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Murphy G, McCormack V, Abedi-Ardekani B, Arnold M, Camargo MC, Dar NA, Dawsey SM, Etemadi A, Fitzgerald RC, Fleischer DE, Freedman ND, Goldstein AM, Gopal S, Hashemian M, Hu N, Hyland PL, Kaimila B, Kamangar F, Malekzadeh R, Mathew CG, Menya D, Mulima G, Mwachiro MM, Mwasamwaja A, Pritchett N, Qiao YL, Ribeiro-Pinto LF, Ricciardone M, Schüz J, Sitas F, Taylor PR, Van Loon K, Wang SM, Wei WQ, Wild CP, Wu C, Abnet CC, Chanock SJ, Brennan P. International cancer seminars: a focus on esophageal squamous cell carcinoma. Ann Oncol 2017; 28:2086-2093. [PMID: 28911061 PMCID: PMC5834011 DOI: 10.1093/annonc/mdx279] [Citation(s) in RCA: 133] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The International Agency for Research on Cancer (IARC) and the US National Cancer Institute (NCI) have initiated a series of cancer-focused seminars [Scelo G, Hofmann JN, Banks RE et al. International cancer seminars: a focus on kidney cancer. Ann Oncol 2016; 27(8): 1382-1385]. In this, the second seminar, IARC and NCI convened a workshop in order to examine the state of the current science on esophageal squamous cell carcinoma etiology, genetics, early detection, treatment, and palliation, was reviewed to identify the most critical open research questions. The results of these discussions were summarized by formulating a series of 'difficult questions', which should inform and prioritize future research efforts.
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Affiliation(s)
- G. Murphy
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | | | | | - M. Arnold
- Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - M. C. Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - N. A. Dar
- Department of Biochemistry, University of Kashmir, Hazratbal, Srinagar, Jammu and Kashmir, India
| | - S. M. Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - A. Etemadi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - R. C. Fitzgerald
- MRC Cancer Unit, Hutchison-MRC Research Centre, University of Cambridge, Cambridge, UK
| | - D. E. Fleischer
- Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona, USA
| | - N. D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - A. M. Goldstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - S. Gopal
- University of North Carolina Project-Malawi, Lilongwe, Malawi
| | - M. Hashemian
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - N. Hu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - P. L. Hyland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - B. Kaimila
- University of North Carolina Project-Malawi, Lilongwe, Malawi
| | - F. Kamangar
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, Maryland, USA
| | - R. Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - C. G. Mathew
- Department of Medical and Molecular Genetics, Kings College London
- Sydney Brenner Institute for Molecular Bioscience, University of Witwatersrand, Johannesburg, South Africa
| | - D. Menya
- School of Public Health, Moi University, Eldoret, Kenya
| | - G. Mulima
- University of North Carolina Project-Malawi, Lilongwe, Malawi
| | | | - A. Mwasamwaja
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - N. Pritchett
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - Y.-L. Qiao
- Department of Etiology and Carcinogenesis & Department of Cancer Epidemiology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - L. F. Ribeiro-Pinto
- Molecular Carcinogenesis Program, Institute Nacional de Cancer, Sao Paulo, Brazil
| | - M. Ricciardone
- National Cancer Institute, Center for Global Health, National Institutes of Health, Bethesda, Maryland, USA
| | - J. Schüz
- Section of Environment and Radiation
| | - F. Sitas
- School of Public Health, University of Sydney, New South Wales, Australia
- School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
| | - P. R. Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - K. Van Loon
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, California, USA
| | - S.-M. Wang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
- Department of Etiology and Carcinogenesis & Department of Cancer Epidemiology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - W.-Q. Wei
- Department of Etiology and Carcinogenesis & Department of Cancer Epidemiology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - C. P. Wild
- Director's office, International Agency for Research on Cancer, Lyon, France
| | - C. Wu
- Department of Etiology and Carcinogenesis & Department of Cancer Epidemiology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - C. C. Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
| | - S. J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda Maryland, USA
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Cook MB, Wood S, Hyland PL, Caron P, Drahos J, Falk RT, Pfeiffer RM, Dawsey SM, Abnet CC, Taylor PR, Guillemette C, Murray LJ, Anderson LA. Sex steroid hormones in relation to Barrett's esophagus: an analysis of the FINBAR Study. Andrology 2017; 5:240-247. [PMID: 28241109 DOI: 10.1111/andr.12314] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 10/25/2016] [Accepted: 11/16/2016] [Indexed: 12/16/2022]
Abstract
Previously, we observed strong positive associations between circulating concentrations of free testosterone and free dihydrotestosterone (DHT) in relation to Barrett's esophagus in a US male military population. To replicate these findings, we conducted a second study of sex steroid hormones and Barrett's esophagus in the Factors Influencing the Barrett/Adenocarcinoma Relationship (FINBAR) Study based in Northern Ireland and Ireland. We used mass spectrometry to quantitate EDTA plasma concentrations of nine sex steroid hormones and ELISA to quantitate sex hormone-binding globulin in 177 male Barrett's esophagus cases and 185 male general population controls within the FINBAR Study. Free testosterone, free DHT, and free estradiol were estimated using standard formulas. Multivariable logistic regression estimated odds ratios (OR) and 95% confidence intervals (95%CI) of associations between exposures and Barrett's esophagus. While plasma hormone and sex hormone-binding globulin concentrations were not associated with all cases of Barrett's esophagus, we did observe positive associations with estrogens in younger men (e.g. estrone + estradiol ORcontinuous per ½IQR = 2.92, 95%CI:1.08, 7.89), and free androgens in men with higher waist-to-hip ratios (e.g. free testosterone ORcontinuous per ½IQR = 2.71, 95%CI:1.06, 6.92). Stratification by body mass index, antireflux medications, and geographic location did not materially affect the results. This study found evidence for associations between circulating sex steroid hormones and Barrett's esophagus in younger men and men with higher waist-to-hip ratios. Further studies are necessary to elucidate whether sex steroid hormones are consistently associated with esophageal adenocarcinogenesis.
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Affiliation(s)
- M B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - S Wood
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - P L Hyland
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - P Caron
- Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval de Québec (CHU de Québec) Research Center and Faculty of Pharmacy, Laval University, Quebec City, QC, Canada
| | - J Drahos
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - R T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - R M Pfeiffer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - S M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - C C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - P R Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
| | - C Guillemette
- Pharmacogenomics Laboratory, Centre Hospitalier de l'Université Laval de Québec (CHU de Québec) Research Center and Faculty of Pharmacy, Laval University, Quebec City, QC, Canada
| | - L J Murray
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland
| | - L A Anderson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, Northern Ireland
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Taylor PR, Baker RE, Simpson MJ, Yates CA. Coupling volume-excluding compartment-based models of diffusion at different scales: Voronoi and pseudo-compartment approaches. J R Soc Interface 2016; 13:20160336. [PMID: 27383421 PMCID: PMC4971222 DOI: 10.1098/rsif.2016.0336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 06/10/2016] [Indexed: 12/18/2022] Open
Abstract
Numerous processes across both the physical and biological sciences are driven by diffusion. Partial differential equations are a popular tool for modelling such phenomena deterministically, but it is often necessary to use stochastic models to accurately capture the behaviour of a system, especially when the number of diffusing particles is low. The stochastic models we consider in this paper are 'compartment-based': the domain is discretized into compartments, and particles can jump between these compartments. Volume-excluding effects (crowding) can be incorporated by blocking movement with some probability. Recent work has established the connection between fine- and coarse-grained models incorporating volume exclusion, but only for uniform lattices. In this paper, we consider non-uniform, hybrid lattices that incorporate both fine- and coarse-grained regions, and present two different approaches to describe the interface of the regions. We test both techniques in a range of scenarios to establish their accuracy, benchmarking against fine-grained models, and show that the hybrid models developed in this paper can be significantly faster to simulate than the fine-grained models in certain situations and are at least as fast otherwise.
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Affiliation(s)
- P R Taylor
- Mathematical Institute, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK
| | - R E Baker
- Mathematical Institute, University of Oxford, Woodstock Road, Oxford OX2 6GG, UK
| | - M J Simpson
- Mathematical Sciences, Queensland University of Technology, G.P.O. Box 2434, Brisbane 4001, Australia
| | - C A Yates
- Department of Mathematical Sciences, University of Bath, Claverton Down, Bath BA2 7AY, UK
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Lascelles BG, Taylor PR, Miller MGR, Dias MP, Oppel S, Torres L, Hedd A, Le Corre M, Phillips RA, Shaffer SA, Weimerskirch H, Small C. Applying global criteria to tracking data to define important areas for marine conservation. DIVERS DISTRIB 2016. [DOI: 10.1111/ddi.12411] [Citation(s) in RCA: 151] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - P. R. Taylor
- RSPB Centre for Conservation Science, The Lodge; Sandy UK
| | | | | | - S. Oppel
- RSPB Centre for Conservation Science, The Lodge; Sandy UK
| | - L. Torres
- Department of Fisheries and Wildlife; Marine Mammal Institute; Oregon State University; Newport OR USA
| | - A. Hedd
- Memorial University; St John's NF Canada
| | | | | | - S. A. Shaffer
- Department of Biological Sciences; San Jose State University; San Jose CA USA
| | - H. Weimerskirch
- Centre d'Etudes Biologiques de Chizé; Villiers-en-Bois France
| | - C. Small
- RSPB Centre for Conservation Science, The Lodge; Sandy UK
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Stote KS, Tracy RP, Taylor PR, Baer DJ. The effect of moderate alcohol consumption on biomarkers of inflammation and hemostatic factors in postmenopausal women. Eur J Clin Nutr 2015; 70:470-4. [PMID: 26554758 DOI: 10.1038/ejcn.2015.182] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/15/2015] [Accepted: 09/18/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND/OBJECTIVES Inflammation and hemostasis contribute to the etiology of cardiovascular disease. We previously demonstrated that moderate alcohol consumption (1-2 drinks/day) may decrease risk for cardiovascular disease because of an improved lipid profile. In addition to these beneficial changes, the alcohol-mediated reduction in risk may be through its effect on inflammation and hemostasis. The objective of the study was to evaluate the effect of moderate alcohol consumption on biomarkers of inflammation and hemostasis in postmenopausal women. SUBJECTS/METHODS As part of a controlled diet study, 53 postmenopausal women each consumed a weight-maintaining diet plus 0, 15 and 30 g/day of alcohol for 8 weeks, in a randomized crossover design. The controlled diet contained 15%, 53% and 32% of energy from protein, carbohydrate and fat, respectively. RESULTS Soluble intercellular adhesion molecule-1 decreased by 5% (P<0.05) with consumption of both 15 and 30 g of alcohol. Fibrinogen concentrations decreased by 4% and 6% (P<0.05) after consumption of 15 and 30 g alcohol, respectively. Fibrin D-dimer decreased by 24% (P<0.05) after consumption of 30 g of alcohol. Plasminogen activator inhibitor-1 (PAI-1) concentrations were increased 27 and 54% (P<0.05) after consumption of 15 and 30 g of alcohol. Plasma high-sensitivity C-reactive protein, interleukin-6 and factor VII coagulant activity did not change with alcohol consumption. CONCLUSIONS These data suggest that moderate alcohol consumption may have beneficial effects on inflammation and hemostasis in postmenopausal women, and this may be somewhat mitigated by an increase in PAI-1.
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Affiliation(s)
- K S Stote
- Beltsville Human Nutrition Research Center, US Department of Agriculture, Agriculture Research Service, Beltsville, MD, USA
| | - R P Tracy
- University of Vermont College of Medicine, Burlington, VT, USA
| | - P R Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - D J Baer
- Beltsville Human Nutrition Research Center, US Department of Agriculture, Agriculture Research Service, Beltsville, MD, USA
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Taylor PR, Yates CA, Simpson MJ, Baker RE. Reconciling transport models across scales: The role of volume exclusion. Phys Rev E Stat Nonlin Soft Matter Phys 2015; 92:040701. [PMID: 26565150 DOI: 10.1103/physreve.92.040701] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Indexed: 06/05/2023]
Abstract
Diffusive transport is a universal phenomenon, throughout both biological and physical sciences, and models of diffusion are routinely used to interrogate diffusion-driven processes. However, most models neglect to take into account the role of volume exclusion, which can significantly alter diffusive transport, particularly within biological systems where the diffusing particles might occupy a significant fraction of the available space. In this work we use a random walk approach to provide a means to reconcile models that incorporate crowding effects on different spatial scales. Our work demonstrates that coarse-grained models incorporating simplified descriptions of excluded volume can be used in many circumstances, but that care must be taken in pushing the coarse-graining process too far.
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Affiliation(s)
- P R Taylor
- Mathematical Institute, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - C A Yates
- Department of Mathematical Sciences, University of Bath, Claverton Down, Bath BA2 7AY, United Kingdom
| | - M J Simpson
- Mathematical Sciences, Queensland University of Technology, G.P.O. Box 2434, Brisbane 4001, Australia
| | - R E Baker
- Mathematical Institute, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
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Taylor PR, Baker RE, Yates CA. Deriving appropriate boundary conditions, and accelerating position-jump simulations, of diffusion using non-local jumping. Phys Biol 2014; 12:016006. [PMID: 25514045 DOI: 10.1088/1478-3975/12/1/016006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In this paper we explore lattice-based position-jump models of diffusion, and the implications of introducing non-local jumping; particles can jump to a range of nearby boxes rather than only to their nearest neighbours. We begin by deriving conditions for equivalence with traditional local jumping models in the continuum limit. We then generalize a previously postulated implementation of the Robin boundary condition for a non-local process of arbitrary maximum jump length, and present a novel implementation of flux boundary conditions, again generalized for a non-local process of arbitrary maximum jump length. In both these cases we validate our results using stochastic simulation. We then proceed to consider two variations on the basic diffusion model: a hybrid local/non-local scheme suitable for models involving sharp concentration gradients, and the implementation of biased jumping. In all cases we show that non-local jumping can deliver substantial time savings for stochastic simulations.
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Affiliation(s)
- P R Taylor
- Wolfson Centre for Mathematical Biology, Mathematical Institute, University of Oxford, Andrew Wiles Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK
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8
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Lai GY, Weinstein SJ, Taylor PR, McGlynn KA, Virtamo J, Gail MH, Albanes D, Freedman ND. Effects of α-tocopherol and β-carotene supplementation on liver cancer incidence and chronic liver disease mortality in the ATBC study. Br J Cancer 2014; 111:2220-3. [PMID: 25314069 PMCID: PMC4264440 DOI: 10.1038/bjc.2014.514] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/14/2014] [Accepted: 09/01/2014] [Indexed: 12/31/2022] Open
Abstract
Background: Recent data suggest the possible benefits of α-tocopherol and β-carotene supplementation on liver cancer and chronic liver disease (CLD), but the long-term trial data are limited. Methods: We evaluated the efficacy of supplemental 50 mg day−1α-tocopherol and 20 mg day−1β-carotene on incident liver cancer and CLD mortality in a randomised trial of 29 105 Finnish male smokers, who received supplementation for 5–8 years and were followed for 16 additional years for outcomes. Results: Supplemental α-tocopherol, β-carotene, or both, relative to placebo, did not reduce the risk of liver cancer or CLD, either overall, during the intervention or during the post-intervention period. Conclusions: Long-term supplemental α-tocopherol or β-carotene had no effect on liver cancer or CLD mortality over 24 years of follow-up.
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Affiliation(s)
- G Y Lai
- 1] Cancer Prevention Fellowship Program, National Cancer Institute, 9609 Medical Center Drive, Rm. 2W136, MSC 9712, Bethesda, MD 20892, USA [2] Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - S J Weinstein
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - P R Taylor
- Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - K A McGlynn
- Hormonal and Reproductive Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - J Virtamo
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, FI-00271 Helsinki, Finland
| | - M H Gail
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - D Albanes
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
| | - N D Freedman
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, USA
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Clough RE, Albayati MA, Donati T, Taylor PR. Uncomplicated type B dissections: which patients should be treated? Lessons learned from the recent literature. J Cardiovasc Surg (Torino) 2014; 55:145-150. [PMID: 24796907] [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: 06/03/2023]
Abstract
The management of type B aortic dissection is complex and decision-making is often based on physician experience and subjective clinical judgment. Thoracic endovascular aortic repair is considered first-line therapy for complicated type B aortic dissection but whether this should be performed in uncomplicated cases has been a matter of debate. Randomized controlled trials have demonstrated the long-term benefit of endovascular treatment to prevent aortic-related mortality, however pre-emptive surgery may not be the solution for all patients because of the occurrence of adverse events such death, stroke and paraplegia. Morphological and false lumen characteristics including aortic diameter, the position, size and number of entry tears and false lumen thrombus volume have been shown to serve as predictors of outcome and may be used to identify high-risk patients. Functional imaging methods such as magnetic resonance and echocardiography are evolving and may be able to provide the clinically-relevant structural, hemodynamic and biomechanical information that is needed for accurate risk stratification of individual patients. A patient-specific approach designed to intervene only in patients that are at high risk of developing complications should improve the long-term outcome of these patients.
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Affiliation(s)
- R E Clough
- Department of Vascular Surgery NIHR Comprehensive Biomedical Research Centre of Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK -
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10
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Lai GY, Weinstein SJ, Albanes D, Taylor PR, McGlynn KA, Virtamo J, Sinha R, Freedman ND. The association of coffee intake with liver cancer incidence and chronic liver disease mortality in male smokers. Br J Cancer 2013; 109:1344-51. [PMID: 23880821 PMCID: PMC3778279 DOI: 10.1038/bjc.2013.405] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 06/24/2013] [Accepted: 06/26/2013] [Indexed: 12/11/2022] Open
Abstract
Background: Coffee intake is associated with reduced risk of liver cancer and chronic liver disease as reported in previous studies, including prospective ones conducted in Asian populations where hepatitis B viruses (HBVs) and hepatitis C viruses (HCVs) are the dominant risk factors. Yet, prospective studies in Western populations with lower HBV and HCV prevalence are sparse. Also, although preparation methods affect coffee constituents, it is unknown whether different methods affect disease associations. Methods: We evaluated the association of coffee intake with incident liver cancer and chronic liver disease mortality in 27 037 Finnish male smokers, aged 50–69, in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, who recorded their coffee consumption and were followed up to 24 years for incident liver cancer or chronic liver disease mortality. Multivariate relative risks (RRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazard models. Results: Coffee intake was inversely associated with incident liver cancer (RR per cup per day=0.82, 95% CI: 0.73–0.93; P-trend across categories=0.0007) and mortality from chronic liver disease (RR=0.55, 95% CI: 0.48–0.63; P-trend<0.0001). Inverse associations persisted in those without diabetes, HBV- and HCV-negative cases, and in analyses stratified by age, body mass index, alcohol and smoking dose. We observed similar associations for those drinking boiled or filtered coffee. Conclusion: These findings suggest that drinking coffee may have benefits for the liver, irrespective of whether coffee was boiled or filtered.
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Affiliation(s)
- G Y Lai
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Drive, Room 2W136 MSC 9712, Bethesda, MD 20892, USA.
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Sadideen H, Thomson DR, Lewis RR, Padayachee TS, Taylor PR. Carotid endarterectomy in the elderly: risk factors, intraoperative carotid hemodynamics and short-term complications: a UK tertiary center retrospective analysis. Vascular 2013; 21:273-7. [PMID: 23508381 DOI: 10.1177/1708538113478740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2012] [Indexed: 11/15/2022]
Abstract
This retrospective analysis aims to demonstrate the safety of carotid endarterectomy (CE) in patients >75 years with particular attention paid to intraoperative hemodynamics. Four hundred and ninety-six consecutive patients with >70% symptomatic and asymptomatic stenosis who underwent CE were prospectively assessed and divided into those <75 years (n = 408; mean 64 years) and those >75 years (n = 88; mean 78 years). Associated risk factors, hemodynamic parameters, surgical techniques and 30-day perioperative complications were compared. Carotid artery stump pressures of <25 mmHg (13 versus 29%) and middle cerebral artery velocities of <20 cm/sec (46 versus 29%) were more common in those >75 years (P = 0.0001 and P <0.005, respectively). However, there was no difference in the frequency of intraluminal shunt (34% in both groups) or synthetic patch usage (primary patching: 12.5%, older group versus 11%, younger group; secondary patching: 34% in both groups), and no difference in the combined 30-day stroke and death rates (3.4%, >75 years versus 1.1%, <75 years; P = 0.425). CE in this cohort of patients >75 years was not associated with increased morbidity or mortality. Altered intraoperative hemodynamics were not associated with increased use of shunting or patching. This analysis supports CE as a safe procedure in the elderly.
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Affiliation(s)
| | | | | | | | - P R Taylor
- Department of Vascular Surgery, Guy's and St Thomas' Hospitals NHS Foundation Trust, London, UK
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12
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Baird DLH, Mani K, Sabharwal T, Taylor PR, Zayed HA. Endovascular treatment of isolated iliac artery aneurysms using a custom-made stent graft with proximal barb fixation: early outcome. Vascular 2013; 21:92-6. [DOI: 10.1177/1708538113478720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Current endovascular treatments for isolated iliac artery aneurysms (IIAAs) include the use of aortoiliac stent grafts with coverage of the distal aorta or stent grafts confined to the iliac artery without active proximal fixation. We report our experience in the use of custom-made Cook Zenith™ iliac limb stent grafts with proximal barb fixation. Patients treated from July 2009 to February 2011 were included. All imaging and patient records were assessed for perioperative and early outcomes. Nine IIAAs (seven patients) were treated. The mean patient age was 80 years (range 58-91 years). The mean aneurysm size was 48 mm (35-80 mm), and the mean length of the proximal landing zone (PLZ) was 29 mm (10-50 mm). The distal landing zone was in the external iliac artery after coil embolization of the internal iliac artery. The Mean diameter of the PLZ was 21 mm (20-24 mm). Technical success was achieved in eight cases. Perioperative complications included reoperation in one patient for groin bleeding and ischemia. On follow-up (mean 12 months, range 1-26), all aneurysms were successfully excluded from the circulation and there was no stent graft migration or thrombosis. Use of custom-made stent grafts with proximal barb fixation in treatment of IIAAs is a feasible option which may reduce the risk of migration when compared with stent grafts with lack of proximal fixation.
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Affiliation(s)
- D L H Baird
- Department of Vascular Surgery, Guy's and St Thomas’ Hospital, London SE1 7EH, UK
| | - K Mani
- Department of Vascular Surgery, Guy's and St Thomas’ Hospital, London SE1 7EH, UK
- Department of Surgical Sciences, Uppsala University, SE-75185, Uppsala, Sweden
| | - T Sabharwal
- Department of Interventional Radiology, Guy's and St Thomas’ Hospital, London SE1 7EH, UK
| | - P R Taylor
- Department of Vascular Surgery, Guy's and St Thomas’ Hospital, London SE1 7EH, UK
| | - H A Zayed
- Department of Vascular Surgery, Guy's and St Thomas’ Hospital, London SE1 7EH, UK
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Mikirova NA, Rogers AM, Taylor PR, Hunninghake RE, Miranda-Massari JR, Gonzalez MJ. Metabolic correction for attention deficit/hyperactivity disorder: A biochemical-physiological therapeutic approach. FFHD 2013. [DOI: 10.31989/ffhd.v3i1.67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Objective: This investigation was undertaken to determine the reference values of specific biochemical markers that have been have been associated with behavior typical of ADHD in a group of patients before and after metabolic correction.Background: Attention deficit hyperactivity disorder (ADHD) affects approximately two million American children, and this condition has grown to become the most commonly diagnosed behavioral disorder of childhood. According to the National Institute of Mental Health (NIMH), the cause of the condition, once called hyperkinesis, is not known. The cause of ADHD is generally acknowledged to be multifactorial, involving both biological and environmental influence. Molecular, genetic, and pharmacological studies suggest the involvement of the neurotransmitter systems in the pathogenesis of ADHD. Polymorphic variants in several genes involved in regulation of dopamine have been identified, and related neurotransmitter pathways alterations are reported to be associated with the disease. Nutritional deficiencies, including deficiencies in fatty acids (EPA, DHA), the amino acid methionine, and the trace minerals zinc and selenium, have been shown to influence neuronal function and produce defects in neuronal plasticity, as well as impact behavior in children with attention deficit hyperactivity disorder. Materials/Methods: This study was based on data extracted from our patient history database covering a period of over ten years. We performed laboratory tests in 116 patients 2.7-25 years old with a diagnosis of ADHD. Sixty-six percent (66%) of patients were males. Patients were followed from 3 month to 3 years. We compared the distributions of fatty acids, essential metals, and the levels of metabolic stress factors with established reference ranges before and after interventions. In addition, we analyzed the association between toxic metal concentrations and the levels of essential metals.Results: This study was based on data extracted from our patient history database covering a period of over ten years. We performed laboratory tests in 116 patients 2.7-25 years old with a diagnosis of ADHD. Sixty-six percent (66%) of patients were males. Patients were followed from 3 month to 3 years. We compared the distributions of fatty acids, essential metals, and the levels of metabolic stress factors with established reference ranges before and after interventions. In addition, we analyzed the association between toxic metal concentrations and the levels of essential metals. According to these data, the metabolic correction of ADHD by supplementation with minerals, vitamins, essential fatty acids, and amino acids can ameliorate ADHD symptoms. Eighty percent (80%) of children who were treated from several weeks to 1-2 years, demonstrated improvement of metabolic stress level, measured by pyrroles. For these patients the levels of EPA were increased and the omega-6/omega-3 ratio was improved. Conclusion: In the studied population it was demonstrated that metabolic correction of biochemical disturbances using essential fatty acids, amino acids, and minerals can improve fatty acid profiles and metabolic stress levels. These disturbances or variations from reference values have been associated with behavior typical of ADHD. Further studies need to be conducted with integrative metabolic correction therapy to determine its value in the management of ADHD.Key words: Attention deficit hyperactivity disorder, metabolic correction, fatty acid composition, essential metals, toxic metals, pyrroles, vitamins and minerals.
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Krysa J, Fraser S, Saha P, Fuller M, Bell RE, Carrell TWG, Modarai B, Taylor PR, Zayed HA. Quality improvement framework for major amputation: are we getting it right? Int J Clin Pract 2012; 66:1230-4. [PMID: 23163504 DOI: 10.1111/j.1742-1241.2012.02905.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The quality improvement framework for major amputation was developed with the aim of improving outcomes and reducing the perioperartive mortality to less than 5% by 2015. The aim of the study was to assess our compliance with the framework guidelines and look for the reasons for non-compliance. METHOD All major amputations performed between 2008 and 2010 were included. The following data were collected: presence of infection ± tissue loss, status of arterial supply, revascularisation attempts, time to surgery, type of amputation, morbidity and mortality. RESULTS A total of 81 patients were included (42 BKAs, 39 AKAs). Ninety percentage had formal preoperative arterial investigations and 84% had an attempted revascularisation procedure. Patients who were transferred late from non-vascular units (n = 12) had a 30-day mortality of 50% whereas patients who presented directly to our unit had a 30-day mortality of 7.2%. The number of amputations has decreased over the last 3 years from 34 to 21 per year, coinciding with the doubling of crural revascularisation procedures performed (from 60 to 120 per year). Ten patients underwent a revision from BKA to AKA because of an inadequate profunda femoris artery (PFA), whereas all those with a healed BKA stump either had a good PFA or a named crural vessel. CONCLUSION The overall number of amputations is decreasing from year to year. By doubling our crural revascularisation procedures we are saving more limbs. Thirty-day mortality is higher than expected, particularly in patients who present late. Expeditious referral may potentially improve the mortality rate among this group of patients.
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Affiliation(s)
- J Krysa
- Department of Vascular Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.
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15
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Affiliation(s)
- J Krysa
- Guy's and St Thomas' NHS Foundation Trust, UK.
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Hammond C, Velard F, Ah Kioon MD, Come D, Hafsia N, Lin H, Ea HK, Liote F, Dudek M, Wallis GA, Paton K, Harris J, Kendall DA, Kelly S, Mercer L, Galloway J, Low A, Watson K, Lunt M, Dixon W, Symmons D, Hyrich K, Ntatsaki E, Watts RA, Mooney J, Scott DGI, Humphreys J, Verstappen SM, Marshall T, Lunt M, Hyrich K, Symmons DP, Khan A, Scott DL, Abraham A, Pearce MS, Mann KD, Francis RM, Birrell F, Moinzadeh P, Fonseca C, Hellmich M, Shah A, Chighizola C, Denton CP, Ong V, Croia C, Bombardieri M, Francesca A, Serafini B, Humby F, Kelly S, Migliorini P, Pitzalis C, Miles K, Heaney J, Sibinska Z, Salter D, Savill J, Gray D, Gray M, Jones GW, Greenhill CJ, Williams AS, Nowell MA, Jenkins BJ, Jones SA, McGovern J, Nguyen DX, Notley CA, Mauri C, Isenberg D, Ehrenstein M, Jacklin C, Bosworth AM, Bateman J, Allen M, Samani D, Davies D, Harris HE, Brannan S, Venters G, McQuillian A, Lovegrove F, Gibson J, Chinn D, Mclaren JS, Gordhan C, Stack RJ, Kumar K, Awad I, Raza K, Bacon P, Arkell P, Ryan S, Brownfield A, Packham J, Jacklin C, Bosworth AM, Wilkinson K, Roberts KJ, Moots RJ, Edwards SW, Headland SE, Perretti M, Norling L, Dalli J, Flower R, Serhan C, Perretti M, Naylor A, Azzam E, Smith S, Croft A, Duffield J, Huso D, Gay S, Ospelt C, Cooper M, Isacke C, Goodyear S, Rogers M, Buckley C, Greenhill CJ, Williams AS, Jones GW, Nowell MA, Moideen AN, Rosas M, Taylor PR, Humphreys IR, Jones SA, Vattakuzhi Y, Horwood NJ, Clark AR, Mueller AJ, Laird EG, Tew SR, Clegg PD, Orozco G, Eyre S, Bowes J, Flynn E, Barton A, Worthington J, Eyre S, Bowes J, Barton A, Amos C, Diogo D, Lee A, Padyukov L, Stahl EA, Martin J, Rantapaa-Dahlqvist S, Raychaudhuri S, Plenge R, Klareskog L, Gregersen P, Worthington J, Jani M, Chinoy H, Lamb J, Hazel P, Wedderburn L, Vencovsky J, Danko K, Lundberg I, O'Callaghan AS, Radstake T, Ollier WER, Cooper RG, Cobb J, Hinks A, Bowes J, Steel K, Sudman M, Marion MC, Keddache M, Wedderburn LR, Haas JP, Glass DN, Langefeld CD, Thomson W, Thompson SD, Cobb J, Hinks A, Flynn E, Hirani S, Patrick F, Kassoumeri L, Ursu S, Moncrieffe H, Bulatovic M, Bohm M, van Zelst B, Dolezalova P, de Jonge R, Wulffraat N, Newman S, Thomson W, Wedderburn L. Oral abstracts 7: Molecular mechanisms of disease--osteoarthritis * S1. Identification of novel osteoarthritis genes using zebrafish. Rheumatology (Oxford) 2012. [DOI: 10.1093/rheumatology/kes117] [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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Affiliation(s)
- J Krysa
- Guy’s and St Thomas’ NHS Foundation Trust,UK
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Hartman TJ, Mahabir S, Baer DJ, Stevens RG, Albert PS, Dorgan JF, Kesner JS, Meadows JW, Shields R, Taylor PR. Moderate alcohol consumption and 24-hour urinary levels of melatonin in postmenopausal women. J Clin Endocrinol Metab 2012; 97:E65-8. [PMID: 22013099 PMCID: PMC3251938 DOI: 10.1210/jc.2011-1904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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: 11/19/2022]
Abstract
CONTEXT Low overnight urinary melatonin metabolite concentrations have been associated with increased risk for breast cancer among postmenopausal women. The Postmenopausal Women's Alcohol Study was a controlled feeding study to test the effects of low to moderate alcohol intake on potential risk factors for breast cancer including serum and urinary levels of hormones and other biomarkers. Previously, we observed significant increases in concentrations of serum estrone sulfate and dehydroepiandrosterone sulfate in participants after consumption of 15 or 30 g (one or two drinks) of alcohol per day. OBJECTIVE In the present analysis, we evaluated the relationship of alcohol consumption with 24-h urinary 6-sulfatoxymelatonin (6-SMT) concentration (micrograms per 24 h). DESIGN AND PARTICIPANTS Healthy postmenopausal women (n = 51) consumed a controlled diet plus each of three treatments (a nonalcoholic placebo beverage or 15 or 30 g alcohol/d) during three 8-wk periods in random order under conditions of weight maintenance. MEASURES 6-SMT was measured in 24-h urine samples that were collected at entry into the study (baseline) and at the midpoint (4 wk) and end (8 wk) of each of the three diet periods. RESULTS Concentration of 6-SMT was not significantly modified by the alcohol treatment after adjustment for body mass index, hours of sleep, daylight hours, and baseline level of 6-SMT. CONCLUSIONS These results suggest that low to moderate daily alcohol consumption does not significantly affect 24-h urinary levels of melatonin among healthy postmenopausal women.
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Affiliation(s)
- T J Hartman
- Departmant of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania 16802, USA.
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Taylor PR, Koski GK, Paustian CC, Bailey E, Cohen PA, Moore FBG, Zimmerman DH, Rosenthal KS. J-LEAPS vaccines initiate murine Th1 responses by activating dendritic cells. Vaccine 2010; 28:5533-42. [PMID: 20600501 DOI: 10.1016/j.vaccine.2010.06.043] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 04/29/2010] [Accepted: 06/10/2010] [Indexed: 11/29/2022]
Abstract
The Ligand Epitope Antigen Presentation System (LEAPS) converts a peptide containing a T cell epitope as small as 8 amino acids into an immunogen and directs the nature of the subsequent response. Tandem synthesis of the J peptide (a peptide from the beta-2-microglobulin) with peptides of 15 or 30 amino acids from HSV-1 or HIV made them immunogenic and promoted Th1 immune responses. Immunization of A/J or C57BL/6 mice with J-LEAPS heteroconjugates containing an epitope from the HSV-1 glycoprotein D (JgD) or an epitope from the HIV gag protein (JH) emulsified with Seppic ISA51 induced increased levels of IL-12p70 by day 3 and increased levels of interferon gamma (IFN-gamma) on days 10 and 24. Interestingly, levels of IL-10, TNF-alpha, and IL-6 did not change. Neither the H nor the gD peptides alone elicited responses and only weak responses followed immunization with the J peptide. Bone marrow (BM) cells became CD86 and CD11c positive within 48 h of treatment with JgD or JH. JH or JgD treatment promoted IL-12p70 production and expression of CD8 denoting the maturation and activation of a subclass of myeloid DCs. Pure cultures of immature myeloid DCs also responded to JgD treatment, forming clusters, developing dendrites, and producing IL-12p70 within 24 h. The JH or JgD treated bone marrow cells (JgD-DC) were necessary and sufficient to activate splenic T cells to produce IFN-gamma and the JgD-DC provided an antigen specific booster response to T cells from JgD immunized mice. Adoptive transfer of JgD-DC was also sufficient to initiate protective antigen specific immunity from lethal challenge with HSV-1. The J-LEAPS vaccines appear to act as an adjuvant and immunogen on DC precursors in a unique manner to promote activation and maturation into IL-12p70 producing DCs which then can initiate sufficient Th1 immune responses to elicit protection without production of acute phase cytokines.
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Affiliation(s)
- P R Taylor
- Northeastern Ohio Universities Colleges of Medicine and Pharmacy, Rootstown, OH 44272, United States
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Islami F, Ren JS, Taylor PR, Kamangar F. Pickled vegetables and the risk of oesophageal cancer: a meta-analysis. Br J Cancer 2009; 101:1641-7. [PMID: 19862003 PMCID: PMC2778505 DOI: 10.1038/sj.bjc.6605372] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Revised: 09/22/2009] [Accepted: 09/22/2009] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Ecological and experimental studies have suggested a relationship between Asian pickled vegetable consumption and oesophageal squamous cell carcinoma (OSCC), but the results of epidemiological studies investigating the association have been inconsistent. We conducted a meta-analysis of observational studies of this association to evaluate the existing evidence. METHODS We searched the PubMed, ISI-Web of Science, J-EAST, IndMed, Vip Chinese Periodical, and China National Knowledge Infrastructure databases for all studies published in English or Chinese languages. Pooled results for all studies combined and for several study subgroups were computed. RESULTS A total of 34 studies were included in this analysis. The overall random effects odds ratio (OR) and 95% confidence interval (CI) for pickled vegetable consumption was 2.08 (1.66-2.60), but the results were heterogeneous across studies. After excluding the three most influential studies, the respective numbers were 2.32 (1.92-2.81). Similar to the overall association, the majority of subgroup analyses showed a statistically significant association between consuming pickled vegetables and OSCC risk. There were only three prospective studies. CONCLUSION Our results suggest a potential two-fold increased risk of oesophageal cancer associated with the intake of pickled vegetables. However, because the majority of data was from retrospective studies and there was a high heterogeneity in the results, further well-designed prospective studies are warranted.
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Affiliation(s)
- F Islami
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran 14117, Iran
- International Agency for Research on Cancer, Lyon 69008, France
- King's College London, Thames Cancer Registry, London SE1 3QD, UK
| | - J-S Ren
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7232, USA
| | - P R Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7232, USA
| | - F Kamangar
- Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran 14117, Iran
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-7232, USA
- Department of Public Health Analysis, School of Community Health and Policy, Morgan State University, Baltimore, MD 21251, USA
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Black SA, Carrell TWG, Bell RE, Waltham M, Reidy J, Taylor PR. Long-term surveillance with computed tomography after endovascular aneurysm repair may not be justified. Br J Surg 2009; 96:1280-3. [DOI: 10.1002/bjs.6732] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract
Background
There is a common perception that a large number of secondary interventions are needed following endovascular aortic aneurysm repair.
Methods
Prospective data were collected for a cohort of 417 consecutive elective patients undergoing infrarenal aortic endograft repair between April 2000 and May 2008. The rate of secondary interventions, associated morbidity and need for reintervention following surveillance imaging were analysed.
Results
The male : female ratio was 11 : 1, median age 76 (range 40–93) years and median aneurysm diameter 6·1 (5·3–11) cm. The overall 30-day mortality rate was 1·7 per cent (seven of 417). Secondary interventions were performed in 31 patients (7·4 per cent), of which six (1·4 per cent) were detected by surveillance. Endoleaks requiring reintervention occurred in 12 patients (2·9 per cent; ten type I and two type III endoleaks). Limb ischaemia secondary to graft occlusion occurred in 17 patients (4·1 per cent); extra-anatomical bypass was needed in 15 patients (3·6 per cent) and the remaining two had an amputation. Graft explantation following late infection was required in two patients (0·5 per cent).
Conclusion
Endoluminal repair of infrarenal aortic aneurysms can be performed with a low reintervention rate. The value of prolonged surveillance seems limited and current surveillance protocols may require revision.
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Affiliation(s)
- S A Black
- Department of Vascular Surgery, Guy's and St Thomas' Hospital, London, UK
| | - T W G Carrell
- Department of Vascular Surgery, Guy's and St Thomas' Hospital, London, UK
| | - R E Bell
- Department of Vascular Surgery, Guy's and St Thomas' Hospital, London, UK
| | - M Waltham
- Department of Vascular Surgery, Guy's and St Thomas' Hospital, London, UK
| | - J Reidy
- Department of Interventional Radiology, Guy's and St Thomas' Hospital, London, UK
| | - P R Taylor
- Department of Vascular Surgery, Guy's and St Thomas' Hospital, London, UK
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Khalique Z, Lyons OTA, Clough RE, Bell RE, Reidy JF, Schwarze U, Byers PH, Taylor PR. Successful endovascular repair of acute type B aortic dissection in undiagnosed Ehlers-Danlos syndrome type IV. Eur J Vasc Endovasc Surg 2009; 38:608-9. [PMID: 19695909 DOI: 10.1016/j.ejvs.2009.07.009] [Citation(s) in RCA: 20] [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] [Received: 03/31/2009] [Accepted: 07/14/2009] [Indexed: 11/17/2022]
Abstract
A 61-year-old man presented with an acute type B aortic dissection for which a stent-graft was introduced. He remains complication-free 4 years onwards and has since been diagnosed with Ehlers-Danlos syndrome type IV (EDS IV). His particular mutation is predicted to result in lesser levels of normal collagen and may explain his favourable outcome from endovascular intervention. Understanding the genotype-phenotype correlation may influence the choice of therapy offered to patients with EDS IV.
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Affiliation(s)
- Z Khalique
- Department of Vascular Surgery, Guy's & St Thomas' NHS Foundation Trust, London, UK
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Clough RE, Bell RE, Salter R, Taylor PR. Letter to the Editor re: indication for intervention in chronic type B aortic dissection. Eur J Vasc Endovasc Surg 2009; 37:498-9. [PMID: 19217808 DOI: 10.1016/j.ejvs.2009.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 01/07/2009] [Indexed: 11/19/2022]
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Clough RE, Black SA, Lyons OT, Bell RE, Zayed H, Carrell T, Waltham M, Sabharwal T, Reidy J, Taylor PR. Endovascular management of mycotic aortic aneurysms. Br J Surg 2009. [DOI: 10.1002/bjs.6510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- R E Clough
- Guy's and St Thomas' NHS Foundation Trust, London
| | - S A Black
- Guy's and St Thomas' NHS Foundation Trust, London
| | - O T Lyons
- Guy's and St Thomas' NHS Foundation Trust, London
| | - R E Bell
- Guy's and St Thomas' NHS Foundation Trust, London
| | - H Zayed
- Guy's and St Thomas' NHS Foundation Trust, London
| | - T Carrell
- Guy's and St Thomas' NHS Foundation Trust, London
| | - M Waltham
- Guy's and St Thomas' NHS Foundation Trust, London
| | - T Sabharwal
- Guy's and St Thomas' NHS Foundation Trust, London
| | - J Reidy
- Guy's and St Thomas' NHS Foundation Trust, London
| | - P R Taylor
- Guy's and St Thomas' NHS Foundation Trust, London
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Clough RE, Taylor PR. Endovascular repair of aortic transection can be a durable treatment option. Eur J Vasc Endovasc Surg 2008; 37:120; author reply 120-1. [PMID: 19008130 DOI: 10.1016/j.ejvs.2008.09.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2008] [Accepted: 09/15/2008] [Indexed: 11/29/2022]
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Abstract
PURPOSE We have evaluated the efficacy of endovascular repair of distal aortic arch aneurysms (DAAA) causing recurrent laryngeal nerve palsy. MATERIAL AND METHODS Eight patients (five male and three female) with median age of 72 years (range: 59-80) presented with left recurrent laryngeal nerve palsy associated with DAAA. All patients were considered unfit for open surgery. The median aneurysm size was 5.9 cm (range: 5-7.3). Thirteen stents were deployed: eight Gore, four Endofit and one Talent. Epidural anaesthesia was used in all patients. The left subclavian artery was covered in all and the left common carotid in three who had a preliminary right to left carotid-carotid bypass. Routine follow-up (FU) was with computed tomography (CT) at 3-6 months and yearly thereafter. RESULTS Exclusion of the aneurysm sac was achieved in all patients. Thirty-day mortality was 0%, with no paraplegia or stroke. Early complications included: rupture of the external iliac artery (one) and common femoral artery thrombectomy (one). One patient died of unknown cause at 17 months. The mean FU in the remaining seven patients was 21 months (range: 6-51). Aneurysm size decreased in five, was unchanged in one and increased in one. Three patients had improvement in voice quality postoperatively. One patient had a recurrent type 1 endoleak which was restented twice. No late deaths have occurred. CONCLUSION Though technically the procedures involved were more complicated, endovascular repair of DAAA causing aorto-vocal syndrome is safe and offers a realistic alternative to open surgery. Hoarseness of the voice can improve postoperatively and is associated with reduction in aortic sac diameter.
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Affiliation(s)
- J P Morales
- Department of Vascular Surgery, Guy's & St. Thomas' NHS Foundation Hospital, St. Thomas' Hospital, London, UK
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Chan YC, Morales JP, Reidy JF, Taylor PR. Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery? Int J Clin Pract 2008; 62:1604-13. [PMID: 17949429 DOI: 10.1111/j.1742-1241.2007.01494.x] [Citation(s) in RCA: 135] [Impact Index Per Article: 8.4] [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: 12/13/2022] Open
Abstract
BACKGROUND Retroperitoneal haematoma is a rare clinical entity with variable aetiology, which is increasing in incidence mainly due to complications related to interventional procedures. There is no general consensus as to the best management plan for patients with retroperitoneal haematoma. METHODS A literature review was undertaken using MEDLINE, all relevant papers on retroperitoneal haemorrhage or haematoma were used. RESULTS The diagnosis is often delayed as symptoms are nonspecific. Retroperitoneal haematoma should be suspected in patients with significant groin, flank, abdominal, back pain or haemodynamic instability following an interventional procedure. Spontaneous haemorrhage usually occurs in patients who are anticoagulated. Multi-slice CT and arteriography are important for diagnosis. Most haemodynamically stable patients can be managed with fluid resuscitation, correction of coagulopathy and blood transfusion. Endovascular treatment involving selective intra-arterial embolisation or the deployment of stent-grafts over the punctured vessel is attaining an increasingly important role. Open repair of retroperitoneal bleeding vessels should be reserved for cases when there is failure of conservative or endovascular measures to control the bleeding. Open repair is also required if endovascular facilities or expertise is unavailable and in cases where the patient is unstable. If treated inappropriately, the mortality of patients with retroperitoneal haematoma remains high. CONCLUSION There is a lack of level I evidence for the best management plans for retroperitoneal haematoma, and evidence is based on small cohort series or isolated case reports. Conservative management should only be reserved for patients who are stable. Interventional radiology with intra-arterial embolisation or stent-grafting is the treatment of choice. Open surgery is now rarely required.
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Affiliation(s)
- Y C Chan
- Department of Vascular & Endovascular Surgery, Guy's & St Thomas' NHS Foundation Hospital, St. Thomas' Hospital, London, UK
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Kamangar F, Ren J, Abnet CC, Taylor PR, Dawsey SM, Qiao Y. Serum pepsinogens and gastrin-17 and gastric and esophageal cancers: A long-term prospective study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4561] [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: 11/20/2022] Open
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Mahabir S, Ettinger S, Johnson L, Baer DJ, Clevidence BA, Hartman TJ, Taylor PR. Measures of adiposity and body fat distribution in relation to serum folate levels in postmenopausal women in a feeding study. Eur J Clin Nutr 2008; 62:644-50. [PMID: 17457338 PMCID: PMC3236439 DOI: 10.1038/sj.ejcn.1602771] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 02/21/2007] [Accepted: 03/02/2007] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To assess the associations between serum folate concentration and measures of adiposity in postmenopausal women. DESIGN This study was conducted as a cross-sectional analysis within the control segment of a randomized, crossover trial in which postmenopausal women (n=51) consumed 0 g (control), 15 g (one drink) and 30 g (two drinks) alcohol (ethanol)/day for 8 weeks as part of a controlled diet. Subjects in one treatment arm were crossed-over to another arm after a 2- to 5-week washout period. Body mass index (BMI) was measured, and dual energy X-ray absorptiometry (DEXA) scan administered to the women during the control (0 g alcohol) treatment, and a blood sample from this group was collected at baseline and week 8 of each diet period and analyzed for folate, B12, homocysteine and methylmalonic acid. SETTING This study was conducted at the Beltsville Human Nutrition Research Center, MD, USA. RESULTS In multivariate analysis, women who were overweight had a 12% lower, and obese women had a 22% lower serum folate concentrations compared to normal weight women (P-trend=0.02). Vitamin B12 also decreased with increasing BMI (P-trend=0.08). Increased BMI, percent body fat, and absolute amounts of central and peripheral fat were all significantly associated with decreased serum folate, but were unrelated to serum B12, homocysteine or methylmalonic acid. CONCLUSIONS Our data show that adiposity is associated with lower serum folate levels in postmenopausal women. With obesity at epidemic proportions, these data, if confirmed by prospective or randomized controlled studies, have important public health implications.
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Affiliation(s)
- S Mahabir
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Worrillow LJ, Smith AG, Scott K, Andersson M, Ashcroft AJ, Dores GM, Glimelius B, Holowaty E, Jackson GH, Jones GL, Lynch CF, Morgan G, Pukkala E, Scott D, Storm HH, Taylor PR, Vyberg M, Willett E, Travis LB, Allan JM. Polymorphic MLH1 and risk of cancer after methylating chemotherapy for Hodgkin lymphoma. J Med Genet 2007; 45:142-6. [PMID: 17959715 DOI: 10.1136/jmg.2007.053850] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVE Methylating agents are effective chemotherapy agents for Hodgkin lymphoma, but are associated with the development of second primary cancers. Cytotoxicity of methylating agents is mediated primarily by the DNA mismatch repair (MMR) system. Loss of MLH1, a major component of DNA MMR, results in tolerance to the cytotoxic effects of methylating agents and persistence of mutagenised cells at high risk of malignant transformation. We hypothesised that a common substitution in the basal promoter of MLH1 (position -93, rs1800734) modifies the risk of cancer after methylating chemotherapy. METHODS 133 patients who developed cancer following chemotherapy and/or radiotherapy (n = 133), 420 patients diagnosed with de novo myeloid leukaemia, 242 patients diagnosed with primary Hodgkin lymphoma, and 1177 healthy controls were genotyped for the MLH1 -93 polymorphism by allelic discrimination polymerase chain reaction (PCR) and restriction fragment length polymorphism assay. Odds ratios and 95% confidence intervals for cancer risk by MLH1 -93 polymorphism status, and stratified by previous exposure to methylating chemotherapy, were calculated using unconditional logistic regression. RESULTS Carrier frequency of the MLH1 -93 variant was higher in patients who developed therapy related acute myeloid leukaemia (t-AML) (75.0%, n = 12) or breast cancer (53.3%. n = 15) after methylating chemotherapy for Hodgkin lymphoma compared to patients without previous methylating exposure (t-AML, 30.4%, n = 69; breast cancer patients, 27.2%, n = 22). The MLH1 -93 variant allele was also over-represented in t-AML cases when compared to de novo AML cases (36.9%, n = 420) and healthy controls (36.3%, n = 952), and was associated with a significantly increased risk of developing t-AML (odds ratio 5.31, 95% confidence interval 1.40 to 20.15), but only in patients previously treated with a methylating agent. CONCLUSIONS These data support the hypothesis that the common polymorphism at position -93 in the core promoter of MLH1 defines a risk allele for the development of cancer after methylating chemotherapy for Hodgkin lymphoma. However, replication of this finding in larger studies is suggested.
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Affiliation(s)
- L J Worrillow
- Department of Biology, University of York, Heslington, York, UK
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Lyons OTA, St John ERC, Morales JP, Chan YC, Taylor PR. Ruptured thoracoabdominal aortic aneurysm in a renal transplant patient with Alport's syndrome. Ann Vasc Surg 2007; 21:816-8. [PMID: 17697765 DOI: 10.1016/j.avsg.2007.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Revised: 04/23/2007] [Accepted: 06/28/2007] [Indexed: 11/25/2022]
Abstract
Alport's syndrome is a rare genetic disorder of type IV basement membrane collagen synthesis that typically presents with nephropathy, deafness, and ocular abnormalities. To the best of our knowledge, this is the first report in the world's literature of ruptured thoracoabdominal aortic aneurysm in a young patient with Alport's syndrome and a renal transplant. Hypotheses on an association between collagen disease in Alport's syndrome and aortic aneurysms are discussed.
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Affiliation(s)
- O T A Lyons
- Department of Vascular and Endovascular Surgery, Guy's and St. Thomas' NHS Foundation Hospital, London, UK
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Abstract
Mass and stiffness matrices are obtained for a general-triangle element and for a right-angled-triangle element. Both bending and in-plane actions are considered, although no coupling is assumed, and the matrices relating to bending actions are obtained independently of those relating to in-plane actions. Coupling is introduced, unless all the elements lie in a single plane, when the transformation from local to global co-ordinates is made. In deriving the stiffness matrices assumptions have been made about the form of the stress components within, and on the boundaries of, the element, together with assumptions about the form of the displacement components on the boundary of the element only. The commonly made assumptions in the derivation of stiffness matrices relate to the form of the displacement components not only on the boundary but throughout the element. In order to derive satisfactory mass matrices it is necessary to assume the form of the displacement components throughout the element. For the right-angled-triangle mass matrices these displacement components have been assumed independently of the assumed boundary displacements needed for the stiffness matrix. For the general-triangle mass matrix, however, the displacements throughout the element have been made consistent with the boundary displacements which were needed for the stiffness matrix. Numerical results are given for the first few natural frequencies of a square simply supported slab and a square encastré slab. Comparison with accepted values shows that the finite-element values are accurate, and convergent as the element size is reduced. For the same number of elements it is indicated that general triangles give a more accurate solution than right-angled triangles, probably because of the more satisfactory derivation of the mass matrix for the general triangle. This advantage is offset, however, by the greater computation time required by general triangles. Calculated and experimental frequency values are also given for a single-curvature arch dam of constant thickness. Mode shapes are not given in any of the numerical solutions although they are produced as an integral part of the computer programme.
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Affiliation(s)
- R Dungar
- Department of Civil Engineering, Univeristy of Bristol
| | - R T Severn
- Department of Civil Engineering, Univeristy of Bristol
| | - P R Taylor
- Department of Civil Engineering, Univeristy of Bristol
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Chen W, Dawsey SM, Qiao YL, Mark SD, Dong ZW, Taylor PR, Zhao P, Abnet CC. Prospective study of serum 25(OH)-vitamin D concentration and risk of oesophageal and gastric cancers. Br J Cancer 2007; 97:123-8. [PMID: 17551495 PMCID: PMC2359654 DOI: 10.1038/sj.bjc.6603834] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
We prospectively examined the relation between pretrial serum vitamin D status and risk of oesophageal and gastric cancers among subjects who developed cancer over 5.25 years of follow-up, including 545 oesophageal squamous cell carcinomas (ESCC), 353 gastric cardia adenocarcinomas, 81 gastric noncardia adenocarcinomas, and an age- and sex-stratified random sample of 1105 subjects. The distribution of serum 25(OH)D was calculated using the known sampling weights. For the cohort as a whole, the 25th, 50th, and 75th percentile concentrations of 25(OH)-vitamin D were 19.6, 31.9, and 48.7 nmol l(-1), respectively, and we found that higher serum 25(OH)D concentrations were associated with monotonically increasing risk of ESCC in men, but not in women. Comparing men in the fourth quartile of serum 25(OH)D concentrations to those in the first, we found a hazard ratio (HR) (95% confidence interval (CI)) of 1.77 (1.16-2.70), P trend=0.0033. The same comparison in women had a HR (95% CI) of 1.06 (0.71-1.59), P trend=0.70. We found no associations for gastric cardia or noncardia adenocarcinoma. Among subjects with low vitamin D status, higher serum 25(OH)D concentrations were associated with significantly increased risk of ESCC in men, but not in women. Further refinements of the analysis did not suggest any factors, which could explain this unexpected result.
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Affiliation(s)
- W Chen
- Department of Epidemiology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - S M Dawsey
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Y-L Qiao
- Department of Epidemiology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Department of Cancer Epidemiology, Cancer Institute, Chinese Academy of Medical Sciences, 17 S Panjiayuan Lane, Chaoyang District, PO Box 2258, Beijing 100021, China
| | - S D Mark
- Departments of Preventive Medicine & Biometrics, University of Colorado Health Sciences Center, Denver, CO, USA
| | - Z-W Dong
- Department of Epidemiology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - P R Taylor
- Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - P Zhao
- Department of Epidemiology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - C C Abnet
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, 6120 Executive Blvd, EPS/320, MSC 7232, Rockville, MD 20852, USA. E-mail:
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Morales JP, Taylor PR, Bell RE, Chan YC, Sabharwal T, Carrell TWG, Reidy JF. Neurological Complications Following Endoluminal Repair of Thoracic Aortic Disease. Cardiovasc Intervent Radiol 2007; 30:833-9. [PMID: 17508247 DOI: 10.1007/s00270-007-9017-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2006] [Accepted: 11/14/2006] [Indexed: 11/26/2022]
Abstract
Open surgery for thoracic aortic disease is associated with significant morbidity and the reported rates for paraplegia and stroke are 3%-19% and 6%-11%, respectively. Spinal cord ischemia and stroke have also been reported following endoluminal repair. This study reviews the incidence of paraplegia and stroke in a series of 186 patients treated with thoracic stent grafts. From July 1997 to September 2006, 186 patients (125 men) underwent endoluminal repair of thoracic aortic pathology. Mean age was 71 years (range, 17-90 years). One hundred twenty-eight patients were treated electively and 58 patients had urgent procedures. Anesthesia was epidural in 131, general in 50, and local in 5 patients. Seven patients developed paraplegia (3.8%; two urgent and five elective). All occurred in-hospital apart from one associated with severe hypotension after a myocardial infarction at 3 weeks. Four of these recovered with cerebrospinal fluid (CSF) drainage. One patient with paraplegia died and two had permanent neurological deficit. The rate of permanent paraplegia and death was 1.6%. There were seven strokes (3.8%; four urgent and three elective). Three patients made a complete recovery, one had permanent expressive dysphasia, and three died. The rate of permanent stroke and death was 2.1%. Endoluminal treatment of thoracic aortic disease is an attractive alternative to open surgery; however, there is still a risk of paraplegia and stroke. Permanent neurological deficits and death occurred in 3.7% of the patients in this series. We conclude that prompt recognition of paraplegia and immediate insertion of a CSF drain can be an effective way of recovering spinal cord function and improving the prognosis.
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Affiliation(s)
- J P Morales
- Department of Vascular Surgery, Guy's and St. Thomas' Foundation Hospital NHS Trust, Lambeth Palace Road, London, UK
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Chan YC, Morales JP, Gulamhuseinwala N, Sabharwal T, Carmichael M, Thomas S, Carrell TWG, Reidy JF, Taylor PR. Large infra-renal abdominal aortic aneurysms: endovascular vs. open repair--single centre experience. Int J Clin Pract 2007; 61:373-8. [PMID: 17263699 DOI: 10.1111/j.1742-1241.2006.01032.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Endovascular aneurysm repair (EVAR) has become an established alternative to open repair (OR). We present a consecutive series of 486 elective patients with large infra-renal aortic abdominal aneurysm, comparing OR with EVAR. Prospective data collected during an 8-year period from January 1997 to October 2005 was reviewed. Statistical analysis performed using SPSS data editor with chi(2) tests and Mann-Whitney U-tests. There were 486 patients with 329 OR (293 males, 36 females) with median age of 72 years with median diameter 6.3 cm and 157 EVAR (148 males, 9 females) with median age 75 years with median diameter 6.1 cm. Mortality was 13 (4%) for OR and 5 (3.2%) for EVAR (three of whom were in the UK EVAR 2 trial). Blood loss was significantly less for EVAR 500 ml vs. 1500 ml for OR. Sixty-five (19.8%) patients with OR had significantly more peri-operative complications compared with 14 (8.9%) with EVAR. The length of stay in hospital was significantly less for EVAR. This non-randomised study shows that although EVAR does not have a statistically significantly lower mortality, it does have statistically significantly lower complication rates compared with OR. EVAR can be achieved with good primary success, but long-term follow-up is essential to assess durability.
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Affiliation(s)
- Y C Chan
- Department of Vascular Surgery, Guy's & St Thomas' NHS Foundation Trust, Lambeth Palace Road, London, UK
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Chan YC, Morales JP, Rocker MD, Bell RE, Carrell TWG, Reidy JF, Taylor PR. Hybrid repair of type B dissecting aneurysm with associated Kommerell's diverticulum. Acta Chir Belg 2007; 107:211-4. [PMID: 17515274] [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: 05/15/2023]
Abstract
Endovascular therapy has revolutionised vascular surgery. Complex open surgical procedures may be replaced with a combination of extra-anatomical reconstruction and endovascular treatment. This minimally invasive approach is associated with a lower peri-operative morbidity and mortality than open repair. We describe a novel 2-stage treatment in a patient with Type B thoracic aortic dissection with subsequent aneurysmal dilatation and the added difficulty of a concomitant aneurysmal aberrant right subclavian artery (Kommerell's diverticulum).
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Affiliation(s)
- Y C Chan
- Department of Vascular & Endovascular Surgery, Guy's & St. Thomas' NHS Foundation Hospital, 1st Floor North Wing, St. Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK
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Affiliation(s)
- Y C Chan
- Department of Vascular, Endovascular Surgery & Interventional Radiology, Guy's & St. Thomas' NHS Foundation Hospital, 1st Floor North Wing, St. Thomas' Hospital, Lambeth Palace Road, London SE1 7EH, UK
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Kamangar F, Qiao YL, Blaser MJ, Sun XD, Katki H, Fan JH, Perez-Perez GI, Abnet CC, Zhao P, Mark SD, Taylor PR, Dawsey SM. Helicobacter pylori and oesophageal and gastric cancers in a prospective study in China. Br J Cancer 2006; 96:172-6. [PMID: 17179990 PMCID: PMC2360212 DOI: 10.1038/sj.bjc.6603517] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In a cohort of 29,584 residents of Linxian, China, followed from 1985 to 2001, we conducted a case-cohort study of the magnitude of the association of Helicobacter pylori seropositivity with cancer risk in a random sample of 300 oesophageal squamous cell carcinomas, 600 gastric cardia adenocarcinomas, all 363 diagnosed gastric non-cardia adenocarcinomas, and a random sample of the entire cohort (N=1050). Baseline serum was evaluated for IgG antibodies to whole-cell and CagA H. pylori antigens by enzyme-linked immunosorbent assay. Risks of both gastric cardia and non-cardia cancers were increased in individuals exposed to H. pylori (Hazard ratios (HRs) and 95% confidence intervals=1.64; 1.26-2.14, and 1.60; 1.15-2.21, respectively), whereas risk of oesophageal squamous cell cancer was not affected (1.17; 0.88-1.57). For both cardia and non-cardia cancers, HRs were higher in younger individuals. With longer time between serum collection to cancer diagnosis, associations became stronger for cardia cancers but weaker for non-cardia cancers. CagA positivity did not modify these associations. The associations between H. pylori exposure and gastric cardia and non-cardia adenocarcinoma development were equally strong, in contrast to Western countries, perhaps due to the absence of Barrett's oesophagus and oesophageal adenocarcinomas in Linxian, making all cardia tumours of gastric origin, rather than a mixture of gastric and oesophageal malignancies.
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Affiliation(s)
- F Kamangar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Rm 3034, Bethesda, MD 20892-7232, USA
- E-mail:
| | - Y-L Qiao
- Department of Cancer Epidemiology, Cancer Institute of the Chinese Academy of Medical Sciences, PO Box 2258, Beijing, 100021 China
- E-mail:
| | - M J Blaser
- Department of Medicine, New York University School of Medicine, New York, NY, USA
- Department of Microbiology, New York University School of Medicine, New York, NY, USA
| | - X-D Sun
- Department of Cancer Epidemiology, Cancer Institute of the Chinese Academy of Medical Sciences, PO Box 2258, Beijing, 100021 China
| | - H Katki
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Rm 3034, Bethesda, MD 20892-7232, USA
| | - J-H Fan
- Department of Cancer Epidemiology, Cancer Institute of the Chinese Academy of Medical Sciences, PO Box 2258, Beijing, 100021 China
| | - G I Perez-Perez
- Department of Medicine, New York University School of Medicine, New York, NY, USA
- Department of Microbiology, New York University School of Medicine, New York, NY, USA
| | - C C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Rm 3034, Bethesda, MD 20892-7232, USA
| | - P Zhao
- Department of Cancer Epidemiology, Cancer Institute of the Chinese Academy of Medical Sciences, PO Box 2258, Beijing, 100021 China
| | - S D Mark
- Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, CO, USA
| | - P R Taylor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Rm 3034, Bethesda, MD 20892-7232, USA
| | - S M Dawsey
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, Rm 3034, Bethesda, MD 20892-7232, USA
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Abstract
Multiple randomised trials over the last decade for both symptomatic and asymptomatic carotid stenosis have proven the efficacy of carotid endarterectomy (CE) in reducing the risk of stroke. The long-term patency of the carotid artery after CE is an important factor in the success of the operation. The incidence of recurrent carotid stenosis (excluding residual lesions) ranges from 1 to 37% with only 0-8% of patients having restenosis-related symptoms (1). Generally, recurrent carotid stenosis is attributed to myointimal hyperplasia during the early postoperative period (within 3 years) or recurrent atherosclerosis thereafter. The management of recurrent carotid stenosis after CE remains a dilemma. It is generally accepted that operation for significant recurrent carotid stenosis is indicated for symptomatic patients, and several authors also recommend CE for >80% asymptomatic recurrent stenosis. Treatment of recurrent carotid stenosis involves repeat endarterectomy with patch angioplasty, although more recently endovascular techniques have been used.
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Affiliation(s)
- H Sadideen
- Department of Ultrasound Angiology, Guy's and St. Thomas' Hospital Trust, London, UK
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Mahabir S, Baer DJ, Giffen C, Subar A, Campbell W, Hartman TJ, Clevidence B, Albanes D, Taylor PR. Calorie intake misreporting by diet record and food frequency questionnaire compared to doubly labeled water among postmenopausal women. Eur J Clin Nutr 2006; 60:561-5. [PMID: 16391574 DOI: 10.1038/sj.ejcn.1602359] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We assessed the extent of energy misreporting from the use of a self-administered 7-day diet record (7-DDR) and a widely used food frequency questionnaire (FFQ) compared to total energy expenditure from doubly labeled water (DLW) in a group of postmenopausal women. DESIGN At baseline, 65 healthy postmenopausal women were instructed to fill out the National Cancer Institute's (NCI) FFQ and a 7-DDR. Average total energy expenditure using the DLW method was also performed at baseline. RESULTS On average, the women underestimated total energy intake compared to total energy expenditure assessed from DLW by 37% on the 7-DDR and 42% on the FFQ. CONCLUSIONS These findings suggest that the interpretation of findings from the 7-DDR- and FFQ-based energy-disease association studies in postmenopausal women needs further evaluation. SPONSORSHIP This research was supported (in part) by the Intramural Program of the NIH (National Cancer Institute).
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Affiliation(s)
- S Mahabir
- Department of Epidemiology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
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Balyasnikova IV, Sun ZL, Metzger R, Taylor PR, Vicini E, Muciaccia B, Visintine DJ, Berestetskaya YV, McDonald TD, Danilov SM. Monoclonal antibodies to native mouse angiotensin-converting enzyme (CD143): ACE expression quantification, lung endothelial cell targeting and gene delivery. ACTA ACUST UNITED AC 2006; 67:10-29. [PMID: 16451197 DOI: 10.1111/j.1399-0039.2005.00516.x] [Citation(s) in RCA: 28] [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: 12/28/2022]
Abstract
We demonstrated previously that the monoclonal antibody 9B9 to angiotensin-converting enzyme (ACE), which accumulates very selectively into the rat lung after systemic injection, is a powerful tool for immunotargeting of therapeutic agents or genes to the rat lung vascular bed. Bearing in mind a high research and therapeutic potential of lung targeting via ACE, we obtained a new set of rat monoclonal antibodies to different epitopes of mouse ACE in order to expand this approach to mice. Nine new monoclonal antibodies, recognizing epitopes on the N- and C-domains of catalytically active mouse ACE, were obtained and examined for their efficacy to bind ACE both in vitro and in vivo. This set of monoclonal antibodies was proved to be useful for ACE quantification (by flow cytometry and cell enzyme-linked immunosorbent assay) on the surface of different mouse ACE-expressing cells: endothelial cells, monocytes, macrophages, dendritic cells and spermatozoa. Moreover, gene delivery into mouse ACE-expressing cells using adenoviruses increased 40-fold after redirecting of these viruses to ACE (by coating these viruses with anti-ACE monoclonal antibodies). Radiolabelled (I(125)) monoclonal antibodies specifically accumulated in the mouse lung after systemic injection. Monoclonal antibodies 3G8.17, 4B10.5 and 4B10.17 demonstrated the highest level of lung uptake, 40-50% of injected dose, and high selectivity of lung uptake. Influence of monoclonal antibodies on ACE shedding was negligible, except monoclonal antibody 1D10.11. None of the tested monoclonal antibodies inhibited ACE activity in vitro. In conclusion, a new set of rat monoclonal antibodies to mouse ACE was obtained suitable to study ACE biology in mice and for ACE expression quantification on mouse cells in particular. These monoclonal antibodies also demonstrated highly efficient and selective lung accumulation and thus has the potential for targeting drugs/genes to the pulmonary vasculature in different mouse models of human lung diseases, including numerous knockout models.
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Affiliation(s)
- I V Balyasnikova
- Department of Anesthesiology, University of Illinois at Chicago, USA
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Sanderson RN, Johnson PRE, Moorman AV, Roman E, Willett E, Taylor PR, Proctor SJ, Bown N, Ogston S, Bowen DT. Population-based demographic study of karyotypes in 1709 patients with adult Acute Myeloid Leukemia. Leukemia 2006; 20:444-50. [PMID: 16424877 DOI: 10.1038/sj.leu.2404055] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Few large demographic studies of acute myeloid leukemia (AML) are derived from population-based registries. Demographic and karyotypic data were provided for AML cases from two regional leukemia registry databases in Scotland and the Northern Region of England. A population-based dataset was compiled, comprising 1709 patients aged >16 years (1235 North England/474 Scotland patients). The most common cytogenetic abnormalities involved chromosomes 5 and/or 7 (17%). Patients with the following abnormal chromosome 5/7 combinations: -5, del(5q), -5/-7 and del(5q)/-7 represented a significantly older population (P < 0.01, ANOVA). t(8;21) was the only 'favourable' karyotype found in older age. Karyotypic complexity varied within chromosome 5/7 combination groups; those containing -5, -5/-7, -5/del(7q), del(5q)/-7 or del(5q)/del(7q) combinations were significantly more frequently complex than those containing -7 and del(7q) (P < 0.01, chi2 test). Additional recurring cytogenetic abnormalities within complex karyotypes containing chromosome 5/7 combinations included (in order of frequency), abnormalities of chromosomes 17, 12, 3 and 18. Complex karyotypes not involving chromosomes 5 or 7 represented 30% of all complex karyotypes, occurred in younger patients than those involving chromosomes 5 and 7, and frequently included additional trisomy 8 (26%). In conclusion, we describe subgroups within adverse karyotypes, with different demographics, degree of complexity and additional chromosome abnormalities.
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Affiliation(s)
- R N Sanderson
- Division of Pathology & Neuroscience, University of Dundee, Dundee, UK
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44
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Taylor PR, Rowe PH, Mason RC, McColl I. Duodenogastric reflux after gastric surgery. Br J Surg 2005. [DOI: 10.1002/bjs.1800740943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - P H Rowe
- Guy's Hospital, London SE1 9RT, UK
| | | | - I McColl
- Guy's Hospital, London SE1 9RT, UK
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46
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Abstract
BACKGROUND Mycotic aneurysms are rare. Conventional surgical options include ligation or excision with in-situ or extra-anatomical reconstruction. The use of endoluminal stenting for mycotic aneurysms in the presence of sepsis is controversial, but may be a temporising measure, or sometimes the only option in the management of critically ill patients who are not fit for surgery. METHODS A literature review was undertaken using Medline, all relevant papers on endoluminal management of mycotic aneurysm were taken into account. RESULTS Open surgical repair of mycotic aortic aneurysm is associated with considerable peri- and post-operative morbidity and mortality. Endoluminal treatment with stent-grafts has been introduced as an alternative, and early results are promising. CONCLUSION No level I evidence for the endoluminal treatment of mycotic aneurysms exists. Ideally a randomised controlled trial of open surgery versus endoluminal treatment should be performed but this may be difficult to perform because of the low incidence of infected aneurysms.
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Affiliation(s)
- Y C Chan
- Department of Vascular and Endovascular Surgery, 1st Floor North Wing, Guy's and St. Thomas' NHS Foundation Hospital, Lambeth Palace Road, London SE1 7EH, UK
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47
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Mahabir S, Baer DJ, Johnson LL, Frenkel K, Dorgan JF, Cambell W, Hartman TJ, Clevidence B, Albanes D, Judd JT, Taylor PR. No association between alcohol supplementation and autoantibodies to DNA damage in postmenopausal women in a controlled feeding study. Eur J Cancer Prev 2005; 14:427-9. [PMID: 16030435 DOI: 10.1097/00008469-200508000-00017] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Alcohol consumption is linked to increased breast cancer risk. Since oestrogens increase breast cancer risk, possibly through oxidative damage, and we have shown that alcohol consumption increases serum oestrogens, we tested whether moderate alcohol supplementation increased oxidative DNA damage among healthy postmenopausal women not on hormone replacement therapy in a randomized controlled crossover study. We used serum 5-hydroxymethyl-2-deoxyuridine (5-HMdU) autoantibodies (aAbs) as a marker of oxidative DNA damage. The results showed no evidence for increased or decreased levels of oxidative DNA damage among women who consumed 15 g or 30 g alcohol per day for 8 weeks compared with women in the 0 g alcohol group. We conclude that among healthy women, it is possible that an 8-week trial of moderate alcohol supplementation might be too short to make enough 5-HMdU aAbs to compare differences by alcohol dose. In future studies, a panel of biomarkers for DNA damage should be used.
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Affiliation(s)
- S Mahabir
- Cancer Prevention Studies Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
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48
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Abstract
Macrophages express a broad range of plasma membrane receptors that mediate their interactions with natural and altered-self components of the host as well as a range of microorganisms. Recognition is followed by surface changes, uptake, signaling, and altered gene expression, contributing to homeostasis, host defense, innate effector mechanisms, and the induction of acquired immunity. This review covers recent studies of selected families of structurally defined molecules, studies that have improved understanding of ligand discrimination in the absence of opsonins and differential responses by macrophages and related myeloid cells.
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Affiliation(s)
- P R Taylor
- Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, United Kingdom, USA
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49
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Stolzenberg-Solomon RZ, Graubard B, Chari S, Limburg P, Taylor PR, Virtamo J, Albanes D. 370: Insulin, Glucose, Insulin Resistance, and Pancreatic Cancer in Male Smokers. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s93a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - B Graubard
- NEB, DCEG, NCI, NIH, Rockville, MD 20852
| | - S Chari
- NEB, DCEG, NCI, NIH, Rockville, MD 20852
| | - P Limburg
- NEB, DCEG, NCI, NIH, Rockville, MD 20852
| | - P R Taylor
- NEB, DCEG, NCI, NIH, Rockville, MD 20852
| | - J Virtamo
- NEB, DCEG, NCI, NIH, Rockville, MD 20852
| | - D Albanes
- NEB, DCEG, NCI, NIH, Rockville, MD 20852
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50
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Wei WQ, Abnet CC, Lu N, Roth MJ, Wang GQ, Dye BA, Dong ZW, Taylor PR, Albert P, Qiao YL, Dawsey SM. Risk factors for oesophageal squamous dysplasia in adult inhabitants of a high risk region of China. Gut 2005; 54:759-63. [PMID: 15888779 PMCID: PMC1774536 DOI: 10.1136/gut.2004.062331] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Oesophageal squamous cell carcinoma (OSCC) is a common cancer worldwide and has a very high mortality rate. Squamous dysplasia is the precursor lesion for OSCC and it can be seen during routine endoscopy with Lugol's iodine staining. We aimed to examine the risk factors for squamous dysplasia and determine if a risk model could be constructed which would be useful in selecting apparently healthy subjects for endoscopic screening in a high risk population in Linzhou, People's Republic of China. SUBJECTS AND METHODS In this cross sectional study, 724 adult volunteers aged 40-65 years were enrolled. All subjects completed a questionnaire regarding potential environmental exposures, received physical and dental examinations, and underwent upper endoscopy with Lugol's iodine staining and biopsy. Subjects were categorised as having or not having histologically proven squamous dysplasia/early cancer. Risk factors for dysplasia were examined using univariate and multivariate logistic regression. The utility of the final multivariate model as a screening tool was assessed using a receiver operating characteristics curve. RESULTS We found that 230 of 720 subjects (32%) with complete data had prevalent squamous dysplasia. In the final multivariate model, more household members (odds ratio (OR) 1.12/member (95% confidence interval (CI) 0.99, 1.25)), a family history of cancer (OR 1.57 (95% CI 1.13-2.18)), higher systolic blood pressure OR 1.11/10 mm Hg (95% CI 1.03-1.19)), heating the home without a chimney (OR 2.22 (95% CI 1.27-3.86)), and having lost more but not all of your teeth (OR 1.91 for 12-31 teeth lost (95% CI 1.17-3.15)) were associated with higher odds of having dysplasia. Higher household income (OR 0.96/100 RMB (95% CI 0.91-1.00)) was associated with a lower odds of having dysplasia. Although we found several statistically significant associations, the final model had little ability to accurately predict dysplasia status, with maximum simultaneous sensitivity and specificity values of 57% and 54%, respectively. CONCLUSIONS We found that risk factors for dysplasia were similar to those previously identified as risk factors for OSCC in this population. The final model did a poor job of identifying subjects who had squamous dysplasia. Other methods will need to be developed to triage individuals to endoscopy in this high risk population.
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Affiliation(s)
- W-Q Wei
- Cancer Prevention Studies Branch, 6116 Executive Blvd, Rm 705, Bethesda, MD 20892-8314, USA
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