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Barisano G, Bergamaschi S, Acharya J, Rajamohan A, Gibbs W, Kim P, Zada G, Chang E, Law M. Complications of Radiotherapy and Radiosurgery in the Brain and Spine. Neurographics (2011) 2018; 8:167-187. [PMID: 35388375 PMCID: PMC8981962 DOI: 10.3174/ng.1700066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Radiation therapy is an integral part of the standard of care for many patients with brain and spine tumors. Stereotactic radiation surgery is increasingly being used as an adjuvant therapy as well as a sole treatment. However, despite newer and more focused techniques, radiation therapy still causes significant neurotoxicity. In this article, we reviewed the scientific literature, presented cases of patients who had developed different complications related to conventional radiation therapy or radiosurgery (gamma knife), demonstrated the imaging findings, and discussed the relevant clinical information for the correct diagnoses. Radiation therapy can cause injury in different ways: directly damaging the structures included in the radiation portal, indirectly affecting the blood vessels, and increasing the chance of tumor development. We also divided radiation complications according to the time of occurrence: acute (0 to 4 weeks), early delayed (4 weeks to months), and late delayed (months to years). With the increasing application of radiation therapy for the treatment of CNS tumors, it is important for the neuroradiologist to recognize the many possible complications of radiation therapy. Although this may cause significant diagnostic challenges, understanding the pathophysiology, time course of onset, and imaging features may help institute early therapy and prevent possible deleterious outcomes. Learning Objectives To recognize the main complications of radiation therapy and stereotactic radiosurgery in the brain and spine, and to highlight the imaging findings to improve the diagnostic process and treatment planning.
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Affiliation(s)
- G Barisano
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
| | - S Bergamaschi
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
| | - J Acharya
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
| | - A Rajamohan
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
| | - W Gibbs
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
| | - P Kim
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
| | - G Zada
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
| | - E Chang
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
| | - M Law
- Departments of Radiology (G.B., S.B., J.A., A.R., W.G., P.K., M.L.), Neurosurgery (G.Z.), Radiation Oncology (E.C.), and Stevens Institute of Neuroimaging and Informatics (M.L.), University of Southern California, Los Angeles, California
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Mina DS, Sabiston CM, Au D, Fong AJ, Capozzi LC, Langelier D, Chasen M, Chiarotto J, Tomasone JR, Jones JM, Chang E, Culos-Reed SN. Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement. ACTA ACUST UNITED AC 2018; 25:149-162. [PMID: 29719431 DOI: 10.3747/co.25.3977] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks ("pathways") that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer.
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Affiliation(s)
- D Santa Mina
- Faculty of Kinesiology and Physical Education and.,Faculty of Medicine, University of Toronto, Toronto, ON.,Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON
| | - C M Sabiston
- Faculty of Kinesiology and Physical Education and
| | - D Au
- Faculty of Kinesiology and Physical Education and.,Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON
| | - A J Fong
- Faculty of Kinesiology and Physical Education and
| | - L C Capozzi
- Cumming School of Medicine, University of Calgary, Calgary, AB
| | - D Langelier
- Cumming School of Medicine, University of Calgary, Calgary, AB
| | - M Chasen
- Faculty of Kinesiology and Physical Education and
| | - J Chiarotto
- Department of Medicine, Scarborough and Rouge Hospital, Toronto, ON
| | - J R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON
| | - J M Jones
- Faculty of Medicine, University of Toronto, Toronto, ON.,Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON
| | - E Chang
- Faculty of Medicine, University of Toronto, Toronto, ON.,Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre, Toronto, ON.,Toronto Rehabilitation Institute, Toronto, ON
| | - S N Culos-Reed
- Cumming School of Medicine, University of Calgary, Calgary, AB.,Faculty of Kinesiology, University of Calgary, Calgary, AB.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB
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Check J, Chang E. No evidence to support the concept that endometrial polyps impair fertility in the majority of cases. CLIN EXP OBSTET GYN 2018. [DOI: 10.12891/ceog4038.2018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Bao T, Togashi R, Cadeiras M, Schaenman J, Masukawa L, Hai J, Chu D, Chang E, Kupiec-Weglinski S, Groysberg V, Le A, Dod R, Kahn C, Oh E, Do J, Lumintang C, Grogan T, Meltzer J, Kwon M, Rossetti M, Elashoff D, Reed E, Ping P, Bondar G, Deng M. Association between Multidimensional Molecular Biomarkers and Functional Recovery Potential in Advanced Heart Failure. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Schaenman J, Rossetti M, Sidwell T, Groysberg V, Sunga G, Liang E, Vangala S, Chang E, Bakir M, Bondar G, Cadeiras M, Kwon M, Reed E, Deng M. Frequency of Monocyte Subtypes and TLR4 Expression Correlate with Clinical Outcomes After Mechanical Circulatory Device Implantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Bakir M, Jackson N, Han S, Chang E, Tseng C, Khuu T, Bui A, Zhang J, Reed E, Deng M, Cadeiras M. Dynamic Phenomapping and HLA Class I and II Antibodies for Heart Transplant Outcomes. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Masukawa L, Bao T, Dod R, Togashi R, Cadeiras M, Schaenman J, Hai J, Chu D, Chang E, Kupiec-Weglinski S, Groysberg V, Le A, Kahn C, Oh E, Do J, Lumintang C, Grogan T, Meltzer J, Kwon M, Rossetti M, Elashoff D, Reed E, Ping P, Bondar G, Deng M. Early Postoperative Organ Function Recovery Score and Long-term Survival in Advanced Heart Failure Patients Undergoing Mechanical Circulatory Support. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Bondar G, Bao T, Manoharan R, Togashi R, Agrawal N, Ramachandrula S, Hai J, Chu D, Masukawa L, Cadeiras M, Schaenman J, Chang E, Le A, Dod R, Kahn C, Oh E, Do J, Lumintang C, Kupiec-Weglinski S, Groysberg V, Grogan T, Rossetti M, Elashoff D, Reed E, Ping P, Deng M. Systems Biological Identification of an Age-related Predictor of Functional Recovery Potential in Advanced Heart Failure. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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59
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Chang E. The Use of Distributed Data Bases for Medical Information Systems. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1636459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The characteristics of the medical information environment favor the use of a network of small computers with limited computing power and moderate storage capacities, interconnected such that data sharing is possible. The advantages of such a system over a large central computer are greater parallel activity, increased security, more flexible information structures for users, and higher efficiency. However, the feasibility of such systems is currently limited by problems related to social priorities and political will, rather than to technology.
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60
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Chang E, Linders J. A Distributed Medical Data Base. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1636152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This paper describes the design and implementation of a distributed medical data base. Basic to this concept is a network of minicomputers, each of which possesses files which can be accessed throughout, the network by a protocol involving the NAMEs of the data fields. Physical and logical descriptor maps for the files provide mechanisms for protecting privileged information as well as tailoring the appearance of the data to suit the needs of jDarticular users.
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61
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Schaenman JM, Rossetti M, Korin Y, Sidwell T, Groysberg V, Liang E, Vangala S, Wisniewski N, Chang E, Bakir M, Bondar G, Cadeiras M, Kwon M, Reed EF, Deng M. T cell dysfunction and patient age are associated with poor outcomes after mechanical circulatory support device implantation. Hum Immunol 2018; 79:203-212. [PMID: 29409843 DOI: 10.1016/j.humimm.2018.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/27/2017] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
Abstract
Immunologic impairment may contribute to poor outcomes after implantation of mechanical circulatory support device (MCSD), with infection often as a terminal event. The study of immune dysfunction is of special relevance given the growing numbers of older patients with heart disease. The aim of the study was to define which immunologic characteristics are associated with development of adverse clinical outcomes after MCSD implantation. We isolated peripheral blood mononuclear cells (PBMC) from patients pre- and up to 20 days post-MCSD implantation and analyzed them by multiparameter flow cytometry for T cell dysfunction, including terminal differentiation, exhaustion, and senescence. We used MELD-XI and SOFA scores measured at each time point as surrogate markers of clinical outcome. Older patients demonstrated increased frequencies of terminally differentiated T cells as well as NKT cells. Increased frequency of terminally differentiated and immune senescent T cells were associated with worse clinical outcome as measured by MELD-XI and SOFA scores, and with progression to infection and death. In conclusion, our data suggest that T cell dysfunction, independently from age, is associated with poor outcomes after MCSD implantation, providing a potential immunologic mechanism behind patient vulnerability to multiorgan dysfunction and death. This noninvasive approach to PBMC evaluation holds promise for candidate evaluation and patient monitoring.
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Affiliation(s)
- Joanna M Schaenman
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States.
| | - Maura Rossetti
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Yael Korin
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Tiffany Sidwell
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Victoria Groysberg
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Emily Liang
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Sitaram Vangala
- UCLA Department of Medicine Statistics Core, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Nicholas Wisniewski
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Eleanor Chang
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Maral Bakir
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Galyna Bondar
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Martin Cadeiras
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Murray Kwon
- Department of Cardiothoracic Surgery, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Elaine F Reed
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
| | - Mario Deng
- Division of Cardiology, Department of Medicine, David Geffen School of Medicine, Los Angeles, CA 90095, United States
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Bondar G, Togashi R, Cadeiras M, Schaenman J, Cheng RK, Masukawa L, Hai J, Bao TM, Chu D, Chang E, Bakir M, Kupiec-Weglinski S, Groysberg V, Grogan T, Meltzer J, Kwon M, Rossetti M, Elashoff D, Reed E, Ping PP, Deng MC. Association between preoperative peripheral blood mononuclear cell gene expression profiles, early postoperative organ function recovery potential and long-term survival in advanced heart failure patients undergoing mechanical circulatory support. PLoS One 2017; 12:e0189420. [PMID: 29236770 PMCID: PMC5728510 DOI: 10.1371/journal.pone.0189420] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 11/25/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Multiorgan dysfunction syndrome contributes to adverse outcomes in advanced heart failure (AdHF) patients after mechanical circulatory support (MCS) implantation and is associated with aberrant leukocyte activity. We tested the hypothesis that preoperative peripheral blood mononuclear cell (PBMC) gene expression profiles (GEP) can predict early postoperative improvement or non-improvement in patients undergoing MCS implantation. We believe this information may be useful in developing prognostic biomarkers. METHODS & DESIGN We conducted a study with 29 patients undergoing MCS-surgery in a tertiary academic medical center from 2012 to 2014. PBMC samples were collected one day before surgery (day -1). Clinical data was collected on day -1 and day 8 postoperatively. Patients were classified by Sequential Organ Failure Assessment score and Model of End-stage Liver Disease Except INR score (measured eight days after surgery): Group I = improving (both scores improved from day -1 to day 8, n = 17) and Group II = not improving (either one or both scores did not improve from day -1 to day 8, n = 12). RNA-sequencing was performed on purified mRNA and analyzed using Next Generation Sequencing Strand. Differentially expressed genes (DEGs) were identified by Mann-Whitney test with Benjamini-Hochberg correction. Preoperative DEGs were used to construct a support vector machine algorithm to predict Group I vs. Group II membership. RESULTS Out of 28 MCS-surgery patients alive 8 days postoperatively, one-year survival was 88% in Group I and 27% in Group II. We identified 28 preoperative DEGs between Group I and II, with an average 93% prediction accuracy. Out of 105 DEGs identified preoperatively between year 1 survivors and non-survivors, 12 genes overlapped with the 28 predictive genes. CONCLUSIONS In AdHF patients following MCS implantation, preoperative PBMC-GEP predicts early changes in organ function scores and correlates with long-term outcomes. Therefore, gene expression lends itself to outcome prediction and warrants further studies in larger longitudinal cohorts.
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Affiliation(s)
- Galyna Bondar
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Ryan Togashi
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Martin Cadeiras
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Joanna Schaenman
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Richard K. Cheng
- University of Washington Medical Center, Seattle, Washington, United States of America
| | - Lindsay Masukawa
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Josephine Hai
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Tra-Mi Bao
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Desai Chu
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Eleanor Chang
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Maral Bakir
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | | | - Victoria Groysberg
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Tristan Grogan
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Joseph Meltzer
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Murray Kwon
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Maura Rossetti
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - David Elashoff
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Elaine Reed
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Pei Pei Ping
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
| | - Mario C. Deng
- David Geffen School of Medicine, University of California Los Angeles Medical Center, Los Angeles, California, United States of America
- * E-mail:
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Neff LM, Broder MS, Beenhouwer D, Chang E, Papoyan E, Wang ZW. Network meta-analysis of lorcaserin and oral hypoglycaemics for patients with type 2 diabetes mellitus and obesity. Clin Obes 2017; 7:337-346. [PMID: 28891142 DOI: 10.1111/cob.12213] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/06/2017] [Accepted: 07/23/2017] [Indexed: 12/11/2022]
Abstract
In addition to weight loss, randomized controlled trials have shown improvement in glycaemic control in patients taking lorcaserin. The aim of this study aim was to compare adding lorcaserin or other glucose lowering medications to metformin on weight and glycaemic control. A systematic review and network meta-analysis of randomized controlled trials were conducted. Included studies (published 1990-2014) were of lorcaserin or glucose lowering medications in type 2 diabetic patients compared to placebo or different active treatments. Studies had to report ≥1 key outcome (change in weight or HbA1c, % HbA1c <7, hypoglycaemia). Direct meta-analysis was performed using DerSimonian and Laird random effects models, and network meta-analysis with Bayesian Markov-chain Monte Carlo random effects models; 6552 articles were screened and 41 included. Lorcaserin reduced weight significantly more than thiazolidinediones, glinides, sulphonylureas and dipeptidyl peptidase-4 inhibitors, some of which may have led to weight gain. There were no significant differences in weight change between lorcaserin and alpha-glucoside inhibitors, glucagon-like peptide-1 agonists and sodium/glucose cotransporter 2 inhibitors. Network meta-analysis showed lorcaserin was non-inferior to all other agents on HbA1c reduction and % achieving HbA1c of <7%. The risk of hypoglycaemia was not significantly different among studied agents except that sulphonylureas were associated with higher risk of hypoglycaemia than lorcaserin. Although additional studies are needed, this analysis suggests in a population of patients with a body mas index of ≥27 who do not achieve glycaemic control on a single agent, lorcaserin may be added as an alternative to an add-on glucose lowering medication.
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Affiliation(s)
- L M Neff
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - M S Broder
- Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA
| | - D Beenhouwer
- Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA
| | - E Chang
- Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA
| | - E Papoyan
- Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA
| | - Z W Wang
- Eisai, Inc., Woodcliff Lake, NJ, USA
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Yang Y, Xiang R, Liu Y, Chang E, Huo Y. [Clinical study on post-stroke urinary retention treated with acupuncture at the twelve jing-well points and bladder function training]. Zhongguo Zhen Jiu 2017; 37:1041-4. [PMID: 29354970 DOI: 10.13703/j.0255-2930.2017.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the methods for the therapeutic effect improvement in the treatment of post-stroke urinary retention. METHODS Sixty-three patients of post-stroke urinary retention were randomized into an observation group (32 cases) and a control group (31 cases). The routine clinical medication of neurology and basic rehabilitation were adopted in the two groups. Additionally, in the control group, the intermittent urinary catheterization and bladder function training were applied. The duration and frequency of catheterization were determined by the autonomic urination and residual urine volume every day. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to the twelve jing-well points in the sequence of qi flowing among the twelve meridians [Shaoshang (LU 11), Shangyang (LI 1), Lidui (ST 45), Yinbai (SP 1), Shaochong (HT 9), Shaoze (SI 1), Zhiyin (BL 67), Yongquan (KI 1), Zhongchong (PC 9), Guanchong (TE 1), Zuqiaoyin (GB 44) and Dadun (LR 1)]. Acupuncture was given once a day, 20 treatments were required. In 20 treatments, the clinical therapeutic effects and the residual urine volume were observed. RESULTS The total effective rate was 90.6% (29/32) in the observation group, better than 67.7% (21/31) in the control group (P<0.01)). After treatment, the residue urine volume was all reduced apparently in the patients of the two groups (both P<0.01). The result of the residue urine volume in the observation group was lower apparently than that in the control group (P<0.01). CONCLUSION Acupuncture at the jing-well points in the sequence of qi flowing among meridians combined with bladder function training achieve the apparent therapeutic effects on post-stroke urinary retention. The results are better than those achieved by the routine western medicine with bladder function training involved.
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Affiliation(s)
- Yuxia Yang
- Department of Rehabilitation and Physical Therapy, Cangzhou Center Hospital, Cangzhou 061001, Hebei Province, China
| | - Rong Xiang
- Department of Rehabilitation and Physical Therapy, Cangzhou Center Hospital, Cangzhou 061001, Hebei Province, China
| | - Yanyan Liu
- Department of Rehabilitation and Physical Therapy, Cangzhou Center Hospital, Cangzhou 061001, Hebei Province, China
| | - E Chang
- Department of Rehabilitation and Physical Therapy, Cangzhou Center Hospital, Cangzhou 061001, Hebei Province, China
| | - Yanling Huo
- Department of Rehabilitation and Physical Therapy, Cangzhou Center Hospital, Cangzhou 061001, Hebei Province, China
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Wisniewski N, Bondar G, Rau C, Chittoor J, Chang E, Esmaeili A, Cadeiras M, Deng M. Integrative model of leukocyte genomics and organ dysfunction in heart failure patients requiring mechanical circulatory support: a prospective observational study. BMC Med Genomics 2017; 10:52. [PMID: 28851355 PMCID: PMC5576384 DOI: 10.1186/s12920-017-0288-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 08/16/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The implantation of mechanical circulatory support devices in heart failure patients is associated with a systemic inflammatory response, potentially leading to death from multiple organ dysfunction syndrome. Previous studies point to the involvement of many mechanisms, but an integrative hypothesis does not yet exist. Using time-dependent whole-genome mRNA expression in circulating leukocytes, we constructed a systems-model to improve mechanistic understanding and prediction of adverse outcomes. METHODS We sampled peripheral blood mononuclear cells from 22 consecutive patients undergoing mechanical circulatory support device (MCS) surgery, at 5 timepoints: day -1 preoperative, and postoperative days 1, 3, 5, and 8. Clinical phenotyping was performed using 12 clinical parameters, 2 organ dysfunction scoring systems, and survival outcomes. We constructed a strictly phenotype-driven time-dependent non-supervised systems-representation using weighted gene co-expression network analysis, and annotated eigengenes using gene ontology, pathway, and transcription factor binding site enrichment analyses. Genes and eigengenes were mapped to the clinical phenotype using a linear mixed-effect model, with Cox models also fit at each timepoint to survival outcomes. RESULTS We inferred a 19-module network, in which most module eigengenes correlated with at least one aspect of the clinical phenotype. We observed a response of advanced heart failure patients to surgery orchestrated into stages: first, activation of the innate immune response, followed by anti-inflammation, and finally reparative processes such as mitosis, coagulation, and apoptosis. Eigengenes related to red blood cell production and extracellular matrix degradation became predictors of survival late in the timecourse corresponding to multiorgan dysfunction and disseminated intravascular coagulation. CONCLUSIONS Our model provides an integrative representation of leukocyte biology during the systemic inflammatory response following MCS device implantation. It demonstrates consistency with previous hypotheses, identifying a number of known mechanisms. At the same time, it suggests novel hypotheses about time-specific targets.
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Affiliation(s)
- Nicholas Wisniewski
- Department of Medicine, Division of Cardiology, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 630, Los Angeles, California, 90095, USA. .,Department of Integrative Biology and Physiology, University of California Los Angeles, 612 Charles E. Young Drive East, Los Angeles, California, 90095, USA.
| | - Galyna Bondar
- Department of Medicine, Division of Cardiology, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 630, Los Angeles, California, 90095, USA
| | - Christoph Rau
- Department of Anesthesiology, Division of Molecular Medicine, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 630, Los Angeles, California, 90095, USA
| | - Jay Chittoor
- Department of Medicine, Division of Cardiology, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 630, Los Angeles, California, 90095, USA
| | - Eleanor Chang
- Department of Medicine, Division of Cardiology, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 630, Los Angeles, California, 90095, USA
| | - Azadeh Esmaeili
- Department of Medicine, Division of Cardiology, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 630, Los Angeles, California, 90095, USA
| | - Martin Cadeiras
- Department of Medicine, Division of Cardiology, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 630, Los Angeles, California, 90095, USA
| | - Mario Deng
- Department of Medicine, Division of Cardiology, University of California Los Angeles, 100 UCLA Medical Plaza, Suite 630, Los Angeles, California, 90095, USA.
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Check JH, Chern R, Chang E. Successful pregnancy following in vitro fertilization-embryo transfer in a woman with diminished oocytereserve despite a slow rising beta human chorionic gonadotropin level. CLIN EXP OBSTET GYN 2017. [DOI: 10.12891/ceog3881.2017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Shih CH, Chang YJ, Huang WC, Jang TH, Kung HJ, Wang WC, Yang MH, Lin MC, Huang SF, Chou SW, Chang E, Chiu H, Shieh TY, Chen YJ, Wang LH, Chen L. EZH2-mediated upregulation of ROS1 oncogene promotes oral cancer metastasis. Oncogene 2017; 36:6542-6554. [PMID: 28759046 PMCID: PMC5702718 DOI: 10.1038/onc.2017.262] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/03/2017] [Accepted: 06/08/2017] [Indexed: 12/28/2022]
Abstract
Current anti-epidermal growth factor receptor (EGFR) therapy for oral cancer does not provide satisfactory efficacy due to drug resistance or reduced EGFR level. As an alternative candidate target for therapy, here we identified an oncogene, ROS1, as an important driver for oral squamous cell carcinoma (OSCC) metastasis. Among tumors from 188 oral cancer patients, upregulated ROS1 expression strongly correlated with metastasis to lung and lymph nodes. Mechanistic studies uncover that the activated ROS1 results from highly expressed ROS1 gene instead of gene rearrangement, a phenomenon distinct from other cancers. Our data further reveal a novel mechanism that reduced histone methyltransferase EZH2 leads to a lower trimethylation of histone H3 lysine 27 suppressive modification, relaxes chromatin, and promotes the accessibility of the transcription factor STAT1 to the enhancer and the intron regions of ROS1 target genes, CXCL1 and GLI1, for upregulating their expressions. Down-regulation of ROS1 in highly invasive OSCC cells, nevertheless, reduces cell proliferation and inhibits metastasis to lung in the tail-vein injection and the oral cavity xenograft models. Our findings highlight ROS1 as a candidate biomarker and therapeutic target for OSCC. Finally, we demonstrate that co-targeting of ROS1 and EGFR could potentially offer an effective oral cancer therapy.
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Affiliation(s)
- C-H Shih
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan, ROC
| | - Y-J Chang
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan, ROC
| | - W-C Huang
- Institute of Molecular and Genomic Medicine, National Health Research Institutes, Miaoli County, Taiwan, ROC
| | - T-H Jang
- Institute of Molecular and Genomic Medicine, National Health Research Institutes, Miaoli County, Taiwan, ROC
| | - H-J Kung
- Institute of Molecular and Genomic Medicine, National Health Research Institutes, Miaoli County, Taiwan, ROC.,School of Medicine, University of California-Davis, Sacramento, CA, USA
| | - W-C Wang
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu, Taiwan, ROC
| | - M-H Yang
- Department of Biotechnology and Laboratory Science in Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - M-C Lin
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan, ROC
| | - S-F Huang
- Institute of Molecular and Genomic Medicine, National Health Research Institutes, Miaoli County, Taiwan, ROC
| | - S-W Chou
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan, ROC
| | - E Chang
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan, ROC
| | - H Chiu
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan, ROC
| | - T-Y Shieh
- Department of Oral Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
| | - Y-J Chen
- Department of Radiation Oncology, MacKay Memorial Hospital, Taipei, Taiwan, ROC
| | - L-H Wang
- Institute of Molecular and Genomic Medicine, National Health Research Institutes, Miaoli County, Taiwan, ROC
| | - L Chen
- Institute of Molecular Medicine, National Tsing Hua University, Hsinchu, Taiwan, ROC.,Department of Medical Science, National Tsing Hua University, Hsinchu, Taiwan, ROC
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Huisingh-Scheetz M, Chang E, Kocherginsky M, Schumm P, Birch S, Dale W, Waite L. THE DISTRIBUTION OF SEDENTARY BEHAVIOR AMONG OLDER U.S. ADULTS BY AGE AND GENDER: IDENTIFYING RISK. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.1454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - E. Chang
- University of Chicago Medicine, Chicago, Illinois,
| | | | - P. Schumm
- University of Chicago Medicine, Chicago, Illinois,
| | - S. Birch
- University of Chicago Medicine, Chicago, Illinois,
| | - W. Dale
- University of Chicago Medicine, Chicago, Illinois,
| | - L.J. Waite
- University of Chicago Medicine, Chicago, Illinois,
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Chiang GC, Mao X, Kang G, Chang E, Pandya S, Vallabhajosula S, Isaacson R, Ravdin LD, Shungu DC. Relationships among Cortical Glutathione Levels, Brain Amyloidosis, and Memory in Healthy Older Adults Investigated In Vivo with 1H-MRS and Pittsburgh Compound-B PET. AJNR Am J Neuroradiol 2017; 38:1130-1137. [PMID: 28341718 PMCID: PMC5471116 DOI: 10.3174/ajnr.a5143] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/19/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Oxidative stress has been implicated as an important pathologic mechanism in the development of Alzheimer disease. The purpose of this study was to assess whether glutathione levels, detected noninvasively with proton MR spectroscopy, are associated with brain amyloidosis and memory in a community-dwelling cohort of healthy older adults. MATERIALS AND METHODS Fifteen cognitively healthy subjects were prospectively enrolled in this study. All subjects underwent 1H-MR spectroscopy of glutathione, a positron-emission tomography scan with an amyloid tracer, and neuropsychological testing by using the Repeatable Battery for the Assessment of Neuropsychological Status. Associations among glutathione levels, brain amyloidosis, and memory were assessed by using multivariate regression models. RESULTS Lower glutathione levels were associated with greater brain amyloidosis in the temporal (P = .03) and parietal (P = .05) regions, adjusted for apolipoprotein E ε4 carrier status. There were no significant associations between glutathione levels and cognitive scores. CONCLUSIONS This study found an association between cortical glutathione levels and brain amyloidosis in healthy older adults, suggesting a potential role for 1H-MR spectroscopy measures of glutathione as a noninvasive biomarker of early Alzheimer disease pathogenesis.
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Affiliation(s)
- G C Chiang
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - X Mao
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - G Kang
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - E Chang
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - S Pandya
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - S Vallabhajosula
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - R Isaacson
- Neurology (R.I., L.D.R.), Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York
| | - L D Ravdin
- Neurology (R.I., L.D.R.), Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York
| | - D C Shungu
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
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Broder M, Chang E, Cai B, Neary M, Papoyan E, Benson A. Treatment Patterns of Lung Neuroendocrine Tumors (NETs). Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.01.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bondar G, Cadeiras M, Wisniewski N, Esmaeili A, Godoy G, Maque J, Chang E, Bakir M, Kupiec-Weglinski S, Chu D, Bao T, Hai J, Yee R, Li A, Rai M, Tran D, Madrigal L, Togashi R, Ping P, Reed E, Deng M. Leukocyte Time-Dependent Biology and Outcomes in Advanced Heart Failure. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Bakir M, Jackson N, Han S, Tseng C, Chang E, Khuu T, Bui A, Zhang Q, Reed E, Liem D, Kubak B, Schaenman J, Ardehali A, Ardehali R, Baas A, Nsair A, Cruz D, Kwon M, DePasquale E, Deng M, Cadeiras M. Cluster Analysis and Dynamic Phenomapping to Guide Clinical Management After Heart Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Chang E, Fishbein G, Bakir M, Liem D, Litovsky S, Tallaj J, Bondar G, Reed E, Deng M, Tabak E, Cadeiras M. Complementary Intragraft and Peripheral Blood Mononuclear Cell Gene Co-Expression Network Analysis of ISHLT Driven versus Unsupervised Molecular Classification. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Lee C, Chang E, Gimenez J, McCarron R. Pheochromocytoma of the Organ Zuckerkandl. J La State Med Soc 2017; 169:53. [PMID: 28414676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Pheochromocytomas (PCCs);, or intra-adrenal paragangliomas (PGLs);, are neuroendocrine tumors arising within the adrenal medulla. Extra-adrenal paragangliomas may arise in the sympathetic or parasympathetic paraganglia and more rarely in other organs. One of the most common extra-adrenal sites is in the organ of Zuckerkandl, a collection of chromaffin cells near the origin of the inferior mesenteric artery or near the aortic bifurcation. The following is a case of a patient with resistant hypertension secondary to an extra-adrenal paraganglioma in the organ of Zuckerkandl. CASE The patient is a 43 year old man with a history of depression, type 2 diabetes mellitus, and hypertension who was sent to the emergency department by his primary care physician for severely elevated blood pressures. Patient also had diaphoresis, tachycardia, and a new, fine tremor of his left hand. Upon presentation, the patient's blood pressure was 260/120 mmHg with a heart rate of 140 beats per minute. Plasma fractionated metanephrines sent on admission revealed significantly elevated levels of total plasma metanephrines (2558 pg/mL);, free metanephrine (74 pg/ml); and free normetanephrine (2484pg/mL);. An I-123 metaiodobenzylguanidine (MIBG); scan showed abnormal uptake in the lower abdomen at the level of the aortic bifurcation. Patient was started on alpha-blockade, with subsequent addition of a beta-blocker prior to surgery. Patient underwent surgical removal of the tumor with pathology consistent with a paraganglioma. DISCUSSION Pheochromocytomas and paragangliomas are responsible for approximately 0.5 percent of cases of secondary hypertension. Many different biochemical markers have been used to aid in the diagnosis of PCC/PGL including plasma catecholamines, plasma metanephrines, urine fractionated metanephrines, urine catecholamines, total metanephrines and vanillymandellic acid. Definitive management of a PCC and PGL involves surgical removal of the tumor. Finally, there should be a discussion with each patient to determine if he or she should undergo genetic testing, as studies show that approximately 25 percent of catecholamine producing PCCs and PGLs are due to heritable genetic mutations.
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Affiliation(s)
- C Lee
- Department of Dermatology, LSU Health Sciences Center, New Orleans, LA
| | - E Chang
- Department of Internal Medicine, LSU Health Sciences Center, New Orleans, LA
| | - J Gimenez
- Department of Radiology, LSU Health Sciences Center, New Orleans, LA
| | - R McCarron
- Department of Internal Medicine, LSU Health Sciences Center, New Orleans, LA
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Cakar B, Chan D, Yan P, Zheng Z, Singh P, Lei JT, Haricharan S, Ellis M, Chang E. Abstract P1-08-07: Assessing the impact of loss of NF1 protein on endocrine therapy resistance. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-08-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The vast majority of breast cancers belong to the luminal subtype, which expresses the estrogen receptor-α (ER). Although great strides have been made in targeting the ER pathway for treating the ER+ tumors, relapse and death is common and ongoing. In order to identify the cause for treatment resistance, we have conducted a retrospective analyses on the tumor genomes of >600 patients treated by tamoxifen monotherapy in the adjuvant setting with a median follow-up of 10.4 years. Our data have revealed that NF1 (Neurofibromatosis type 1) gene loss of function mutations were greatly associated with poor prognosis. NF1 is a tumor suppressor acting mostly as a GAP (GTP ase activating protein) to switch off activated Ras. We aim to define the impact of loss of NF1 protein on patient outcome in ER+ breast cancer patients by establishing an immunohistochemistry (IHC) protocol to detect NF1.
Method and results: We have first surveyed commercially available antibodies by Western blot and found one that could efficiently detect endogenous NF1. We then use this to validate inducible shRNA clones against NF1, as well as a breast cancer cell line that is NF1-null. This antibody has high background. We have thus partially purified a commercially available NF1 antibody by preclearing using NF1-null cell lysate. We then performed immunostaining using NF1-silenced and null cells as control and found that NF1 is mostly cytoplasmic and nuclear. To get antibody of high quality, we have decided to make our own antibody by expressing a C-terminal fragment of NF1 as a GST-tagged protein (GST-NF1c). Production of polyclonal and monoclonal antibody is in progress.
Conclusion: Our clinical profiling data suggest that loss of NF1 protein, a very common event in a wide range of other cancers, promotes endocrine therapy resistance. An efficient IHC protocol will enable us to firmly validate whether loss of the NF1 protein indeed correlates with poor patient outcome. This method will ultimately enable us to identify high risk NF1 deficient patients and to properly treat them.
Citation Format: Cakar B, Chan D, Yan P, Zheng Z, Singh P, Lei JT, Haricharan S, Ellis M, Chang E. Assessing the impact of loss of NF1 protein on endocrine therapy resistance [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-08-07.
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Affiliation(s)
- B Cakar
- Baylor College of Medicine, Houston, TX
| | - D Chan
- Baylor College of Medicine, Houston, TX
| | - P Yan
- Baylor College of Medicine, Houston, TX
| | - Z Zheng
- Baylor College of Medicine, Houston, TX
| | - P Singh
- Baylor College of Medicine, Houston, TX
| | - JT Lei
- Baylor College of Medicine, Houston, TX
| | | | - M Ellis
- Baylor College of Medicine, Houston, TX
| | - E Chang
- Baylor College of Medicine, Houston, TX
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Jennings J, Robinson C, Wallace A, Howard C, Brower J, Sayed D, Tran N, Vrionis F, Lekht I, Chang E, Bagla S, Papadouris D, Vadlamudi V, Meyer J, Timmerman R, Barr J, Chason D, Sichlau M, Sewall L, So G, Baek D, Tutton S, Lea W, Morris J, Callstrom M. Prospective, multicenter evaluation of targeted radiofrequency ablation (t-RFA) and vertebral augmentation (VA) prior to or following radiation therapy (RT) to treat painful metastatic vertebral body tumors (STARRT Study): Interim analysis. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Check JH, Aly J, Chang E. Improving the chance of successful implantation – part I – embryo attachment to the endometrium and adequate trophoblast invasion. CLIN EXP OBSTET GYN 2016. [DOI: 10.12891/ceog3852.2016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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78
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Chang E, Yoon S, Kim J, Hur Y, Yu E, Lee W, Choi Y. Transcriptomic analysis of isolated single primordial and primary follicle using RNA-Seq in human. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Sarmiento C, Miller SR, Chang E, Zazove P, Kumagai AK. From Impairment to Empowerment: A Longitudinal Medical School Curriculum on Disabilities. Acad Med 2016; 91:954-957. [PMID: 26422593 DOI: 10.1097/acm.0000000000000935] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PROBLEM All physicians will care for individuals with disabilities; however, education about disabilities is lacking at most medical schools. Most of the schools that do include such education exclusively teach the medical model, in which disability is viewed as an impairment to be overcome. Disability advocates contest this approach because it overlooks the social and societal contexts of disability. A collaboration between individuals with disabilities, educators, and physicians to design a medical school curriculum on disabilities could overcome these differences. APPROACH A curriculum on disabilities for first- and second-year medical students was developed during the 2013-2014 academic year and involved a major collaboration between a medical student, medical educators, disability advocates, and academic disability specialists. The guiding principle of the project was the Disability Rights Movement motto, "Nothing about us without us." Two small-group sessions were created, one for each medical school class. They included discussions about different models of disability, video and in-person narratives of individuals with disabilities, and explorations of concepts central to social perceptions of disability, such as power relationships, naming and stigmatization, and disability as identity. OUTCOMES According to evaluations conducted after each session, students reported positive feedback about both sessions. NEXT STEPS Through this curriculum, first- and second-year medical students learned about the obstacles faced by individuals with disabilities and became better equipped to understand and address the concerns, hopes, and societal challenges of their future patients. This inclusive approach may be used to design additional curricula about disabilities for the clinical and postgraduate years.
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Affiliation(s)
- Cristina Sarmiento
- C. Sarmiento is a third-year medical student, University of Michigan Medical School, Ann Arbor, Michigan. S.R. Miller is assistant professor of physical medicine and rehabilitation and of medical education, University of Michigan Medical School, Ann Arbor, Michigan. E. Chang is a social worker and disability advocate, Ann Arbor Center for Independent Living, Ann Arbor, Michigan. P. Zazove is professor and George Dean, MD Chair of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan. A.K. Kumagai is professor of internal medicine and medical education and director, Family Centered Experience and Longitudinal Case Studies Programs, University of Michigan Medical School, Ann Arbor, Michigan
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Cui G, Trakul N, Chang E, Shiu A. SU-F-T-644: Reproducibility of Target Position Using Moderate Voluntary Breath- Hold During Liver Stereotactic Ablative Radiotherapy. Med Phys 2016. [DOI: 10.1118/1.4956829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Liao Y, Lin C, Huang P, Chang E. 629 Combination treatment with ARMS silencing and flunarizine enhances autophagy-associated cell death in malignant melanoma cells. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wormser D, Chen D, Brunetta P, Broder M, Chang E, Reddy S. 128 Cumulative oral corticosteroid use increases risk of glucocorticoid-related adverse events in patients with pemphigus. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wisniewski N, Bondar G, Rau C, Chittoor J, Chang E, Esmaeili A, Deng M. A Gene Expression Biomarker Panel for Predicting Mechanical Circulatory Support Outcomes. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Schaenman J, Korin Y, Sidwell T, Chang E, Bakir M, Wisniewski N, Bondar G, Cadeiras M, Kwon M, Reed E, Deng M. Increase in Frequency of Terminally Differentiated and Exhausted CD8+ T Cells Is Associated with Worse Clinical Outcomes after Mechanical Circulatory Support Device Implantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Check JH, Aly J, Chang E. Improving the chance of successful implantation - part I - embryo attachment to the endometrium and adequate trophoblast invasion. CLIN EXP OBSTET GYN 2016; 43:787-791. [PMID: 29944223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED The first in a series on improving embryo implantation is presented with emphasis on embryo attachment and trophoblast invasion. PURPOSE To present knowledge of events needed for embryo attachment to the endometrium and subsequent trophoblast invasion and uterine remodeling leading to successful pregnancy. MATERIALS AND METHODS Based on normal events, some practical suggestions are proposed as to possible means of improving pregnancy rates by enhancing possible embryo attachment and trophoblast invasion. RESULTS Potential benefits of achieving adequate serum estradiol levels at peak follicular maturation, and the benefits of progesterone in the luteal phase are discussed. Also the potential benefits of purposeful endometrial injury is considered. CONCLUSIONS Knowledge of the events leading to embryo attachment and trophoblast invasion could lead to novel research ideas helping to improve pregnancy rates in addition to proper hormone supplementation and endometrial biopsy.
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Ahuja S, Mukund S, Deng L, Khakh K, Chang E, Ho H, Shriver S, Young C, Lin S, Johnson JP, Wu P, Li J, Coons M, Tam C, Brillantes B, Sampang H, Mortara K, Bowman KK, Clark KR, Estevez A, Xie Z, Verschoof H, Grimwood M, Dehnhardt C, Andrez JC, Focken T, Sutherlin DP, Safina BS, Starovasnik MA, Ortwine DF, Franke Y, Cohen CJ, Hackos DH, Koth CM, Payandeh J. Structural basis of Nav1.7 inhibition by an isoform-selective small-molecule antagonist. Science 2015; 350:aac5464. [DOI: 10.1126/science.aac5464] [Citation(s) in RCA: 218] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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87
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Yoon S, Eum J, Jang H, Yang N, Lee J, Shin D, Chang E, Choi Y, Yoon T, Lee D, Lee W. Artificial primordial follicles activation by peroxisome proliferator-activated receptor gamma modulator on neonatal mouse ovary in vitro. Fertil Steril 2015. [DOI: 10.1016/j.fertnstert.2015.07.798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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88
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Jiang Y, Yang Y, Xiang R, Chang E, Zhang Y, Zuo B, Zhang Q. [Clinical study of post-stroke speech apraxia treated with scalp electric acupuncture under anatomic orientation and rehabilitation training]. Zhongguo Zhen Jiu 2015; 35:661-664. [PMID: 26521575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To compare the differences in the clinical efficacy on post-stroke speech disorder between scalp electric acupuncture (EA) under anatomic orientation combined with rehabilitation training and simple rehabilitation training. METHODS Sixty patients of post-stroke speech apraxia were randomized into an observation group and a control group, 30 cases in each one. In the observation group, under anatomic orientation, the scalp EA was adopted to the dominant hemisphere Broca area on the left cerebrum. Additionally, the speech rehabilitation training was combined. In the control group, the speech rehabilitation training was simply,used. The treatment lasted for 4 weeks totally. The speech movement program module in the psychological language assessment and treatment system of Chinese aphasia was used for the evident of efficacy assessment. The scores of counting, singing scale, repeating phonetic alphabet, repeating monosyllable and repeating disyllable were observed in the patients of the two groups. The assessment was done separately on the day of grouping and 4 weeks after treatment. RESULTS In 4 weeks of treatment, the scores of counting, singing scale, repeating phonetic alphabet, repeating monosyllable and repeating disyllable were all improved as compared with those before treatment in the two groups (all P<0. 001). The results in the observation group were better than those in the control group (all P< 0. 05). The total effective rate was 100. 0% (30/30) in the observation group, superior apparently to 53. 3% (16/30) in the control group (P<0. 001). CONCLUSION The scalp EA under anatomic orientation combined with' speech rehabilitation training obviously improves speech apraxia in stroke patients so that the speech disorder cani be relieved. The efficacy is better than that in simple rehabilitation training.
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Baker W, Chang E, Pelkofski E, Duska L. Abstract 1: Gynecologic oncologists as benign gynecologic surgeons. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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90
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Kurtin S, Chang E, Bentley T. 204 MDS PATIENT CHARACTERISTICS ASSOCIATED WITH USE OF DISEASE-MODIFYING THERAPY: RESULTS OF A PATIENT SURVEY. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30205-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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91
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Bakir M, Henriquez-Ticas D, Chang E, Maque J, Chittoor J, Starling C, Bondar G, Wisniewski N, Adigopula S, Khuu T, Reed E, Zhang J, Cadeiras M, Deng M. Time Course of Immunosuppression Minimization and HLA Class I and Class II Antibody Emergence in Heart Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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92
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Kurtin S, Chang E, Bentley T. 7 SYMPTOM BURDEN AND QUALITY OF LIFE AMONG PATIENTS WITH MYELODYSPLASTIC SYNDROMES (MDS): ANALYSIS OF SURVEY DATA. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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93
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Cogle C, Kurtin S, Bentley T, Broder M, Chang E, Lawrence M, McKearn T, Megaffin S, Petrone M. 76 POPULATION INCIDENCE OF MDS FOLLOWING HYPOMETHYLATING AGENT (HMA) TREATMENT FAILURE: ANALYSIS OF US COMMERCIAL CLAIMS DATA. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30077-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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94
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Beane SR, Chang E, Cohen S, Detmold W, Lin HW, Orginos K, Parreño A, Savage MJ, Tiburzi BC. Magnetic moments of light nuclei from lattice quantum chromodynamics. Phys Rev Lett 2014; 113:252001. [PMID: 25554875 DOI: 10.1103/physrevlett.113.252001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Indexed: 06/04/2023]
Abstract
We present the results of lattice QCD calculations of the magnetic moments of the lightest nuclei, the deuteron, the triton, and ^{3}He, along with those of the neutron and proton. These calculations, performed at quark masses corresponding to m_{π}∼800 MeV, reveal that the structure of these nuclei at unphysically heavy quark masses closely resembles that at the physical quark masses. In particular, we find that the magnetic moment of ^{3}He differs only slightly from that of a free neutron, as is the case in nature, indicating that the shell-model configuration of two spin-paired protons and a valence neutron captures its dominant structure. Similarly a shell-model-like moment is found for the triton, μ_{^{3}H}∼μ_{p}. The deuteron magnetic moment is found to be equal to the nucleon isoscalar moment within the uncertainties of the calculations. Furthermore, deviations from the Schmidt limits are also found to be similar to those in nature for these nuclei. These findings suggest that at least some nuclei at these unphysical quark masses are describable by a phenomenological nuclear shell model.
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Affiliation(s)
- S R Beane
- Department of Physics, University of Washington, Box 351560, Seattle, Washington 98195, USA
| | - E Chang
- Department of Physics, University of Washington, Box 351560, Seattle, Washington 98195, USA and Institute for Nuclear Theory, Box 351550, Seattle, Washington 98195-1550, USA
| | - S Cohen
- Department of Physics, University of Washington, Box 351560, Seattle, Washington 98195, USA and Institute for Nuclear Theory, Box 351550, Seattle, Washington 98195-1550, USA
| | - W Detmold
- Center for Theoretical Physics, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - H W Lin
- Department of Physics, University of Washington, Box 351560, Seattle, Washington 98195, USA
| | - K Orginos
- Department of Physics, College of William and Mary, Williamsburg, Virginia 23187-8795, USA and Jefferson Laboratory, 12000 Jefferson Avenue, Newport News, Virginia 23606, USA
| | - A Parreño
- Dept. d'Estructura i Constituents de la Matèria. Institut de Ciències del Cosmos (ICC), Universitat de Barcelona, Martí Franquès 1, E08028-Spain
| | - M J Savage
- Department of Physics, University of Washington, Box 351560, Seattle, Washington 98195, USA and Institute for Nuclear Theory, Box 351550, Seattle, Washington 98195-1550, USA
| | - B C Tiburzi
- Department of Physics, The City College of New York, New York, New York 10031, USA and Graduate School and University Center, The City University of New York, New York, New York 10016, USA and RIKEN BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973, USA
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Bondar G, Cadeiras M, Wisniewski N, Maque J, Chittoor J, Chang E, Bakir M, Starling C, Shahzad K, Ping P, Reed E, Deng M. Comparison of whole blood and peripheral blood mononuclear cell gene expression for evaluation of the perioperative inflammatory response in patients with advanced heart failure. PLoS One 2014; 9:e115097. [PMID: 25517110 PMCID: PMC4269402 DOI: 10.1371/journal.pone.0115097] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 11/14/2014] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Heart failure (HF) prevalence is increasing in the United States. Mechanical Circulatory Support (MCS) therapy is an option for Advanced HF (AdHF) patients. Perioperatively, multiorgan dysfunction (MOD) is linked to the effects of device implantation, augmented by preexisting HF. Early recognition of MOD allows for better diagnosis, treatment, and risk prediction. Gene expression profiling (GEP) was used to evaluate clinical phenotypes of peripheral blood mononuclear cells (PBMC) transcriptomes obtained from patients' blood samples. Whole blood (WB) samples are clinically more feasible, but their performance in comparison to PBMC samples has not been determined. METHODS We collected blood samples from 31 HF patients (57±15 years old) undergoing cardiothoracic surgery and 7 healthy age-matched controls, between 2010 and 2011, at a single institution. WB and PBMC samples were collected at a single timepoint postoperatively (median day 8 postoperatively) (25-75% IQR 7-14 days) and subjected to Illumina single color Human BeadChip HT12 v4 whole genome expression array analysis. The Sequential Organ Failure Assessment (SOFA) score was used to characterize the severity of MOD into low (≤ 4 points), intermediate (5-11), and high (≥ 12) risk categories correlating with GEP. RESULTS Results indicate that the direction of change in GEP of individuals with MOD as compared to controls is similar when determined from PBMC versus WB. The main enriched terms by Gene Ontology (GO) analysis included those involved in the inflammatory response, apoptosis, and other stress response related pathways. The data revealed 35 significant GO categories and 26 pathways overlapping between PBMC and WB. Additionally, class prediction using machine learning tools demonstrated that the subset of significant genes shared by PBMC and WB are sufficient to train as a predictor separating the SOFA groups. CONCLUSION GEP analysis of WB has the potential to become a clinical tool for immune-monitoring in patients with MOD.
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Affiliation(s)
- Galyna Bondar
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Martin Cadeiras
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Nicholas Wisniewski
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Jetrina Maque
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Jay Chittoor
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Eleanor Chang
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Maral Bakir
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Charlotte Starling
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Khurram Shahzad
- Columbia University, New York, NY, United States of America
- East Carolina University, Greenville, NC, United States of America
| | - Peipei Ping
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Elaine Reed
- University of California Los Angeles, Los Angeles, CA, United States of America
| | - Mario Deng
- University of California Los Angeles, Los Angeles, CA, United States of America
- Columbia University, New York, NY, United States of America
- * E-mail:
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Ashley C, Chang E, Davis J, Mangione A, Frame V, Nugent DJ. Efficacy and safety of prophylactic treatment with plasma-derived factor XIII concentrate (human) in patients with congenital factor XIII deficiency. Haemophilia 2014; 21:102-8. [PMID: 25377187 DOI: 10.1111/hae.12524] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2014] [Indexed: 12/01/2022]
Abstract
UNLABELLED Congenital factor XIII (FXIII) deficiency is an extremely rare, potentially life-threatening bleeding disorder. Routine prophylactic management is recommended for individuals with clinically relevant FXIII deficiency. This prospective, multicentre, open-label study evaluated the long-term efficacy and safety of prophylactic infusions of FXIII concentrate (human) 40 IU kg(-1) in patients with congenital FXIII deficiency. FXIII concentrate (human) was administered every 4 weeks for 12 months. Dosing was adjusted to maintain trough FXIII activity levels of 5-20%. Logistical and ethical constraints precluded use of a placebo control group. Annualized incidence of spontaneous bleeding was compared with historical rates; safety was assessed as a secondary objective. Forty-one patients were enrolled and completed the study. The annualized rate for spontaneous bleeding episodes requiring FXIII treatment was 0.000 episodes per patient-year (95% CI: 0.000; 0.097). The study met its primary endpoint: the upper limit of the 95% CI was substantially below the historical rate of 2.5 bleeding episodes per patient-year. Five spontaneous bleeding episodes (involving three patients; none requiring FXIII treatment) and eight trauma-related bleeding episodes (two requiring FXIII treatment) occurred. Five patients had surgery during the study, only one of whom required FXIII treatment for post-surgical bleeding. Most patients (≥ 85%) had trough FXIII activity levels ≥ 10%. No patient discontinued treatment due to an adverse event. No adverse events related to thromboembolism or viral transmission were reported. Prophylactic treatment with FXIII concentrate (human) was well tolerated and prevented spontaneous bleeding episodes that were serious enough to require treatment with FXIII-containing product. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov/ct2/show/NCT00885742.
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Affiliation(s)
- C Ashley
- Alabama Clinical Therapeutics, LLC, Birmingham, AL, USA
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Chang E, Abbasi T, D'Souza A, Gowrishankar G, Mallick P, Gambhir SS. DD-03 * THE NATURALLY OCCURRING STEROID, WITHAFERIN A, IN SYNERGISTIC CONCERT WITH HER2/EGFR INHIBITORS ABROGATES PROLIFERATION OF HUMAN GLIOBLASTOMA CELL CULTURES AT NANOMOLAR CONCENTRATIONS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou246.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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98
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Redmond K, Lo S, Chang E, Gerszten P, Chao S, Rhines L, Ryu S, Fehlings M, Gibbs I, Sahgal A. SO-04 * INTERNATIONAL CONSENSUS GUIDELINES FOR POST-OPERATIVE STEREOTACTIC BODY RADIATION THERAPY (SBRT) FOR MALIGNANT SPINE TUMORS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou274.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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99
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Thibault I, Atenafu E, Chang E, Chao S, Al-Omair A, Boehling N, Balagamwala E, Cunha M, Angelov L, Brown P, Suh J, Rhines L, Fehlings M, Sahgal A. Factors Influencing Vertebral Compression Fracture Specific to Renal Cell Carcinoma Spinal Metastases After Stereotactic Body Radiation Therapy: A Multi-institutional Study. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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100
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Leonard C, Lei R, Alvarado M, Guenther J, Hagans J, Manders J, Schultz M, Sing A, Broder M, Chang E, Cherepanov D, Eagan M, Hsiao W, Carter D. Clinical Utility of the 12-Gene Ductal Carcinoma In Situ (DCIS) Score Assay: Impact on Treatment (tx) Recommendations. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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