teaching Hospital, Idi-Araba; Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria
| | - W L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos; Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - A L Ladeinde
- Department of Oral and Maxillofacial Surgery, University of Lagos; Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - M O Ogunlewe
- Department of Oral and Maxillofacial Surgery, University of Lagos; Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
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Fudim M, Fathallah M, Shaw LK, James O, Samad Z, Piccini JP, Hess PL, Borges-Neto S. The prognostic value of diastolic and systolic mechanical left ventricular dyssynchrony among patients with coronary artery disease and heart failure. J Nucl Cardiol 2020; 27:1622-1632. [PMID: 31392509 DOI: 10.1007/s12350-019-01843-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 07/20/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Prevalence and prognostic value of diastolic and systolic dyssynchrony in patients with coronary artery disease (CAD) + heart failure (HF) or CAD alone are not well understood. METHODS We included patients with gated single-photon emission computed tomography (GSPECT) myocardial perfusion imaging (MPI) between 2003 and 2009. Patients had at least one major epicardial obstruction ≥ 50%. We assessed the association between dyssynchrony and outcomes, including all-cause and cardiovascular death. RESULTS Of the 1294 patients, HF was present in 25%. Median follow-up was 6.7 years (IQR 4.9-9.3) years with 537 recorded deaths. Patients with CAD + HF had a higher incidence of dyssynchrony than patients with CAD alone (diastolic BW 28.8% for the HF + CAD vs 14.7% for the CAD alone). Patients with CAD + HF had a lower survival than CAD alone at 10 years (33%; 95% CI 27-40 vs 59; 95% CI 55-62, P < 0.0001). With one exception, HF was found to have no statistically significant interaction with dyssynchrony measures in unadjusted and adjusted survival models. CONCLUSIONS Patients with CAD + HF have a high prevalence of mechanical dyssynchrony as measured by GSPECT MPI, and a higher mortality than CAD alone. However, clinical outcomes associated with mechanical dyssynchrony did not differ in patients with and without HF.
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Affiliation(s)
- Marat Fudim
- Division of Cardiology, Duke Department of Medicine, 2301 Erwin Road, Durham, NC, 27710, USA.
- Duke Clinical Research Institute, Durham, NC, USA.
| | - Mouhammad Fathallah
- Division of Cardiology, Duke Department of Medicine, 2301 Erwin Road, Durham, NC, 27710, USA
| | - Linda K Shaw
- Division of Cardiology, Duke Department of Medicine, 2301 Erwin Road, Durham, NC, 27710, USA
| | - Olga James
- Division of Nuclear Medicine, Duke Department of Radiology, Durham, NC, USA
| | - Zainab Samad
- Division of Cardiology, Duke Department of Medicine, 2301 Erwin Road, Durham, NC, 27710, USA
| | - Jonathan P Piccini
- Division of Cardiology, Duke Department of Medicine, 2301 Erwin Road, Durham, NC, 27710, USA
- Duke Clinical Research Institute, Durham, NC, USA
| | - Paul L Hess
- VA Eastern Colorado and Health Care System, Denver, CO, USA
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Powell-Chandler A, Boyce K, James O, Scourfield L, Torkington J, Bisson J, Cornish JA. Psychological sequelae of colonic resections. Colorectal Dis 2020; 22:945-951. [PMID: 31981271 DOI: 10.1111/codi.14986] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 01/15/2020] [Indexed: 02/08/2023]
Abstract
AIM The prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in the general population has been estimated to be 5.9%, 3.3% and 4.4% respectively. The aim of this study was to determine whether psychological problems are more prevalent following colorectal surgery. METHOD Patients who had undergone colorectal resection in a 2-year period across four centres were asked to complete validated screening questionnaires for anxiety, depression and PTSD (GAD-7, PHQ-9, PCL-5) 12-48 months after surgery. Risk factors were identified using multiple linear regression analysis. RESULTS After excluding those who had died or received palliative diagnoses, questionnaires were sent to 1150 patients. 371 responded (32.3% response rate); median age 67 (20-99) years; 51% were men. 58% of patients underwent surgery for cancer; 23% had emergency surgery. 28% of patients screened positive for at least one psychological condition, with 20% screening positive for anxiety, 22% for depression and 14% for PTSD. Patients who were younger, women, had surgery as an emergency, for benign conditions, had stomas and had critical care stay were more likely to have poorer psychological outcomes. Multiple linear regression found that only younger age (P = 0.000) and female gender (P = 0.048) were significant risk factors. CONCLUSION The prevalence of anxiety, depression and PTSD appears to be high in patients who have undergone colorectal surgery. Younger patients and women are particularly at risk. Further work is needed to determine how best to prevent, detect and treat people with adverse psychological outcomes following colorectal surgery.
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Affiliation(s)
| | - K Boyce
- Health Education and Improvement Wales, Cardiff, UK
| | - O James
- Health Education and Improvement Wales, Cardiff, UK
| | | | - J Torkington
- Cardiff University, Cardiff, UK.,University Hospital of Wales, Cardiff, UK
| | | | - J A Cornish
- Cardiff University, Cardiff, UK.,University Hospital of Wales, Cardiff, UK.,Royal Glamorgan Hospital, Llantrisant, UK
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Schwartz FR, James O, Kuo PH, Witte MH, Koweek LM, Pabon-Ramos WM. Lymphatic Imaging: Current Noninvasive and Invasive Techniques. Semin Intervent Radiol 2020; 37:237-249. [PMID: 32773949 DOI: 10.1055/s-0040-1713441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
After nearly disappearing, invasive lymphangiography not only has resurged, but new approaches have been developed to guide lymphatic interventions. At the same time, noninvasive lymphatic imaging is playing a larger role in the evaluation of lymphatic pathologies. Lymphangioscintigraphy, computed tomography lymphangiography, and magnetic resonance lymphangiography are increasingly being used as alternatives to invasive diagnostic lymphangiography. The purpose of this article is to review current invasive and noninvasive lymphatic imaging techniques.
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Affiliation(s)
- Fides R Schwartz
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Olga James
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Phillip H Kuo
- Department of Medical Imaging, University of Arizona College of Medicine, Tucson, Arizona
| | - Marlys H Witte
- Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona
| | - Lynne M Koweek
- Department of Radiology, Duke University Medical Center, Durham, North Carolina
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Adalarasu K, Jagannath M, James O. Assessment of Techniques for Teaching School Children with Autism. Ing Rech Biomed 2020. [DOI: 10.1016/j.irbm.2019.10.003] [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: 10/25/2022]
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Kelsey CR, Broadwater G, James O, Chino J, Diehl L, Beaven AW, Chang C, Koontz BF, Prosnitz LR. Phase 2 Study of Dose-Reduced Consolidation Radiation Therapy in Diffuse Large B-Cell Lymphoma. Int J Radiat Oncol Biol Phys 2019; 105:96-101. [PMID: 30858144 PMCID: PMC10171462 DOI: 10.1016/j.ijrobp.2019.02.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 02/04/2019] [Accepted: 02/26/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE To evaluate the feasibility of reducing the dose of consolidation radiation therapy (RT) in diffuse large B-cell lymphoma. METHODS AND MATERIALS This phase 2 study enrolled patients with diffuse large B-cell lymphoma, not otherwise specified and primary mediastinal (thymic) large B-cell lymphoma in complete response on positron emission tomography-computed tomography imaging after ≥4 cycles of a rituximab/anthracycline-containing combination chemotherapy regimen. Consolidation RT used a dose of 19.5 to 20 Gy. The primary endpoint was 5-year freedom from local recurrence. RESULTS Sixty-two patients were enrolled between 2010 and 2016. Stage distribution was as follows: I to II (n = 49, 79%) and III to IV (n = 13, 21%). Bulky disease (defined as ≥7.5 cm or ≥10 cm) was present in 23 (40%) and 16 (28%) patients, respectively. Chemotherapy was R-CHOP (then list the drugs) in 58 (94%) and R-EPOCH (then list the drugs) in 4 (6%) with a median of 6 cycles. With a median follow-up of 51 months, 7 patients developed disease progression (6 outside the RT field, 1 within the RT field). Freedom from local recurrence at 5 years was 98% (90% lower confidence bound, 88%). Progression-free and overall survival at 5 years were 83% and 90%, respectively. CONCLUSIONS With more effective systemic therapy (e.g., addition of rituximab) and more refined chemotherapy response assessment (e.g., positron emission tomography-computed tomography), the dose of RT in combined modality treatment programs may potentially be reduced to 20 Gy. This achieves excellent local control with the potential to decrease acute and long-term side effects.
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Affiliation(s)
- Chris R Kelsey
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina.
| | - Gloria Broadwater
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina
| | - Olga James
- Department of Radiology, Division of Nuclear Medicine, Duke University Medical Center, Durham, North Carolina
| | - Junzo Chino
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Louis Diehl
- Department of Medicine, Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, Durham, North Carolina
| | - Anne W Beaven
- Department of Medicine, Division of Medical Oncology, University of North Carolina Medical Center, Chapel Hill, North Carolina
| | - Catherine Chang
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Bridget F Koontz
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
| | - Leonard R Prosnitz
- Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina
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Crago F, James O, Shea G, Schemann K, Mcgreevy P. An opportunistic pilot study of radiographs of equine nasal bones at the usual site of nosebands. J Vet Behav 2019. [DOI: 10.1016/j.jveb.2018.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Background and context: Cervical cancer is the second most commonly-diagnosed cancer among Nigerian women, even though it is one of the most highly-preventable cancers. Worldwide, this most populated country in Africa ranks 10th in terms of cervical cancer mortality and 7 of every 10 Nigerian women diagnosed with cervical cancer annually die annually. With about 47.72 million women aged 15 years and above who are at risk for cervical cancer and median age of first sexual intercourse being 16 years, there is a huge opportunity to prevent cervical cancer deaths through HPV vaccination. Unfortunately, Nigeria has been unable to access GAVI funding for implementation of country-wide HPV vaccination. Hence, most of the HPV vaccination has been by the private sector, NGOs/CSOs and through out-of pocket payments. In spite of this, uptake of HPV vaccines have been reported to be as low as 8% in some studies. Aim: To determine the barriers to uptake of HPV vaccination among mothers of school-age children and opportunities to increase the uptake from the perspective of mothers. Strategy/Tactics: Use qualitative and quantitative methods to gather relevant information about HPV vaccination uptake from all stakeholders including school heads, teachers, school nurses, mothers/guardians and school associations. Program/Policy process: Through funds provided by the American Cancer Society (ACS) and GlaxoSmithkline, Nigeria, we had a one-day HPV vaccination awareness program targeted at school heads, distributed HPV vaccination consent forms, followed-up with awareness in school PTA meetings, gathered data through questionnaires, FGD and KII after a year to determine project effectiveness. Outcomes: Increased understanding of motivators and demotivating factors of HPV vaccination uptake among mothers of school-aged children, increased understanding of strategies to increase uptake and identification of allies in HPV vaccination advocacy. What was learned: 1. There is a need for consistent, “360 campaign” about HPV vaccination as an effective strategy for prevention of cervical cancer targeted at mothers. 2. Since government at federal and state level is unable to access GAVI funding for HPV vaccination, they do have a role to play in validating the effectiveness and safety of HPV vaccines, as well as the efforts of CSOs and NGOs to encourage parents to consent to HPV vaccination for their children. 3. Working in partnership with school associations could be an effective strategy to increasing HPV vaccination uptake among school-aged children. 4. Female teachers are viable advocates for increasing HPV vaccination uptake in schools, if their knowledge is increased and advocacy tools are provided. 5. There is a possibility that reluctance by the government to incorporate awareness of HPV vaccination into its cervical cancer prevention programs is due to its inability to meet the anticipated demand for free HPV vaccination.
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Affiliation(s)
- O. James
- Breast Without Spot, Lagos, Nigeria
| | - O. Onigbogi
- College of Medicine, University of Lagos, Community Health and Primary Care, Lagos, Nigeria
| | - I. Okoye
- Breast Without Spot, Enugu, Nigeria
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James O, Borges-Neto S. Scintigraphic outlook of patients and regions with myocardial necrosis at myocardial perfusion scintigraphy. J Nucl Cardiol 2018; 25:506-507. [PMID: 28176256 DOI: 10.1007/s12350-017-0796-0] [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] [Received: 01/10/2017] [Revised: 01/11/2017] [Indexed: 10/20/2022]
Affiliation(s)
- Olga James
- Duke University, School of Medicine, Department of Radiology, Durham, USA.
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James O, Borges-Neto S. Erratum to: Scintigraphic outlook of patients and regions with myocardial necrosis at myocardial perfusion scintigraphy. J Nucl Cardiol 2018; 25:508. [PMID: 28357810 DOI: 10.1007/s12350-017-0861-8] [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: 10/19/2022]
Affiliation(s)
- Olga James
- Department of Radiology, School of Medicine, Duke University, Durham, USA.
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Eshete MA, Liu H, Li M, Adeyemo WL, Gowans LJJ, Mossey PA, Busch T, Deressa W, Donkor P, Olaitan PB, Aregbesola BS, Braimah RO, Oseni GO, Oginni F, Audu R, Onwuamah C, James O, Augustine-Akpan E, Rahman LA, Ogunlewe MO, Arthur FKN, Bello SA, Agbenorku P, Twumasi P, Abate F, Hailu T, Demissie Y, Hailu A, Plange-Rhule G, Obiri-Yeboah S, Dunnwald MM, Gravem PE, Marazita ML, Adeyemo AA, Murray JC, Cornell RA, Butali A. Loss-of-Function GRHL3 Variants Detected in African Patients with Isolated Cleft Palate. J Dent Res 2017; 97:41-48. [PMID: 28886269 DOI: 10.1177/0022034517729819] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In contrast to the progress that has been made toward understanding the genetic etiology of cleft lip with or without cleft palate, relatively little is known about the genetic etiology for cleft palate only (CPO). A common coding variant of grainyhead like transcription factor 3 ( GRHL3) was recently shown to be associated with risk for CPO in Europeans. Mutations in this gene were also reported in families with Van der Woude syndrome. To identify rare mutations in GRHL3 that might explain the missing heritability for CPO, we sequenced GRHL3 in cases of CPO from Africa. We recruited participants from Ghana, Ethiopia, and Nigeria. This cohort included case-parent trios, cases and other family members, as well as controls. We sequenced exons of this gene in DNA from a total of 134 nonsyndromic cases. When possible, we sequenced them in parents to identify de novo mutations. Five novel mutations were identified: 2 missense (c.497C>A; p.Pro166His and c.1229A>G; p.Asp410Gly), 1 splice site (c.1282A>C p.Ser428Arg), 1 frameshift (c.470delC; p.Gly158Alafster55), and 1 nonsense (c.1677C>A; p.Tyr559Ter). These mutations were absent from 270 sequenced controls and from all public exome and whole genome databases, including the 1000 Genomes database (which includes data from Africa). However, 4 of the 5 mutations were present in unaffected mothers, indicating that their penetrance is incomplete. Interestingly, 1 mutation damaged a predicted sumoylation site, and another disrupted a predicted CK1 phosphorylation site. Overexpression assays in zebrafish and reporter assays in vitro indicated that 4 variants were functionally null or hypomorphic, while 1 was dominant negative. This study provides evidence that, as in Caucasian populations, mutations in GRHL3 contribute to the risk of nonsyndromic CPO in the African population.
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Affiliation(s)
- M A Eshete
- 1 School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.,2 Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.,3 Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - H Liu
- 4 Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, USA.,5 State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine of Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - M Li
- 6 Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - W L Adeyemo
- 7 Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - L J J Gowans
- 8 Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - P A Mossey
- 9 Department of Orthodontics, University of Dundee, Dundee, UK
| | - T Busch
- 6 Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - W Deressa
- 1 School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - P Donkor
- 8 Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - P B Olaitan
- 10 Department of Plastic Surgery, Ladoke Akintola University of Science and Technology, Osogbo, Nigeria
| | - B S Aregbesola
- 11 Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University, Ile Ife, Nigeria
| | - R O Braimah
- 12 Department of Oral and Maxillofacial Surgery, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - G O Oseni
- 10 Department of Plastic Surgery, Ladoke Akintola University of Science and Technology, Osogbo, Nigeria
| | - F Oginni
- 11 Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University, Ile Ife, Nigeria
| | - R Audu
- 13 Department of Virology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - C Onwuamah
- 13 Department of Virology, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - O James
- 7 Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - E Augustine-Akpan
- 6 Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - L A Rahman
- 14 Division of Pediatric Surgery, Department of Surgery, University of Ilorin, Ilorin, Nigeria
| | - M O Ogunlewe
- 7 Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - F K N Arthur
- 8 Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - S A Bello
- 15 State House Clinic, Abuja, Nigeria
| | - P Agbenorku
- 8 Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - P Twumasi
- 8 Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - F Abate
- 2 Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - T Hailu
- 2 Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - Y Demissie
- 2 Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.,3 Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - A Hailu
- 2 Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.,3 Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - G Plange-Rhule
- 8 Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - S Obiri-Yeboah
- 8 Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - M M Dunnwald
- 4 Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, USA
| | - P E Gravem
- 16 Plastic and Reconstructive Surgery Department, Haukeland University Hospital, Bergen, Norway
| | - M L Marazita
- 17 Center for Craniofacial and Dental Genetics, Department of Oral Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - A A Adeyemo
- 18 National Human Genomic Research Institute, Bethesda, MD, USA
| | - J C Murray
- 19 Department of Pediatrics University of Iowa, Iowa City, IA, USA
| | - R A Cornell
- 4 Department of Anatomy and Cell Biology, University of Iowa, Iowa City, IA, USA
| | - A Butali
- 6 Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
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16
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James O, Pagnanelli R, Neto SB. Resolution recovery and noise regularization in nuclear cardiology. J Nucl Cardiol 2017; 24:138-141. [PMID: 27220877 DOI: 10.1007/s12350-016-0532-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 01/25/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Olga James
- Duke University Medical Center, Durham, NC, USA.
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Imran M, Wang L, McCrohon J, Yu C, Huang J, Holloway C, James O, Stehning C, Moffat K, Ross J, Kotlyar E, Hayward C, Keogh A, Macdonald P, Jabbour A. Role of Novel Cardiovascular Magnetic Resonance Based Tissue Characterization in the Detection of Cardiac Transplant Rejection. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kim C, Pabon-Ramos W, Semmel D, Sopko D, James O, Wong T, Smith T, Suhocki P. Predictive factors of an insigificant pulmonary shunt fraction for radioembolization. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.366] [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: 11/27/2022] Open
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19
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Adeyemo WL, James O, Adeyemi MO, Ogunlewe MO, Ladeinde AL, Butali A, Taiwo OA, Emeka CI, Ayodele AOS, Ugwumba CU. An evaluation of surgical outcome of bilateral cleft lip surgery using a modified Millard's (Fork Flap) technique. Afr J Paediatr Surg 2013; 10:307-10. [PMID: 24469478 PMCID: PMC4066456 DOI: 10.4103/0189-6725.125419] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The central third of the face is distorted by the bilateral cleft of the lip and palate and restoring the normal facial form is one of the primary goals for the reconstructive surgeons. The history of bilateral cleft lip repair has evolved from discarding the premaxilla and prolabium and approximating the lateral lip elements to a definitive lip and primary cleft nasal repair utilising the underlying musculature. The aim of this study was to review surgical outcome of bilateral cleft lip surgery (BCLS) done at the Lagos University Teaching Hospital. MATERIALS AND METHODS A review of all cases of BCLS done between January 2007 and December 2012 at the Lagos University Teaching Hospital was done. Data analysis included age and sex of patients, type of cleft deformity and type of surgery (primary or secondary) and whether the cleft deformity was syndromic and non-syndromic. Techniques of repair, surgical outcome and complications were also recorded. RESULTS A total of 39 cases of BCLS involving 21 males and 18 females were done during the period. This constituted 10% (39/390) of all cases of cleft surgery done during the period. There were 5 syndromic and 34 non-syndromic cases. Age of patients at time of surgery ranged between 3 months and 32 years. There were 24 bilateral cleft lip and palate deformities and 15 bilateral cleft lip deformities. Thirty-one of the cases were primary surgery, while 8 were secondary (revision) surgery. The most common surgical technique employed was modified Fork flap (Millard) technique, which was employed in 37 (95%) cases. CONCLUSION Bilateral cleft lip deformity is a common cleft deformity seen in clinical practice, surgical repair of which can be a challenge to an experienced surgeon. A modified Fork flap technique for repair of bilateral cleft lip is a reliable and versatile technique associated with excellent surgical outcome.
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Affiliation(s)
- W L Adeyemo
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria
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20
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Butali A, Adeyemo WL, Mossey PA, Olasoji HO, Onah II, Adebola A, Efunkoya, Akintububo A, James O, Adeosun OO, Ogunlewe MO, Ladeinde AL, Mofikoya BO, Adeyemi MO, Ekhaguere OA, Emeka C, Awoyale TA, The Nigeriacran Collaboration. Prevalence of orofacial clefts in Nigeria. Cleft Palate Craniofac J 2013; 51:320-5. [PMID: 23557093 DOI: 10.1597/12-135] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Orofacial clefts are the most common malformations of the head and neck. In Africa, orofacial clefts are underascertained, with little or no surveillance system in most parts for clefts and other birth defects. A Nigerian craniofacial anomalies study, NigeriaCRAN, was established in 2006 to support cleft research specifically for epidemiological studies, treatment outcomes, and studies into etiology and prevention. We pooled data from seven of the largest Smile Train treatment centers in the six geopolitical zones in Nigeria. Data from September 2006 to June 2011 were analyzed and clefts compared between sides and genders using the Fisher exact test. A total of 2197 cases were identified during the study period, with an estimated prevalence rate of 0.5 per 1000. Of the total number of orofacial clefts, 54.4% occur in males and 45.6% in females. There was a significant difference (P = .0001) between unilateral left clefts and unilateral right clefts, and there was a significant difference (P = .0001) between bilateral clefts and clefts on either the left or right side. A significant gender difference (P = .03) was also observed for cleft palate, with more females than males. A total of 103 (4.7%) associated anomalies were identified. There were nine syndromic cleft cases, and 10.4% of the total number of individuals with clefts have an affected relative. The significant difference between unilateral clefts and the gender differences in the proportion of cleft palate only are consistent with the literature. The present study emphasizes the need for birth defects registries in developing countries in order to estimate the exact prevalence of birth defects including orofacial clefts.
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Shah DJ, Kim HW, James O, Parker M, Wu E, Bonow RO, Judd RM, Kim RJ. Prevalence of regional myocardial thinning and relationship with myocardial scarring in patients with coronary artery disease. JAMA 2013; 309:909-18. [PMID: 23462787 PMCID: PMC3979456 DOI: 10.1001/jama.2013.1381] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
IMPORTANCE Regional left ventricular (LV) wall thinning is believed to represent chronic transmural myocardial infarction and scar tissue. However, recent case reports using delayed-enhancement cardiovascular magnetic resonance (CMR) imaging raise the possibility that thinning may occur with little or no scarring. OBJECTIVE To evaluate patients with regional myocardial wall thinning and to determine scar burden and potential for functional improvement. DESIGN, SETTING, AND PATIENTS Investigator-initiated, prospective, 3-center study conducted from August 2000 through January 2008 in 3 parts to determine (1) in patients with known coronary artery disease (CAD) undergoing CMR viability assessment, the prevalence of regional wall thinning (end-diastolic wall thickness ≤5.5 mm), (2) in patients with thinning, the presence and extent of scar burden, and (3) in patients with thinning undergoing coronary revascularization, any changes in myocardial morphology and contractility. MAIN OUTCOMES AND MEASURES Scar burden in thinned regions assessed using delayed-enhancement CMR and changes in myocardial morphology and function assessed using cine-CMR after revascularization. RESULTS Of 1055 consecutive patients with CAD screened, 201 (19% [95% CI, 17% to 21%]) had regional wall thinning. Wall thinning spanned a mean of 34% (95% CI, 32% to 37% [SD, 15%]) of LV surface area. Within these regions, the extent of scarring was 72% (95% CI, 69% to 76% [SD, 25%]); however, 18% (95% CI, 13% to 24%) of thinned regions had limited scar burden (≤50% of total extent). Among patients with thinning undergoing revascularization and follow-up cine-CMR (n = 42), scar extent within the thinned region was inversely related to regional (r = -0.72, P < .001) and global (r = -0.53, P < .001) contractile improvement. End-diastolic wall thickness in thinned regions with limited scar burden increased from 4.4 mm (95% CI, 4.1 to 4.7) to 7.5 mm (95% CI, 6.9 to 8.1) after revascularization (P < .001), resulting in resolution of wall thinning. On multivariable analysis, scar extent had the strongest association with contractile improvement (slope coefficient, -0.03 [95% CI, -0.04 to -0.02]; P < .001) and reversal of thinning (slope coefficient, -0.05 [95% CI, -0.06 to -0.04]; P < .001). CONCLUSIONS AND RELEVANCE Among patients with CAD referred for CMR and found to have regional wall thinning, limited scar burden was present in 18% and was associated with improved contractility and resolution of wall thinning after revascularization. These findings, which are not consistent with common assumptions, warrant further investigation.
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Affiliation(s)
- Dipan J Shah
- Duke Cardiovascular MRI Center, DUMC 3934, Durham, NC 27710, USA
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Affiliation(s)
- W.L. Adeyemo
- Faculty of Dental Sciences, College of Medicine, University of Lagos, Nigeria
| | - B.O. Mofikoya
- Faculty of Clinical Sciences, College of Medicine, University of Lagos, Nigeria
| | - O.A. Akadiri
- Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Nigeria
| | - O. James
- Faculty of Dentistry, University of Maiduguri, Nigeria
| | - A.A. Fashina
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Nigeria
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Arotiba GT, Effiom AO, Ayodele ASO, Ogundana MO, Gbotolorun MO, Olasoji HO, James O, Ladeinde AL, Ugboko VI, Ndukwe KC, Ikem IC, Braimah RO. A classification system for recurrent ameloblastoma of the jaws--review of 30 cases in Nigerians. Nig Q J Hosp Med 2012; 22:44-51. [PMID: 23175880] [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: 06/01/2023]
Abstract
This paper reviewed the clinicopathologic presentation of recurrent ameloblastoma in 30 Nigerian patients at three tertiary referral centers with the sole objective of developing a classification system. Most recurrences occurred in patients in their 3rd decade of life (20-29years) and males were more frequently affected than females (1.5 to 1). Though enucleation resulted in the highest rate of recurrences (30%), hemi-mandibulectomy also resulted in a 20% recurrence rate. Majority of the recurrences occurred within 5 to 9 years after primary surgery. Most primary jaw sites of the lesion corresponded with the primary jaw sites of the recurrent tumor which in itself may be a reflection of inadequate primary treatment. The most frequent anatomic site of primary tumors that recurred was c4 (highest level of ramus involvement). The most frequent anatomic classification of the recurrent tumors was recurrence at one bone margin (Bla) and recurrence at intervening /adjacent soft tissues between the resected bone edges (Blc). Mandible to maxilla recurrence increases the likelihood of extension to the skull and brain.
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Affiliation(s)
- G T Arotiba
- Department of Oral & Maxillofacial Surgery, Faculty of Dental Sciences, Lagos University Teaching Hospital, Lagos.
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Ogunlewe MO, James O, Ajuluchukwu JNA, Ladeinde AL, Adeyemo WL, Gbotolorun OM. Evaluation of haemodynamic changes in hypertensive patients during tooth extraction under local anaesthesia. W INDIAN MED J 2011; 60:91-95. [PMID: 21809720] [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: 05/31/2023]
Abstract
OBJECTIVE This study was conducted to determine the changes in blood pressure and the pulse rate of patients with controlled hypertension having dental extraction under local anaesthesia utilizing 2% lignocaine with adrenaline, and to evaluate whether these changes in blood pressure were are attributable to addition of adrenaline. METHODS This prospective study was carried out in 33 consecutive hypertensive patients who presented at the exodontia clinic of the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, from December 2004 to August 2005 for intra-alveolar tooth extraction. Patients were randomly allocated to two groups according to the type of anaesthetic solution employed. Group A had tooth extraction done under 2% lignocaine with 1:80 000 adrenaline while group B had tooth extraction done under 2% lignocaine without vasoconstrictor (plain lignocaine). One tooth was extracted from each patient. Blood pressure and pulse rate measurements were recorded in the waiting room before surgery, in the surgery after local anaesthetic injection, during tooth extraction and 15 minutes after tooth extraction. RESULTS The sample consisted of 20 females and 13 males age range 24 to 75 years (mean +/- SD = 50.1 +/- 11.7 years). There was no statistically significant difference between the systolic and diastolic blood pressure and pulse rate in the two groups after administration of local anaesthesia. However the highest alteration in parameters was observed during tooth extraction in the two groups. CONCLUSION The haemodynamic changes induced by injecting 2% lignocaine with adrenaline in patients with controlled hypertension during tooth extraction is within normal range and is not different from that induced by 2% lignocaine without adrenaline. We consider it essential that all precautions to prevent inadvertent intravascular injection be undertaken by the care provider.
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Affiliation(s)
- M O Ogunlewe
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Lagos, Nigeria.
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Collerton J, Davies K, Jagger C, Kingston A, Eccles M, James O, Bond J, Robinson L, Von Zglinicki T, Martin-Ruiz C, Kirkwood T. Health and disease in a UK cohort of 85-year-olds: the Newcastle 85+ study. Br J Soc Med 2009. [DOI: 10.1136/jech.2009.096727t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ogunlewe MO, Agbelusi GA, Gbotolorun OM, James O. A review of temporomandibular joint disorders (TMD's) presenting at the Lagos University Teaching Hospital. Nig Q J Hosp Med 2008; 18:57-60. [PMID: 19068552 DOI: 10.4314/nqjhm.v18i2.44980] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To evaluate the patterns of presentation of Temporomandibular joint Disorders (TMDs) in our institution in a 6 year period. PATIENT AND METHODS A retrospective study of patients who presented in the Oral Medicine and Oral and Maxillofacial surgery clinics of the Lagos University Teaching Hospital (LUTH) between January 2000 and December 2005 with TMDs was done. Case files of these patients were retrieved and data collected included patients' age, sex, presenting complains and history of associated risk factors. Also collected were findings on clinical examination and mode of treatment. The data collected were evaluated and descriptive analysis was used as appropriate. RESULT A total of 94 patients were seen. There were 55 males (58.5%) and 39 female (41.5%), male to female ratio was ratio was 1.5:1. The age ranged from 13 to 98 years (mean age 42.7 +/- 16.4 years). Majority, 59 (62.8%) of the patients seen were between the ages of 20 and 49 years. Nine (9.6%) had a previous history of stress, 18 (19.1%) a previous history of trauma while 5 (5.3%) had a history of associated habits. Pain was the most common presenting complaint. It occurred as a singular presenting complaint in 66 (70.2%) patients and in association with other complaints in 10 (10.6%) patients. Conservative management was the treatment of choice in all cases. CONCLUSION Most patients with TMD in the studied environment are middle aged in agreement with the literature. However, there were more reported cases in males in contrast to previous studies. Previous history of trauma and stress were important risk factors elicited from patients with TMD in this study.
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Affiliation(s)
- M O Ogunlewe
- Department of Oral Medicine, College of Medicine University of Lagos, Nigeria
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Adeyemo WL, James O, Ogunlewe MO, Ladeinde AL, Taiwo OA, Olojede ACO. Indications for extraction of third molars: a review of 1763 cases. Niger Postgrad Med J 2008; 15:42-46. [PMID: 18408783] [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: 05/26/2023]
Abstract
OBJECTIVE Third molars have been described as different from other teeth in the oral cavity. They have the highest rate of developmental abnormalities and, most importantly, are last in the eruption sequence. We investigated reasons for third molar teeth extraction in patients attending the outpatient oral surgery clinic of the Lagos University Teaching Hospital, Nigeria. MATERIALS AND METHODS A retrospective review of patients who had third molar extractions between January 2001 and June 2006 was conducted. Data retrieved and analysed were: age and sex of patients, indication for extractions, type of teeth extracted, technique of extractions (surgical and non-surgical) and angulations of impaction in case of impacted lower third molars. RESULTS A total of 1763 patients (mean age +/-SD, 33.74+/- 13.3 years; range 15 - 92 years) had their third molars extracted during the period. Majority (58%) of them were females. Surgical extraction was carried out in 506 (28.7%) patients while 1257 (71.3%) patients had non-surgical extractions. Caries and its sequela (63.2%) was the major reason for teeth extraction followed by recurrent pericoronitis (26.3%) and periodontitis (9.2%). Only 11 (0.6%) cases were removed for prophylactic reason. Patients who had their teeth removed for caries were significantly younger than those for periodontitis (P=0.000) but older than those for pericoronitis (P=0.000). CONCLUSIONS Caries and periodontal diseases occurring in relatively older age group were the major reasons for non-surgical extraction of third molars while recurrent pericoronitis occurring in relatively younger age was the major reason for surgical extraction of impacted third molars. Prophylactic surgical extraction of third molars is not a common practice in our environment.
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Affiliation(s)
- W L Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Nigeria.P.M.B 12003, Lagos, Nigeria.
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Abstract
BACKGROUND Maxillofacial fractures in children are rare when compared to those occurring in adults. To establish the incidence, pattern, and aetiology of maxillofacial fractures in children aged 15 years and below in Lagos, Nigeria. DESIGN A review of patients with maxillofacial fractures aged 15 years and below seen and treated at the Lagos University Teaching Hospital, Lagos, Nigeria between January 1997 and December 2004 was conducted. RESULTS Of the 225 patients with maxillofacial fractures seen within the study period, 37 (16.4%) were children aged 15 years and below, with a male-to-female ratio of 1.5 : 1. The highest incidence recorded was found within the age group 12-15 years (41%), with the lowest incidence occurring in the age group 0-5 years (27%). Multiple fractures were commoner in older patients (P > 0.05), and in boys (P > 0.05). There were no statistically significant relationships between the age of the patients, gender distribution, and mechanisms of injury. Road traffic crashes were the most common aetiological factor (64.9%), with the mandible being the most involved facial bone (63.8%). Majority of the mandibular fractures (33.3%) were located in parasymphyseal region. Zygomatic complex fractures were the most common in the mid-facial region. Most of the fractures (81.1%) were immobilized by simple methods (arch bars, eyelet wires, acrylic splint with circum-mandibular wiring) with or without intermaxillary fixation. Of the cases, 18.9% were managed conservatively. CONCLUSION The incidence of facial fractures in this study was found to be higher than previously reported in Nigeria and worldwide, with almost two-thirds of cases a result of road traffic crashes. There is a need to enforce legislation aimed at preventing road traffic crashes to reduce maxillofacial injuries in children.
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Affiliation(s)
- M O Ogunlewe
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Nigeria.
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Adeyemo WL, Ogunlewe MO, Ladeinde AL, James O. Closure of oro-antral fistula with pedicled buccal fat pad. A case report and review of literature. ACTA ACUST UNITED AC 2004. [DOI: 10.4314/ajoh.v1i1.31304] [Citation(s) in RCA: 17] [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: 11/17/2022]
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Abstract
OBJECTIVES Graves' disease is associated with different human leucocyte antigen (HLA) genes in different populations. This studywasdesigned to examinethe HLA class II associations with Graves' disease in Jamaicans. PATIENTS One hundred and six Jamaicans with Graves' disease and 104 controls. DESIGN Oligotyping for HLA-DRB1, DRB3, DQA1 and DQB1 alleles was performed using the polymerase chain reaction sequence specific oligonucleotide probe (PCR-SSOP) technique. RESULTS The frequency of HLA-DRB3 *0101 was increased significantly in the patients compared to controls (38.7% vs. 19.2%; RR = 2.72; Pc < 0.015). The protective alleles for Graves' disease were DRB1 *0901 (0.9% vs. 20.2%; RR = 0.04; Pc < 0.001), DRB1*1001 (0.0% vs. 11%; RR = 0.0%; Pc < 0.01) and DRB4 *0101 (0.0% vs. 12.5%; RR = 0.0; Pc < 0.05). A high female to male ratio of Graves' disease, 25 :1, was observed. Other associated autoimmune diseases were rare and no significant HLA class II associations were found with clinical markers of disease. CONCLUSIONS Jamaican patients with Graves' disease share the DRB3 *0101 susceptible allele and the DRB4 *01 protective allele but not the susceptible haplotype DRB1 *0301, DRB3*0101, DQA1*0501 with Caucasians.
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Affiliation(s)
- M F Smikie
- Department of Microbiology, University of the West Indies, Jamaica.
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32
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Sambhara S, Kurichh A, Miranda R, Tumpey T, Rowe T, Renshaw M, Arpino R, Tamane A, Kandil A, James O, Underdown B, Klein M, Katz J, Burt D. Heterosubtypic immunity against human influenza A viruses, including recently emerged avian H5 and H9 viruses, induced by FLU-ISCOM vaccine in mice requires both cytotoxic T-lymphocyte and macrophage function. Cell Immunol 2001; 211:143-53. [PMID: 11591118 DOI: 10.1006/cimm.2001.1835] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Induction of heterosubtypic immunity to influenza viral antigens is of paramount importance to the prevention of epidemics and potential pandemics. The 1997 incidence of avian influenza infections in humans in Hong Kong heightened the need for pandemic preparedness and a search for vaccines and vaccine delivery systems that can confer broad protection. In this report, we demonstrate that the delivery of H1N1 subtype influenza viral antigens as immunostimulating complexes (ISCOM) induces broad cross-protection in mice against challenge with various influenza virus subtypes, including the avian H9 and the H5 strains that were recently responsible for deaths in humans. The ISCOM delivery system induced high and long-lived serum antiviral antibodies and class I-restricted cytotoxic T-lymphocytes (CTL). Studies with perforin, IFN-gamma, and mu-chain gene knock-out mice demonstrated that the heterosubtypic protection required cross-reactive, functional cytotoxic T cells and nonhemagglutination inhibiting serum antibodies. Interferon-gamma, a major player in viral clearance by nonlytic mechanisms, did not appear to play a role in heterosubtypic immunity. Nonformulated H1N1 influenza antigens failed to induce significant CTL or long-lasting antibody responses or to protect mice against challenge with heterosubtypic viruses. Furthermore, while influenza virus infection induced a dominant nucleoprotein (NP)-specific CTL response in H2 mice, the ISCOM delivery system induced a dominant hemagglutinin-specific CTL response. Moreover, non-neutralizing but cross-reactive antibodies played a role in reducing viral titers by macrophages. These results suggest that exogenous delivery of influenza antigens as ISCOM can influence their antigen processing and presentation, their ability to induce/recall CTL specificities, and their capacity to mediate broad cross-protection against influenza virus variants.
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Affiliation(s)
- S Sambhara
- Aventis Pasteur Canada Ltd., 1755 Steeles Avenue West, Toronto, Ontario, M2R 3T4, Canada
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Abstract
BACKGROUND Primary biliary cirrhosis (PBC) is increasingly being diagnosed in the earlier non-cholestatic stages of disease. Accepted wisdom has been that PBC is frequently complicated by osteoporosis. Whether this association holds true for the broader spectrum of PBC patients now recognised has not as yet been studied. AIMS To examine the extent to which osteoporosis occurs more commonly in PBC patients than in normal individuals of the same age and sex. DESIGN Retrospective review of a large cohort of well characterised PBC patients. PATIENTS A total of 272 PBC patients with definite or probable PBC followed up for a mean of 10.1 years (total follow up 2726 patient years) who had at least one bone mineral density measurement (BMD). RESULTS In this unselected group of PBC patients, mean Z scores (number of SDs from age and sex matched normal mean values) at the neck of femur (NOF) and lumbar spine (LS) at first BMD measurement (7 (6) years after PBC diagnosis) were -0.1 (1.4) and 0.1 (1.4), respectively. At first BMD measurement, 18 PBC patients had Z scores less than -2.0 and 85 had T scores less than -2.5. No factors predictive of osteoporosis were found in affected patients. A total of 957 BMD measurements were performed (0.35 per patient year of follow up); 220 patients had two or more measurements. No patient went on to develop de novo osteoporosis during follow up. In the 51 patients (who were clinically representative of the whole group) who received no PBC or bone related treatment during follow up, %BMD changes per year at the NOF and LS were -1.6 (3.2) and 0.1 (2.2), respectively. No variance in this "natural" rate of BMD measurement was seen in patients receiving PBC modulating agents (including prednisolone and UDCA) or osteoporosis prophylaxis/therapy. Significant improvement at the LS was seen in patients undergoing liver transplantation. CONCLUSIONS Osteoporosis is not a specific complication of PBC.
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Affiliation(s)
- J Newton
- Centre for Liver Research, University of Newcastle, Newcastle upon Tyne, UK
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Sambhara S, Kurichh A, Miranda R, James O, Underdown B, Klein M, Tartaglia J, Burt D. Severe impairment of primary but not memory responses to influenza viral antigens in aged mice: costimulation in vivo partially reverses impaired primary immune responses. Cell Immunol 2001; 210:1-4. [PMID: 11485346 DOI: 10.1006/cimm.2001.1799] [Citation(s) in RCA: 28] [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: 11/22/2022]
Abstract
Profound alterations in humoral and cellular immune responses are a hallmark of aging, and understanding the immunobiology of aging is key to the success of preventive vaccination strategies. With aging, while recall or memory responses to influenza viral antigens for the most part remained unaltered, primary immune responses are severely impaired. The impaired primary responses are partly due to a lack of costimulation, as providing costimulation at the time of induction of primary immune responses against influenza virus vaccine partially reversed aged-related immune dysfunction and conferred enhanced protection. Inclusion of immunomodulators that up-regulate the expression of costimulatory molecules must be considered to improve the efficacy of vaccination in the elderly, particularly to novel immunogens.
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Affiliation(s)
- S Sambhara
- Aventis Pasteur Canada, Ltd., Research Center, 1755 Steeles Avenue West, North York, Ontario, M2R 3T4, Canada
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Donaldson P, Agarwal K, Craggs A, Craig W, James O, Jones D. HLA and interleukin 1 gene polymorphisms in primary biliary cirrhosis: associations with disease progression and disease susceptibility. Gut 2001; 48:397-402. [PMID: 11171832 PMCID: PMC1760119 DOI: 10.1136/gut.48.3.397] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Twin and family studies suggest that there is a genetic component to primary biliary cirrhosis (PBC) but the genetic associations which have been described are weak with marked variations between centres. PBC is heterogeneous and genetic associations with disease progression may be obscured when the PBC population is analysed only as a whole and not subdivided. METHODS We have investigated two candidate gene loci in 164 well characterised patients, 88 (54%) of whom had advanced disease. RESULTS There was an increased frequency of the HLA DRB1*0801-DQA1*0401-DQB1*0402 haplotype in patients who had progressed to late stage disease (23% v 2% of controls; p=0000044; odds ratio (OR) 15.5, 95% confidence interval (CI) 3.52-68.4) but not in those with early stage disease (4% v 2%). Patients had a higher frequency of the IL-1B*1,1 genotype and lower frequencies of the IL-1B*1,2 and *2,2 genotypes (p=0.00078; OR 2.37, 95% CI 1.38-4.06), and higher frequency of the IL-1RN*1,1 genotype and lower frequency of the IL-1RN*1,2 genotype (p=0.0011; OR 2.28, 95% CI 1.34-3.89). The difference in the IL-1B*1,1 genotype distribution was most marked in patients with early stage disease (77% v 43% of controls; p=0.000003; OR 4.8, 95% CI 2.31-10) but the IL-1RN genotype distribution was similar in patients with early and late stage disease. CONCLUSIONS These data indicate a complex relationship between immunoregulatory genes and PBC. While the IL-1 genes are markers of both disease susceptibility and progression, HLA genes appear to be principally associated with disease progression.
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Affiliation(s)
- P Donaldson
- Centre for Liver Research, 4th Floor Willliam Leech Building, University of Newcastle, The Medical School, Framlington Place, Newcastle-upon-Tyne NE2 4HH, UK.
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Li X, Sambhara S, Li CX, Ettorre L, Switzer I, Cates G, James O, Parrington M, Oomen R, Du RP, Klein M. Plasmid DNA encoding the respiratory syncytial virus G protein is a promising vaccine candidate. Virology 2000; 269:54-65. [PMID: 10725198 DOI: 10.1006/viro.2000.0186] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Respiratory syncytial virus (RSV) remains a major cause of severe respiratory diseases in infants, young children, and the elderly. However, development of a RSV vaccine has been hampered by the outcome of the infant trials in the 1960s with a formalin-inactivated RSV preparation. Enhanced lung disease was induced by the vaccination post-RSV exposure. Previous studies in mice primed with RSV G protein either formulated in adjuvants or delivered by recombinant vaccinia viruses have indicated that enhanced lung pathology resulted from a Th2-type host immune response against the viral G protein. However, in the present report, we have demonstrated that vaccination with plasmid vectors encoding either a full-length or a secreted G protein (DNA-G) clearly elicited balanced systemic and pulmonary Th1/Th2 cytokine responses in mice and did not induce an atypical pulmonary inflammatory reaction post-RSV challenge in cotton rats. DNA-G immunization also induced marked virus neutralizing antibody responses and protection against RSV infection of the lower respiratory tract of both mice and cotton rats. So far, only genetic immunization has been able to induce a balanced Th1/Th2 response with the RSV G protein, reminiscent of that induced by live RSV. Therefore, DNA-G is a promising immunogen for inclusion in a nucleic acid RSV vaccine.
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MESH Headings
- Animals
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Cytokines/analysis
- Cytokines/genetics
- Cytokines/immunology
- HN Protein
- Immunoglobulin G/blood
- Immunoglobulin G/immunology
- Inflammation/immunology
- Inflammation/pathology
- Lung/immunology
- Lung/metabolism
- Lung/pathology
- Lung/virology
- Male
- Mice
- Mice, Inbred BALB C
- Plasmids/administration & dosage
- Plasmids/genetics
- Plasmids/immunology
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Rats
- Respiratory Syncytial Virus Infections/immunology
- Respiratory Syncytial Virus Infections/pathology
- Respiratory Syncytial Virus Infections/prevention & control
- Respiratory Syncytial Virus Infections/virology
- Respiratory Syncytial Viruses/genetics
- Respiratory Syncytial Viruses/immunology
- Sigmodontinae
- Spleen/immunology
- T-Lymphocytes, Cytotoxic/immunology
- Th1 Cells/immunology
- Th2 Cells/immunology
- Vaccination
- Vaccines, DNA/administration & dosage
- Vaccines, DNA/adverse effects
- Vaccines, DNA/genetics
- Vaccines, DNA/immunology
- Viral Envelope Proteins
- Viral Proteins/genetics
- Viral Proteins/immunology
- Viral Vaccines/administration & dosage
- Viral Vaccines/adverse effects
- Viral Vaccines/genetics
- Viral Vaccines/immunology
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Affiliation(s)
- X Li
- Research Center, Pasteur Mérieux Connaught Canada, 1755 Steeles Avenue West, North York, Ontario, M2R 3T4, Canada
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37
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Affiliation(s)
- J Neuberger
- Liver Unit, Queen Elizabeth Hospital, Birmingham, UK.
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38
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Affiliation(s)
- O James
- Centre for Liver Research, Medical School, University of Newcastle, Newcastle upon Tyne, UK
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39
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Sambhara S, Kurichh A, Miranda R, Tamane A, Arpino R, James O, McGuinness U, Kandil A, Underdown B, Klein M, Burt D. Enhanced immune responses and resistance against infection in aged mice conferred by Flu-ISCOMs vaccine correlate with up-regulation of costimulatory molecule CD86. Vaccine 1998; 16:1698-704. [PMID: 9778744 DOI: 10.1016/s0264-410x(98)00130-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ageing is associated with a decline in immune function and our primary objective is to 'reverse' age-related decline in protective immune responses to vaccination by formulating vaccines in appropriate delivery systems. In this paper, we demonstrate that influenza vaccine formulated as ISCOMs is highly immunogenic and confers protection in aged mice, when compared to current influenza vaccine. The enhanced protection conferred by Flu-ISCOMs in aged mice correlates with the up-regulation of co-stimulatory molecule, CD86 (B7.2) and to a lesser extent, CD80 (B7.1) expression on antigen presenting cells.
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Affiliation(s)
- S Sambhara
- Pasteur Mérieux Connaught Canada, Research Center, North York, Ontario, Canada.
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Li X, Sambhara S, Li CX, Ewasyshyn M, Parrington M, Caterini J, James O, Cates G, Du RP, Klein M. Protection against respiratory syncytial virus infection by DNA immunization. J Exp Med 1998; 188:681-8. [PMID: 9705950 PMCID: PMC2213364 DOI: 10.1084/jem.188.4.681] [Citation(s) in RCA: 95] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Respiratory syncytial virus (RSV) remains a major cause of morbidity and mortality in infants and the elderly and is a continuing challenge for vaccine development. A murine T helper cell (Th) type 2 response associates with enhanced lung pathology, which has been observed in past infant trials using formalin-inactivated RSV vaccine. In this study, we have engineered an optimized plasmid DNA vector expressing the RSV fusion (F) protein (DNA-F). DNA-F was as effective as live RSV in mice at inducing neutralizing antibody and cytotoxic T lymphocyte responses, protection against infection, and high mRNA expression of lung interferon gamma after viral challenge. Furthermore, a DNA-F boost could switch a preestablished anti-RSV Th2 response towards a Th1 response. Critical elements for the optimization of the plasmid constructs included expression of a secretory form of the F protein and the presence of the rabbit beta-globin intron II sequence upstream of the F-encoding sequence. In addition, anti-F systemic immune response profile could be modulated by the route of DNA-F delivery: intramuscular immunization resulted in balanced responses, whereas intradermal immunization resulted in a Th2 type of response. Thus, DNA-F immunization may provide a novel and promising RSV vaccination strategy.
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MESH Headings
- Animals
- Antibodies, Viral/immunology
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Cells, Cultured
- Disease Models, Animal
- Drug Administration Routes
- Genetic Vectors
- HN Protein
- Humans
- Interferon-gamma/immunology
- Interleukin-4/immunology
- Interleukin-5/immunology
- Lung/immunology
- Male
- Mice
- Mice, Inbred BALB C
- Plasmids
- Rabbits
- Respiratory Syncytial Virus Infections/immunology
- Respiratory Syncytial Virus Infections/prevention & control
- Respiratory Syncytial Virus, Human/genetics
- Respiratory Syncytial Virus, Human/immunology
- Th1 Cells/immunology
- Th2 Cells/immunology
- Vaccination
- Vaccines, DNA/genetics
- Vaccines, DNA/immunology
- Viral Envelope Proteins
- Viral Fusion Proteins/genetics
- Viral Fusion Proteins/immunology
- Viral Proteins/genetics
- Viral Proteins/immunology
- Viral Vaccines/genetics
- Viral Vaccines/immunology
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Affiliation(s)
- X Li
- Research Centre, Pasteur Mérieux Connaught Canada, North York, Ontario, Canada M2R 3T4.
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41
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Sambhara S, Switzer I, Kurichh A, Miranda R, Urbanczyk L, James O, Underdown B, Klein M, Burt D. Enhanced antibody and cytokine responses to influenza viral antigens in perforin-deficient mice. Cell Immunol 1998; 187:13-8. [PMID: 9681998 DOI: 10.1006/cimm.1998.1314] [Citation(s) in RCA: 32] [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: 11/22/2022]
Abstract
Cytotoxic T lymphocytes (CTL) lyse virus-infected target cells by secreting the pore-forming effector molecule, perforin. Perforin-mediated cell death appears to be a major mechanism in viral clearance but its role in regulating immune responses in vivo is unclear. In this report, we show that following immunization with influenza viral antigens, perforin-deficient mice generated about 100-fold greater serum antibody responses than wild-type mice. Further, immune spleen cells from perforin knock-out mice secreted over 10-fold more IFN-gamma following in vitro restimulation than immune spleen cells from control mice. Finally, there were over 10-fold more IFN-gamma-secreting cells in cultures from perforin-deficient mice than those from control mice, suggesting that the enhanced cytokine release by T cells from perforin-deficient mice is due to an increase in the effector cell pool. Collectively, these results suggest that perforin-mediated effector function is required in the down-regulation of the immune response by way of limiting antigen-presenting cell function.
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Affiliation(s)
- S Sambhara
- Pàsteur Mérieux Connaught Canada, Research Centre, North York, Ontario, Canada
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Ochieng J, Green B, Evans S, James O, Warfield P. Modulation of the biological functions of galectin-3 by matrix metalloproteinases. Biochim Biophys Acta 1998; 1379:97-106. [PMID: 9468337 DOI: 10.1016/s0304-4165(97)00086-x] [Citation(s) in RCA: 107] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Galectin-3 is an important intracellular and extracellular lectin which is presumed to interact with extracellular matrix proteins and cell surface glycoproteins in normal and pathophysiological conditions. The exact physiological role of the protein is presently not known. We have previously demonstrated that recombinant human galectin-3 is a novel substrate for metalloproteinases, particularly MMP-2 and MMP-9. These enzymes are capable of efficiently cleaving the Ala62-Tyr63 bond of the ca. 30 kDa galectin-3, generating a 22 kDa fragment with intact carbohydrate recognition domain and a ca. 9 kDa polypeptide comprising the amino terminal end of the intact galectin-3. In this study, we analyzed interactions of the 22 kDa fragment of galectin-3 with immobilized laminins. We have also compared the hemagglutination as well as homodimerization potentials of this fragment with that of intact galectin-3. Our data suggest that cleavage of galectin-3 by metalloproteinases; (a) alters the carbohydrate recognition domain of the lectin so that it binds more tightly to the glycoconjugates and, (b) reduces selfassociation of the galectin molecules thereby abrogating the biological properties dependent on such associations or homodimerization.
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Affiliation(s)
- J Ochieng
- Department of Biochemistry, Meharry Medical College, Nashville TN 37208, USA.
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Gani A, Rodgers H, Dobson R, Murphy J, Herd B, James O, Thomson R. The Tees Stroke Register: The Value of Multiple Sources of Case Ascertainment. Age Ageing 1998. [DOI: 10.1093/ageing/27.suppl_2.54-a] [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: 11/12/2022] Open
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Davies D, Oates J, Close P, Rodgers H, James O, Gibson G. Obstructive Sleep Apnoea and Stroke. A Case-Control Study in First-Ever Stroke. Age Ageing 1998. [DOI: 10.1093/ageing/27.suppl_1.p66-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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45
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Chong P, Chan N, Kandil A, Tripet B, James O, Yang YP, Shi SP, Klein M. A strategy for rational design of fully synthetic glycopeptide conjugate vaccines. Infect Immun 1997; 65:4918-25. [PMID: 9393776 PMCID: PMC175709 DOI: 10.1128/iai.65.12.4918-4925.1997] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The present study describes a strategy to rationally design fully synthetic glycopeptide conjugate vaccines. Glycopeptide immunogens were constructed by coupling synthetic oligosaccharides comprising repeating units of synthetic 3-beta-D-ribose-(1-1)-D-ribitol-5-phosphate (sPRP) to synthetic peptides containing potent T-helper cell determinants and B-cell epitopes of the Haemophilus influenzae type b (Hib) outer membrane proteins (OMPs) P1, P2, and P6. Rabbit immunogenicity studies revealed that some of these fully synthetic glycoconjugates were capable of eliciting high titers of both anti-PRP and anti-OMP immunoglobulin G antibodies. In addition, we systematically investigated the factors which could influence their immunogenicity. We observed that the magnitude of the anti-PRP antibody response markedly depended on the relative spatial orientation of sPRP and T-cell epitopes, the anti-PRP antibody response was enhanced when a multiple antigenic peptide was used as a carrier, the anti-PRP antibody response was optimal for three PRP repeating units, and lipidation of peptide-PRP conjugates had a minimal effect on the magnitude of the anti-PRP antibody response. The results of this study clearly demonstrate that coupling a carbohydrate hapten to a peptide can provide T-cell help and convert it into a T-cell-dependent antigen. The antisera raised against these conjugates were also found to be protective against Hib infection in the infant rat model of bacteremia.
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Affiliation(s)
- P Chong
- Research Centre, Pasteur Merieux Connaught Canada, North York, Ontario.
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Yang YP, Munson RS, Grass S, Chong P, Harkness RE, Gisonni L, James O, Kwok Y, Klein MH. Effect of lipid modification on the physicochemical, structural, antigenic and immunoprotective properties of Haemophilus influenzae outer membrane protein P6. Vaccine 1997; 15:976-87. [PMID: 9261944 DOI: 10.1016/s0264-410x(96)00296-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The outer membrane lipoprotein, P6 of Haemophilus influenzae was studied to determine the importance of the native palmitoyl moiety on its physicochemical and immunological properties. A recombinant P6 (rP6) molecule devoid of lipidation signal sequence was expressed in Escherichia coli and its properties were compared to those of the palmitylated protein purified from H. influenzae. The isoelectric point of rP6 was more acidic than that of the native protein and also exhibited less secondary structure than P6 as judged by circular dichroism. However, both forms of P6 induced identical P6-specific antibody titers in guinea pigs when Freund's adjuvant was used. These antisera reacted with a panel of overlapping P6 peptides in a comparable manner and in addition, rabbit antisera raised against the P6 peptides reacted equally well with P6 and rP6. Furthermore, all human convalescent sera tested exhibited similar anti-P6 and anti-rP6 antibody titers. However, rP6 was less immunogenic than P6 when administered either without adjuvant or in alum and when tested in competitive inhibition studies with anti-P6 antibodies, was a less effective inhibitor than native P6, suggesting a diminution in some of the antigenic activity of rP6. In spite of these differences, rP6 was capable of eliciting a protective antibody response against live H. influenzae type b challenge in a modified infant rat model of bacteremia. These findings demonstrate that the non-fatty acylated rP6 could possibily be substituted for native P6 in a vaccine against H. influenzae.
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Affiliation(s)
- Y P Yang
- Research Center, Pasteur Merieux, Connaught, Ontario, Canada
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Abstract
There are apparently large geographical and secular variations in the prevalence of primary biliary cirrhosis worldwide. Most studies suggest that the disease is most common in Northern Europe, particularly northern Britain and Scandinavia, and that the prevalence is increasing. This comprehensive review of the literature explores to what extent these variations could be real rather than artifactual due to lack of comparability among studies. The major design flaws are examined and guidelines for better practice are outlined. It is hoped that other researches will utilize these recommendations for future studies so that true variations can be identified and hypotheses regarding disease causation may be formulated and investigated. These guidelines include: stringent case inclusion criteria; definition of date of disease onset; well-defined study period, area and population; multiple case finding methods; rigorous tracing of all possible cases. Preliminary results of the authors' study using these guidelines are described and report a point prevalence of 235 per million population in 1994 in the north of England, the highest yet reported.
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Affiliation(s)
- J Metcalf
- Department of Medicine, University of Newcastle, England, United Kingdom
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O'Mahony P, Rodgers H, Dobson R, Thomson R, James O. The Prevalence of Stroke and Associated Dependency in Northern England. Age Ageing 1997. [DOI: 10.1093/ageing/26.suppl_3.p26-c] [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: 11/12/2022] Open
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50
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Davies D, Oates J, Close P, Rodgers H, James O, Gibson G. Obstructive Sleep Apnoea in an Elderly Population. Age Ageing 1997. [DOI: 10.1093/ageing/26.suppl_3.p21-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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