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Barton SM, Janve VA, McClure R, Anderson A, Matsubara JA, Gore JC, Pham W. Lipopolysaccharide Induced Opening of the Blood Brain Barrier on Aging 5XFAD Mouse Model. J Alzheimers Dis 2020; 67:503-513. [PMID: 30584141 DOI: 10.3233/jad-180755] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The development of neurotherapeutics for many neurodegenerative diseases has largely been hindered by limited pharmacologic penetration across the blood-brain barrier (BBB). Previous attempts to target and clear amyloid-β (Aβ) plaques, a key mediator of neurodegenerative changes in Alzheimer's disease (AD), have had limited clinical success due to low bioavailability in the brain because of the BBB. Here we test the effects of inducing an inflammatory response to disrupt the BBB in the 5XFAD transgenic mouse model of AD. Lipopolysaccharide (LPS), a bacterial endotoxin recognized by the innate immune system, was injected at varying doses. 24 hours later, mice were injected with either thioflavin S, a fluorescent Aβ-binding small molecule or 30 nm superparamagnetic iron oxide (SPIO) nanoparticles, both of which are unable to penetrate the BBB under normal physiologic conditions. Our results showed that when pretreated with 3.0 mg/kg LPS, thioflavin S can be found in the brain bound to Aβ plaques in aged 5XFAD transgenic mice. Following the same LPS pretreatment, SPIO nanoparticles could also be found in the brain. However, when done on wild type or young 5XFAD mice, limited SPIO was detected. Our results suggest that the BBB in aged 5XFAD mouse model is susceptible to increased permeability mediated by LPS, allowing for improved delivery of the small molecule thioflavin S to target Aβ plaques and SPIO nanoparticles, which are significantly larger than antibodies used in clinical trials for immunotherapy of AD. Although this approach demonstrated efficacy for improved delivery to the brain, LPS treatment resulted in significant weight loss even at low doses, resulting from the induced inflammatory response. These findings suggest inducing inflammation can improve delivery of small and large materials to the brain for improved therapeutic or diagnostic efficacy. However, this approach must be balanced with the risks of systemic inflammation.
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Affiliation(s)
- Shawn M Barton
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Vaibhav A Janve
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Richard McClure
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Adam Anderson
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Joanne A Matsubara
- Department of Ophthalmology and Visual Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - John C Gore
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.,Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA.,Vanderbilt Ingram Cancer Center, Nashville, TN, USA.,Vanderbilt Institute of Chemical Biology, Nashville, TN, USA
| | - Wellington Pham
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA.,Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA.,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA.,Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA.,Vanderbilt Ingram Cancer Center, Nashville, TN, USA.,Vanderbilt Institute of Chemical Biology, Nashville, TN, USA.,Vanderbilt Institute of Nanoscale Science and Engineering, Nashville, TN, USA
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Cox EQ, Killenberg S, Frische R, McClure R, Hill M, Jenson J, Pearson B, Meltzer-Brody SE. Repetitive transcranial magnetic stimulation for the treatment of postpartum depression. J Affect Disord 2020; 264:193-200. [PMID: 32056750 DOI: 10.1016/j.jad.2019.11.069] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/10/2019] [Accepted: 11/12/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Postpartum depression (PPD) is a common and gravely disabling health concern. Repetitive transcranial magnetic stimulation (rTMS) is an FDA approved treatment for major depression and may be a valuable tool in the treatment of PPD. The treatment effect of rTMS is rapid, generally well tolerated, without systemic effects, and without medication exposure to a fetus and/or breastfed infant. METHODS Six women with PPD received 20 sessions of 10 Hz rTMS over the left dorsolateral prefrontal cortex (DLPFC) over a 4 week period. Psychiatric rating scales (BDI, EPDS, STATI), cognitive assessments (MMSE, Trails B, List Generation) and breastfeeding practices were surveyed at baseline and post rTMS treatment. BDI and EPDS were obtained weekly, as well as 3 months and 6 months post study conclusion. RESULTS Average BDI, EPDS, and STAI scores declined over the 4-week duration of rTMS treatment. Of the six patients, four achieved remission as assessed by EPDS and one achieved remission and two responded as assessed by BDI. Mean BDI and EPDS scores at 3 and 6 months follow-up remained below levels at study entry. No evidence of cognitive changes or breastfeeding disruptions. LIMITATIONS This was an exploratory study with small sample size with no sham control arm. Daily administration of rTMS provides potential for confounding of behavioral activation in the otherwise often isolative postpartum period. CONCLUSIONS rTMS was safe and well tolerated among participants with evidence of sustained improvements in depression and anxiety scores. This study supports rTMS as a promising non-pharmacologic treatment modality for perinatal depression.
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Affiliation(s)
- E Q Cox
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - S Killenberg
- Disability Determination Services, 40 Fountain Street, Providence, RI 02903, United States.
| | - R Frische
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - R McClure
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - M Hill
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - J Jenson
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - B Pearson
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
| | - S E Meltzer-Brody
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive Campus Box 7160, Chapel Hill, NC 27514, United States.
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Abstract
A robust fluorescent readout assay using topologically-sensitive dyes improves the screening of novel amyloid-binding molecules. One of the key components that make this assay more realistic is the use of endogenous amyloid obtained from 5XFAD mouse brains. The assay conditions were optimized for high throughput screening operation with Z-prime values >0.6. Using a combination of library of 3,500 compounds including known drugs, natural-derived molecules and random organic molecules, 8 unique molecules were identified as potential amyloid-binding agents.
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Affiliation(s)
- Richard McClure
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
| | - Rey Redha
- Vanderbilt High-Throughput Screening Facility, Nashville, TN, USA
| | - Paige Vinson
- Vanderbilt High-Throughput Screening Facility, Nashville, TN, USA
- Department of Biochemistry, Vanderbilt University, Nashville, TN, USA
| | - Wellington Pham
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Ingram Cancer Center, Nashville, TN, USA
- Vanderbilt Institute of Chemical Biology, Nashville, TN, USA
- Vanderbilt Institute of Nanoscale Science and Engineering, Nashville, TN, USA
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Senaratne J, Norris C, McClure R, Nagendran J, Butler C, Meyer S, Anderson T, Van Diepen S. 2200Adherence to cardiac surgical waitlist guidelines is a poor predictor of cardiac surgery waitlist mortality. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.2200] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cheema PK, Raphael S, El-Maraghi R, Li J, McClure R, Zibdawi L, Chan A, Victor JC, Dolley A, Dziarmaga A. Rate of EGFR mutation testing for patients with nonsquamous non-small-cell lung cancer with implementation of reflex testing by pathologists. ACTA ACUST UNITED AC 2017; 24:16-22. [PMID: 28270720 DOI: 10.3747/co.24.3266] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Testing for mutation of the EGFR (epidermal growth factor receptor) gene is a standard of care for patients with advanced nonsquamous non-small-cell lung cancer (nsclc). To improve timely access to EGFR results, a few centres implemented reflex testing, defined as a request for EGFR testing by the pathologist at the time of a nonsquamous nsclc diagnosis. We evaluated the impact of reflex testing on EGFR testing rates. METHODS A retrospective observational review of the Web-based AstraZeneca Canada EGFR Database from 1 April 2010 to 31 March 2014 found centres within Ontario that had requested EGFR testing through the database and that had implemented reflex testing (with at least 2 years' worth of data, including the pre- and post-implementation period). RESULTS The 7 included centres had requested EGFR tests for 2214 patients. The proportion of pathologists requesting EGFR tests increased after implementation of reflex testing (53% vs. 4%); conversely, the proportion of medical oncologists requesting tests decreased (46% vs. 95%, p < 0.001). After implementation of reflex testing, the mean number of patients having EGFR testing per centre per month increased significantly [12.6 vs. 4.9 (range: 4.5-14.9), p < 0.001]. Before reflex testing, EGFR testing rates showed a significant monthly increase over time (1.37 more tests per month; 95% confidence interval: 1.19 to 1.55 tests; p < 0.001). That trend could not account for the observed increase with reflex testing, because an immediate increase in EGFR test requests was observed with the introduction of reflex testing (p = 0.003), and the overall trend was sustained throughout the post-reflex testing period (p < 0.001). CONCLUSIONS Reflex EGFR testing for patients with nonsquamous nsclc was successfully implemented at multiple centres and was associated with an increase in EGFR testing.
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Affiliation(s)
- P K Cheema
- Division of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto
| | - S Raphael
- Department of Anatomic Pathology, North York General Hospital, Toronto
| | - R El-Maraghi
- Department of Medical Oncology/Hematology, Royal Victoria Regional Health Centre, Barrie
| | - J Li
- Department of Medical Oncology/Hematology, Michael Garron Hospital, Toronto
| | - R McClure
- Department of Anatomic Pathology, Health Sciences North, Sudbury
| | - L Zibdawi
- Department of Medical Oncology/Hematology, Southlake Regional Health Centre, Newmarket
| | - A Chan
- Department of Medical Oncology/Hematology, Thunder Bay Regional Health Sciences Centre, Thunder Bay
| | - J C Victor
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto; and
| | - A Dolley
- AstraZeneca Canada Inc., Mississauga, ON
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McClure R, Ong H, Janve V, Barton S, Zhu M, Li B, Dawes M, Jerome WG, Anderson A, Massion P, Gore JC, Pham W. Aerosol Delivery of Curcumin Reduced Amyloid-β Deposition and Improved Cognitive Performance in a Transgenic Model of Alzheimer's Disease. J Alzheimers Dis 2017; 55:797-811. [PMID: 27802223 PMCID: PMC5848215 DOI: 10.3233/jad-160289] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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: 01/07/2023]
Abstract
We report a novel approach for the delivery of curcumin to the brain via inhalation of the aerosol for the potential treatment of Alzheimer's disease. The percentage of plaque fraction in the subiculum and hippocampus reduced significantly when young 5XFAD mice were treated with inhalable curcumin over an extended period of time compared to age-matched nontreated counterparts. Further, treated animals demonstrated remarkably improved overall cognitive function, no registered systemic or pulmonary toxicity associated with inhalable curcumin observed during the course of this work.
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Affiliation(s)
- Richard McClure
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Henry Ong
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Vaibhab Janve
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Shawn Barton
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Meiying Zhu
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Bo Li
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
| | - Mary Dawes
- Vanderbilt Cell Imaging Core Laboratory, Nashville, TN, USA
| | - W. Gray Jerome
- Department of Pathology, Microbiology and Immunology, Vanderbilt University, Nashville, TN, USA
| | - Adam Anderson
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Pierre Massion
- Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | - John C. Gore
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Wellington Pham
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
- Vanderbilt Institute of Chemical Biology, Nashville, TN, USA
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
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Allen T, McClure R, Newstead SV, Lenné MG, Hillard P, Symmons M, Day L. Exposure factors of Victoria's active motorcycle fleet related to serious injury crash risk. Traffic Inj Prev 2016; 17:870-877. [PMID: 26980668 DOI: 10.1080/15389588.2016.1159304] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/23/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The purpose of this study was to describe the nature and extent of current powered 2-wheeler (PTW) risk exposures in order to support future efforts to improve safety for this mode of transport. METHODS A cross-sectional analysis of the control arm of a population-based case-control study was conducted. The control sample was selected from 204 sites on public roads within 150 km of the city of Melbourne that were locations of recent serious injury motorcycle crashes. Traffic observations and measurements at each site were sampled for a mean of 2 h on the same type of day (weekday, Saturday, or Sunday) and within 1 h of the crash time. Photographs of passing riders during this observation period recorded data relating to characteristics of PTWs, age of riders, travel speed of PTWs and all vehicles, time gaps between vehicles, visibility, and protective clothing use. RESULTS Motorcycles and scooters represented 0.6% of all traffic (compared with 4% of all vehicle registrations). Riders were significantly more likely to have larger time gaps in front and behind when compared to other vehicles. The average travel speed of motorcycles was not significantly different than the traffic, but a significantly greater proportion were exceeding the speed limit when compared to other vehicles (6 vs. 3%, respectively). The age of registered owners of passing motorcycles was 42 years. Over half of riders were wearing dark clothing with no fluorescent or reflective surfaces. One third of motorcyclists had maximum coverage of motorcycle-specific protective clothing. CONCLUSIONS A very low prevalence of motorcyclists combined with relatively higher rates of larger time gaps to other vehicles around motorcycles may help explain their overrepresentation in injury crashes where another vehicle fails to give way. An increased risk of injury in the event of a crash exists for a small but greater proportion of motorcyclists (compared to other vehicle types) who were exceeding the speed limit. An apparent shift toward older age of the active rider population may be reducing injury crash risk relative to exposure time. There is significant scope to improve the physical conspicuity of motorcyclists and the frequency of motorcycle specific protective clothing use. These results can be used to inform policy development and monitor progress of current and future road safety initiatives.
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Affiliation(s)
- T Allen
- a Monash University Accident Research Centre , Clayton , Victoria , Australia
| | - R McClure
- b Harvard Injury Control Research Center , Harvard School of Public Health , Boston , Massachusetts
| | - S V Newstead
- a Monash University Accident Research Centre , Clayton , Victoria , Australia
| | - M G Lenné
- a Monash University Accident Research Centre , Clayton , Victoria , Australia
| | - P Hillard
- a Monash University Accident Research Centre , Clayton , Victoria , Australia
| | - M Symmons
- c Faculty of Education , Monash University , Melbourne , Victoria , Australia
| | - L Day
- d Monash Injury Research Institute, Monash University , Melbourne , Victoria , Australia
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Cao N, Kalet A, Fang L, Dempsey C, Young L, Kim J, Mayr N, Lavilla M, Richardson H, McClure R, Meyer J. SU-G-TeP1-11: Predictors of Cardiac and Lung Dose Sparing in DIBH for Left Breast Treatment. Med Phys 2016. [DOI: 10.1118/1.4957001] [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: 11/07/2022] Open
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9
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McClure R, Yanagisawa D, Stec D, Abdollahian D, Koktysh D, Xhillari D, Jaeger R, Stanwood G, Chekmenev E, Tooyama I, Gore JC, Pham W. Inhalable curcumin: offering the potential for translation to imaging and treatment of Alzheimer's disease. J Alzheimers Dis 2015; 44:283-95. [PMID: 25227316 DOI: 10.3233/jad-140798] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Curcumin is a promising compound that can be used as a theranostic agent to aid research in Alzheimer's disease. Beyond its ability to bind to amyloid plaques, the compound can also cross the blood-brain barrier. Presently, curcumin can be applied only to animal models, as the formulation needed for iv injection renders it unfit for human use. Here, we describe a novel technique to aerosolize a curcumin derivative, FMeC1, and facilitate its safe delivery to the brain. Aside from the translational applicability of this approach, a study in the 5XFAD mouse model suggested that inhalation exposure to an aerosolized FMeC1 modestly improved the distribution of the compound in the brain. Additionally, immunohistochemistry data confirms that following aerosol delivery, FMeC1 binds amyloid plaques expressed in the hippocampal areas and cortex.
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Affiliation(s)
- Richard McClure
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, Nashville, TN, USA Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Daijiro Yanagisawa
- Shiga University of Medical Science, Otsu, Japan Molecular Neuroscience Research Center, Shiga University of Medical Science, Otsu, Japan
| | - Donald Stec
- Department of Chemistry, Vanderbilt University, Nashville, TN, USA
| | - Dave Abdollahian
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, Nashville, TN, USA
| | - Dmitry Koktysh
- Department of Chemistry, Vanderbilt University, Nashville, TN, USA Vanderbilt Institute of Nanoscale Science and Engineering, Nashville, TN, USA
| | | | | | - Gregg Stanwood
- Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA Department of Pharmacology, Vanderbilt University, Nashville, TN, USA
| | - Eduard Chekmenev
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, Nashville, TN, USA Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Ikuo Tooyama
- Shiga University of Medical Science, Otsu, Japan Molecular Neuroscience Research Center, Shiga University of Medical Science, Otsu, Japan
| | - John C Gore
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, Nashville, TN, USA Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN, USA
| | - Wellington Pham
- Institute of Imaging Science, Vanderbilt University, Nashville, TN, USA Department of Radiology and Radiological Sciences, Vanderbilt School of Medicine, Nashville, TN, USA Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, USA Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA Vanderbilt Institute of Chemical Biology, Nashville, TN, USA
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Sakuma S, Kumagai H, Shimosato M, Kitamura T, Mohri K, Ikejima T, Hiwatari KI, Koike S, Tobita E, McClure R, Gore JC, Pham W. Toxicity studies of coumarin 6-encapsulated polystyrene nanospheres conjugated with peanut agglutinin and poly(N-vinylacetamide) as a colonoscopic imaging agent in rats. Nanomedicine 2015; 11:1227-36. [PMID: 25725490 DOI: 10.1016/j.nano.2015.02.003] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/31/2015] [Accepted: 02/12/2015] [Indexed: 11/25/2022]
Abstract
UNLABELLED We are investigating an imaging agent that detects early-stage primary colorectal cancer on the mucosal surface in real time under colonoscopic observation. The imaging agent, which is named the nanobeacon, is fluorescent nanospheres conjugated with peanut agglutinin and poly(N-vinylacetamide). Its potential use as an imaging tool for colorectal cancer has been thoroughly validated in numerous studies. Here, toxicities of the nanobeacon were assessed in rats. The nanobeacon was prepared according to the synthetic manner which is being established as the Good Manufacturing Practice-guided production. The rat study was performed in accordance with Good Laboratory Practice regulations. No nanobeacon treatment-related toxicity was observed. The no observable adverse effect levels (NOAEL) of the nanobeacon in 7-day consecutive oral administration and single intrarectal administration were estimated to be more than 1000mg/kg/day and 50mg/kg/day, respectively. We concluded that the nanobeacon could be developed as a safe diagnostic agent for colonoscopy applications. FROM THE CLINICAL EDITOR Colon cancer remains a major cause of death. Early detection can result in early treatment and thus survival. In this article, the authors tested potential systemic toxicity of coumarin 6-encapsulated polystyrene nanospheres conjugated with peanut agglutinin (PNA) and poly(N-vinylacetamide) (PNVA), which had been shown to bind specifically to colonic cancer cells and thus very promising in colonoscopic detection of cancer cells.
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Affiliation(s)
- Shinji Sakuma
- Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka Japan.
| | | | - Moe Shimosato
- Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka Japan
| | - Tokio Kitamura
- Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka Japan
| | - Kohta Mohri
- Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka Japan
| | | | | | - Seiji Koike
- Life Science Materials Laboratory, ADEKA Co., Tokyo, Japan
| | - Etsuo Tobita
- Life Science Materials Laboratory, ADEKA Co., Tokyo, Japan
| | - Richard McClure
- Institute of Imaging Science, Medical Center, Vanderbilt University, Nashville, TN, USA
| | - John C Gore
- Institute of Imaging Science, Medical Center, Vanderbilt University, Nashville, TN, USA
| | - Wellington Pham
- Institute of Imaging Science, Medical Center, Vanderbilt University, Nashville, TN, USA.
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11
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Cornelissen M, Salmon PM, Stanton NA, McClure R. Assessing the 'system' in safe systems-based road designs: using cognitive work analysis to evaluate intersection designs. Accid Anal Prev 2015; 74:324-338. [PMID: 24225066 DOI: 10.1016/j.aap.2013.10.002] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 09/19/2013] [Accepted: 10/01/2013] [Indexed: 06/02/2023]
Abstract
While a safe systems approach has long been acknowledged as the underlying philosophy of contemporary road safety strategies, systemic applications are sparse. This article argues that systems-based methods from the discipline of Ergonomics have a key role to play in road transport design and evaluation. To demonstrate, the Cognitive Work Analysis framework was used to evaluate two road designs - a traditional Melbourne intersection and a cut-through design for future intersections based on road safety safe systems principles. The results demonstrate that, although the cut-through intersection appears different in layout from the traditional intersection, system constraints are not markedly different. Furthermore, the analyses demonstrated that redistribution of constraints in the cut-through intersection resulted in emergent behaviour, which was not anticipated and could prove problematic. Further, based on the lack of understanding of emergent behaviour, similar design induced problems are apparent across both intersections. Specifically, incompatibilities between infrastructure, vehicles and different road users were not dealt with by the proposed design changes. The importance of applying systems methods in the design and evaluation of road transport systems is discussed.
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Affiliation(s)
- M Cornelissen
- Monash Injury Research Institute, Monash University, Melbourne, Australia.
| | - P M Salmon
- Monash Injury Research Institute, Monash University, Melbourne, Australia; University of Sunshine Coast Accident Research, Faculty of Arts and Business, University of the Sunshine Coast, Maroochydore, Australia
| | - N A Stanton
- Civil, Maritime, Environmental Engineering and Science Unit, Faculty of Engineering and the Environment, University of Southampton, United Kingdom
| | - R McClure
- Monash Injury Research Institute, Monash University, Melbourne, Australia
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12
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Sakuma S, Yu JYH, Quang T, Hiwatari KI, Kumagai H, Kao S, Holt A, Erskind J, McClure R, Siuta M, Kitamura T, Tobita E, Koike S, Wilson K, Richards-Kortum R, Liu E, Washington K, Omary R, Gore JC, Pham W. Fluorescence-based endoscopic imaging of Thomsen-Friedenreich antigen to improve early detection of colorectal cancer. Int J Cancer 2014; 136:1095-103. [PMID: 25052906 DOI: 10.1002/ijc.29093] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/10/2014] [Indexed: 12/12/2022]
Abstract
Thomsen-Friedenreich (TF) antigen belongs to the mucin-type tumor-associated carbohydrate antigen. Notably, TF antigen is overexpressed in colorectal cancer (CRC) but is rarely expressed in normal colonic tissue. Increased TF antigen expression is associated with tumor invasion and metastasis. In this study, we sought to validate a novel nanobeacon for imaging TF-associated CRC in a preclinical animal model. We developed and characterized the nanobeacon for use with fluorescence colonoscopy. In vivo imaging was performed on an orthotopic rat model of CRC. Both white light and fluorescence colonoscopy methods were utilized to establish the ratio-imaging index for the probe. The nanobeacon exhibited specificity for TF-associated cancer. Fluorescence colonoscopy using the probe can detect lesions at the stage which is not readily confirmed by conventional visualization methods. Further, the probe can report the dynamic change of TF expression as tumor regresses during chemotherapy. Data from this study suggests that fluorescence colonoscopy can improve early CRC detection. Supplemented by the established ratio-imaging index, the probe can be used not only for early detection, but also for reporting tumor response during chemotherapy. Furthermore, since the data obtained through in vivo imaging confirmed that the probe was not absorbed by the colonic mucosa, no registered toxicity is associated with this nanobeacon. Taken together, these data demonstrate the potential of this novel probe for imaging TF antigen as a biomarker for the early detection and prediction of the progression of CRC at the molecular level.
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Affiliation(s)
- Shinji Sakuma
- Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
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Goode N, Spencer C, Archer F, McArdle D, Salmon PM, McClure R. HAVE WE LEARNT THE LESSONS FROM DISASTER INQUIRIES? THEMES FROM RECENT AUSTRALIAN DISASTER INQUIRIES IN THE CONTEXT OF THE NATIONAL STRATEGY FOR DISASTER RESILIENCE. Inj Prev 2012. [DOI: 10.1136/injuryprev-2012-040580g.10] [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: 11/03/2022]
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Seedat M, McClure R, Suffla S, van Niekerk A. Developing the evidence-base for Safe Communities: a multi-level, partly randomised, controlled trial. Int J Inj Contr Saf Promot 2012; 19:231-41. [PMID: 22873717 DOI: 10.1080/17457300.2012.705303] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Safe Communities, representing a global activation of the public health logic, may be strengthened through theoretical, methodological and empirical support. In the spirit of this Special Issue that aims to analyse the achievements and challenges inherent to Safe Communities, we offer our contribution in the form of a methodology of a multi-country child safety, peace and health promotion study. The study, situated within an African-centred initiative called Ukuphepha - an isiZulu word meaning demonstrating African safety - is underpinned by four theoretical claims that frame injury and violence prevention as a multi-disciplinary issue to be addressed through a suite of interventions to family and extended social systems. The interventions, sensitive to the priorities of each participating country, have been informed by the literature on effective interventions and the authors' joint experiences of community development. The study is designed as a population-based, multi-level, multi-intervention partly randomised controlled trial, and there are potentially 24 participant communities representing South Africa, Mozambique, Egypt, Zambia, Uganda, Bangladesh, Malaysia and Australia - over three commencement phases. Whereas process evaluation will focus on community engagement, impact evaluation will consider risk and protective factors, and outcome evaluation will examine the overall effectiveness of the interventions. Notwithstanding the many challenges, the study will provide insights into the methodology and mechanisms of ecologically-oriented interventions that locate injury and violence prevention as an activity arising from safety, peace and health promotion.
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Affiliation(s)
- M Seedat
- Institute for Social and Health Sciences, University of South Africa, Johannesburg, South Africa.
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Yiengprugsawan V, Stephan K, McClure R, Kelly M, Seubsman S, Bain C, Sleigh AC. Risk factors for injury in a national cohort of 87,134 Thai adults. Public Health 2011; 126:33-9. [PMID: 22137094 PMCID: PMC3267036 DOI: 10.1016/j.puhe.2011.09.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Revised: 07/31/2011] [Accepted: 09/26/2011] [Indexed: 11/17/2022]
Abstract
BACKGROUND Information is needed regarding risk factors associated with injury. In middle- and lower-income countries, injury studies have focused on road traffic injuries and less attention has been given to other types of injuries. METHODS This study is part of overarching health-risk transition research in Thailand with a large national cohort study that began in 2005 (n = 87,134). Associations between potential determinants and overall injury were measured, as well as injury by location (transport, home, work and sport), using data gathered from the baseline questionnaire. RESULTS In total, 21.5% of the cohort reported at least one incidence of injury over the last 12 months. Risk factors associated with injury were being male [odds ratio (OR) 1.20], having lower income (OR 1.70), having problems with vision (OR 1.46), having epilepsy (OR 3.02), having depression/anxiety (OR 1.62), poor self-assessed health (OR 1.68), being obese (OR 1.24) and death of father due to injury (OR 1.59). Analysis of injury by location provided more specific information on risk factors. For example, females were more likely to report injuries at home, while males, urban residents and regular alcohol drinkers were more likely to report transport injuries. CONCLUSIONS The risk of injury in Thailand varies considerably by location, sociodemographic group and several categories of co-existing morbidities. Such epidemiological information identifying risk factors for injury is useful for designing targeted injury prevention programmes in Thailand and other middle-income countries.
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Affiliation(s)
- V Yiengprugsawan
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
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Bugeja L, Ibrahim JE, Ozanne-Smith J, Brodie L, McClure R. Coroners recommendations and the prevention of fatal injury. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.480] [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: 11/03/2022]
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Stephan K, Kelly M, McClure R, Seubsman S, Yiengprugsawan V, Bain C, Sleigh A. Transport injury and road safety behaviours in a Thai national adult cohort. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Spinks AB, Cameron CM, Scuffham RA, Scott R, Ng SK, McClure R. Maternal psychological distress and injury in the first year of life. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.669] [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: 11/03/2022]
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Mitchell R, McClure R, Olivier J, Watson W. Allocation of Australia's research dollars: does injury research funding reflect injury burden? Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.399] [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: 11/03/2022]
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Bugeja L, McClure R. Amending the public policy model underlying the public health approach to injury prevention in order to improve the translation of research-to-practice. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Davey T, Davey J, Freeman J, McClure R. Empirical basis for adopting a theory-driven approach to preventing alcohol and other drug impairment (AOD) in the workplace. Inj Prev 2010. [DOI: 10.1136/ip.2010.029215.489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Turner C, Bain C, Schluter PJ, Yorkston E, Bogossian F, McClure R, Huntington A. Cohort Profile: The Nurses and Midwives e-Cohort Study--A Novel Electronic Longitudinal Study. Int J Epidemiol 2008; 38:53-60. [DOI: 10.1093/ije/dym294] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [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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Huang XL, Isabel de Michelena M, Leon E, Maher TA, McClure R, Milunsky A. Pallister-Killian syndrome: tetrasomy of 12pter→12p11.22 in a boy with an analphoid, inverted duplicated marker chromosome. Clin Genet 2007; 72:434-40. [PMID: 17894838 DOI: 10.1111/j.1399-0004.2007.00894.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Supernumerary marker chromosomes (SMCs) without detectable alphoid DNA are predicted to have a neocentromere and have been referred to as mitotically stable neocentromere marker chromosomes (NMCs). Here we report the molecular cytogenetic characterization of a new case of Pallister-Killian syndrome (PKS) in a boy with an analphoid, inverted duplicated NMC derived from 12pter-->12p11.22 in his fibroblasts by using high-resolution comparative genetic hybridization (HR-CGH), multiplex fluorescent in situ hybridization (FISH) and bacterial artificial chromosome (BAC)-FISH mapping analyses with various alpha-satellite DNA probes, subtelomere probes and BAC-DNA probes. Precise identification of SMCs and NMCs is of essential importance in genetic counseling. HR-CGH is a more informative and often a faster way of precisely identifying the origin of SMCs. This case is the third report of PKS with an NMC containing an inverted duplication of partial 12p with available clinical data. These observations may help to determine the critical region for PKS and the mechanisms leading to the origin of the NMC derived from 12pter-->12p11.22 - a region that appears to be susceptible to the formation of neocentromeres. The use of subtelomeric probe PCP12p in buccal cells appears superior to the use of the centromere probe D12Z3 for the diagnosis of the PKS.
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Affiliation(s)
- X-L Huang
- Center for Human Genetics, Boston University School of Medicine, Boston, MA, USA
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Rayman R, Croome K, Galbraith N, McClure R, Morady R, Peterson S, Smith S, Subotic V, Van Wynsberghe A, Patel R, Primak S. Robotic telesurgery: a real-world comparison of ground- and satellite-based internet performance. Int J Med Robot 2007; 3:111-6. [PMID: 17554810 DOI: 10.1002/rcs.133] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Telesurgery was performed with ground vs. satellite networks, and differing satellite bandwidths. METHODS The networks were compared during internal mammary artery (LIMA) dissection in pigs (n = 8). Length of LIMA dissected and surgical quality (five-point scale) were recorded. Also, satellite bandwidth was decreased (n = 7) to determine a limit for telesurgery. RESULTS No significant differences existed in LIMA dissection during the ground (4.3 +/- 0.5 cm) and satellite phases (5.4 +/- 1.1 cm; p > 0.05) or in quality of surgery, although latency on satellite was 10 times greater (55 vs. 600 ms). With decreasing satellite bandwidth, surgery was not possible below 3 Mb/s, and quality of surgery was significantly decreased comparing 9 Mb/s (4.38 +/- 0.66/5) to 3 Mb/s (4.10 +/- 0.80/5; p < 0.05). CONCLUSIONS Satellite communication is a viable telesurgical modality. Satellite bandwidth should be above 5 Mb/s during telesurgery if used primarily or as back-up.
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Affiliation(s)
- R Rayman
- Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada.
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Rayman R, Croome K, Galbraith N, McClure R, Morady R, Peterson S, Smith S, Subotic V, Van Wynsberghe A, Primak S. Long-distance robotic telesurgery: a feasibility study for care in remote environments. Int J Med Robot 2007; 2:216-24. [PMID: 17520635 DOI: 10.1002/rcs.99] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Basic telesurgical manoeuvres were conducted with signal delays. METHODS Eight test subjects conducted four manoeuvres. Time delays of 0-1000 ms were investigated. Time to task completion and error rate were recorded in sequential delays of 0-600 ms. Additionally, blinded random delays of 0-1000 ms were studied. RESULTS In the sequential trials (0-600 ms), there were no significant differences in average task time compared to zero latency. The error rate remained low despite increasing time delay, and was significantly less at 500 ms (p < 0.05). In the random trials, task time was significantly greater at delays of 500, 600, 800 and 1000 ms (p < 0.05). There were no significant differences in error rates (p = 0.252). CONCLUSIONS Operators are capable of performing surgical exercises at significant delays. Latent video feedback is difficult for telesurgery. Visual or virtual reality cues should be implemented to aid the operator in a high-cadence telesurgery environment.
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Affiliation(s)
- R Rayman
- Canadian Surgical Technologies and Advanced Robotics (CSTAR), London Health Sciences Centre, London, Ontario, Canada.
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McClure R, Mai M, Lasho T. Validation of two clinically useful assays for evaluation of JAK2 V617F mutation in chronic myeloproliferative disorders. Leukemia 2005; 20:168-71. [PMID: 16270039 DOI: 10.1038/sj.leu.2404007] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
BACKGROUND The safe communities approach has been embraced around the world as a model for coordinating community efforts to enhance safety and reduce injury. Over 80 communities throughout the world have been formally designated as 'Safe Communities' by the World Health Organization. It is of public health interest to determine to what degree the model is successful, and whether its application does indeed reduce injury rates in communities to which it is introduced. OBJECTIVES To determine the effectiveness of the Safe Communities model to prevent injury in whole populations, or targeted sub-groups of populations. SEARCH STRATEGY The search strategy was based on electronic searches, handsearches of selected journals, snowballing from reference lists of selected publications and contacting a key person from each WHO-designated Safe Community. SELECTION CRITERIA Studies were independently screened for inclusion by two reviewers. Included studies were those conducted within a WHO Safe Community that reported changes in population injury rates within the community compared to a control community. DATA COLLECTION AND ANALYSIS Data were independently extracted by two reviewers. Meta-analysis was not appropriate, due to the heterogeneity of the included studies. MAIN RESULTS Only seven WHO Safe Communities, of more than 80 worldwide, have undertaken controlled evaluations using objective sources of injury data. These communities represent only four countries from two geographical regions in the world: the Scandinavian countries of Sweden and Norway and the Pacific nations of Australia and New Zealand. Safe Communities in Sweden and Norway have resulted in significant reductions in injury rates. The Australian and New Zealand communities have been unable to replicate the same level of success. AUTHORS' CONCLUSIONS Evidence suggests the WHO Safe Communities model is effective in reducing injuries in whole populations. However, important methodological limitations exist in all studies from which evidence can be obtained. A lack of reported detail makes it unclear which factors facilitate or hinder a programme's success, and makes uncertain, whether the success of any particular application of the model is necessarily replicable in other communities. In evaluated programmes that did not report significant decreases in injury rates, this lack of information makes it difficult to distinguish between evidence of no effect of the model, or no evidence of effect. The four countries that have evaluated their Safe Communities with a sufficiently rigorous study design have higher economic wealth and health standards and lower injury rates than much of the world. No evaluations were available from other parts of the world, despite the designation of WHO Safe Communities in countries such as South Africa, Bangladesh, China, Vietnam, Canada, UK and USA. Generalisation of results of studies conducted in just four countries, to the international population needs to be done with caution. There is a need for more high-quality, methodologically strong evaluations of the model in a range of diverse communities and detailed reporting of implementation processes.
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Affiliation(s)
- A Spinks
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia, 4006.
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Abstract
This paper provides an overview of the ecological study design and its application to injury prevention. The advantages and disadvantages of ecological designs are described and the principle characteristics of the ecological design are highlighted. The paper concludes by highlighting the pivotal role that ecological studies can have in our understanding of the complex interaction between the environment and injury, and the application of this design in elucidating key population based strategies for injury prevention.
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Affiliation(s)
- M Stevenson
- Injury Prevention and Trauma Care Division, The George Institute for International Health and School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
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McClure R, Turner C, Peel N, Spinks A, Eakin E, Hughes K. Population-based interventions for the prevention of fall-related injuries in older people. Cochrane Database Syst Rev 2005:CD004441. [PMID: 15674948 DOI: 10.1002/14651858.cd004441.pub2] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fall-related injuries are a significant cause of morbidity and mortality in the older population. Summary information about counter-measures that successfully address the risk factors for fall-related injuries in research settings has been widely disseminated. However, less available is evidence-based information about successful roll-out of these counter-measures in public health programmes in the wider community. Population-based interventions in the form of multi-strategy, multi-focused programmes are hypothesised to result in a reduction in population-wide injury rates. This review tests this hypothesis with regards to fall-related injuries among older people. OBJECTIVES To assess the effectiveness of population-based interventions, defined as coordinated, community-wide, multi-strategy initiatives, for reducing fall-related injuries among older people. SEARCH STRATEGY The search strategy was based on electronic searches, handsearches of selected journals and snowballing from reference lists of selected publications. SELECTION CRITERIA Studies were independently screened for inclusion by two reviewers. Included studies were those that reported changes in medically treated fall-related injuries among older people following the implementation of a controlled population-based intervention. DATA COLLECTION AND ANALYSIS Data were independently extracted by two reviewers. Meta-analysis was not appropriate, due to the heterogeneity of the included studies. MAIN RESULTS Out of 23 identified studies, five met the criteria for inclusion. There were no randomised controlled trials. Significant decreases or downward trends in fall-related injuries were reported in all five of the included studies with the relative reduction in fall-related injuries ranging from 6 to 33%. AUTHORS' CONCLUSIONS Despite methodological limitations of the evaluation studies reviewed, the consistency of reported reductions in fall-related injuries across all programmes support the preliminary claim that the population-based approach to the prevention of fall-related injury is effective and can form the basis of public health practice. Randomised, multiple community trials of population-based interventions are indicated to increase the level of evidence in support of the population-based approach. Research is also required to elucidate the barriers and facilitators in population-based interventions that influence the extent to which population programmes are effective.
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Abstract
OBJECTIVE Community based models for injury prevention have become an accepted part of the overall injury control strategy. This systematic review of the scientific literature examines the evidence for their effectiveness in reducing all-cause injury in children 0-14 years of age. METHODS A comprehensive search of the literature was performed using the following study selection criteria: community based intervention study; children under 14 years; outcome measure was injury rates; and either a community control or an historical control was used in the design. Quality assessment and data abstraction were guided by a standardized procedure and performed independently by two authors. Data synthesis was in tabular and text form with meta-analysis not being possible due to the discrepancy in methods and measures between the studies. RESULTS Thorough electronic and library search techniques yielded only nine formally evaluated community based all-cause child injury prevention programs that have reported actual injury outcomes. Of these nine studies, seven provided high level evidence where contemporary control communities were used for comparison; the remaining two used a pre and post-design or time trend analysis where historical data from the community were used as the comparison. Only three of the seven studies with contemporary control communities found significant effect of the intervention; the two studies without controls noted significant reductions in injury rates after the intervention period. CONCLUSION There is a paucity of research from which evidence regarding the effectiveness of community based childhood injury prevention programs can be obtained and hence a clear need to increase the effort on developing this evidence base.
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Affiliation(s)
- A Spinks
- Injury Research Unit, School of Population Health, Mayne Medical School, University of Queensland, Brisbane, Australia
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Abstract
OBJECTIVE Community based models for injury prevention have become an accepted part of the overall injury control strategy. This systematic review of the scientific literature examines the evidence for their effectiveness in preventing poisoning in children 0-15 years of age. METHODS A comprehensive search of the literature was performed using the following study selection criteria: community based intervention study; target population was children under 15 years; outcome measure was poisoning rates; and either a community control or an historical control was used in the study design. Quality assessment and data abstraction were guided by a standardized procedure and performed independently by two authors. Data synthesis was in tabular and text form with meta-analysis not being possible due to the discrepancy in methods and measures between the studies. RESULTS The review found only four studies, which met all the inclusion criteria. Only two studies used a trial design with a contemporary control and only one study provided convincing evidence of an effective community program for reducing poisoning in children. CONCLUSION There is a paucity of research studies in the literature from which evidence regarding the effectiveness of community based childhood poisoning prevention programs can be obtained and hence a clear need to increase the effort on developing this evidence base.
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Affiliation(s)
- J Nixon
- Department of Paediatrics and Child Health, School of Medicine, University of Queensland, Brisbane, Australia
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Turner C, Spinks A, McClure R, Nixon J. Community-based interventions for the prevention of burns and scalds in children. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2003. [DOI: 10.1002/14651858.cd004335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Risk taking behaviour has been identified as an important host-related determinant of injury in young adults. The aim of this study is to clarify the relationship between the two key elements of risk taking behaviour--ie, risk assessment and risk acceptance--in participants of a high risk sporting activity. Skydivers registered with the Australian Parachute Federation were sampled at several jump meetings held at three 'drop-zones' in North Eastern Australia. A cross sectional survey of 215 skydivers ascertained each subject's risk assessment of each of nine hypothetical sky diving scenes and whether or not they would jump in the described conditions. Variables which independently predicted an individual's risk assessment were age group (p < 0.05). gender (p < 0.05) and scene details (p < 0.001). Risk assessment was found to be a statistically significant predictor of the decision to jump, with a 22% decrease in the odds of jumping with every unit increase in risk assessment (OR = 0.78: 95% CI: 0.76, 0.80). Gender was also found to be a statistically significant predictor of the decision to jump, with males being 19% more likely to jump than females, after controlling for age, experience, currency and risk assessment (OR = 1. 19: 95% CI; 1.04, 1.38). The importance of these results is that, by quantifying the relationship between two key elements of risk taking behaviour and several important host factor determinants, they facilitate more informed discussion about the possible role of risk taking behaviour in the causation of injury.
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Affiliation(s)
- M Green
- School of Population Health, University of Queensland, Brisbane, Australia
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Vidershaĭn GI, Koul O, Bovin NV, Nifant'ev NE, McClure R. [Determination of substrate specificity of fucosyltransferase from rat brain using synthetic acceptors]. Bioorg Khim 2000; 26:448-51. [PMID: 10923193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
The substrate specificity of fucosyltransferase (FT) from rat forebrain and cerebellum was studied using synthetic acceptors. Of 16 acceptors tested, only those containing the Gal beta 1-4GlcNAc beta 1-R fragment were subjected to enzymic fucosylation. The isomer with a 1-3 bond as well as lactose and oligosaccharides with an additional Neu5Ac residue attached to Gal or a Fuc residue attached to GlcNAc were not fucosylated whereas Fuc alpha 1-2Gal beta 1-4GlcNAc displayed the same substrate properties as Gal beta 1-4GlcNAc. FT from cerebellum and forebrain was shown to have the specificity similar to that of mammalian FT IV. The activity of the cerebellum FT with all types of substrates was higher than that of FT isolated from forebrain, the specificity profiles being similar.
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Affiliation(s)
- G Ia Vidershaĭn
- Department of Biomedical Sciences, E.K. Shriver Center, Waltham, MA 02452, USA
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Snowden S, Weech P, McClure R, Smye SW, Dear PRF. A neural network to predict attendance of paediatric patients at outpatient clinics. Neural Comput Appl 1995. [DOI: 10.1007/bf01414648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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McClure R. Injury and general practice in Australia. Aust Fam Physician 1995; 24:2059-63. [PMID: 8579542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To describe the extent to which general practices are involved in the initial management of injury in Australia. METHODS Data were derived from a secondary analysis of the 1989-1990 National Health Survey (NHS); a population-based multi-stage and list sample survey of the Australian population. The study variables used in this analysis included age, sex, country of birth, employment status, place of most recent accident, number of reduced activity days subsequent to injury and where presenting for treatment of the injury. RESULTS The ratio of general practice to hospital emergency department attendance for treatment of injury was 1.5:1 (95% confidence limits = 1-2:1). The two groups of patients differed by age, employment status, place of most recent accident but not by sex or country of birth. CONCLUSION Results from hospital studies should not be extrapolated to produce community estimates of injury incidence in Australia. General practice should be specifically included in future injury research and control projects.
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Affiliation(s)
- R McClure
- Department of Social and Preventive Medicine, University of Queensland
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Affiliation(s)
- R McClure
- Institute of Child Health, Royal Liverpool Children's Hospital Alder Hey, UK
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Nissen SE, Gurley JC, Grines CL, Booth DC, McClure R, Berk M, Fischer C, DeMaria AN. Intravascular ultrasound assessment of lumen size and wall morphology in normal subjects and patients with coronary artery disease. Circulation 1991; 84:1087-99. [PMID: 1884441 DOI: 10.1161/01.cir.84.3.1087] [Citation(s) in RCA: 484] [Impact Index Per Article: 14.7] [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: 12/29/2022]
Abstract
BACKGROUND Necropsy studies demonstrate that coronary artery disease (CAD) is frequently complex and eccentric. However, angiography provides only a silhouette of the vessel lumen. Intravascular ultrasound is a new tomographic imaging method for evaluation of coronary dimensions and wall morphology. Few data exist regarding intravascular ultrasound in patients with CAD, and no data exist for subjects with normal coronaries. METHODS AND RESULTS We used a multielement 5.5F, 20-MHz ultrasound catheter to examine eight normal subjects and 43 patients with CAD. We assessed the safety of coronary ultrasound and the effect of vessel eccentricity on comparison of minimum luminal diameter by angiography and ultrasound. Normal and atherosclerotic wall morphology and stenosis severity were also evaluated by intravascular ultrasound. The only untoward effect was transient coronary spasm in five patients. At 33 sites in normal subjects, the lumen was nearly circular, yielding a close correlation between angiographic and ultrasonic minimum diameter (r = 0.92). At 90 sites in patients with CAD, ultrasound demonstrated a concentric cross section; correlation was also close (r = 0.93). However, at 72 eccentric sites, correlation was not as close (r = 0.77). For 41 stenoses, correlation between angiography and ultrasound for area reduction was moderate (r = 0.63). In normal subjects, wall morphology revealed a thin (0.30 mm or less) intimal leading edge and subadjacent sonolucent zone (0.20 mm or less). Patients with CAD exhibited increased thickness and echogenicity of the leading edge, thickened sonolucent zones, and/or attenuation of ultrasound transmission. CONCLUSIONS These data establish that intravascular ultrasound is feasible and safe and yields luminal measurements that correlate generally with angiography. Differences between angiographic and ultrasound measures of lumen size in eccentric vessels probably reflect the dissimilar perspectives of tomographic and silhouette imaging techniques. Intravascular ultrasound provides detailed images of normal and abnormal wall morphology not previously possible in vivo.
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Affiliation(s)
- S E Nissen
- Division of Cardiovascular Medicine, University of Kentucky Medical Center, Lexington 40536-0084
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al-Bagdadi F, Hoyt P, Karns P, Martin G, Memon M, McClure R, McCoy D, Shoemaker S. The morphology of abdominal and inguinal cryptorchid testes in stallions: a light and electron microscopic study. Int J Fertil 1991; 36:57-64. [PMID: 1672678] [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: 12/28/2022]
Abstract
Eleven unilateral cryptorchid stallions, two to three years old, were castrated at Louisiana State University Veterinary Teaching Hospital. Five of these cryptorchid cases were abdominal and the rest were inguinal. This study was initiated to document the differences between the abdominal and inguinal equine cryptorchid testes. Specimens were obtained from the abepididymal side of each cryptorchid testes and processed for light and electron microscopic study. The cryptorchid testes were smaller than the scrotal testes, with the abdominal testes being one-fourth the size of the scrotal testes. Two of the abdominal testes had cysts filled with a straw-colored fluid. The seminiferous tubules of the abdominal testes were larger than those in the inguinal testes. The epithelial linings of the seminiferous tubules of the abdominal testes were vacuolated and did not contain more than two layers of undifferentiated cells. The interstitial collagen fibers of the abdominal testes were coarse and more abundant than those of the inguinal testes. The seminiferous tubules of the inguinal testes were smaller and contained many layers of epithelial cells at different stages of embryological differentiation, with scattered primordial germ cells. The necrotic, degenerative changes of the epithelial cells of the abdominal testes were distinct, while the inguinal testes had healthy cells at embryological arrest.
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Affiliation(s)
- F al-Bagdadi
- Department of Veterinary Anatomy and Fine Structure, School of Veterinary Medicine, Louisiana State University, Baton Rouge
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Olson LM, Klintmalm GB, Husberg BS, Nery JR, Whitten CW, Paulsen AW, McClure R. Superoxide dismutase improves organ preservation in liver transplantation. Transplant Proc 1988; 20:961-4. [PMID: 3279677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- L M Olson
- Department of Transplantation Surgery, Baylor University Medical Center, Dallas, TX
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McMurry JF, Long D, McClure R, Kotchen TA. Addison's disease with adrenal enlargement on computed tomographic scanning. Report on two cases of tuberculosis and review of the literature. Am J Med 1984; 77:365-8. [PMID: 6087660 DOI: 10.1016/0002-9343(84)90723-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Two patients with Addison's disease related to urogenital tuberculosis had enlargement of one or both adrenal glands detected with computed tomographic scanning. Review of reports of adrenal size on computed tomographic examination suggests that adrenal enlargement in the presence of Addison's disease demands further investigation about the cause of the adrenal insufficiency.
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Abstract
This study discriminated between students who used a university counseling center and those who did not on the basis of several simple measures. Highly neurotic subjects, those who acknowledged problems freely, and subjects with low self-concepts were more likely to use the counseling center. Canonical function predicted use of a counseling center for a second group of students. Such information may be used to plan preventive counseling early for those with potential problems.
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McClure R, Rivett P. Model Building for Decision Analysis. J Am Stat Assoc 1981. [DOI: 10.2307/2287619] [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: 11/10/2022]
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Cruise LJ, McClure R. Posterior pathway for aqueous humor drainage in the dog. Am J Vet Res 1981; 42:992-5. [PMID: 7283249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A posterior route for the drainage of aqueous humor was determined, using latex spheres as tracers. Continuous intracameral injections were made on live Beagles for periods up to 1 hour. Intraocular pressure was maintained between 15 and 30 mm of Hg during the infusion process. Tissue macrophages ingested many of the spheres, and their ingestion served to fix the position of the markers as they passively followed aqueous drainage routes. Thin sections were prepared from tissues that reportedly constituted the uveoscleral route. The electron microscope was used to visualize the latex spheres within the macrophages. In this manner, a uveoscleral pathway was demonstrated in normal Beagles.
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McClure R, Ross A. Additions and Corrections-S-Alkoxymethyl and S-Alkylmercaptomethyl Derivatives( of 2-Pyridinethiol 1-Oxide). J Org Chem 1962. [DOI: 10.1021/jo01059a616] [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: 11/30/2022]
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