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Pinnelas R, Cole R, Megna D, Lorber J, Ramzy D, Emerson D, Benck L, Sedrak S, Czer L, Chang D, Esmailian F, Kobashigawa J, Moriguchi J. Heparin-Induced Thrombocytopenia and Thrombosis with Axillary Impella 5.5 as Bridge-to-Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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52
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Chang D, Kittleson M, Patel J, Kransdorf E, Hamilton M, Hage A, Nikolova A, Patel N, Singer-Englar T, Czer L, Trento A, Kobashigawa J. Is a Switch to Cyclosporine from Tacrolimus a Risk in Heart Transplant Recipients? J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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van Dyk S, Khaw P, Lin MY, Chang D, Bernshaw D. Ultrasound-guided Brachytherapy for Cervix Cancer. Clin Oncol (R Coll Radiol) 2021; 33:e403-e411. [PMID: 33715936 DOI: 10.1016/j.clon.2021.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/19/2021] [Indexed: 11/17/2022]
Abstract
Radiotherapy and brachytherapy are the definitive treatments for locally advanced cervix cancer. The use of soft-tissue imaging, particularly magnetic resonance imaging, has enhanced their effectiveness and improved clinical outcomes. However, the use of magnetic resonance imaging is largely restricted to well-resourced centres in both the first and developing world and remains elusive to many less advantaged centres, particularly those in areas with a high burden of cervix cancer. Ultrasound is an accessible, affordable and accurate imaging modality that can be used throughout the brachytherapy procedure. Ultrasound is primarily used to ensure safe insertion of the applicator but can also be used to guide planning. The methods used to utilise ultrasound images for planning are described. Ultrasound is particularly useful as a verification aid to confirm applicator placement after patients are moved and transferred around the radiotherapy department. It can also be used to verify the dimensions of treatment volumes over the course of brachytherapy. There is a crucial unmet need for an accessible economical soft-tissue imaging modality in cervical brachytherapy. Ultrasound has the potential to meet this need.
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Dumanski S, Anderson T, Kalenga C, Chang D, Ramesh S, Holroyd-Leduc J, Nerenberg K, Sola D, Pajevic M, Ahmed S. Parity and cardiovascular disease risk in women with chronic kidney disease. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2020.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Chang D, Yan XF, Cliff D, Wang S. [Pay attention to silicosis of sandblasting jeans workers]. ZHONGHUA LAO DONG WEI SHENG ZHI YE BING ZA ZHI = ZHONGHUA LAODONG WEISHENG ZHIYEBING ZAZHI = CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES 2021; 38:551-552. [PMID: 32746586 DOI: 10.3760/cma.j.cn121094-20190916-00377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kim H, Kang JH, Jung DI, Kang BT, Chang D, Yang MP. A preliminary evaluation of the circulating leptin/adiponectin ratio in dogs with pituitary-dependent hyperadrenocorticism and concurrent diabetes mellitus. Domest Anim Endocrinol 2021; 74:106506. [PMID: 32920447 DOI: 10.1016/j.domaniend.2020.106506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 12/24/2022]
Abstract
Leptin and adiponectin are thought to modulate insulin sensitivity and pancreatic β-cell function, but there is limited information regarding the adipokine status of hyperglycemic dogs with hyperadrenocorticism. This study aimed to determine whether alterations in the leptin/adiponectin ratio, insulin sensitivity, and/or pancreatic β-cell function are associated with diabetes mellitus (DM) in dogs with pituitary-dependent hyperadrenocorticism (PDH). A total of 48 client-owned dogs were included in this prospective observational study: 20 dogs with PDH (10 normoglycemic and 10 with DM), 15 dogs with DM, and 13 healthy dogs. The serum concentrations of leptin, adiponectin, resistin, interleukin (IL)-1β, IL-6, IL-10, IL-18, and tumor necrosis factor (TNF)-α were measured, and homeostatic model assessment indices (HOMAs) were calculated and compared among the groups. Serum leptin was significantly higher in PDH dogs with and without DM than in healthy and DM dogs, and it was lower in DM dogs than in PDH dogs without DM. Serum adiponectin was significantly lower in PDH dogs with DM than in healthy and PDH dogs, and it was significantly lower in DM dogs than in healthy dogs. Serum IL-10 was significantly higher in PDH dogs with DM than in healthy and PDH dogs without DM. The leptin/adiponectin ratio was significantly higher in PDH dogs with DM than in normoglycemic PDH dogs. Serum IL-6 concentrations were significantly higher in DM dogs than in healthy dogs. Serum IL-1β concentration was significantly higher in DM dogs than in healthy dogs and PDH dogs with DM and without DM. Serum TNF-α and IL-18 concentrations were not different among groups. The HOMAβ-cell function was significantly lower in PDH dogs with DM than in normoglycemic PDH dogs, while HOMAinsulin sensitivity was significantly lower in PDH dogs with DM than in healthy dogs. These results suggest that adipokine dysregulation, a reduction in insulin sensitivity, and a further impairment in pancreatic β-cell function might predispose PDH dogs to DM. Further longitudinal study will be necessary to confirm this result.
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de la Rosa A, Aguilar J, Barbu A, Chang D, Kobashigawa J. Uniqueness of Laryngeal Nerve Injury Following Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Patel J, Kittleson M, Chang D, Nishihara K, Shen A, Harris G, Velleca A, Azarbal B, Czer L, Ramzy D, Kobashigawa J. Pre-Transplant Collagen Vascular Disease as a Risk Factor for Increase in Cardiac Allograft Vasculopathy after Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Patel J, Kittleson M, Kransdorf E, Chang D, Czer L, Shen A, Nishihara K, Sharoff R, Hamilton M, Esmailian F, Kobashigawa J. The Natural History of Pre-Existing Donor Specific Antibody and Amnestic Responses after Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Nguyen V, Kransdorf E, Patel J, Kittleson M, Chang D, Czer L, Kobashigawa J. Predictors of Renal Graft Failure in Heart/Kidney Transplant Recipients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Kittleson M, Patel J, Chang D, Nishihara K, Shen A, Velleca A, Hamilton M, Zakowski P, Czer L, Esmailian F, Kobashigawa J. Effect of the Shingles Vaccine in Altering Clinical Shingles after Heart Transplantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Chang D, Wang S. [Occupational hazards in construction industry]. ZHONGHUA LAO DONG WEI SHENG ZHI YE BING ZA ZHI = ZHONGHUA LAODONG WEISHENG ZHIYEBING ZAZHI = CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES 2020; 37:953-956. [PMID: 31937044 DOI: 10.3760/cma.j.issn.1001-9391.2019.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Kim YJ, Lee S, Jung J, Jung H, In S, Chang J, Chang D, Fahie M. Atlantoaxial bands in small breed dogs: influence of external pressure by the endotracheal tube tie. J Small Anim Pract 2020; 61:163-169. [PMID: 31960442 DOI: 10.1111/jsap.13094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the prevalence of dorsal cervical spinal compression in a population of dogs susceptible to caudal occipital dysplasia. To determine whether endotracheal tube ties iatrogenically alter the dorsal compression ratio in the atlantoaxial region. MATERIALS AND METHODS Prospective, randomised, controlled, cross-over, blinded cohort study of dogs weighing <15 kg and presenting for neurologic signs localised to the cervical region. In mid-sagittal T2-weighted MR images, dorsal cervical compression and cerebellar compression were evaluated. Dorsal cervical compression ratios were calculated and compared to determine the effect of the endotracheal tube tie on the atlantoaxial region depending on whether dogs were in extended or flexed neck position. RESULTS Prevalence of dorsal cervical spinal compression consistent with an atlantoaxial band was 32/44 (73%) dogs without tie pressure and 37/44 (84%) dogs with tie pressure. Significantly higher compression ratios were found with tie placement over the craniocervical region. Dorsal compression ratios of dogs with cerebellar compression were significantly greater than those without it. CLINICAL SIGNIFICANCE The location of the endotracheal tube tie can influence interpretation of MR images of the craniocervical region of small breed dogs. These breeds more often had greater dorsal cervical spinal compression with tie pressure, especially when they had cerebellar compression.
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Young G, Greaves K, Chang D, Hwan Lam J, Krastins D, Kriel Y, Russell F, Stanton T, Askew C. 724 Contrast-Enhanced Ultrasound Measures of Skeletal Muscle Post-Occlusive Hyperaemia: What is the Effect of Occlusion Duration? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Amarasekera A, Tan T, Schwarz P, Chang D. 760 Vascular Endothelial Dysfunction May be an Early Marker of Physical Frailty and Sarcopenia. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zhu A, Huo R, Malik A, Foroutan F, Rigobon A, Chang D, Liu H, Vargas JD, O'Brien K, Stein M, Ng N, Borgo A, Siemieniuk R, Sekercioglu N, Evaniew N, Ross H, Alba A. PREDICTING MORTALITY AND HOSPITALIZATION IN CHRONIC HEART FAILURE PATIENTS WITH ISCHEMIC CARDIOMYOPATHY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Buchan T, Ching C, Malik A, Lu Y, Lau K, Foroutan F, Liu H, O'Brien K, Stein M, Rigobon A, Chang D, Vargas JD, Ng N, Borgo A, Siemieniuk R, Sekercioglu N, Evaniew N, Ross H, Alba A. NATRIURETIC PEPTIDES AS PREDICTORS OF MORTALITY IN ADULT AMBULATORY HEART FAILURE PATIENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Lau K, Malik A, Foroutan F, Ching C, Lu Y, Buchan T, Liu H, Kim H, Qiao A, Tan C, Leda M, Wang J, O'Brien K, Stein M, Elmslie C, Rigobon A, Chang D, Vargas JD, Ng N, Borgo A, Siemieniuk R, Sekercioglu N, Evaniew N, Ross H, Alba A. RESTING HEART RATE AS A PREDICTOR OF MORTALITY IN PATIENTS WITH HEART FAILURE. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Brecher E, Kutner M, Viswanath A, Finkelman M, Reid D, Chang D, Papageorge M. Homeopathic arnica montana in reducing edema and pain following third molar extraction. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Patel J, Kittleson M, Chang D, Kransdorf E, Levine R, Dimbil S, Kao T, Czer L, Cole R, Esmailian F, Kobashigawa J. 5-Year Outcome of Photopheresis in Heart-Transplantation with Refractory/Persistent Rejection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Patel J, Kittleson M, Chang D, Kransdorf E, Levine R, Dimbil S, Sharoff R, Czer L, Hage A, Esmailian F, Kobashigawa J. Heightened Immune Response in Heart Transplant Patients Surviving Severe Primary Graft Dysfunction. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Kransdorf E, Patel J, Kittleson M, Chang D, Dimbil S, Levine R, Shen A, Jain A, Olymbios M, Czer L, Zhang X, Kobashigawa J. What Antigens to Avoid in Heart Transplant to Optimize Outcome via the Virtual Crossmatch. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Swersky A, Fox B, Sandhu J, Amin A, Vasani J, Chang D, Studenski M, Mohan P. 03:54 PM Abstract No. 185 The difference between the predicted vs actual microwave ablation (MWA) zone is dependent on liver function tests. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Fox B, Swersky A, Sandhu J, Amin A, Chang D, Kwon D, Mohan P. 03:27 PM Abstract No. 182 Microwave ablation (MWA) in cirrhotic patients: prediction of underablation or overablation based on the energy and volume of ablation. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Chang D. Abstract ES11-3: Microsurgical treatment of lymphedema. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-es11-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Lymphedema is a chronic, debilitating condition that causes physical and psychological morbidity, affecting up to 250 million people worldwide. In the United States and other developed countries, cancer and its treatments are the most common causes of lymphedema. Lymphedema can evolve into progressive swelling, fibrosis, functional deficits, and chronic infections, thus adversely affecting quality of life and health care costs.
Unfortunately, no definitive treatment for lymphedema currently exists. The advents of microsurgery, and more recently supermicrosurgery, have had a major impact on the evolution of these physiologic procedures, which have gained popularity to help reduce the severity of lymphedema.
Lymphatic Bypass
LVB are typically performed through incisions 2-3 cm in length and the number of bypasses can vary depending on a patient as well as a surgeon. In our prospective study in 100 consecutive patients, we have found that LVB can be effective in reducing lymphedema severity, particularly in patients with early-stage, upper-extremity lymphedema with reasonable amount of intact functioning lymphatic vessels and minimal tissue fibrosis.
One recent technological advance in lymphovenous bypass procedures is the use of indocyanine green (ICG) fluorescence lymphangiography to map lymphatic vessels. ICG fluorescence lymphangiography enables surgeons to locate and make incisions precisely over functional lymphatic vessels for the lymphovenous bypass, substantially reducing operating time and may significantly improve the outcomes of LVB surgeries.
Vascularized Lymph Node Transfer
This procedure aims to bring vascularized tissue and healthy lymph nodes into sites affected by lymphedema. A flap containing lymph nodes can then be harvested typically from either the cervical region, axillary region or from the inguinal region.
One proposed theory for mechanism is that lymphangiogenesis occur via growth factors produced by the transplanted lymph nodes and thereby bridging lymphatic pathways. A second proposed theory of mechanism is that vascularized lymph node transfer act as a lymphatic pump. Recently, simultaneous breast reconstruction using the transverse lower abdominal flap harvested with inguinal lymph nodes have gained popularity as a convenient option for lymphedematous women who desire reconstruction after mastectomy.
Conclusions
Currently there is no cure for lymphedema. Worldwide interest in using microsurgical procedures to treat lymphedema is gaining momentum. However, there is no consensus on the indications for which procedure to perform, when to intervene, or how to comparatively grade outcomes. We need further research and better understanding of lymphatic anatomy and lymphedema pathophysiology. In addition, more prospective and controlled studies are needed to objectively evaluate the outcomes of various treatment methods.
Citation Format: Chang D. Microsurgical treatment of lymphedema [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr ES11-3.
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