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1.
Toxicol Appl Pharmacol ; 387: 114856, 2020 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-31836523

RESUMEN

This 90-day repeated-dose inhalation toxicology study of brake-dust (BD) (brakes manufactured with chrysotile) in rats provides a comprehensive understanding of the biokinetics and potential toxicology in the lung and pleura. Exposure was 6 h/d, 5d/wk., 13wks followed by lifetime observation (~20 % survival). Control groups included a particle control (TiO2), chrysotile, commercial crocidolite and amosite asbestos. Aerosol fiber distributions of the chrysotile, crocidolite and amosite were similar (fibers L > 20 µm/cm3: chrysotile-Low/High 29/72; crocidolite 24; amosite 47 fibers/cm3; WHO-fibers/cm3: chrysotile-Low/High 119/233; crocidolite 181; amosite 281 fibers/cm3). The number of particles/cm3 in the BD was similar to that in the chrysotile, crocidolite & amosite exposures (BD 470-715; chrysotile 495-614; crocidolite 415; amosite 417 particles/cm3). In the BD groups, few fibers L > 20 µm were observed in the lungs at the end of exposure and no fibers L > 20 µm at 90d post exposure. In the chrysotile groups, means of 204,000 and 290,000 fibers(L > 20 µm)/lung were measured at 89d. By 180d, means of 1 and 3.9 fibers were counted on the filter corresponding to 14,000 and 55,000 fibers(L > 20 µm)/lung. In the crocidolite and amosite groups mean lung concentrations were 9,055,000 and 11,645,000 fibers(L > 20 µm)/lung at 89d. At 180d the means remained similar with 8,026,000 and 11,591,000 fibers(L > 20 µm)/lung representing 10-13% of the total lung fibers. BAL determined the total number of macrophages, lymphocytes, neutrophils, eosinophils, epithelial-cells and IL-1 beta, TNF-alpha and TGF-beta. At the moderate aerosol concentrations used in this study, neutrophil counts increased ~5 fold in the amphibole asbestos exposure groups. All other groups and parameters showed no important differences at these exposure concentrations. The exposure and lung burden results provide a sound basis for assessing the potential toxicity of the brake dust in comparison to the TiO2 particle control and the chrysotile, crocidolite and amosite asbestos control groups. The BAL results provide an initial indication of the differential response. Part 2 presents the presentation and discussion of the histopathological and confocal microscopy findings in this study through 90 days post exposure.


Asunto(s)
Asbestos Serpentinas/toxicidad , Inflamación/diagnóstico , Exposición por Inhalación/efectos adversos , Pulmón/patología , Pleura/patología , Aerosoles/efectos adversos , Animales , Asbesto Amosita/toxicidad , Asbesto Crocidolita/toxicidad , Líquido del Lavado Bronquioalveolar/química , Líquido del Lavado Bronquioalveolar/citología , Colágeno/análisis , Relación Dosis-Respuesta a Droga , Polvo , Fibrosis , Humanos , Inflamación/sangre , Inflamación/inducido químicamente , Inflamación/inmunología , Pulmón/efectos de los fármacos , Pulmón/inmunología , Macrófagos Alveolares/efectos de los fármacos , Macrófagos Alveolares/inmunología , Masculino , Neutrófilos/inmunología , Pleura/efectos de los fármacos , Pleura/inmunología , Ratas , Proyectos de Investigación , Titanio/toxicidad , Pruebas de Toxicidad Subcrónica/métodos , Contaminación por Tráfico Vehicular/efectos adversos
2.
Toxicol Appl Pharmacol ; 387: 114847, 2020 01 15.
Artículo en Inglés | MEDLINE | ID: mdl-31830492

RESUMEN

The interim results from this 90-day multi-dose, inhalation toxicology study with life-time post-exposure observation has shown an important fundamental difference in persistence and pathological response in the lung between brake dust derived from brake-pads manufactured with chrysotile, TiO2 or chrysotile alone in comparison to the amphiboles, crocidolite and amosite asbestos. In the brake dust exposure groups no significant pathological response was observed at any time. Slight macrophage accumulation of particles was noted. Wagner-scores, were from 1 to 2 (1 = air-control group) and were similar to the TiO2 group. Chrysotile being biodegradable, shows a weakening of its matrix and breaking into short fibers & particles that can be cleared by alveolar macrophages and continued dissolution. In the chrysotile exposure groups, particle laden macrophage accumulation was noted leading to a slight interstitial inflammatory response (Wagner-score 1-3). There was no peribronchiolar inflammation and occasional very slight interstitial fibrosis. The histopathology and the confocal analyses clearly differentiate the pathological response from amphibole asbestos, crocidolite and amosite, compared to that from the brake dust and chrysotile. Both crocidolite and amosite induced persistent inflammation, microgranulomas, and fibrosis (Wagner-scores 4), which persisted through the post exposure period. The confocal microscopy of the lung and snap-frozen chestwalls quantified the extensive inflammatory response and collagen development in the lung and on the visceral and parietal surfaces. The interim results reported here, provide a clear basis for differentiating the effects from brake dust exposure from those following amphibole asbestos exposure. The subsequent results through life-time post-exposure will follow.


Asunto(s)
Asbestos Serpentinas/toxicidad , Exposición por Inhalación/efectos adversos , Pulmón/patología , Pleura/patología , Contaminación por Tráfico Vehicular/efectos adversos , Animales , Asbesto Amosita/toxicidad , Asbesto Crocidolita/toxicidad , Líquido del Lavado Bronquioalveolar/química , Líquido del Lavado Bronquioalveolar/citología , Colágeno/análisis , Relación Dosis-Respuesta a Droga , Polvo , Fibrosis , Pulmón/efectos de los fármacos , Pulmón/inmunología , Macrófagos Alveolares/efectos de los fármacos , Masculino , Microscopía Confocal , Pleura/efectos de los fármacos , Pleura/inmunología , Ratas , Titanio/toxicidad , Pruebas de Toxicidad Subcrónica
3.
Toxicol Appl Pharmacol ; 351: 74-92, 2018 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-29705295

RESUMEN

This study provides an understanding of the biokinetics and potential toxicology in the lung and pleura following inhalation of brake-dust (brakes manufactured with chrysotile). The design included a 28-day repeated multi-dose inhalation exposure (6 h/d, 5 d/wk, 4 wks) followed by 28-days without exposure. Fiber control groups included a similar grade chrysotile as used in the brakes and a commercial crocidolite asbestos. Aerosol fiber distributions of the chrysotile and crocidolite were similar (fiber-length > 20 µm/cm3: Chrysotile-low/high 42/62; Crocidolite-low/high 36/55; WHO-fibers/cm3: Chrysotile-low/high 192/219; Crocidolite-low/high 211/255). The total number of aerosol particles/cm3 in the brake-dust was similar to that in the chrysotile (Brake-dust 710-1065; Chrysotile 532-1442). Brake-dust at particle exposure levels equal to or greater than chrysotile or crocidolite caused no indication of microgranulomas, epithelial hyperplasia, or fibrosis (Wagner score < 1.7) or changes in bronchoalveolar lavage (BAL) indices from the air control. Chrysotile BAL indices did not differ from the air control. Pathologically, there was low level of inflammation and epithelial hyperplasia, but no fibrosis (Wagner score ≤ 3). Crocidolite induced elevated neutrophils and cell damage (BAL), persistent inflammation, microgranulomas, and fibrosis (Wagner scores 4) which persisted through the post exposure period. Confocal microscopy of snap-frozen chestwalls showed no difference between control, brake-dust and chrysotile-HD groups or in thickness of visceral or parietal pleural. The crocidolite exposure resulted in extensive inflammatory response, collagen development and adhesions between the visceral and parietal surfaces with double the surface thickness. These results provide essential information for the design of a subsequent subchronic study.


Asunto(s)
Asbesto Crocidolita/toxicidad , Asbestos Serpentinas/toxicidad , Polvo , Exposición por Inhalación/efectos adversos , Pulmón/efectos de los fármacos , Pleura/efectos de los fármacos , Animales , Asbesto Crocidolita/administración & dosificación , Asbestos Serpentinas/administración & dosificación , Relación Dosis-Respuesta a Droga , Tamaño de la Partícula , Ratas , Factores de Tiempo
4.
Am J Transplant ; 17(6): 1525-1539, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27931092

RESUMEN

Significant racial disparity remains in the incidence of unfavorable outcomes following heart transplantation. We sought to determine which pediatric posttransplantation outcomes differ by race and whether these can be explained by recipient demographic, clinical, and genetic attributes. Data were collected for 80 black and 450 nonblack pediatric recipients transplanted at 1 of 6 centers between 1993 and 2008. Genotyping was performed for 20 candidate genes. Average follow-up was 6.25 years. Unadjusted 5-year rates for death (p = 0.001), graft loss (p = 0.015), acute rejection with severe hemodynamic compromise (p = 0.001), late rejection (p = 0.005), and late rejection with hemodynamic compromise (p = 0.004) were significantly higher among blacks compared with nonblacks. Black recipients were more likely to be older at the time of transplantation (p < 0.001), suffer from cardiomyopathy (p = 0.004), and have public insurance (p < 0.001), and were less likely to undergo induction therapy (p = 0.0039). In multivariate regression models adjusting for age, sex, cardiac diagnosis, insurance status, and genetic variations, black race remained a significant risk factor for all the above outcomes. These clinical and genetic variables explained only 8-19% of the excess risk observed for black recipients. We have confirmed racial differences in survival, graft loss, and several rejection outcomes following heart transplantation in children, which could not be fully explained by differences in recipient attributes.


Asunto(s)
Biomarcadores/metabolismo , Variación Genética , Rechazo de Injerto/mortalidad , Trasplante de Corazón/mortalidad , Grupos Raciales/genética , Adolescente , Niño , Preescolar , Femenino , Estudios de Seguimiento , Genotipo , Rechazo de Injerto/epidemiología , Rechazo de Injerto/genética , Supervivencia de Injerto , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Pronóstico , Factores de Riesgo , Tasa de Supervivencia , Estados Unidos/epidemiología
6.
Pharmacogenomics J ; 15(2): 189-95, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25156213

RESUMEN

Cotinine is a proxy for secondhand smoke (SHS) exposure. Genetic variation along nicotine and cotinine metabolic pathways may alter the internal cotinine dose, leading to misinterpretations of exposure-health outcome associations. Caucasian children with available SHS exposure and hair cotinine data were genotyped for metabolism-related genes. SHS-exposed children had 2.4-fold higher hair cotinine (0.14±0.22 ng mg(-1)) than unexposed children (0.06±0.05 ng mg(-1), P<0.001). SHS-exposed children carrying the NAT1 minor allele had twofold higher hair cotinine (0.18 ng mg(-1) for heterozygotes and 0.17 ng mg(-1) for homozygotes) compared with major allele homozygotes (0.09 ng mg(-1), P=0.0009), even after adjustment for SHS dose. These findings support that NAT1 has a role in the metabolic pathway of nicotine/cotinine and/or their metabolites. The increased cotinine levels observed for those carrying the minor allele may lead to SHS exposure misclassification in studies utilizing cotinine as a biomarker. Additional studies are required to identify functional single-nucleotide polymorphism(s) (SNP(s)) in NAT1 and elucidate the biological consequences of the mutation(s).


Asunto(s)
Arilamina N-Acetiltransferasa/genética , Cotinina/metabolismo , Isoenzimas/genética , Polimorfismo de Nucleótido Simple/genética , Población Blanca/genética , Alelos , Biomarcadores/metabolismo , Niño , Preescolar , Femenino , Genotipo , Humanos , Lactante , Masculino , Nicotina/efectos adversos , Nicotina/metabolismo , Fumar/efectos adversos , Fumar/metabolismo , Contaminación por Humo de Tabaco
7.
Toxicol Appl Pharmacol ; 283(1): 20-34, 2015 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-25560675

RESUMEN

This study was designed to provide an understanding of the biokinetics and potential toxicology in the lung and pleura following inhalation of brake dust following short term exposure in rats. The deposition, translocation and pathological response of brake-dust derived from brake pads manufactured with chrysotile were evaluated in comparison to the amphibole, crocidolite asbestos. Rats were exposed by inhalation 6h/day for 5 days to either brake-dust obtained by sanding of brake-drums manufactured with chrysotile, a mixture of chrysotile and the brake-dust or crocidolite asbestos. The chrysotile fibers were relatively biosoluble whereas the crocidolite asbestos fibers persisted through the life-time of the animal. This was reflected in the lung and the pleura where no significant pathological response was observed at any time point in the brake dust or chrysotile/brake dust exposure groups through 365 days post exposure. In contrast, crocidolite asbestos produced a rapid inflammatory response in the lung parenchyma and the pleura, inducing a significant increase in fibrotic response in both of these compartments. Crocidolite fibers were observed embedded in the diaphragm with activated mesothelial cells immediately after cessation of exposure. While no chrysotile fibers were found in the mediastinal lymph nodes, crocidolite fibers of up to 35 µm were observed. These results provide support that brake-dust derived from chrysotile containing brake drums would not initiate a pathological response in the lung or the pleural cavity following short term inhalation.


Asunto(s)
Asbesto Crocidolita/toxicidad , Asbestos Serpentinas/toxicidad , Automóviles , Polvo , Pulmón/efectos de los fármacos , Pleura/efectos de los fármacos , Administración por Inhalación , Animales , Asbesto Crocidolita/farmacocinética , Asbestos Serpentinas/farmacocinética , Diafragma/metabolismo , Polvo/análisis , Fibrosis , Pulmón/metabolismo , Pulmón/patología , Ganglios Linfáticos/metabolismo , Masculino , Pleura/patología , Ratas Wistar
8.
Allergy ; 70(3): 302-9, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25495666

RESUMEN

BACKGROUND: Patients with asthma may be more susceptible to adverse events (AEs) with sublingual immunotherapy tablet (SLIT-tablet) treatment, such as severe systemic reactions and asthma-related events. Using data from eight trials of grass SLIT-tablet in subjects with allergic rhinitis with/without conjunctivitis (AR/C), AE frequencies were determined in adults and children with and without reported asthma. METHODS: Data from randomized, double-blind, placebo-controlled trials of Timothy grass SLIT-tablet MK-7243 (2800 BAU/75 000 SQ-T, Merck/ALK-Abelló) were pooled for post hoc analyses. Subjects with uncontrolled and severe asthma were excluded from the trials. Frequencies for treatment-emergent AEs (TEAEs), local allergic swelling (mouth or throat), systemic allergic reactions, and asthma-related treatment-related AEs (TRAEs) were calculated. RESULTS: Among adults (n = 3314) and children (n = 881), 24% and 31%, respectively, had reported asthma. No serious local allergic swellings or serious systemic allergic reactions occurred in subjects with asthma treated with SLIT-tablet. There was no evidence of increased TEAEs, systemic allergic reactions, or severe local allergic swellings in adults or children with asthma treated with grass SLIT-tablet versus subjects without asthma in or outside of pollen season. There were 6/120 asthma-related TRAEs assessed as severe with grass SLIT-tablet and 2/60 with placebo, without a consistent trend among subjects with and without asthma (5 and 3 events, respectively). CONCLUSIONS: In the AR/C subjects with reported well-controlled mild asthma included in these studies, grass SLIT-tablet did not increase TEAE frequency, severe local allergic swelling, or systemic allergic reactions versus subjects without asthma. There was no indication that treatment led to acute asthma worsening.


Asunto(s)
Alérgenos/inmunología , Asma/complicaciones , Conjuntivitis/complicaciones , Phleum/efectos adversos , Rinitis Alérgica/complicaciones , Rinitis Alérgica/terapia , Inmunoterapia Sublingual , Adolescente , Adulto , Anciano , Alérgenos/administración & dosificación , Alérgenos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Pruebas de Función Respiratoria , Rinitis Alérgica/fisiopatología , Inmunoterapia Sublingual/efectos adversos , Resultado del Tratamiento , Adulto Joven
9.
Nat Mater ; 12(4): 293-8, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23503010

RESUMEN

Ultrafast laser techniques have revealed extraordinary spin dynamics in magnetic materials that equilibrium descriptions of magnetism cannot explain. Particularly important for future applications is understanding non-equilibrium spin dynamics following laser excitation on the nanoscale, yet the limited spatial resolution of optical laser techniques has impeded such nanoscale studies. Here we present ultrafast diffraction experiments with an X-ray laser that probes the nanoscale spin dynamics following optical laser excitation in the ferrimagnetic alloy GdFeCo, which exhibits macroscopic all-optical switching. Our study reveals that GdFeCo displays nanoscale chemical and magnetic inhomogeneities that affect the spin dynamics. In particular, we observe Gd spin reversal in Gd-rich nanoregions within the first picosecond driven by the non-local transfer of angular momentum from larger adjacent Fe-rich nanoregions. These results suggest that a magnetic material's microstructure can be engineered to control transient laser-excited spins, potentially allowing faster (~ 1 ps) spin reversal than in present technologies.

10.
Clin Exp Allergy ; 44(10): 1228-39, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24773171

RESUMEN

Symptom and medication use are the key outcomes for assessing the efficacy of subcutaneous (SCIT) and sublingual allergen immunotherapy (SLIT). Our objective was to explore the similarities and differences between existing scoring mechanisms used in clinical trials of SLIT for seasonal allergens and characterize the impact that such differences may have on efficacy reporting. Randomized, double-blind, placebo-controlled clinical trials investigating the efficacy of SLIT for seasonal allergic rhinitis (2009-2013) were selected for review. Simulated and published data were used to demonstrate differences in scoring methods. Symptom and medication scoring methods across trials, although all designed to achieve the same objective, included important differences. The maximum daily symptom score (DSS) can vary widely depending on the number of symptoms assessed, and terminology of symptoms is not consistent. Similarly, daily medication scoring (DMS) methods differ greatly among studies and are dependent on medications allowed and weighting of scores assigned to each medication. When published DSS and DMS scores were used to calculate simulated daily combined scores (DCSs) based on various published methods, changes from placebo ranged from 19% to 29% when assuming all variables other than the DSS and DMS methods were equal. Variations in trial design, analysis, and seasonal characteristics also have effects on symptom and medication scoring outcomes. We identified multiple differences in trial scoring methods and design that make comparison among trials difficult. Symptom, medication, or combined scores cannot be indirectly compared among trials without taking the methods of scoring and other trial differences into account.


Asunto(s)
Rinitis Alérgica Estacional/terapia , Inmunoterapia Sublingual , Ensayos Clínicos como Asunto , Humanos , Proyectos de Investigación , Escala Visual Analógica
11.
Clin Exp Allergy ; 44(10): 1274-81, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25179746

RESUMEN

BACKGROUND: Studies vary with respect to the reported effects of day care attendance on childhood asthma. OBJECTIVES: To evaluate the independent and combined effects of day care attendance and respiratory infections on the development of asthma at the age of seven in a prospective birth cohort. METHOD: At the age of seven, the study sample included 589 children with complete data of 762 enrolled at birth. Day care hours and number of respiratory infections were reported in follow-up questionnaires through age four. At 7 years of age, asthma was diagnosed in 95 children (16%), based on predefined symptoms criteria confirmed by either asthma FEV1 reversibility after bronchodilator or a positive methacholine test (PC20 ≤ 4 mg/mL). Logistic regression was used to investigate the relationships between asthma at the age of seven, cumulative hours of day care attendance and reported respiratory infections at ages 1-4. RESULTS: In the univariate analyses, day care attendance at 12 months was associated with an increased risk of asthma [odds ratio (OR) = 1.8, 95% confidence interval (CI) = 1.1-3.0]. Both upper and lower respiratory infections at 12 months also increased the likelihood of asthma [OR = 2.4 (1.4-4.1); OR = 2.3 (1.5-3.7), respectively]. In the final multivariate logistic model, cumulative hours of day care attendance and number of lower respiratory infections at 12 months were associated with asthma [OR = 1.2 (1.1-1.5); OR = 1.4 (1.2-1.7), respectively]. However, a threshold of greater than 37.5 hours per week of day care attendance was associated with a lower risk of asthma [OR = 0.6 (0.4-0.9)]. CONCLUSION: Depending on duration of attendance, day care during infancy can either increase or reduce risk of asthma at the age of seven.


Asunto(s)
Contaminación del Aire/efectos adversos , Asma/etiología , Guarderías Infantiles , Niño , Femenino , Humanos , Lactante , Modelos Logísticos , Masculino , Infecciones del Sistema Respiratorio/complicaciones , Encuestas y Cuestionarios , Factores de Tiempo
12.
Allergy ; 69(5): 617-23, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24605984

RESUMEN

BACKGROUND: The objective was to evaluate the association between grass pollen exposure, allergy symptoms and impact on measured treatment effect after grass sublingual immunotherapy (SLIT)-tablet treatment. METHODS: The association between grass pollen counts and total combined rhinoconjunctivitis symptom and medication score (TCS) was based on a post hoc analysis of data collected over six trials and seven grass pollen seasons across North America and Europe, including 2363 subjects treated with grass SLIT-tablet or placebo. Daily pollen counts were obtained from centralized pollen databases. The effect of treatment on the relationship between the TCS and pollen counts was investigated, and the relative difference between grass SLIT-tablet and placebo as a function of average grass pollen counts was modelled by linear regression. RESULTS: The magnitude of treatment effect based on TCS was greater with higher pollen exposure (P < 0.001). The relative treatment effect in terms of TCS for each trial was correlated with the average grass pollen exposure during the first period of the season, with predicted reduction in TCS = 12% + 0.35% × pollen count (slope significantly different from 0, P = 0.003; R(2)  = 0.66). Corresponding correlations to the entire grass pollen season and to the peak season were equally good, whereas there was a poor correlation between difference in measured efficacy and pollen exposure during the last part of the season. CONCLUSIONS: In seasonal allergy trials with grass SLIT-tablet, the observed treatment effect is highly dependent on pollen exposure with the magnitude being greater with higher pollen exposure. This is an important relationship to consider when interpreting individual clinical trial results.


Asunto(s)
Alérgenos/inmunología , Poaceae/efectos adversos , Polen/inmunología , Rinitis Alérgica Estacional/inmunología , Rinitis Alérgica Estacional/terapia , Inmunoterapia Sublingual , Adolescente , Adulto , Anciano , Alérgenos/administración & dosificación , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Estaciones del Año , Resultado del Tratamiento , Adulto Joven
13.
Clin Oncol (R Coll Radiol) ; 35(6): 354-369, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-36803407

RESUMEN

Auto-contouring could revolutionise future planning of radiotherapy treatment. The lack of consensus on how to assess and validate auto-contouring systems currently limits clinical use. This review formally quantifies the assessment metrics used in studies published during one calendar year and assesses the need for standardised practice. A PubMed literature search was undertaken for papers evaluating radiotherapy auto-contouring published during 2021. Papers were assessed for types of metric and the methodology used to generate ground-truth comparators. Our PubMed search identified 212 studies, of which 117 met the criteria for clinical review. Geometric assessment metrics were used in 116 of 117 studies (99.1%). This includes the Dice Similarity Coefficient used in 113 (96.6%) studies. Clinically relevant metrics, such as qualitative, dosimetric and time-saving metrics, were less frequently used in 22 (18.8%), 27 (23.1%) and 18 (15.4%) of 117 studies, respectively. There was heterogeneity within each category of metric. Over 90 different names for geometric measures were used. Methods for qualitative assessment were different in all but two papers. Variation existed in the methods used to generate radiotherapy plans for dosimetric assessment. Consideration of editing time was only given in 11 (9.4%) papers. A single manual contour as a ground-truth comparator was used in 65 (55.6%) studies. Only 31 (26.5%) studies compared auto-contours to usual inter- and/or intra-observer variation. In conclusion, significant variation exists in how research papers currently assess the accuracy of automatically generated contours. Geometric measures are the most popular, however their clinical utility is unknown. There is heterogeneity in the methods used to perform clinical assessment. Considering the different stages of system implementation may provide a framework to decide the most appropriate metrics. This analysis supports the need for a consensus on the clinical implementation of auto-contouring.


Asunto(s)
Oncología por Radiación , Planificación de la Radioterapia Asistida por Computador , Humanos , Planificación de la Radioterapia Asistida por Computador/métodos , Benchmarking , Radiometría/métodos , Órganos en Riesgo
14.
J Viral Hepat ; 19(11): 766-74, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23043383

RESUMEN

It is unclear whether the current threshold for 'high' hepatitis C virus (HCV) RNA level (800,000 IU/mL) is optimal for predicting sustained virological response (SVR). We retrospectively analysed pretreatment HCV RNA levels and SVR rates in 1529 mono-infected and 176 HIV-HCV co-infected patients treated with peginterferon alfa-2a (40 kD) plus ribavirin. We improved the threshold for differentiating low and high viral load by fitting semiparametric generalized additive logistic regression models to the data and constructing receiver operating characteristics curves. Among HCV genotype 1 mono-infected patients, the difference in SVR rates between those with low and high baseline HCV RNA levels was 27% (70%vs 43%) when 400,000 IU/mL was used and 16% (59%vs 43%) when 800,000 IU/mL was used. In HIV-HCV genotype 1 co-infected patients, the difference was 51% (71%vs 20%) when 400,000 IU/mL was used and 43% (61%vs 18%) when 800,000 IU/mL was used. A lower threshold (200,000 IU/mL) was identified for genotype 1 mono-infected patients with 'normal' alanine aminotransferase (ALT) levels. No threshold could be identified in HCV genotype 2 or 3 patients. A threshold HCV RNA level of 400,000 IU/mL is optimal for differentiating high and low probability of SVR in genotype 1-infected individuals with elevated ALT.


Asunto(s)
Antivirales/uso terapéutico , Hepacivirus/fisiología , Hepatitis C/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Polietilenglicoles/uso terapéutico , ARN Viral/sangre , Ribavirina/uso terapéutico , Carga Viral , Adulto , Alanina Transaminasa/sangre , Quimioterapia Combinada , Femenino , Hepacivirus/genética , Hepatitis C/virología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Curva ROC , Proteínas Recombinantes/uso terapéutico , Estudios Retrospectivos , Resultado del Tratamiento
15.
Inhal Toxicol ; 23(7): 372-91, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21639707

RESUMEN

The marked difference in biopersistence and pathological response between chrysotile and amphibole asbestos has been well documented. This study is unique in that it has examined a commercial chrysotile product that was used as a joint compound. The pathological response was quantified in the lung and translocation of fibers to and pathological response in the pleural cavity determined. This paper presents the final results from the study. Rats were exposed by inhalation 6 h/day for 5 days to a well-defined fiber aerosol. Subgroups were examined through 1 year. The translocation to and pathological response in the pleura was examined by scanning electron microscopy and confocal microscopy (CM) using noninvasive methods. The number and size of fibers was quantified using transmission electron microscopy and CM. This is the first study to use such techniques to characterize fiber translocation to and the response of the pleural cavity. Amosite fibers were found to remain partly or fully imbedded in the interstitial space through 1 year and quickly produced granulomas (0 days) and interstitial fibrosis (28 days). Amosite fibers were observed penetrating the visceral pleural wall and were found on the parietal pleural within 7 days postexposure with a concomitant inflammatory response seen by 14 days. Pleural fibrin deposition, fibrosis, and adhesions were observed, similar to that reported in humans in response to amphibole asbestos. No cellular or inflammatory response was observed in the lung or the pleural cavity in response to the chrysotile and sanded particles (CSP) exposure. These results provide confirmation of the important differences between CSP and amphibole asbestos.


Asunto(s)
Asbesto Amosita/toxicidad , Asbestos Serpentinas/toxicidad , Exposición por Inhalación/efectos adversos , Pulmón/patología , Pleura/patología , Aerosoles , Animales , Asbesto Amosita/farmacocinética , Asbestos Serpentinas/farmacocinética , Determinación de Punto Final , Fibrosis , Masculino , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Tamaño de la Partícula , Material Particulado/farmacocinética , Material Particulado/toxicidad , Proyectos Piloto , Pleura/ultraestructura , Cavidad Pleural/patología , Ratas , Ratas Wistar , Factores de Tiempo , Estudios de Validación como Asunto
16.
Clin Oncol (R Coll Radiol) ; 33(5): 307-313, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33640196

RESUMEN

AIMS: Target delineation uncertainty is arguably the largest source of geometric uncertainty in radiotherapy. Several factors can affect it, including the imaging modality used for delineation. It is accounted for by applying safety margins to the target to produce a planning target volume (PTV), to which treatments are designed. To determine the margin, the delineation uncertainty is measured as the delineation error, and then a margin recipe used. However, there is no published evidence of such analysis for recurrent gynaecological cancers (RGC). The aims of this study were first to quantify the delineation uncertainty for RGC gross tumour volumes (GTVs) and to calculate the associated PTV margins and then to quantify the difference in GTV, delineation uncertainty and PTV margin, between a computed tomography-magnetic resonance imaging (CT-MRI) and MRI workflow. MATERIALS AND METHODS: Seven clinicians delineated the GTV for 20 RGC tumours on co-registered CT and MRI datasets (CT-MRI) and on MRI alone. The delineation error, the standard deviation of distances from each clinician's outline to a reference, was measured and the required PTV margin determined. Differences between using CT-MRI and MRI alone were assessed. RESULTS: The overall delineation error and the resulting margin were 3.1 mm and 8.5 mm, respectively, for CT-MRI, reducing to 2.5 mm and 7.1 mm, respectively, for MRI alone. Delineation errors and therefore the theoretical margins, varied widely between patients. MRI tumour volumes were on average 15% smaller than CT-MRI tumour volumes. DISCUSSION: This study is the first to quantify delineation error for RGC tumours and to calculate the corresponding PTV margin. The determined margins were larger than those reported in the literature for similar patients, bringing into question both current margins and margin calculation methods. The wide variation in delineation error between these patients suggests that applying a single population-based margin may result in PTVs that are suboptimal for many. Finally, the reduced tumour volumes and safety margins suggest that patients with RGC may benefit from an MRI-only treatment workflow.


Asunto(s)
Neoplasias , Planificación de la Radioterapia Asistida por Computador , Humanos , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Carga Tumoral
17.
J Exp Med ; 136(4): 799-815, 1972 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-4403474

RESUMEN

All 110 rabbits immunized with Group A, A-variant, and C streptococcal vaccines produced 19S anti-IgG in addition to antibodies to the streptococcal carbohydrates. 19S anti-IgG was detected by hemagglutination of rabbit red blood cells coated with rabbit anti-blood group F antibody. Antisera of 88 of these animals were also tested for 7S anti-IgG with a coprecipitation assay. This assay is based on the coprecipitation of 7S anti-IgG with complexes of streptococcal carbohydrate and anti-carbohydrate antibody. 50 of the 88 anti-Group C streptococcal antisera contained 7S anti-IgGs. In eight antisera the concentration was greater than 5 mg/ml. The data suggest a genetic influence on the occurrence of 7S anti-IgG. The eight rabbits which produced more than 5 mg/ml of 7S anti-IgG belonged to three related families. Moreover, there were families in which almost every member produced 7S anti-IgG and other families in which only 30% of the members manufactured 7S anti-IgG. The streptococcal vaccine was an especially efficient stimulus for the production of 19S anti-IgG, whereas the pneumococcal vaccine was much less effective in this respect. Furthermore, 7S anti-IgGs were not detected in antipneumococcal antisera, although the concentration of anti-capsular antibodies was similar to that of anti-carbohydrate antibodies in antistreptococcal antisera.


Asunto(s)
Formación de Anticuerpos , Antígenos , Inmunoglobulina G/biosíntesis , Inmunoglobulina M/biosíntesis , Streptococcus/inmunología , Animales , Complejo Antígeno-Anticuerpo/análisis , Vacunas Bacterianas , Cabras/inmunología , Pruebas de Hemaglutinación , Sueros Inmunes , Inmunización Secundaria , Inmunodifusión , Polisacáridos Bacterianos , Precipitinas/análisis , Proteínas/análisis , Conejos , Streptococcus pneumoniae/inmunología , Ultracentrifugación
18.
J Exp Med ; 137(6): 1354-68, 1973 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-4541124

RESUMEN

7S anti-IgGs were isolated from four rabbit antistreptococcal antisera by the use of immunoabsorbent columns. The isolated proteins were of restricted molecular heterogeneity; they formed a monodisperse band on microzone electrophoresis and had a limited number of light chain bands when analyzed on urea polyacrylamide gel. The binding site of the 7S anti-IgGs was detected in the F(ab')(2) portion of the molecule. The binding site has antibody specificity for the Fc portion of IgG. For one 7S anti-IgG the combining site on the Fc portion could further be defined. A pepsin fragment of Fc, described as Pep-III', was a potent inhibitor of the coprecipitation of 7S anti-IgG with antigen-antibody complexes. An idiotypic cross-reaction was detected between the 7S and 19S anti-IgGs isolated from the same rabbit with anti-idiotype sera prepared in guinea pigs. This idiotypic specificity was not detected in the 7S anti-IgGs of 20 other rabbits.


Asunto(s)
Anticuerpos Antiidiotipos/aislamiento & purificación , Vacunas Bacterianas , Inmunoglobulina G/aislamiento & purificación , Inmunoglobulina M/aislamiento & purificación , Streptococcus/inmunología , Animales , Complejo Antígeno-Anticuerpo , Cromatografía , Electroforesis en Gel de Poliacrilamida , Sueros Inmunes/análisis , Inmunoquímica , Inmunoglobulina G/análisis , Isoantígenos/aislamiento & purificación , Pruebas de Precipitina , Conejos , Radioinmunoensayo
19.
J Exp Med ; 138(5): 1184-93, 1973 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-4126769

RESUMEN

The relationship between 7S anti-IgG and antibodies to streptococcal cell wall peptidoglycan was examined for four streptococcal Group C antisera. Homogeneous 7S anti-IgG components in these sera were isolated by means of an IgG immunoadsorbent column. For two of the four antisera, the anti-peptidoglycan activity of the 7S anti-IgG had specificity for the pentapeptide, L-Ala-D-Glu-gamma-L-Lys-D-Ala-D-Ala, the antigenic determinant of peptidoglycan, as well as for the Fc of IgG. Detailed studies on the 7S anti-IgG from one of the antisera revealed that the pentapeptide inhibited the coprecipitation reaction of 7S anti-IgG R3387 with antigen-antibody complexes and the precipitin reaction between 7S anti-IgG R3387 and its anti-idiotype serum.


Asunto(s)
Anticuerpos Antiidiotipos , Especificidad de Anticuerpos , Inmunoglobulina G , Peptidoglicano , Animales , Anticuerpos Antiidiotipos/análisis , Complejo Antígeno-Anticuerpo , Sitios de Unión de Anticuerpos , Pared Celular/inmunología , Epítopos , Fragmentos Fc de Inmunoglobulinas , Péptidos/farmacología , Pruebas de Precipitina , Conejos/inmunología , Streptococcus/inmunología
20.
Inhal Toxicol ; 22(11): 937-62, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20695727

RESUMEN

The pathological response and translocation of a commercial chrysotile product similar to that which was used through the mid-1970s in a joint compound intended for sealing the interface between adjacent wall boards was evaluated in comparison to amosite asbestos. This study was unique in that it presents a combined real-world exposure and was the first study to investigate whether there were differences between chrysotile and amosite asbestos fibers in time course, size distribution, and pathological response in the pleural cavity. Rats were exposed by inhalation 6 h/day for 5 days to either sanded joint compound consisting of both chrysotile fibers and sanded joint compound particles (CSP) or amosite asbestos. Subgroups were examined through 1-year postexposure. No pathological response was observed at any time point in the CSP-exposure group. The long chrysotile fibers (L > 20 microm) cleared rapidly (T(1/2) of 4.5 days) and were not observed in the pleural cavity. In contrast, a rapid inflammatory response occurred in the lung following exposure to amosite resulting in Wagner grade 4 interstitial fibrosis within 28 days. Long amosite fibers had a T(1/2) > 1000 days and were observed in the pleural cavity within 7 days postexposure. By 90 days the long amosite fibers were associated with a marked inflammatory response on the parietal pleural. This study provides support that CSP following inhalation would not initiate an inflammatory response in the lung, and that the chrysotile fibers present do not migrate to, or cause an inflammatory response in the pleural cavity, the site of mesothelioma formation.


Asunto(s)
Asbesto Amosita/administración & dosificación , Asbestos Serpentinas/administración & dosificación , Exposición por Inhalación/efectos adversos , Pulmón/patología , Material Particulado/administración & dosificación , Pleura/patología , Animales , Asbesto Amosita/metabolismo , Asbesto Amosita/toxicidad , Asbestos Serpentinas/metabolismo , Asbestos Serpentinas/toxicidad , Pulmón/efectos de los fármacos , Pulmón/metabolismo , Masculino , Material Particulado/toxicidad , Proyectos Piloto , Pleura/efectos de los fármacos , Pleura/metabolismo , Ratas , Factores de Tiempo
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