• T cells in multiple sclerosis and experimental autoimmune encephalomyelitis.

      Fletcher, J M; Lalor, S J; Sweeney, C M; Tubridy, N; Mills, K H G; Immune Regulation Research Group, School of Biochemistry and Immunology, Trinity , College, St Vincent's University Hospital, Dublin, Ireland. (2012-02-01)
      Multiple sclerosis (MS) is a demyelinating inflammatory disorder of the central nervous system (CNS), which involves autoimmune responses to myelin antigens. Studies in experimental autoimmune encephalomyelitis (EAE), an animal model for MS, have provided convincing evidence that T cells specific for self-antigens mediate pathology in these diseases. Until recently, T helper type 1 (Th1) cells were thought to be the main effector T cells responsible for the autoimmune inflammation. However more recent studies have highlighted an important pathogenic role for CD4(+) T cells that secrete interleukin (IL)-17, termed Th17, but also IL-17-secreting gammadelta T cells in EAE as well as other autoimmune and chronic inflammatory conditions. This has prompted intensive study of the induction, function and regulation of IL-17-producing T cells in MS and EAE. In this paper, we review the contribution of Th1, Th17, gammadelta, CD8(+) and regulatory T cells as well as the possible development of new therapeutic approaches for MS based on manipulating these T cell subtypes.
    • T251 The impact of radiofrequency lesioning on patients with trigeminal neuralgia: A ten-year audit

      Rahman, N.; Fullen, B.M.; Canavan, D.; Keaveny, J.; Stassen, L. (2011-09)
    • Takayasu's arteritis: a challenging diagnosis.

      Fanning, D M; Hickey, D P; Department of Urology and Transplantation, Beaumont Hospital, Dublin 9, Ireland. fanningdee@yahoo.co.uk (2009-03)
      The practices of medicine and surgery are inherently and irrevocably entwined. This case report highlights the need for an integrated, multi-disciplinary approach to care of the modern patient. Our patient fulfils the traditional Ishikawa's criteria and the modified Ishikawa's criteria for the clinical diagnosis of Takayasu's disease. Her case underpins the need for co-ordinated care and careful periodic review of the symptomatology and signs of the multiple clinic attendees.
    • The tale of a blue toddler.

      Sharif, F; Hussey, S; Gill, D (2003-09)
    • "Tarantula keratitis": a case report.

      McAnena, L; Murphy, C; O'Connor, J; Royal Victoria Eye and Ear Hospital (RVEEH), Adelaide Road, Dublin 2, Ireland. lmcanena@yahoo.co.uk (2013-09)
      A case of an 11-year-old boy presenting with a two-week history of a red, irritated right eye after handling a Chilean Rose Tarantula at an exotic pet exhibition. Examination revealed innumerable microscopic hairs embedded at all levels of the cornea. He was commenced on steroid drops with subjective and objective improvement at follow up.
    • Targeted neonatal echocardiography (TnECHO) service in a Canadian neonatal intensive care unit: a 4-year experience.

      El-Khuffash, A; Herbozo, C; Jain, A; Lapointe, A; McNamara, P J; Department of Paediatrics, The Rotunda Hospital, Dublin, Ireland. (2013-09)
      To characterize the effect of a targeted neonatal echocardiography (TnECHO) program on decision making in a tertiary level unit.
    • Targeted neonatal echocardiography services: need for standardized training and quality assurance.

      Finan, Emer; Sehgal, Arvind; Khuffash, Afif El; McNamara, Patrick J; Mount Sinai Hospital, Toronto, Ontario, Canada (E.F.); Monash Medical Center, Melbourne, Victoria, Australia (A.S.); Rotunda Hospital, Dublin, Ireland (A.E.K.); Hospital for Sick Children, Toronto, Ontario, Canada (P.J.M.); and Departments of Pediatrics (E.F., P.J.M.) and Physiology (P.J.M.), University of Toronto, Toronto, Ontario, Canada. (2014-10)
      Targeted neonatal echocardiography refers to a focused assessment of myocardial performance and hemodynamics directed by a specific clinical question. It has become the standard of care in many parts of the world, but practice is variable, and there has been a lack of standardized training and evaluation to date. Targeted neonatal echocardiography was first introduced to Canada in 2006. The purpose of this study was to examine the characteristics of targeted neonatal echocardiography practice and training methods in Canadian neonatal intensive care units (NICUs).
    • Taurine attenuates radiation-induced lung fibrosis in C57/Bl6 fibrosis prone mice.

      Robb, W B; Condron, C; Moriarty, M; Walsh, T N; Bouchier-Hayes, D J; Department of Surgery, Beaumont Hospital, The Royal College of Surgeons in Ireland, Dublin, Ireland. wrobb@rcsi.ie (2010-03)
      The amino acid taurine has an established role in attenuating lung fibrosis secondary to bleomycin-induced injury. This study evaluates taurine's effect on TGF-beta1 expression and the development of lung fibrosis after single-dose thoracic radiotherapy.
    • Taurine modulates neutrophil function but potentiates uropathogenic E. coli infection in the murine bladder.

      Condron, Claire; Casey, Rowan G; Kehoe, Siobhan; Toomey, Deirdre; Creagh, Tom; Bouchier-Hayes, David J; Department of Surgery, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland. (2010-08)
      Eradication of a urinary tract infection (UTI) appears to be related to a number of innate host defence mechanisms and their interactions with invading bacteria. Recurrent UTIs (rUTIs) pose a difficult problem in that these bacteria use both host and bacterial factors to evade elimination. Neutrophil bactericidal function is depressed, both systemically and in urine, in patients with a history of recurrent UTI. Taurine is a semi-essential amino acid and is successful in preserving neutrophil bactericidal function in urine. Taurine may preserve neutrophil function at the urothelium and thus aid UTI resolution. Adult female (6 weeks old) C57Bl/6 mice were randomised into three groups: a saline gavage only control group, a saline gavage + E. coli group, and a taurine gavage + E. coli group [21 g/70 kg taurine in 0.9% normal saline (N/S) for 5 days]. Whilst taurine gavage pre-treatment resulted in increased serum neutrophils respiratory burst activity, at the urothelial-endothelial interface it caused higher colony forming units in the urine and a higher incidence of E. coli invasion in the bladder wall with no evidence of increased bladder wall neutrophils infiltration on MPO assay of histological assessment. Histologically there was also evidence of reduced bladder inflammation and urothelial cell apoptosis. In conclusion, taurine effectively increases neutrophils activity but given its anti-inflammatory properties, at the expense of decreased urothelial-endothelial activation thus preventing clearance of active E. coli infection in the bladder. Despite the negative results, this study demonstrates the importance of modulating interactions at the urothelial interface.
    • Taxing your memory.

      Martin, Ruth; O'Neill, Desmond; Centre for Ageing, Neuroscience and the Humanities, Adelaide and Meath Hospital, , Dublin 24, Ireland. (2012-02-01)
    • TB or not TB?: a case of isolated testicular TB with scrotal involvement.

      Bhargava, A; Davenport, C; Gibbons, N; McConkey, S; Department of Infectious Diseases, Beaumont Hospital, Dublin 9, Ireland. abhargava99@yahoo.com (2009-06)
      Despite the genitourinary tract being the most common site affected by extrapulmonary TB, isolated testicular TB remains a rare clinical entity. In patients with co-morbidities such as hepatic impairment, treatment proves a challenge, as first-line hepatotoxic pharmaceuticals are contraindicated. Here, we report a case of isolated testicular TB with scrotal involvement, on a background of hepatic dysfunction.
    • Team Objective Structured Bedside Assessment (TOSBA) as formative assessment in undergraduate Obstetrics and Gynaecology: a cohort study.

      Deane, Richard P; Joyce, Pauline; Murphy, Deirdre J (BioMed Central, 2015-10-09)
      Team Objective Structured Bedside Assessment (TOSBA) is a learning approach in which a team of medical students undertake a set of structured clinical tasks with real patients in order to reach a diagnosis and formulate a management plan and receive immediate feedback on their performance from a facilitator. TOSBA was introduced as formative assessment to an 8-week undergraduate teaching programme in Obstetrics and Gynaecology (O&G) in 2013/14. Each student completed 5 TOSBA sessions during the rotation. The aim of the study was to evaluate TOSBA as a teaching method to provide formative assessment for medical students during their clinical rotation. The research questions were: Does TOSBA improve clinical, communication and/or reasoning skills? Does TOSBA provide quality feedback?
    • Technetium myocardial perfusion scanning in prerenal transplant evaluation in the United kingdom.

      Wong, C F; Little, M A; Vinjamuri, S; Hammad, A; Harper, J M; Department of Nephrology and Transplantation, Royal Liverpool University Hospital, Liverpool, United Kingdom. chriswong@doctors.org.uk (Transplantation proceedings, 2008-06)
      Because death with a functioning graft remains one of the most important causes of long-term renal transplant failure, cardiac risk stratification and screening for coronary artery disease are essential components of pretransplant assessment. Pretransplant screening for occult coronary artery disease in a subset of these patients may improve outcome. The UK follows the European Best practice guideline 1.5.5 E. Although echocardiography, thallium myocardial perfusion scanning (MPS), dobutamine stress echocardiography, and coronary angiography have been suggested as means of cardiovascular assessment, the best means of assessment remains undetermined. Therefore, we investigated the role of 99m technetium sestamibi myocardial perfusion scanning as an assessment tool for identifying those patients with end-stage renal failure at high risk of cardiovascular death after renal transplantation. Retrospectively, we studied 126 patients that had a MPS as part of their pretransplant assessment. Overall unadjusted survival was 65% at 3 years. Twelve deaths resulted from cardiovascular causes. A reversible defect on MPS was associated with a fatal cardiac event and all-cause mortality. The unadjusted hazard ratio of cardiac event with reversible defect on MPS was 3.1 (95% confidence interval, 1.1 to 18.2) and hazard ratio of death with reversible defect on MPS was 1.92 (95% confidence interval, 1.1 to 4.4). Thus, MPS may be a useful tool in cardiac risk stratification and in selecting patients with a favorable outcome after renal transplantation. Our patients with a reversible defect in particular have increased cardiac mortality. This group may benefit from coronary angiography.
    • A Technical Assessment of the Utility of Reverse Phase Protein Arrays for the Study of the Functional Proteome in Non-microdissected Human Breast Cancers.

      Hennessy, Bryan T; Lu, Yiling; Gonzalez-Angulo, Ana Maria; Carey, Mark S; Myhre, Simen; Ju, Zhenlin; Davies, Michael A; Liu, Wenbin; Coombes, Kevin; Meric-Bernstam, Funda; et al. (2010-12)
      INTRODUCTION: The lack of large panels of validated antibodies, tissue handling variability, and intratumoral heterogeneity potentially hamper comprehensive study of the functional proteome in non-microdissected solid tumors. The purpose of this study was to address these concerns and to demonstrate clinical utility for the functional analysis of proteins in non-microdissected breast tumors using reverse phase protein arrays (RPPA). METHODS: Herein, 82 antibodies that recognize kinase and steroid signaling proteins and effectors were validated for RPPA. Intraslide and interslide coefficients of variability were <15%. Multiple sites in non-microdissected breast tumors were analyzed using RPPA after intervals of up to 24 h on the benchtop at room temperature following surgical resection. RESULTS: Twenty-one of 82 total and phosphoproteins demonstrated time-dependent instability at room temperature with most variability occurring at later time points between 6 and 24 h. However, the 82-protein functional proteomic "fingerprint" was robust in most tumors even when maintained at room temperature for 24 h before freezing. In repeat samples from each tumor, intratumoral protein levels were markedly less variable than intertumoral levels. Indeed, an independent analysis of prognostic biomarkers in tissue from multiple tumor sites accurately and reproducibly predicted patient outcomes. Significant correlations were observed between RPPA and immunohistochemistry. However, RPPA demonstrated a superior dynamic range. Classification of 128 breast cancers using RPPA identified six subgroups with markedly different patient outcomes that demonstrated a significant correlation with breast cancer subtypes identified by transcriptional profiling. CONCLUSION: Thus, the robustness of RPPA and stability of the functional proteomic "fingerprint" facilitate the study of the functional proteome in non-microdissected breast tumors.
    • Technical skill set training in natural orifice transluminal endoscopic surgery: how should we approach it?

      Nugent, Emmeline; Traynor, Oscar; Neary, Paul; National Surgical Training Centre, Royal College of Surgeons in Ireland, Dublin, Ireland. emelinenugent@rcsi.ie (Journal of laparoendoscopic & advanced surgical techniques. Part A, 2011-03)
      The boundaries in minimally invasive techniques are continually being pushed further. Recent years have brought new and exciting changes with the advent of natural orifice transluminal endoscopic surgery. With the evolution of this field of surgery come challenges in the development of new instruments and the actual steps of the procedure. Included in these challenges is the idea of developing a proficiency-based curriculum for training.
    • Technique of extracting a compression intramedullary nail that preserves knee arthrodesis.

      Murphy, Terence P; Mulhall, Kevin J; Department of Orthopaedic Surgery, Mater Misericordiae University Hospital, Dublin, Ireland. terencepmurphy@gmail.com (2011-06)
    • Technique tips--management of a de-bonded, fixed-fixed, resin-bonded bridge.

      Alkadhimi, Aslam Fadel; Ashkanani, Mohammad; Sultan, Ahmed; Warreth, Abdulhadi; Restorative and Periodontology Division, Dublin Dental University Hospital, Dublin, Ireland. (2012-09)