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1.
Eur J Nucl Med Mol Imaging ; 50(10): 2997-3010, 2023 08.
Article in English | MEDLINE | ID: mdl-37184682

ABSTRACT

Peptide Receptor Radionuclide Therapy (PRRT) delivers targeted radiation to Somatostatin Receptor (SSR) expressing Neuroendocrine Neoplasms (NEN). We sought to assess the predictive and prognostic implications of tumour dosimetry with respect to response by 68 Ga DOTATATE (GaTate) PET/CT molecular imaging tumour volume of SSR (MITVSSR) change and RECIST 1.1, and overall survival (OS). METHODS: Patients with gastro-entero-pancreatic (GEP) NEN who received LuTate followed by quantitative SPECT/CT (Q-SPECT/CT) the next day (Jul 2010 to Jan 2019) were retrospectively reviewed. Single time-point (STP) lesional dosimetry was performed for each cycle using population-based pharmacokinetic modelling. MITVSSR and RECIST 1.1 were measured at 3-months post PRRT. RESULTS: Median of 4 PRRT cycles were administered to 90 patients (range 2-5 cycles; mean 27.4 GBq cumulative activity; mean 7.6 GBq per cycle). 68% received at least one cycle with radiosensitising chemotherapy (RSC). RECIST 1.1 partial response was 24%, with 70% stable and 7% progressive disease. Cycle 1 radiation dose in measurable lesions was associated with local response (odds ratio 1.5 per 50 Gy [95% CI: 1.1-2.0], p = 0.002) when adjusted by tumour grade and RSC. Median change in MITVSSR was -63% (interquartile range -84 to -29), with no correlation with radiation dose to the most avid lesion on univariable or multivariant analyses (5.6 per 10 Gy [95% CI: -1.6, 12.8], p = 0.133). OS at 5-years was 68% (95% CI: 56-78%). Neither baseline MITVSSR (hazard ratio 1.1 [95% CI: 1.0, 1.2], p = 0.128) nor change in baseline MITVSSR (hazard ratio 1.0 [95% CI: 1.0, 1.1], p = 0.223) were associated with OS when adjusted by tumour grade and RSC but RSC was (95% CI: 0.2, 0.8, p = 0.012). CONCLUSION: Radiation dose to tumour during PRRT was predictive of radiologic response but not survival. Survival outcomes may relate to other biological factors. There was no evidence that MITVSSR change was associated with OS, but a larger study is needed.


Subject(s)
Neuroendocrine Tumors , Organometallic Compounds , Pancreatic Neoplasms , Humans , Positron Emission Tomography Computed Tomography , Retrospective Studies , Positron-Emission Tomography , Neuroendocrine Tumors/diagnostic imaging , Neuroendocrine Tumors/radiotherapy , Organometallic Compounds/therapeutic use , Octreotide/therapeutic use , Octreotide/adverse effects
2.
Rev Mal Respir ; 39(6): 561-565, 2022 Jun.
Article in French | MEDLINE | ID: mdl-35570035

ABSTRACT

INTRODUCTION: We are reporting the case of a 64-year-old patient with chronic cough who has been diagnosed with an intercostal hernia with pleural and hepatic content associated with a diaphragmatic hernia of non-traumatic origin. CASE REPORT: The patient was treated for an acutely febrile cough with signs of respiratory distress. Thoracic scan showed an intercostal hernia containing an encysted hematoma and a right anterior diaphragmatic hernia with epiploic content. The COVID PCR was negative. This is one of the rare reported cases of intercostal hernia associated with a homolateral diaphragmatic rupture. Visceral and thoracic surgery enabled treatment of the two hernial orifices by raphy as well as omentectomy of the necrotic omentum ascending to the right pulmonary hilum. CONCLUSION: These two parietal complications of chronic cough should be considered in case of intercostal flap or acute respiratory distress. Surgery must then be carried out as a matter of urgency to reduce the content of the hernias and treat the musculoaponeurotic dehiscent orifices.


Subject(s)
COVID-19 , Hernia, Diaphragmatic, Traumatic , Hernias, Diaphragmatic, Congenital , Respiratory Distress Syndrome , Chronic Disease , Cough/complications , Cough/etiology , Hernia/complications , Hernia/diagnosis , Hernia, Diaphragmatic, Traumatic/complications , Hernia, Diaphragmatic, Traumatic/diagnosis , Hernia, Diaphragmatic, Traumatic/surgery , Hernias, Diaphragmatic, Congenital/complications , Humans , Middle Aged
3.
Ann Oncol ; 30(5): 804-814, 2019 05 01.
Article in English | MEDLINE | ID: mdl-30838379

ABSTRACT

BACKGROUND: The advent of effective adjuvant therapies for patients with resected melanoma has highlighted the need to stratify patients based on risk of relapse given the cost and toxicities associated with treatment. Here we assessed circulating tumor DNA (ctDNA) to predict and monitor relapse in resected stage III melanoma. PATIENTS AND METHODS: Somatic mutations were identified in 99/133 (74%) patients through tumor tissue sequencing. Personalized droplet digital PCR (ddPCR) assays were used to detect known mutations in 315 prospectively collected plasma samples from mutation-positive patients. External validation was performed in a prospective independent cohort (n = 29). RESULTS: ctDNA was detected in 37 of 99 (37%) individuals. In 81 patients who did not receive adjuvant therapy, 90% of patients with ctDNA detected at baseline and 100% of patients with ctDNA detected at the postoperative timepoint relapsed at a median follow up of 20 months. ctDNA detection predicted patients at high risk of relapse at baseline [relapse-free survival (RFS) hazard ratio (HR) 2.9; 95% confidence interval (CI) 1.5-5.6; P = 0.002] and postoperatively (HR 10; 95% CI 4.3-24; P < 0.001). ctDNA detection at baseline [HR 2.9; 95% CI 1.3-5.7; P = 0.003 and postoperatively (HR 11; 95% CI 4.3-27; P < 0.001] was also associated with inferior distant metastasis-free survival (DMFS). These findings were validated in the independent cohort. ctDNA detection remained an independent predictor of RFS and DMFS in multivariate analyses after adjustment for disease stage and BRAF mutation status. CONCLUSION: Baseline and postoperative ctDNA detection in two independent prospective cohorts identified stage III melanoma patients at highest risk of relapse and has potential to inform adjuvant therapy decisions.


Subject(s)
Circulating Tumor DNA/blood , Melanoma/blood , Neoplasm Recurrence, Local/blood , Skin Neoplasms/blood , Adult , Aged , Aged, 80 and over , Biomarkers, Tumor/genetics , Circulating Tumor DNA/genetics , Female , GTP Phosphohydrolases/genetics , Humans , Male , Melanoma/genetics , Melanoma/pathology , Membrane Proteins/genetics , Middle Aged , Mutation , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/genetics , Neoplasm Staging , Prognosis , Prospective Studies , Proto-Oncogene Proteins B-raf/genetics , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Survival Rate , Young Adult , Melanoma, Cutaneous Malignant
4.
Dalton Trans ; 46(7): 2249-2254, 2017 Feb 14.
Article in English | MEDLINE | ID: mdl-28128830

ABSTRACT

One-dimensional 27Al, 23Na Magic-Angle-Spinning (MAS) NMR and 27Al Multiple-Quantum Magic-Angle-Spinning NMR (MQMAS) measurements are reported for the δ-isomer of the Al13 Keggin structure at high spinning speed and 14.1 T field. Values for the CQ and η parameters are on the same scale as those seen in other isomers of the Al13 structure. Density functional theory (DFT) calculations are performed for comparison to the experimental fits using the B3PW91/6-31+G* and PBE0/6-31+G* levels of theory, with the Polarizable Continuum Model (PCM).

5.
Clin Biochem ; 48(13-14): 823-6, 2015 Sep.
Article in English | MEDLINE | ID: mdl-26210846

ABSTRACT

All areas of healthcare, including pathology, are being challenged by the reality that the days of ever increasing budgets are over and the key debate is about how to provide value for money. As originally described by Porter and Tiesberg, value-based healthcare is defined as maximising outcomes over cost by moving away from fee for service models to ones that reward providers on the basis of outcomes (1). While production efficiencies will continue to evolve, the opportunities for future stepwise improvements in production costs are likely to have diminished. The focus now is on delivering improved testing outcomes in a relatively cost neutral or at least cost effective way. This brings pathology into line with other health services that focus on value for money for payers, and maximising health outcomes for consumers. This would signal a break from the existing pathology funding model, which does not directly recognise or reward the contribution of pathology towards improved health outcomes, or seek to decommission tests that offer little clinical value. Pathology has a direct impact on clinical and economic outcomes that extend from testing and it is important to garner support for a new approach to funding that incentivises improvements of the overall quality and contribution of the pathology service.


Subject(s)
Laboratories, Hospital/economics , Health Planning Guidelines , Humans , Pathology/economics
6.
Med Phys ; 39(9): 5372-83, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22957605

ABSTRACT

PURPOSE: The use of time-resolved four-dimensional computed tomography (4D-CT) in radiotherapy requires strict quality assurance to ensure the accuracy of motion management protocols. The aim of this work was to design and test a phantom capable of large amplitude motion for use in 4D-CT, with particular interest in small lesions typical for stereotactic body radiotherapy. METHODS: The phantom of "see-saw" design is light weight, capable of including various sample materials and compatible with several surrogate marker signal acquisition systems. It is constructed of polymethylmethacrylate (Perspex) and its movement is controlled via a dc motor and drive wheel. It was tested using two CT scanners with different 4D acquisition methods: the Philips Brilliance Big Bore CT (helical scan, pressure belt) and a General Electric Discovery STE PET∕CT (axial scan, infrared marker). Amplitudes ranging from 1.5 to 6.0 cm and frequencies of up to 40 cycles per minute were used to study the effect of motion on image quality. Maximum intensity projections (MIPs), as well as average intensity projections (AIPs) of moving objects were investigated and their quality dependence on the number of phase reconstruction bins assessed. RESULTS: CT number discrepancies between moving and stationary objects were found to have no systematic dependence on amplitude, frequency, or specific interphase variability. MIP-delineated amplitudes of motion were found to match physical phantom amplitudes to within 2 mm for all motion scenarios tested. Objects undergoing large amplitude motions (>3.0 cm) were shown to cause artefacts in MIP and AIP projections when ten phase bins were assigned. This problem can be mitigated by increasing the number of phase bins in a 4D-CT scan. CONCLUSIONS: The phantom was found to be a suitable tool for evaluating the image quality of 4D-CT motion management technology, as well as providing a quality assurance tool for intercenter∕intervendor testing of commercial 4D-CT systems. When imaging objects with large amplitudes, the completeness criterion described here indicates the number of phase bins required to prevent missing data in MIPs and AIPs. This is most relevant for small lesions undergoing large motions.


Subject(s)
Four-Dimensional Computed Tomography/instrumentation , Neoplasms/diagnostic imaging , Neoplasms/surgery , Phantoms, Imaging , Radiosurgery/methods , Artifacts , Neoplasms/pathology , Tumor Burden
7.
Australas Phys Eng Sci Med ; 35(1): 93-100, 2012 Mar.
Article in English | MEDLINE | ID: mdl-22119931

ABSTRACT

A commercially available motion phantom (QUASAR, Modus Medical) was modified for programmable motion control with the aim of reproducing patient respiratory motion in one dimension in both the anterior-posterior and superior-inferior directions, as well as, providing controllable breath-hold and sinusoidal patterns for the testing of radiotherapy gating systems. In order to simulate realistic patient motion, the DC motor was replaced by a stepper motor. A separate 'chest-wall' motion platform was also designed to accommodate a variety of surrogate marker systems. The platform employs a second stepper motor that allows for the decoupling of the chest-wall and insert motion. The platform's accuracy was tested by replicating patient traces recorded with the Varian real-time position management (RPM) system and comparing the motion platform's recorded motion trace with the original patient data. Six lung cancer patient traces recorded with the RPM system were uploaded to the motion platform's in-house control software and subsequently replicated through the phantom motion platform. The phantom's motion profile was recorded with the RPM system and compared to the original patient data. Sinusoidal and breath-hold patterns were simulated with the motion platform and recorded with the RPM system to verify the systems potential for routine quality assurance of commercial radiotherapy gating systems. There was good correlation between replicated and actual patient data (P 0.003). Mean differences between the location of maxima in replicated and patient data-sets for six patients amounted to 0.034 cm with the corresponding minima mean equal to 0.010 cm. The upgraded motion phantom was found to replicate patient motion accurately as well as provide useful test patterns to aid in the quality assurance of motion management methods and technologies.


Subject(s)
Neoplasms/radiotherapy , Phantoms, Imaging , Respiratory-Gated Imaging Techniques/methods , Algorithms , Computer Simulation , Humans , Motion , Radiotherapy Planning, Computer-Assisted , Software
8.
Australas Phys Eng Sci Med ; 34(4): 489-95, 2011 Dec.
Article in English | MEDLINE | ID: mdl-22081269

ABSTRACT

To assess the effect of lesion motion and respiration rate on Standardised Uptake Value (SUV) and the ability of 4D PET to restore any loss in SUV and distortion of lesion volume on two PET/CT systems. A Perspex phantom with four cylindrical reservoirs filled with (18)F-FDG was used in this study. The cylinders measured 5, 10, 15, and 20 mm in diameter. A GE Discovery STE8 (GE Medical Systems Milwaukee, WI) and a Siemens Biograph 64/40 (Siemens Medical Solutions, Erlangen, Germany) scanner was used to acquire a stationary un-gated PET scan of the phantom. Multiple 10 min list mode 4D PET scans were acquired using the Varian RPM on the GE camera and the Anzai Gating system on the Siemens camera. The phantom was scanned at five different respiratory rates and motion amplitudes in a sinusoidal fashion, 15 RPM/1 cm, 15 RPM/2 cm, 15 RPM/4 cm, 30 RPM/2 cm and 7.5 RPM/2 cm (RPM-respirations per minute). Each scan was reconstructed into ten bins and as an un-gated static image. The SUVmax, SUVmean and volume were measured for all four reservoirs using Siemens TrueD analysis software. With increasing lesion movement the SUVmax and SUVmean decreased and the volume increased with the SUVmax in the smallest lesion underestimated by up to a factor of four. The SUVmax, SUVmean and volume were mostly recovered using 4D imaging regardless of amount of lesion displacement. The larger lesions showed better count recovery and volume correction than the smaller lesions. The respiratory rate had no effect of SUV or volume. Un-gated imaging of moving lesions decreases apparent SUV in small lesions significantly and overestimates volumes. 4D PET scanning recovers most of the apparent loss in SUV and distortion of volumes.


Subject(s)
Imaging, Three-Dimensional/methods , Phantoms, Imaging , Positron-Emission Tomography/methods , Tomography, X-Ray Computed/methods , Humans , Models, Biological , Movement/physiology , Neoplasms/pathology , Reproducibility of Results , Respiration
9.
Mol Oral Microbiol ; 26(2): 99-116, 2011 Apr.
Article in English | MEDLINE | ID: mdl-21375701

ABSTRACT

Streptococcus sanguinis is a major component of the oral flora and an important cause of infective endocarditis. Although S. sanguinis is naturally competent, genome sequencing has suggested significant differences in the S. sanguinis competence system relative to those of other streptococci. An S. sanguinis mutant possessing an in-frame deletion in the comC gene, which encodes competence-stimulating peptide (CSP), was created. Addition of synthetic CSP induced competence in this strain. Gene expression in this strain was monitored by microarray analysis at multiple time-points from 2.5 to 30 min after CSP addition, and verified by quantitative reverse transcription-polymerase chain reaction. Over 200 genes were identified whose expression was altered at least two-fold in at least one time point, with the majority upregulated. The 'late' response was typical of that seen in previous studies. However, comparison of the 'early' response in S. sanguinis with that of other oral streptococci revealed unexpected differences with regard to the number of genes induced, the nature of those genes, and their putative upstream regulatory sequences. Streptococcus sanguinis possesses a comparatively limited early response, which may define a minimal streptococcal competence regulatory circuit.


Subject(s)
Bacterial Proteins/genetics , Gene Expression Regulation, Bacterial/genetics , Streptococcus sanguis/genetics , Bacterial Load , Bacteriological Techniques , Conserved Sequence/genetics , Down-Regulation/genetics , Frameshift Mutation/genetics , Gene Expression Profiling , Genes, Bacterial/genetics , Humans , Microarray Analysis , Plasmids/genetics , Reverse Transcriptase Polymerase Chain Reaction , Sequence Deletion/genetics , Streptococcus gordonii/genetics , Streptococcus pneumoniae/genetics , Streptococcus sanguis/physiology , Transcription, Genetic/physiology , Transcriptional Activation/genetics , Transformation, Bacterial/genetics , Up-Regulation/genetics
10.
Poult Sci ; 89(8): 1744-9, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20634532

ABSTRACT

The effects of hydrodynamic pressure processing (HDP) on marination and meat quality characteristics of turkey breasts were investigated. Breast muscles from 45 turkey hens were removed from the carcasses within 30 min postmortem. From each bird, the breast from one side was treated with HDP and the other side served as a nontreated control. Breasts were then marinated in either 15 or 30% brine (water, salt, and phosphate) based on muscle weight with vacuum tumbling for 30 min or nonmarinated. The control and HDP-treated breasts from each bird received the same marination treatment. Brine uptake, processing yield, and cooking loss were measured as processing characteristics and texture, color, and expressible moisture were measured to document changes in meat quality. Hydrodynamic pressure processing increased (P < 0.001) brine uptake after 10 and 30 min of marination and increased (P < 0.001) processing yield compared with controls. The HDP-induced improvements in these processing characteristics were augmented at 30% brine levels compared with 15% brine. Cooking loss was lower (P < 0.001) in marinated breasts compared with nonmarinated samples. Hydrodynamic pressure processing decreased (P < 0.0001) Warner-Bratzler shear force and significantly influenced texture profile parameters, resulting in reduced hardness but increased cohesiveness and springiness compared with controls at both marination levels. Hydrodynamic pressure processing did not influence color (L*, a*, and b*) or expressible moisture values compared with controls at either marination level. Marinated samples (15 and 30% brine levels) had lower (P < 0.001) Warner-Bratzler shear force values and lower (P < 0.05) hardness, cohesiveness, and chewiness values compared with nonmarinated samples. Data from this study suggest that HDP enhances brine absorption, increases processing yield, and improves texture characteristics in marinated turkey breasts.


Subject(s)
Food Handling/methods , Meat/standards , Muscle, Skeletal/physiology , Pressure , Animals , Body Weight , Cooking , Female , Humans , Mastication , Salts , Turkeys
11.
J Food Sci ; 75(4): S237-44, 2010 May.
Article in English | MEDLINE | ID: mdl-20546427

ABSTRACT

UNLABELLED: The objective of this study was to determine the influence of hydrodynamic pressure processing (HDP) and aging on the processing characteristics and final meat quality of moisture-enhanced pork loins. Boneless pork loins (n = 24) were split into 3 portions and assigned treatments: control (non-HDP treated, brine-injected), HDP treated before brine-injection, or HDP treated after brine-injection. Pork loins were injected with a salt/phosphate/water solution to 110% of original weight on day 0, intermittently tumbled 3 h, and then held overnight. Meat quality and protein characteristics were measured on days 1 and 8. HDP-treated loins had greater (P < 0.05) brine retention after overnight equilibration and a higher (P < 0.05) processing yield than controls. Warner-Bratzler shear force and expressible moisture decreased (P < 0.0001) with aging from days 1 to 8, but were not significantly affected by either HDP treatment. When the drip loss data from HDP treatments were pooled, HDP samples had lower drip loss values than controls. L* and b* measurements exhibited significant HDP by aging interaction effects, but a* was not influenced by either HDP or aging. Myofibrillar protein solubility and gel electrophoresis measurements of protein degradation were influenced by aging treatments. Data from this study suggest that HDP may have beneficial effects on the processing and final product quality of moisture-enhanced pork loins. PRACTICAL APPLICATION: This study demonstrates that hydrodynamic pressure processing (HDP) is an effective postharvest technology for improving the processing and meat quality characteristics of moisture-enhanced pork loin products, benefiting both meat processors and consumers.


Subject(s)
Chemical Phenomena , Food Handling/methods , Meat/analysis , Water/analysis , Animals , Electrophoresis, Polyacrylamide Gel , Hardness , Hydrogen-Ion Concentration , Hydrostatic Pressure/adverse effects , Molecular Weight , Muscle Proteins/chemistry , Muscle Proteins/isolation & purification , Muscles/chemistry , Myofibrils/chemistry , Pigmentation , Quality Control , Salts/chemistry , Shear Strength , Solubility , Sus scrofa , Time Factors
12.
Mol Genet Metab ; 92(4): 325-35, 2007 Dec.
Article in English | MEDLINE | ID: mdl-17723315

ABSTRACT

Glycogen storage disease, type II (GSDII; Pompe disease; acid maltase deficiency) is an autosomal recessive disease caused by mutations of the GAA gene that lead to deficient acid alpha-glucosidase enzyme activity and accumulation of lysosomal glycogen. Although measurement of acid alpha-glucosidase enzyme activity in fibroblasts remains the gold standard for the diagnosis of GSDII, analysis of the GAA gene allows confirmation of clinical or biochemical diagnoses and permits predictive and prenatal testing of individuals at risk of developing GSDII. We have developed a clinical molecular test for the detection of GAA mutations based on cycle sequencing of the complete coding region. GAA exons 2-20 are amplified in six independent PCR using intronic primers. The resulting products were purified and sequenced. Preliminary studies using this protocol were conducted with DNA from 21 GSDII-affected individuals from five centers across Canada. In total, 41 of 42 mutations were detected (96.7% detection rate). Mutations spanned intron 1 through exon 19 and included nine novel mutations. Haplotype analysis of recurrent mutations further suggested that three of these mutations are likely to have occurred independently at least twice. Additionally, we report the identification of the c.-32-13T>G GAA mutation in an individual with infantile variant GSDII, despite reports of this mutation being associated almost exclusively with late-onset forms of the disease. The development of a clinical molecular test provides an important tool for the management and counseling of families and individuals with GSDII, and has provided useful information about the GAA mutation spectrum in Canada.


Subject(s)
Genetic Predisposition to Disease/genetics , Glycogen Storage Disease Type II/genetics , alpha-Glucosidases/genetics , Alleles , DNA Mutational Analysis , Glycogen Storage Disease Type II/diagnosis , Glycogen Storage Disease Type II/enzymology , Humans , Mutation , alpha-Glucosidases/deficiency
13.
J Perinatol ; 26(9): 533-9, 2006 Sep.
Article in English | MEDLINE | ID: mdl-16826190

ABSTRACT

OBJECTIVE: To enhance the clinical utility of the Perinatal Post-Traumatic Stress Disorder (PTSD) Questionnaire (PPQ), the current study sought to refine the measure by changing the item response options from dichotomous choices to a likert scale format. STUDY DESIGN: Using a convergent/divergent validity design and two data sources (traditional survey and World Wide Web), 58 high-risk and 86 low-risk mothers answered four questionnaires. RESULTS: Principal components analysis of items on the modified PPQ revealed three components conceptually similar to the diagnostic criterion associated with PTSD. In addition, convergent and divergent validity of the modified measure was supported. The clinical utility of the modified PPQ was established with a strong positive likelihood ratio. CONCLUSION: The modified PPQ is a useful clinical tool for identifying mothers experiencing significant emotional distress during the postnatal period so they may be referred for mental health services.


Subject(s)
Psychiatric Status Rating Scales , Puerperal Disorders/diagnosis , Stress Disorders, Post-Traumatic/diagnosis , Surveys and Questionnaires , Adult , Female , Humans , Infant, Newborn , Pregnancy , Puerperal Disorders/psychology , Reproducibility of Results , Stress Disorders, Post-Traumatic/psychology
14.
J Inherit Metab Dis ; 29(1): 195-200, 2006 Feb.
Article in English | MEDLINE | ID: mdl-16601891

ABSTRACT

Maple syrup urine disease (MSUD) is a metabolic disorder due to a block in the decarboxylation step in the catabolic pathways of the branched-chain amino acids (BCAAs). We describe an atypical presentation in an infant male. The patient presented with psychomotor retardation, profound hypotonia and elevated plasma levels of BCAAs, but no elevation of alloisoleucine. Cranial magnetic resonance imaging showed prominent diffuse CSF spaces, delayed myelin maturation and symmetrical signal abnormality within the globi pallidi, midbrain, dorsal pons and medulla. The cerebellar white matter was specifically spared. A mitochondrial disorder was suggested. After correction of feeding problems with G-tube feeds, his high BCAAs persisted and, on fourth analysis, alloisoleucine was seen. Subsequent fibroblast enzyme and mutation analysis confirmed MSUD due to E(1)-alpha subunit deficiency. After starting dietary treatment, there was no significant improvement in his hypotonia or his psychomotor development. However, the high signal within the globi pallidi had resolved. MSUD may have diverse clinical presentations, and should be considered in children who present with chronic psychomotor delay but no acute encephalopathic episodes. BCAA levels may not be very high, alloisoleucine may not always be detected in MSUD even with severe enzyme deficiency, and imaging may be misleading if seen in the chronic phase only.


Subject(s)
Maple Syrup Urine Disease/diagnosis , Maple Syrup Urine Disease/therapy , Amino Acids, Branched-Chain/blood , Brain/pathology , Cerebellum/pathology , Developmental Disabilities/diagnosis , Humans , Infant , Intellectual Disability , Isoleucine/blood , Male , Maple Syrup Urine Disease/blood , Phenotype
15.
J Clin Microbiol ; 43(1): 112-9, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15634958

ABSTRACT

A fluorogenic probe hydrolysis (TaqMan) PCR assay for African swine fever virus (ASFV) was developed and evaluated in experimentally infected swine. This sensitive and specific one-step single-tube assay, which can be performed in 2 h or less, detected viral DNA in tonsil scraping samples 2 to 4 days prior to onset of clinical disease. Thus, the assay would have application for preclinical diagnosis of African swine fever and surveillance and/or emergency management of a disease outbreak.


Subject(s)
African Swine Fever Virus/isolation & purification , African Swine Fever/diagnosis , Polymerase Chain Reaction/methods , African Swine Fever Virus/genetics , Animals , DNA Probes , Palatine Tonsil/virology , Sensitivity and Specificity , Swine/virology , Taq Polymerase
16.
J Clin Microbiol ; 43(1): 468-71, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15635018

ABSTRACT

A fluorogenic-probe hydrolysis (TaqMan)-reverse transcriptase (RT) PCR for classical swine fever virus (CSFV) was evaluated for diagnostic sensitivity and specificity by using clinical samples obtained from the Dominican Republic, where the disease is enzootic. The sensitivity of this test, using nasal swab samples taken from both symptomatic and asymptomatic animals, exceeded the diagnostic sensitivity of virus isolation (100% versus 72.4%, respectively) with little loss of specificity (98.9% versus 100%, respectively). At the herd level, three of four infected farms were identified by virus isolation, while the CSFV real-time RT-PCR assay identified all four infected premises. This simple and accurate test permits rapid detection of CSFV in affected herds.


Subject(s)
Classical Swine Fever Virus/isolation & purification , Classical Swine Fever/virology , Reverse Transcriptase Polymerase Chain Reaction/methods , Animals , Classical Swine Fever/diagnosis , Classical Swine Fever Virus/genetics , RNA, Viral/analysis , Sensitivity and Specificity , Swine/virology
17.
J Inherit Metab Dis ; 28(6): 991-1004, 2005.
Article in English | MEDLINE | ID: mdl-16435192

ABSTRACT

Cytoplasmic granules in fibroblasts, visualized without stains, or labelled with Nile red, Filipin, or anti-LAMP-1 (lysosome-associated membrane protein 1), were imaged using the real-time microscope (RTM). New advances in light microscope technology were applied to detect cytoplasmic granules (RTM-visible granules) and characterize them by imaging contrast, size, shape, cellular distribution, composition, motion dynamics and quantity. Appearing as solid spheroids or ring structures, the majority of the RTM-visible granules contained Nile-red labelled neutral lipids. A smaller subpopulation, appearing dimmer, with less imaging contrast, contained Filipin-labelled free cholesterol. Most lipid storage granules have a diameter ranging from 0.3 mum to 0.6 mum, with a small population measuring up to 1 mum. They typically clustered in the perinuclear region and displayed relatively small oscillatory motion. Immunofluorescence based on LAMP-1 labelling highlighted granular structures that were distinct and separate from RTM-visible granules and other structures in the light modality of the microscope. RTM-visible granules were associated with disease phenotypes that have increased cellular neutral lipid stores corresponding to the Nile red-labelled droplets (e.g. triacylglycerides, cholesterol esters). As predicted, the fibroblast strains with a defect resulting in Wolman disease, when compared to control samples, consistently had RTM-visible granules, higher in imaging contrast and with larger diameters, that were labelled with Nile red, and also an increased frequency of Filipin-cholesterol complexes. By comparison, in fibroblasts where the lipid storage is less evident (Gaucher and Farber diseases) or from GM(1) gangliosidosis, where the primary storage substances are oligosaccharides, fewer and smaller RTM-visible granules were observed. In some cases, changes in contrast and morphology in the unstained cytoplasmic compartments were more evident than in the labelled structures. In summary, applying the RTM imaging system to fibroblasts enables differences between the various disease types to be seen and, in specific examples, a unique phenotype can be readily discerned.


Subject(s)
Cytoplasm/metabolism , Cytoplasmic Granules/metabolism , Fibroblasts/metabolism , Filipin/metabolism , Lipidoses/metabolism , Lipidoses/pathology , Microscopy, Fluorescence/methods , Oxazines/pharmacology , Antifungal Agents/pharmacology , Cholesterol/metabolism , G(M1) Ganglioside/metabolism , Humans , Image Processing, Computer-Assisted , Lipid Metabolism , Lipids/chemistry , Lysosomal Membrane Proteins/metabolism , Microscopy , Microscopy, Fluorescence/instrumentation , Phenotype , Wolman Disease/metabolism
18.
J Clin Microbiol ; 42(10): 4453-61, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15472293

ABSTRACT

Transmission of porcine reproductive and respiratory syndrome virus (PRRSV) via boar semen has been documented. Since semen is widely disseminated for artificial insemination and the virus can cause significant health and economic consequences, it is essential to have well-validated, rapid diagnostic techniques to detect and quantitate the virus for diagnostic and research purposes. Previously, boar semen was tested by a nested PCR (nPCR) assay which was compared to the "gold standard" swine bioassay. A correlation of 94% was observed, indicating that, most of the time, PCR detected infectious virus. Subsequently, a real-time PCR targeting the 3' untranslated region of the PRRSV genome was compared with nPCR by testing 413 serum and semen samples from PRRSV-inoculated and control boars. There was 95% agreement between the results of the two tests, with the majority of samples with discordant results containing virus at the lower range of detection by the assays. The virus in all samples was quantitated by using a standard curve obtained by serial dilution of an in vitro transcript. By using the in vitro transcript, the lower limit of sensitivity was observed to be approximately 33 copies/ml. Reactivity with a panel of more than 100 PRRSV isolates from various geographical regions in the United States was also documented. No reactivity with nine nonrelated swine viruses was noted. A real-time PCR was also developed for the detection of the European Lelystad virus and the European-like PRRSV now found in the United States. In six of six PRRSV-inoculated boars, peak levels of viremia occurred at 5 days postinoculation (DPI) and were most consistently detectable throughout 22 DPI. In five of six boars, PRRSV was shed in semen for 0 to 2 days during the first 10 DPI; however, one of six boars shed the virus in semen through 32 DPI. Therefore, in general, the concentration and duration of PRRSV shedding in semen did not correlate with the quantity or duration of virus in serum. These differences warrant further studies into the factors that prevent viral replication in the reproductive tract.


Subject(s)
Polymerase Chain Reaction/methods , Porcine Reproductive and Respiratory Syndrome/virology , Porcine respiratory and reproductive syndrome virus/isolation & purification , RNA, Viral/blood , Semen/virology , Sus scrofa/virology , Animals , Male , Porcine respiratory and reproductive syndrome virus/genetics , RNA, Viral/isolation & purification , Reproducibility of Results , Sensitivity and Specificity , Swine Diseases/virology , Viral Load
19.
J Membr Biol ; 201(2): 77-84, 2004 Sep 15.
Article in English | MEDLINE | ID: mdl-15630545

ABSTRACT

We investigated the effect of salinity on the relationship between Na(+)-K(+)-ATPase and sulfogalactosyl ceramide (SGC) in the basolateral membrane of rainbow trout (Oncorhynchus mykiss) gill epithelium. SGC has been implicated as a cofactor in Na(+)-K(+)-ATPase activity, especially in Na(+)-K(+)-ATPase rich tissues. However, whole-tissue studies have questioned this role in the fish gill. We re-examined SGC cofactor function from a gill basolateral membrane perspective. Nine SGC fatty acid species were quantified by tandem mass spectrometry (MS/MS) and related to Na(+)-K(+)-ATPase activity in trout acclimated to freshwater or brackish water (20 ppt). While Na(+)-K(+)-ATPase activity increased, the total concentration and relative proportion of SGC isoforms remained constant between salinities. However, we noted a negative correlation between SGC concentration and Na(+)-K(+)-ATPase activity in fish exposed to brackish water, whereas no correlation existed in fish acclimated to freshwater. Differential Na(+)-K(+)-ATPase/SGC sensitivity is discussed in relation to enzyme isoform switching, the SGC cofactor site model and saltwater adaptation.


Subject(s)
Adaptation, Physiological , Gills/metabolism , Oncorhynchus mykiss/metabolism , Sodium-Potassium-Exchanging ATPase/metabolism , Sulfoglycosphingolipids/metabolism , Animals , Basement Membrane/metabolism , Fresh Water , Osmolar Concentration , Seawater , Water-Electrolyte Balance/physiology
20.
J Clin Microbiol ; 41(1): 500-5, 2003 Jan.
Article in English | MEDLINE | ID: mdl-12517907

ABSTRACT

A fluorogenic-probe hydrolysis (TaqMan)-reverse transcriptase PCR assay for classical swine fever virus (CSFV) was developed and evaluated in experimentally infected swine. The assay detected CSFV, representing different phylogenetic groupings, but did not amplify viral RNA from related pestiviruses. The assay met or exceeded the sensitivity (1 to 100 50% tissue culture infective doses per ml) of viral cultures of samples from experimentally infected animals. Viral RNA was detected in nasal and tonsil scraping samples 2 to 4 days prior to the onset of clinical disease. The assay can be performed in 2 h or less, thus providing a rapid method for the diagnosis of classical swine fever.


Subject(s)
Classical Swine Fever Virus/isolation & purification , Classical Swine Fever/virology , Reverse Transcriptase Polymerase Chain Reaction/methods , Animals , Classical Swine Fever Virus/genetics , RNA, Viral/analysis , RNA, Viral/cerebrospinal fluid , Reagent Kits, Diagnostic , Swine
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