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1.
Acta Virol ; 63(3): 261-269, 2019.
Article in English | MEDLINE | ID: mdl-31507191

ABSTRACT

Bovine viral diarrhea virus (BVDV) exists in two main biotypes: cytopathic (cp) and noncytopathic (ncp). Although some studies were done on the effect of interferon alpha (IFN-α) on BVDV, the effect of exogenous IFN against BVDV biotypes remains unclear. In the present study, we evaluated the comparative effect of exogenous human IFN-α (HuIFN-α) on different BVDV biotypes and genotypes. The results showed that exogenous HuIFN-α greatly inhibited the growth of different BVDV biotypes and genotypes. However, HuINF-α has a significant inhibitory effect on cp biotype compared to ncp one without significant variation between different genotypes. The effect of HuIFN-α on BVDV reached the maximum level at early stages of infection (0-20 h post infection) and increased in a dose-dependent manner (10-500 U/ml). Quantitative real-time RT-PCR was used to evaluate the effect of exogenous HuIFN-α on RNA synthesis of both BVDV biotypes. HuIFN-α reduced RNA production of cp by 4 logs compared to only 2 logs for ncp strains. Additionally, the antiviral effect of IFN-α against both BVDV biotypes seems to be independent of the RNA-dependent protein kinase (PKR) activation as assayed by direct analysis of in vivo phosphorylation of eIF2-α and by 2-aminopurine (2-AP) treatment. Collectively, these results indicated that the exogenous HuIFN-α treatment has an inhibitory effect not only on cp BVDV biotype but also on the ncp BVDV. The antiviral effect of exogenous HuIFN-α was biotype, time, dose but not genotype dependent. PKR has no role in the inhibitory effect suggesting that other IFN-antiviral pathways were involved. Keywords: BVDV biotypes; HuIFN-α; RNA synthesis; PKR-independent.


Subject(s)
Bovine Virus Diarrhea-Mucosal Disease , Diarrhea Viruses, Bovine Viral , Interferon-alpha , Animals , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Bovine Virus Diarrhea-Mucosal Disease/drug therapy , Bovine Virus Diarrhea-Mucosal Disease/virology , Cattle , Diarrhea Viruses, Bovine Viral/drug effects , Humans , Interferon-alpha/pharmacology , Interferon-alpha/therapeutic use , Virus Replication/drug effects
2.
Strahlenther Onkol ; 194(12): 1124-1131, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30109361

ABSTRACT

BACKGROUND: Cochlea sparing can reduce late ototoxicity in head and neck cancer patients treated with cisplatin-based radiochemotherapy. In this situation, a mean cochlear dose (MCD) constraint of 10 Gy has been suggested by others based on the dose-effect relationship of clinical data. We aimed to investigate whether this is feasible for primary and postoperative radiochemotherapy in locoregionally advanced tumors without compromising target coverage. PATIENTS AND METHODS: Ten patients treated with definitive and ten patients treated with adjuvant intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy were investigated. The cochleae and a planning risk volume (PRV) with a 3 mm margin were newly delineated, whereas target volumes and other organs at risk were not changed. The initial plan was recalculated with a constraint of 10 Gy (MCD) on the low-risk side. The quality of the resulting plan was evaluated using the difference in the equivalent uniform dose (EUD). RESULTS: A unilateral MCD of below 10 Gy could be achieved in every patient. The mean MCD was 6.8 Gy in the adjuvant cohort and 7.6 Gy in the definitive cohort, while the non-spared side showed a mean MCD of 18.7 and 30.3 Gy, respectively. The mean PRV doses were 7.8 and 8.4 Gy for the spared side and 18.5 and 29.8 Gy for the non-spared side, respectively. The mean EUD values of the initial and recalculated plans were identical. Target volume was not compromised. CONCLUSION: Unilateral cochlea sparing with an MCD of less than 10 Gy is feasible without compromising the target volume or dose coverage in locoregionally advanced head and neck cancer patients treated with IMRT. A prospective evaluation of the clinical benefit of this approach as well as further investigation of the dose-response relationship for future treatment modification appears promising.


Subject(s)
Chemoradiotherapy/adverse effects , Cisplatin/adverse effects , Cochlea/drug effects , Cochlea/radiation effects , Organ Sparing Treatments , Otorhinolaryngologic Neoplasms/therapy , Radiotherapy, Intensity-Modulated/adverse effects , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chemoradiotherapy, Adjuvant/adverse effects , Cisplatin/therapeutic use , Combined Modality Therapy , Feasibility Studies , Female , Humans , Male , Neoplasm Grading , Neoplasm Staging , Otorhinolaryngologic Neoplasms/pathology , Radiation Dosage , Radiotherapy Planning, Computer-Assisted
3.
Phys Rev Lett ; 117(19): 197201, 2016 Nov 04.
Article in English | MEDLINE | ID: mdl-27858446

ABSTRACT

Terahertz magnetic fields with amplitudes of up to 0.4 Tesla drive magnon resonances in nickel oxide while the induced dynamics is recorded by femtosecond magneto-optical probing. We observe distinct spin-mediated optical nonlinearities, including oscillations at the second harmonic of the 1 THz magnon mode. The latter originate from coherent dynamics of the longitudinal component of the antiferromagnetic order parameter, which are probed by magneto-optical effects of second order in the spin deflection. These observations allow us to dynamically disentangle electronic from lattice-related contributions to magnetic linear birefringence and dichroism-information so far only accessible by ultrafast THz spin control. The nonlinearities discussed here foreshadow physics that will become essential in future subcycle spin switching.

4.
Trials ; 25(1): 620, 2024 Sep 19.
Article in English | MEDLINE | ID: mdl-39300465

ABSTRACT

INTRODUCTION: High-quality evidence is crucial for guiding effective humanitarian responses, yet conducting rigorous research, particularly randomised controlled trials, in humanitarian crises remains challenging. The TISA ("traitement intégré de la sous-nutrition aiguë") trial aimed to evaluate the impact of a Water, Sanitation and Hygiene (WASH) intervention on the standard national treatment of uncomplicated Severe Acute Malnutrition (SAM) in children aged 6-59 months. Implemented in two northern Senegalese regions from December 22, 2021, to February 20, 2023, the trial faced numerous challenges, which this paper explores along with the lessons learned. METHODS: The study utilised trial documentation, including field reports, meeting minutes, training plans, operational monitoring data and funding proposals, to retrace the trial timeline, identify challenges and outline implemented solutions. Contributions from all TISA key staff-current and former, field-based and headquarters-were essential for collecting and interpreting information. Challenges were categorised as internal (within the TISA consortium) or external (broader contextual issues). RESULTS: The TISA trial, executed by a consortium of academic, operational, and community stakeholders, enrolled over 2000 children with uncomplicated SAM across 86 treatment posts in a 28,000 km2 area. The control group received standard outpatient SAM care, while the intervention group also received a WASH kit and hygiene promotion. Initially planned to start in April 2019 for 12 months, the trial faced a 30-month delay and was extended to 27 months due to challenges like the COVID-19 pandemic, national strikes, health system integration issues and weather-related disruptions. Internal challenges included logistics, staffing, data management, funding and aligning diverse stakeholder priorities. DISCUSSION AND CONCLUSION: Despite these obstacles, the trial concluded successfully, underscoring the importance of tailored monitoring, open communication, transparency and community involvement. Producing high-quality evidence in humanitarian contexts demands extensive preparation and strong coordination among local and international researchers, practitioners, communities, decision-makers and funders from the study's inception. TRIAL REGISTRATION: Clinicaltrials.gov NCT04667767 .


Subject(s)
Hygiene , Sanitation , Humans , Infant , Child, Preschool , Senegal , Altruism , Child Nutrition Disorders/prevention & control , Child Nutrition Disorders/diagnosis , Child Nutrition Disorders/therapy , Child Nutrition Disorders/epidemiology , Treatment Outcome , Female , Male , Time Factors , Research Design , COVID-19/epidemiology , Relief Work
5.
Am J Transplant ; 13(10): 2653-63, 2013 Oct.
Article in English | MEDLINE | ID: mdl-24034142

ABSTRACT

The risk of fractures after kidney transplantation is high. Hyperparathyroidism frequently persists after successful kidney transplantation and contributes to bone loss, but its impact on fracture has not been demonstrated. This longitudinal study was designed to evaluate hyperparathyroidism and its associations with mineral disorders and fractures in the 5 posttransplant years. We retrospectively analyzed 143 consecutive patients who underwent kidney transplantation between August 2004 and April 2006. The biochemical parameters were determined at transplantation and at 3, 12 and 60 months posttransplantation, and fractures were recorded. The median intact parathyroid hormone (PTH) level was 334 ng/L (interquartile 151-642) at the time of transplantation and 123 ng/L (interquartile 75-224) at 3 months. Thirty fractures occurred in 22 patients. The receiver operating characteristic (ROC) curve analysis for PTH at 3 months (area under the ROC curve = 0.711, p = 0.002) showed that a good threshold for predicting fractures was 130 ng/L (sensitivity = 81%, specificity = 57%). In a multivariable analysis, independent risk factors for fracture were PTH >130 ng/L at 3 months (adjusted hazard ratio [AHR] = 7.5, 95% CI 2.18-25.50), and pretransplant osteopenia (AHR = 2.7, 95% CI 1.07-7.26). In summary, this study demonstrates for the first time that persistent hyperparathyroidism is an independent risk factor for fractures after kidney transplantation.


Subject(s)
Calcification, Physiologic , Fractures, Bone/etiology , Hyperparathyroidism/etiology , Kidney Failure, Chronic/surgery , Kidney Transplantation , Parathyroid Hormone/blood , Postoperative Complications , Adult , Aged , Female , Follow-Up Studies , Fractures, Bone/blood , Fractures, Bone/diagnosis , Glomerular Filtration Rate , Humans , Hyperparathyroidism/blood , Hyperparathyroidism/diagnosis , Kidney Function Tests , Longitudinal Studies , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , Young Adult
7.
Int J Clin Pract ; 67(8): 717-25, 2013 Aug.
Article in English | MEDLINE | ID: mdl-23279674

ABSTRACT

BACKGROUND: Antihypertensive medicines are to known to cause diverse disturbances to electrolyte homeostasis; however, their potential to affect zinc is less well known. The primary aim was to explore whether antihypertensive medicines have the potential to affect zinc status. METHODS: A review of electronic databases was undertaken. Full-length English language articles describing clinical trials involving antihypertensive medicines and reporting on zinc measurements were reviewed. RESULTS: Eight eligible studies were identified which involved the use of ACE inhibitors, thiazide diuretics, beta blockers, or ARB drugs of which five included a control group Studies used urinary zinc excretion, plasma zinc levels or erythrocyte zinc as key measures of zinc status. Studies reported increased urinary zinc losses for captopril (from 50 mg/day), enalapril (20 mg/day), losartan (50 mg/day), losartan (50 mg/day) together with hydrochlorothiazide (12.5 mg/day), captopril (75 mg/day) together with frusemide (40 mg/day) and stand-alone hydrochlorothiazide (25 mg/day). Serum levels of zinc decreased with captopril (50-150 mg/day), verapamil (240 mg/day), atenolol (50-150 mg/day) and the combination of losartan (50 mg/day) and hydrochlorothiazide (12.5 mg/day), eryrthrocyte levels decreased with use of valsartan (80 mg/day) and in some studies for captopril, but not for metoprolol (100 mg/day), atenolol (50-150 mg/day), verapamil (240 mg/day), doxazosin (4 mg/day) or amlodipine 10 mg/day). Major limitations were that most studies were small and did not report on dietary zinc intake. CONCLUSION: The available evidence suggests that use of ACE inhibitors and angiotensin 2 receptor antagonists or thiazide diuretics have the potential to reduce zinc levels in hypertensive patients. Additional research using larger participant numbers and accounting for dietary zinc intakes are required.


Subject(s)
Antihypertensive Agents/adverse effects , Trace Elements/metabolism , Zinc/metabolism , Adrenergic beta-Antagonists/adverse effects , Angiotensin Receptor Antagonists/adverse effects , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Calcium Channel Blockers/adverse effects , Food-Drug Interactions , Humans , Hypertension/drug therapy , Risk Factors , Sodium Chloride Symporter Inhibitors/adverse effects , Trace Elements/deficiency , Zinc/deficiency
8.
Am J Transplant ; 12(12): 3296-307, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22974211

ABSTRACT

We report here on a European cohort of 27 kidney transplant recipients displaying operational tolerance, compared to two cohorts of matched kidney transplant recipients under immunosuppression and patients who stopped immunosuppressive drugs and presented with rejection. We report that a lower proportion of operationally tolerant patients received induction therapy (52% without induction therapy vs. 78.3%[p = 0.0455] and 96.7%[p = 0.0001], respectively), a difference likely due to the higher proportion (18.5%) of HLA matched recipients in the tolerant cohort. These patients were also significantly older at the time of transplantation (p = 0.0211) and immunosuppression withdrawal (p = 0.0002) than recipients who rejected their graft after weaning. Finally, these patients were at lower risk of infectious disease. Among the 27 patients defined as operationally tolerant at the time of inclusion, 19 still display stable graft function (mean 9 ± 4 years after transplantation) whereas 30% presented slow deterioration of graft function. Six of these patients tested positive for pre-graft anti-HLA antibodies. Biopsy histology studies revealed an active immunologically driven mechanism for half of them, associated with DSA in the absence of C4d. This study suggests that operational tolerance can persist as a robust phenomenon, although eventual graft loss does occur in some patients, particularly in the setting of donor-specific alloantibody.


Subject(s)
Graft Rejection/immunology , Graft Survival/immunology , Immune Tolerance/immunology , Immunosuppression Therapy , Isoantibodies/immunology , Kidney Transplantation/immunology , Adult , Case-Control Studies , Cohort Studies , Female , Humans , Immunoenzyme Techniques , Kidney Transplantation/mortality , Living Donors , Male , Middle Aged , Survival Rate
9.
J Exp Med ; 171(1): 129-40, 1990 Jan 01.
Article in English | MEDLINE | ID: mdl-2295875

ABSTRACT

The two genes for the C4A and C4B isotypes of the fourth component of human complement are located in the MHC class III region. Previous studies have demonstrated the unusual expression of C4 genes in the form of aberrant or duplicated haplotypes. Null alleles of C4A or C4B (AQ0 or BQ0) have been defined by the absence of gene products and occur at frequencies of 0.1-0.3. However, only some C4 null alleles are due to gene deletions, the remainder were thought to be nonexpressed genes. We have analyzed the C4 gene structure of 26 individuals lacking either C4A or C4B protein. The DNA of individuals with apparently nonexpressed C4 genes was tested for the presence of C4A- and C4B-specific sequences using restriction fragment analysis and isotype-specific oligonucleotide hybridization of DNA amplified by polymerase chain reaction. All nondeleted AQ0 allels had C4A-specific sequences and may thus be described as pseudogenes, whereas the nondeleted BQ0 alleles had C4A-instead of C4B-specific sequences. Gene conversion is the probable mechanism by which a C4A gene is found at the second C4 locus normally occupied by C4B genes.


Subject(s)
Alleles , Complement C4/genetics , Gene Conversion , Genes , Pseudogenes , Base Sequence , Complement C4/deficiency , Complement C4a/genetics , Complement C4b/genetics , DNA/genetics , DNA Probes , Homozygote , Humans , Molecular Sequence Data , Oligonucleotide Probes , Polymerase Chain Reaction
10.
Clin Transl Radiat Oncol ; 24: 83-87, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32642564

ABSTRACT

BACKGROUND: Anal cancer (AC) is a malignancy with increasing incidence and commonly treated with radiochemotherapy. Positron-emission tomography-computed tomography (PET/CT) has been shown to improve treatment outcome in various oncological diseases, however, for AC long-term outcome data is sparse. The aim of the present study is therefore to report outcomes in our cohort of PET/CT staged AC patients treated with radiochemotherapy. METHODS: Patients with AC who were treated with radiochemotherapy in curative intent were included in this retrospective study if a PET/CT scan was performed pre-therapeutically. Information from PET/CT was considered for nodal and primary target volume definition. Radiotherapy dose to the primary tumor was 50-66 Gy and concomitant chemotherapy included 5-fluorouracil and mitomycin-C. The uptake of 18F-fluorodeoxyglucose (FDG) was quantified using 50%-isocontour volumes of interests (VOIs) and measuring the standardized uptake value (SUV) and the metabolic tumor volume (MTV).18F-FDG uptake was correlated with baseline clinical parameters and long-term oncological outcome. Survival estimates were determined according to Kaplan-Meier. RESULTS: A total of 60 patients were included in this study. Estimates for three-year overall survival (OS) and disease free survival (DFS) were 94.5% and 80%. Five patients developed local (n = 2) or locoregional and local (n = 3) failure. Baseline PET/CT related parameters correlated with primary tumor stage, nodal stage and tumor grading. DFS was independent of T-stage, N-stage and baseline 18F-FDG-uptake. CONCLUSION: In this cohort of PET/CT staged AC patients, excellent outcomes for DFS were seen. PET-based markers of tumor burden correlate with local stage of AC, however, are not of prognostic relevance for disease-free survival.

11.
Science ; 178(4064): 984-6, 1972 Dec 01.
Article in English | MEDLINE | ID: mdl-5084666

ABSTRACT

Labeled morphine, codeine, heroin, or methadone was injected as a bolus into the common carotid artery of the rat, and the rat was decapitated 15 seconds later. The brain uptake of the drug was calculated by measurement of the brain content of the drug as a percentage of a labeled, highly diffusible reference substance simultaneously injected. The uptake of morphine was below measurability; the uptake of codeine was 24 percent; heroin, 68 percent; and methadone, 42 percent. Brain uptakes of morphine and codeine were also studied after intravenous injection and correlated well with uptakes after carotid injection; the uptake of codeine being nearly complete by 30 seconds. These studies indicate that brain uptake of certain of these drugs is very rapid and that uptake of heroin injected intravenously is probably limited by the regional flow of blood in the brain. The possible relation of this rapid penetration of the blood-brain barrier by heroin to its strongly addictive properties is discussed.


Subject(s)
Blood-Brain Barrier , Codeine/metabolism , Heroin/metabolism , Methadone/metabolism , Morphine/metabolism , Animals , Brain/metabolism , Brain Chemistry , Carbon Isotopes , Carotid Arteries , Codeine/administration & dosage , Codeine/analysis , Heroin/administration & dosage , Heroin/analysis , Injections, Intravenous , Mannitol/metabolism , Methadone/administration & dosage , Methadone/analysis , Morphine/administration & dosage , Morphine/analysis , Rats , Time Factors , Tritium
12.
Vet J ; 250: 79-85, 2019 Aug.
Article in English | MEDLINE | ID: mdl-31383424

ABSTRACT

Kinetic analyses are becoming increasingly important for biomechanical research in veterinary medicine and as a diagnostic tool for orthopaedic examinations in dogs. Such analysis enables accurate evaluation of the vertical force distribution (VFD) in canine paw pads. The aim of this study was to assess peak vertical force (PFz) as a percent of total force (%TF), vertical impulse (IFz, %TF) and time of occurrence of PFz (TPFz) as a percent of the stance phase (%SP) in the pads of all four limbs in 23 dogs with osteoarthritis in the elbow joint and 22 healthy dogs. Dogs walked over a pressure plate, and the pads were divided into four quadrants for VFD analysis. For statistical analysis, a general linear model was used to examine the difference in VFD between both groups, between fore- and hindlimbs, between body sides, and between medial/lateral and cranial/caudal quadrants. Lame dogs had lower PFz in the lame forelimb than in other limbs and transferred their weight to the caudal quadrants of the contralateral forelimb and the caudomedial quadrant of both hindlimbs. IFz was also lower in the affected forelimb and was compensated through higher loading of the caudal quadrants of the contralateral forelimb, the caudomedial quadrants of both hindlimbs and the caudolateral quadrant of the contralateral hindlimb. TPFz (%SP) occurred later in both forelimbs of the lame dogs than in those of healthy dogs. The analysis of force distribution over the paw quadrants can be used for further biomechanical studies of dogs with orthopaedic and neurological diseases.


Subject(s)
Dog Diseases/physiopathology , Dogs , Forelimb/physiology , Hindlimb/physiology , Osteoarthritis/veterinary , Walking/physiology , Animals , Biomechanical Phenomena , Body Weight , Female , Kinetics , Male , Osteoarthritis/physiopathology
13.
Sci Rep ; 9(1): 2255, 2019 02 19.
Article in English | MEDLINE | ID: mdl-30783157

ABSTRACT

Radiation pneumonitis (RP) is a serious complication that can occur after thoracic radiotherapy. The goal of this study is to investigate the incidence of RP after radiochemotherapy with intensity modulated radiotherapy (IMRT) in patients with esophageal cancer and correlate this with dose volume histogram (DVH) related parameters. For this purpose, the clinical course of 73 patients was evaluated and irradiation doses to the lungs were extracted from radiotherapy treatment plans. Furthermore, a systematic review on this topic was conducted across PubMed. In our institutional cohort, Common Terminology Criteria for Adverse Events (CTCAE) grade II or higher RP occurred in four patients (5.5%). The systematic review identified 493 titles of which 19 studies reporting 874 patients qualified for the final analysis. No grade IV or V RP after radiochemotherapy with IMRT for esophageal cancer was reported in the screened literature. Grade II or higher RP is reported in 6.6% of the patients. A higher incidence can be seen with increasing values for lung V20. In conclusion, our institutional data and the literature consistently show a low incidence of symptomatic RP after radiochemotherapy in patients with esophageal cancer treated with IMRT. However, efforts should be made to keep the lung V20 below 23% and specific caution is warranted in patients with pre-existing lung conditions.


Subject(s)
Esophageal Neoplasms/epidemiology , Esophageal Neoplasms/radiotherapy , Radiation Pneumonitis/epidemiology , Aged , Female , Humans , Male , Middle Aged , Radiotherapy, Intensity-Modulated
14.
Parasite ; 15(3): 206-10, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18814682

ABSTRACT

The activity state of a gene is determined by a complex regulatory network of co-acting factors affecting the structure of the chromatin into which the gene is embedded. While significant changes of the transcriptome occur during cell differentiation in apicomplexan parasites, basic mechanisms controlling gene expression are still unknown. Recent studies support and expand the concept of the chromatin environment being key factor for the control of transcriptional activity in these lower eukaryotes organisms. Here, we review recent advances in the field of epigenetic gene regulation in Toxoplasma gondii, the model apicomplexan.


Subject(s)
Chromatin/genetics , Chromatin/metabolism , Epigenesis, Genetic , Toxoplasma/genetics , Toxoplasma/metabolism , Animals , Gene Expression Regulation , Toxoplasmosis/parasitology
15.
Int J Stroke ; 13(9): 949-984, 2018 12.
Article in English | MEDLINE | ID: mdl-30021503

ABSTRACT

The 2018 update of the Canadian Stroke Best Practice Recommendations for Acute Stroke Management, 6th edition, is a comprehensive summary of current evidence-based recommendations, appropriate for use by healthcare providers and system planners caring for persons with very recent symptoms of acute stroke or transient ischemic attack. The recommendations are intended for use by a interdisciplinary team of clinicians across a wide range of settings and highlight key elements involved in prehospital and Emergency Department care, acute treatments for ischemic stroke, and acute inpatient care. The most notable changes included in this 6th edition are the renaming of the module and its integration of the formerly separate modules on prehospital and emergency care and acute inpatient stroke care. The new module, Acute Stroke Management: Prehospital, Emergency Department, and Acute Inpatient Stroke Care is now a single, comprehensive module addressing the most important aspects of acute stroke care delivery. Other notable changes include the removal of two sections related to the emergency management of intracerebral hemorrhage and subarachnoid hemorrhage. These topics are covered in a new, dedicated module, to be released later this year. The most significant recommendation updates are for neuroimaging; the extension of the time window for endovascular thrombectomy treatment out to 24 h; considerations for treating a highly selected group of people with stroke of unknown time of onset; and recommendations for dual antiplatelet therapy for a limited duration after acute minor ischemic stroke and transient ischemic attack. This module also emphasizes the need for increased public and healthcare provider's recognition of the signs of stroke and immediate actions to take; the important expanding role of paramedics and all emergency medical services personnel; arriving at a stroke-enabled Emergency Department without delay; and launching local healthcare institution code stroke protocols. Revisions have also been made to the recommendations for the triage and assessment of risk of recurrent stroke after transient ischemic attack/minor stroke and suggested urgency levels for investigations and initiation of management strategies. The goal of this updated guideline is to optimize stroke care across Canada, by reducing practice variations and reducing the gap between current knowledge and clinical practice.


Subject(s)
Emergency Medical Services/legislation & jurisprudence , Emergency Service, Hospital/legislation & jurisprudence , Ischemic Attack, Transient/therapy , Stroke/therapy , Canada , Critical Care/legislation & jurisprudence , Delivery of Health Care/legislation & jurisprudence , Hospitalization/legislation & jurisprudence , Humans , Inpatients , Stroke/diagnosis
16.
J Clin Invest ; 63(6): 1241-8, 1979 Jun.
Article in English | MEDLINE | ID: mdl-447842

ABSTRACT

Tryptophol (3-indole ethanol) is a compound which induces sleep, and is formed: (a) in the liver after disulfiram treatment, and (b) by the parasite in trypanosomal sleeping sickness. We prepared, purified, and characterized radiolabeled tryptophol for the purpose of defining its tissue distribution in animals. Tryptophol was found to be highly lipophilic, with an octanol:water partition coefficient of 29.8. Brain extraction, determined after intracarotid injection, was high (brain uptake index = 117 +/- 3.5%), and nonsaturable, suggesting the absence of a carrier system. After intravenous administration, tryptophol distribution to tissues correlated with relative blood flow. More than 85% of the radioactivity remaining in brain 2-5 min after intravenous injection co-migrated with tryptophol standards when analyzed by thin-layer chromatography. Other evidence suggested that tryptophol binds to serum and in vivo may be stripped from serum albumin and taken up by brain in a single capillary transit. Our study suggests that in states such as trypanosomal sleeping sickness or disulfiram treatment, remotely formed tryptophol gains ready access to brain (it is 100% cleared in a single capillary passage), and could thus cause somnolence.


Subject(s)
Brain/metabolism , Indoles/metabolism , Animals , Blood Circulation , Indoles/blood , Indoles/pharmacology , Kidney Cortex/metabolism , Liver/metabolism , Male , Mesencephalon/metabolism , Muscles/metabolism , Rats , Sleep
17.
J Natl Cancer Inst ; 66(5): 831-5, 1981 May.
Article in English | MEDLINE | ID: mdl-6262558

ABSTRACT

The peroxidase-antiperoxidase technique with the use of paraffin sections of 67 cervical biopsy specimens and an antiserum cross-reactive with all papillomaviruses provided immunologic confirmation for the observation that papillomavirus infection of the cervix is not uncommon and that it most often presents as a flat, colposcopically unremarkable lesion. Papillomavirus antigen was detected in 21 or 35 condylomata of the cervix. Antigen-positive nuclei were found in the upper layers of the epithelium. Electron-microscopic examination of five reprocessed antigen-positive sections revealed, in each instance, papillomavirus particles in the nuclei of the most superficial layers of the condylomatous epithelium. The viral antigen was not detected in dysplasia, carcinoma in situ, or invasive carcinoma.


Subject(s)
Antigens, Viral/analysis , Condylomata Acuminata/etiology , Papillomaviridae , Tumor Virus Infections/diagnosis , Uterine Cervical Neoplasms/etiology , Animals , Cell Nucleus/microbiology , Cell Nucleus/ultrastructure , Epithelium/microbiology , Female , Humans , Immunoenzyme Techniques , Microscopy, Electron , Papillomaviridae/immunology
18.
Cancer Res ; 49(6): 1554-61, 1989 Mar 15.
Article in English | MEDLINE | ID: mdl-2647288

ABSTRACT

In rats maintained on a carcinogenic diet (choline deficient containing 0.1% ethionine), the levels of c-myc and p53 mRNAs increased by 4 wk after animals were placed on the diet. Cell isolation studies showed that the change in c-myc takes place in oval cells, while p53 increases predominantly in oval cells but also in hepatocytes. To determine whether this increase is a consequence of cell proliferation or is associated with transformation, we have developed an in vitro model of hepatocarcinogenesis using epithelial cells isolated from the livers of rats fed the carcinogenic diet. When maintained in vitro with infrequent subculture, this cell line (LE/6) undergoes spontaneous transformation. Inoculation s.c. of the transformed cells into nude mice yields tumors histologically identified as hepatocellular carcinoma. We have used these cell lines to compare the cell cycle expression of c-myc and p53 mRNAs in untransformed, partially transformed, and tumorigenic LE/6 cells. We find that the expression of both genes is under cell cycle control in untransformed and partially transformed cells. However, complete transformation of this cell line is associated with constitutive expression of myc but not p53 transcripts. On the basis of this work we suggest that constitutive expression of c-myc may be a late event in hepatocarcinogenesis.


Subject(s)
Cell Transformation, Neoplastic , Liver Neoplasms, Experimental/etiology , Liver/pathology , Neoplasm Proteins/analysis , Phosphoproteins/analysis , Proto-Oncogenes , Animals , Blotting, Southern , Cell Cycle , Epidermal Growth Factor/pharmacology , Gene Expression Regulation , Liver Neoplasms, Experimental/genetics , Liver Neoplasms, Experimental/pathology , Male , Mice , Neoplasm Transplantation , Rats , Rats, Inbred Strains , Tumor Suppressor Protein p53
19.
Cancer Res ; 50(22): 7324-32, 1990 Nov 15.
Article in English | MEDLINE | ID: mdl-2171761

ABSTRACT

The transforming growth factor (TGF) beta s are multifunctional polypeptide growth factors with diverse biological effects, including inhibition of epithelial cell proliferation both in vitro and in vivo. To investigate the possible role of TGF beta 1 in the regulation of papillomavirus infection and papillomavirus-associated transformation, we compared the response to TGF beta 1 of normal keratinocytes, human papillomavirus, type 16 (HPV 16)-positive-immortalized keratinocytes (nontumorigenic), and HPV 16-positive cervical carcinoma cells (tumorigenic) with respect to DNA synthesis and protooncogene expression. All HPV 16-immortalized cell lines were nearly as inhibited by TGF beta 1 as normal keratinocytes, whereas two cervical carcinoma cell lines (Caski and Siha) were refractory to growth inhibition by TGF beta 1. Cell surface receptors for TGF beta 1 were present on both normal and carcinoma cell lines. In all cases, growth inhibition by TGF beta 1 was accompanied by suppression of Steady-state levels of c-myc mRNA. In contrast, TGF beta 1 induced the expression of c-jun mRNA transcripts in normal, immortalized, and tumorigenic cells. We also studied the effect of TGF beta 1 on HPV 16 mRNA expression. Steady-state levels of HPV 16 mRNA transcripts were suppressed by TGF beta 1 in the nontumorigenic HPK cells but were unaffected in the tumorigenic lines. These findings suggest that TGF beta 1 may be an in vivo modulator of HPV infection and that loss of responsiveness to this growth inhibitory signal may be involved in HPV-associated malignant transformation.


Subject(s)
Papillomaviridae/pathogenicity , Transforming Growth Factor beta/therapeutic use , Tumor Virus Infections/therapy , Cell Division/drug effects , Cervix Uteri/microbiology , Cervix Uteri/pathology , DNA/biosynthesis , DNA-Binding Proteins/genetics , Epithelium/microbiology , Female , Gene Expression/drug effects , Humans , In Vitro Techniques , Keratinocytes/microbiology , Papillomaviridae/genetics , Papillomaviridae/growth & development , Proto-Oncogene Proteins/genetics , Proto-Oncogene Proteins c-fos , Proto-Oncogene Proteins c-jun , Proto-Oncogene Proteins c-myc/genetics , RNA, Messenger/genetics , RNA, Viral/genetics , Receptors, Cell Surface/metabolism , Receptors, Transforming Growth Factor beta , Transcription Factors/genetics
20.
Cancer Res ; 47(15): 4116-24, 1987 Aug 01.
Article in English | MEDLINE | ID: mdl-2440558

ABSTRACT

Two epithelial cell lines designated LE/2 and LE/6 were established from cells isolated by centrifugal elutriation from the livers of carcinogen-treated rats. Both cell lines exhibit some characteristics of fetal liver cells, such as the expression of the 2.3-kilobase alpha-fetoprotein mRNA, aldolase A, and lactate dehydrogenases 4 and 5. Primary cultures contain gamma-glutamyl transferase-positive cells which do not proliferate in vitro. After the first passage, the LE/2 and LE/6 cell lines are uniformly gamma-glutamyl transferase negative. Neither cell line is transformed as assayed by morphology, anchorage-independent growth, or tumor formation in nude mice. By the 50th passage, LE/6 cells form numerous colonies in soft agar in the presence of epidermal growth factor, while no colonies grow in medium lacking this growth factor. Clonal cell populations derived from five epidermal growth factor-induced soft agar colonies were not tumorigenic in nude mice. This indicates that, although epidermal growth factor-responsive late passage cells had acquired some of the phenotypic properties commonly associated with tumor cells, these cells were not fully transformed. Transformation of LE/6 cells was accomplished by transfection of the rasH oncogene (EJ). Subcutaneous inoculation of rasH (EJ)-transfected LE/6 cells produced tumors at the site of injection with histological features of moderate to well-differentiated trabecular hepatocellular carcinomas. Tumor cell lines derived from the nude mouse tumors are gamma-glutamyl transferase positive and express alpha-fetoprotein mRNA. One clonal cell line expresses both alpha-fetoprotein and albumin mRNA. These results show that nonparenchymal liver epithelial cells transfected with an activated oncogene can give rise to differentiated hepatocellular tumors similar to those induced in livers of rats fed a carcinogenic diet.


Subject(s)
Cell Transformation, Neoplastic/etiology , Choline Deficiency/pathology , Liver Neoplasms, Experimental/etiology , Liver/pathology , Oncogenes , Proto-Oncogene Proteins/physiology , Animals , Cells, Cultured , Epidermal Growth Factor/pharmacology , Epithelium/analysis , Epithelium/pathology , Isoenzymes/analysis , Liver Neoplasms, Experimental/analysis , Liver Neoplasms, Experimental/pathology , Male , Mice , Mice, Nude , Neoplasm Proteins/analysis , Proto-Oncogene Proteins/genetics , Proto-Oncogene Proteins p21(ras) , RNA, Messenger/analysis , RNA, Neoplasm/analysis , Rats , Rats, Inbred Strains , Recombinant Proteins/physiology , Transfection , alpha-Fetoproteins/analysis , gamma-Glutamyltransferase/analysis
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