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Yancy AJ, Lee BR, Kuebbing SE, Neufeld HS, Spicer ME, Heberling JM. Evaluating the definition and distribution of spring ephemeral wildflowers in eastern North America. Am J Bot 2024:e16323. [PMID: 38659163 DOI: 10.1002/ajb2.16323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 04/26/2024]
Abstract
PREMISE The herbaceous layer accounts for the majority of plant biodiversity in eastern North American forests, encompassing substantial variation in life history strategy and function. One group of early-season herbaceous understory species, colloquially referred to as spring ephemeral wildflowers, are ecologically and culturally important, but little is known about the prevalence and biogeographic patterns of the spring ephemeral strategy. METHODS We used observations collected by the Global Biodiversity Information Facility (GBIF) to quantify the ephemerality of 559 understory forb species across eastern North America and classify them according to a continuous ephemerality index (ranging from 0 = never ephemeral to 1 = always ephemeral). We then used this information to model where ephemeral forbs were most common across the landscape with the goal of identifying geographic and environmental drivers important to their distributions and ranges. RESULTS Only 3.4% of all understory wildflower species were spring ephemerals in all parts of their range, and 18.4% (103 species) were ephemeral in at least part of their range. Spring ephemerals peaked in absolute species richness and relative proportion at mid latitudes. CONCLUSIONS Spring ephemeral phenology is an important shade-avoidance strategy for a large segment of the total understory species in temperate deciduous forests. In North America, the strategy is relatively most important for forest understories at mid latitudes. The definitions of spring ephemerality we provide here serve as an important ecological context for conservation priorities and to evaluate responses of this biodiverse group to future environmental change.
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Affiliation(s)
- Abby J Yancy
- Carnegie Museum of Natural History, Section of Botany, 4400 Forbes Ave., Pittsburgh, 15213 USA, PA
- Department of Geology and Environmental Sciences, University of Pittsburgh, 4107 O'Hara Street, Pittsburgh, 15260, PA, USA
| | - Benjamin R Lee
- Carnegie Museum of Natural History, Section of Botany, 4400 Forbes Ave., Pittsburgh, 15213 USA, PA
- Department of Biological Sciences, University of Pittsburgh, 4249 Fifth Ave, Pittsburgh, 15260, PA, USA
- Holden Arboretum, 9550 Sperry Road, Kirtland, 44094, OH, USA
| | - Sara E Kuebbing
- Carnegie Museum of Natural History, Section of Botany, 4400 Forbes Ave., Pittsburgh, 15213 USA, PA
- The Forest School, Yale School of the Environment, Yale University, New Haven, 06511, CT, USA
| | - Howard S Neufeld
- Appalachian State University Dept. of Biology, 572 Rivers Street, Boone, 28608, NC, USA
| | - Michelle Elise Spicer
- Lehigh University Dept. of Earth and Environmental Science, 1 West Packer Avenue, Bethlehem, 18015, PA, USA
| | - J Mason Heberling
- Carnegie Museum of Natural History, Section of Botany, 4400 Forbes Ave., Pittsburgh, 15213 USA, PA
- Department of Biological Sciences, University of Pittsburgh, 4249 Fifth Ave, Pittsburgh, 15260, PA, USA
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Lee BR, Schaffer-Morrison S. Forests of the future: The importance of tree seedling research in understanding forest response to anthropogenic climate change. Tree Physiol 2024:tpae039. [PMID: 38598325 DOI: 10.1093/treephys/tpae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/19/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Affiliation(s)
- Benjamin R Lee
- University of Michigan Institute for Global Change Biology, 440 Church St., Ann Arbor, MI, USA
- Carnegie Museum of Natural History, 4400 Forbes Ave., Pittsburgh, PA, USA
| | - Samuel Schaffer-Morrison
- University of Michigan Dept. of Ecology and Evolutionary Biology, 1105 N. University Ave, Ann Arbor, MI, USA
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Valencia CI, Wightman P, Morrill KE, Hsu C, Arif‐Tiwari H, Kauffman E, Gachupin FC, Chipollini J, Lee BR, Garcia DO, Batai K. Neighborhood social vulnerability and disparities in time to kidney cancer surgical treatment and survival in Arizona. Cancer Med 2024; 13:e7007. [PMID: 38400688 PMCID: PMC10891465 DOI: 10.1002/cam4.7007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 12/21/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Hispanics and American Indians (AI) have high kidney cancer incidence and mortality rates in Arizona. This study assessed: (1) whether racial and ethnic minority patients and patients from neighborhoods with high social vulnerability index (SVI) experience a longer time to surgery after clinical diagnosis, and (2) whether time to surgery, race and ethnicity, and SVI are associated with upstaging to pT3/pT4, disease-free survival (DFS), and overall survival (OS). METHODS Arizona Cancer Registry (2009-2018) kidney and renal pelvis cases (n = 4592) were analyzed using logistic regression models to assess longer time to surgery and upstaging. Cox-regression hazard models were used to test DFS and OS. RESULTS Hispanic and AI patients with T1 tumors had a longer time to surgery than non-Hispanic White patients (median time of 56, 55, and 45 days, respectively). Living in neighborhoods with high (≥75) overall SVI increased odds of a longer time to surgery for cT1a (OR 1.54, 95% CI: 1.02-2.31) and cT2 (OR 2.32, 95% CI: 1.13-4.73). Race and ethnicity were not associated with time to surgery. Among cT1a patients, a longer time to surgery increased odds of upstaging to pT3/pT4 (OR 1.95, 95% CI: 0.99-3.84). A longer time to surgery was associated with PFS (HR 1.52, 95% CI: 1.17-1.99) and OS (HR 1.63, 95% CI: 1.26-2.11). Among patients with cT2 tumor, living in high SVI neighborhoods was associated with worse OS (HR 1.66, 95% CI: 1.07-2.57). CONCLUSIONS High social vulnerability was associated with increased time to surgery and poor survival after surgery.
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Affiliation(s)
- Celina I. Valencia
- Department of Family and Community Medicine, College of Medicine – TucsonThe University of ArizonaTucsonArizonaUSA
| | - Patrick Wightman
- Center for Population Health SciencesThe University of ArizonaTucsonArizonaUSA
| | - Kristin E. Morrill
- Community and Systems Health Science Division, College of NursingThe University of ArizonaTucsonArizonaUSA
| | - Chiu‐Hsieh Hsu
- Department of Epidemiology and BiostatisticsThe University of ArizonaTucsonArizonaUSA
| | - Hina Arif‐Tiwari
- Department of Medical ImagingThe University of ArizonaTucsonArizonaUSA
| | - Eric Kauffman
- Department of UrologyRoswell Park Comprehensive Cancer CenterBuffaloNew YorkUSA
| | - Francine C. Gachupin
- Department of Family and Community Medicine, College of Medicine – TucsonThe University of ArizonaTucsonArizonaUSA
| | - Juan Chipollini
- Department of UrologyThe University of ArizonaTucsonArizonaUSA
| | - Benjamin R. Lee
- Department of UrologyThe University of ArizonaTucsonArizonaUSA
| | - David O. Garcia
- Department of Health Promotion SciencesThe University of ArizonaTucsonArizonaUSA
| | - Ken Batai
- Department of Cancer Prevention and ControlRoswell Park Comprehensive Cancer CenterBuffaloNew YorkUSA
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Liu G, Liu R, Lee BR, Song X, Zhang W, Zhu Z, Shi Y. The Invasion of Galinsoga quadriradiata into High Elevations Is Shaped by Variation in AMF Communities. Plants (Basel) 2023; 12:3190. [PMID: 37765354 PMCID: PMC10534310 DOI: 10.3390/plants12183190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
Mountain ranges have been previously suggested to act as natural barriers to plant invasion due to extreme environmental conditions. However, how arbuscular mycorrhizal fungi (AMF) affect invasion into these systems has been less explored. Here, we investigated how changes in AMF communities affect the performance of Galinsoga quadriradiata in mountain ranges. We performed a greenhouse experiment to study the impact of inoculations of AMF from different elevations on the performance and reproduction of invaders and how competition with native plants changes the effects of invader-AMF interactions. We found strong evidence for a nuanced role of AMF associations in the invasion trajectory of G. quadriradiata, with facilitative effects at low elevations and inhibitory effects at high elevations. Galinsoga quadriradiata performed best when grown with inoculum collected from the same elevation but performed worst when grown with inoculum collected from beyond its currently invaded range, suggesting that AMF communities can help deter invasion at high elevations. Finally, the invasive plants grown alone experienced negative effects from AMF, while those grown in competition experienced positive effects, regardless of the AMF source. This suggests that G. quadriradiata lowers its partnerships with AMF in stressful environments unless native plants are present, in which case it overpowers native plants to obtain AMF support during invasion. Finally, our results indicate that invader-AMF interactions can inhibit invasive range expansion at high elevations, and biotic interactions, in addition to harsh environmental conditions, make high-elevation mountain ranges natural barriers against continued invasion.
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Affiliation(s)
- Gang Liu
- College of Life Sciences, Shaanxi Normal University, Xi’an 710119, China; (R.L.); (X.S.); (W.Z.); (Z.Z.); (Y.S.)
- Research Center for UAV Remote Sensing, Shaanxi Normal University, Xi’an 710119, China
- Changqing Teaching & Research Base of Ecology, Shaanxi Normal University, Xi’an 710119, China
| | - Ruiling Liu
- College of Life Sciences, Shaanxi Normal University, Xi’an 710119, China; (R.L.); (X.S.); (W.Z.); (Z.Z.); (Y.S.)
| | - Benjamin R. Lee
- Carnegie Museum of Natural History, Pittsburgh, PA 15213, USA;
- Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Holden Forest and Gardens, Kirtland, OH 44094, USA
| | - Xingjiang Song
- College of Life Sciences, Shaanxi Normal University, Xi’an 710119, China; (R.L.); (X.S.); (W.Z.); (Z.Z.); (Y.S.)
| | - Wengang Zhang
- College of Life Sciences, Shaanxi Normal University, Xi’an 710119, China; (R.L.); (X.S.); (W.Z.); (Z.Z.); (Y.S.)
| | - Zhihong Zhu
- College of Life Sciences, Shaanxi Normal University, Xi’an 710119, China; (R.L.); (X.S.); (W.Z.); (Z.Z.); (Y.S.)
- Research Center for UAV Remote Sensing, Shaanxi Normal University, Xi’an 710119, China
- Changqing Teaching & Research Base of Ecology, Shaanxi Normal University, Xi’an 710119, China
| | - Yan Shi
- College of Life Sciences, Shaanxi Normal University, Xi’an 710119, China; (R.L.); (X.S.); (W.Z.); (Z.Z.); (Y.S.)
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Zeng J, Funk J, Lee BR, Hsu CH, Messing EM, Chipollini J. Gemcitabine as first-line therapy for high-grade non-muscle invasive bladder cancer: results from a tertiary center in the contemporary BCG-shortage era. Transl Androl Urol 2023; 12:960-966. [PMID: 37426602 PMCID: PMC10323448 DOI: 10.21037/tau-22-772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/22/2022] [Accepted: 03/16/2023] [Indexed: 07/11/2023] Open
Abstract
Background To evaluate the safety profile and efficacy of intravesical gemcitabine as first-line adjuvant therapy for non-muscle invasive bladder cancer (NMIBC) in the setting of ongoing Bacillus Calmette-Guérin (BCG) shortage. Methods We performed an institutional, retrospective review of patients treated with intravesical gemcitabine induction and maintenance therapy from March 2019 to October 2021. Patients with intermediate or high-risk NMIBC who were BCG-naïve or experienced a high-grade (HG) recurrence after 12 months since the last dose of BCG were included in the analysis. The primary endpoint was complete response (CR) rate at the 3-month visit. Secondary endpoints were recurrence-free survival (RFS) and assessment of adverse events. Results A total of 33 patients were included. All had HG disease and 28 (84.8%) were BCG-naive. The median follow-up was 21.4 months (range, 4.1-39.4). Tumor stages were cTa in 39.4%, cT1 in 54.5%, and cTis in 6.1% of patients. Most patients (90.9%) were in the AUA high-risk category. The 3-month CR was 84.8%. Among patients who achieved CR with adequate follow-up, 86.9% (20/23) remained disease-free at 6 months. The 6-month and 12-month RFS were 87.2% and 76.5%, respectively. The estimated median RFS was not reached. Approximately 78.8% of patients were able to complete full induction. Common adverse events (incidence ≥10%) included dysuria and fatigue/myalgia. Conclusions Intravesical gemcitabine for intermediate and high-risk NMIBC in areas where BCG supply is limited was safe and feasible at short-term follow-up. Larger prospective studies are needed to better ascertain the oncologic efficacy of gemcitabine.
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Affiliation(s)
- Jiping Zeng
- Department of Urology, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Joel Funk
- Department of Urology, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Benjamin R. Lee
- Department of Urology, The University of Arizona College of Medicine, Tucson, AZ, USA
| | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | | | - Juan Chipollini
- Department of Urology, The University of Arizona College of Medicine, Tucson, AZ, USA
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Pearse WD, Stemkovski M, Lee BR, Primack RB, Lee SD. Consistent, linear phenological shifts across a century of observations in South Korea. New Phytol 2023. [PMID: 37285120 DOI: 10.1111/nph.18938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 03/15/2023] [Indexed: 06/08/2023]
Affiliation(s)
- William D Pearse
- Department of Life Sciences, Imperial College London, Ascot, SL5 7PY, UK
| | - Michael Stemkovski
- Department of Biology & Ecology Center, Utah State University, 5305 Old Main Hill, Logan, UT, 84322, USA
| | - Benjamin R Lee
- Section of Botany, Carnegie Museum of Natural History, 4400 Forbes Ave, Pittsburgh, PA, 15213, USA
- Department of Biological Sciences, University of Pittsburgh, 4249 Fifth Ave, Pittsburgh, PA, 15260, USA
- Holden Arboretum, 9550 Sperry Rd., Kirtland, OH, 44094, USA
| | - Richard B Primack
- Biology Department, Boston University, 5 Cummington Mall, Boston, MA, 02215, USA
| | - Sang Don Lee
- Department of Environmental Science and Engineering, Ewha Womans University, Seoul, 03760, Korea
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Batai K, Chen Y, Rheinheimer BA, Arora A, Pandey R, Heimark RL, Bracamonte ER, Ellis NA, Lee BR. Clear cell renal cell carcinoma molecular variations in non-Hispanic White and Hispanic patients. Cancer Med 2023. [PMID: 37081700 DOI: 10.1002/cam4.5929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/22/2023] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The United States is becoming increasingly diverse, but few molecular studies have assessed the progression of clear cell renal cell carcinoma (ccRCC) in diverse patient populations. This study examined ccRCC molecular variations in non-Hispanic White (NHW) and Hispanic patients and their effect on the association of gene expression with high-grade (Grade 3 or 4) ccRCC and overall mortality. METHODS A total of 156 patients were included in VHL sequencing and/or TempO-Seq analysis. DESeq2 was used to identify the genes associated with high-grade ccRCC. Logistic regression analysis was performed to assess whether race and ethnicity was associated with high/moderate impact VHL somatic mutations and the ccA/ccB subtype. Cox regression analysis was performed to assess association of molecular subtype and gene expression with overall mortality. RESULTS NHWs had moderate or high impact mutations in the VHL gene at a higher frequency than Hispanics (40.2% vs. 27.4%), while Hispanics had a higher frequency of the ccA subtype than NHWs (61.9% vs. 45.8%). ccA was more common in patients with BMI≥35 (65.2%) than in those with BMI < 25 (45.0%). There were 11 differentially expressed genes between high- and low-grade tumors. The Haptoglobin (HP) gene was most significantly overexpressed in high- compared to low-grade ccRCC in all samples (p-adj = 1.7 × 10-12 ). When stratified by subtype, the 11 genes were significantly differentially expressed in the ccB subtype, but none of them were significant after adjusting for multiple testing in ccA. Finally, patients with the ccB subtype had a significantly increased risk of overall mortality (HR 4.87; p = 0.01) compared to patients with ccA, and patients with high HP expression and ccB, had a significantly increased risk of mortality compared to those with low HP expression and ccA (HR 6.45, p = 0.04). CONCLUSION This study reports ccRCC molecular variations in Hispanic patients who were previously underrepresented.
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Affiliation(s)
- Ken Batai
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Yuliang Chen
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | | | - Amit Arora
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Ritu Pandey
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, Arizona, USA
| | - Ronald L Heimark
- Department of Surgery, University of Arizona, Tucson, Arizona, USA
| | | | - Nathan A Ellis
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, Arizona, USA
| | - Benjamin R Lee
- Department of Urology, University of Arizona, Tucson, Arizona, USA
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Jones TM, Espitia CM, Chipollini J, Lee BR, Wertheim JA, Carew JS, Nawrocki ST. Targeting NEDDylation is a Novel Strategy to Attenuate Cisplatin-induced Nephrotoxicity. Cancer Res Commun 2023; 3:245-257. [PMID: 36860653 PMCID: PMC9973416 DOI: 10.1158/2767-9764.crc-22-0340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/26/2022] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Although cisplatin remains a backbone of standard-of-care chemotherapy regimens for a variety of malignancies, its use is often associated with severe dose-limiting toxicities (DLT). Notably, 30%-40% of patients treated with cisplatin-based regimens are forced to discontinue treatment after experiencing nephrotoxicity as a DLT. New approaches that simultaneously prevent renal toxicity while improving therapeutic response have the potential to make a major clinical impact for patients with multiple forms of cancer. Here, we report that pevonedistat (MLN4924), a first-in-class NEDDylation inhibitor, alleviates nephrotoxicity and synergistically enhances the efficacy of cisplatin in head and neck squamous cell carcinoma (HNSCC) models. We demonstrate that pevonedistat protects normal kidney cells from injury while enhancing the anticancer activity of cisplatin through a thioredoxin-interacting protein (TXNIP)-mediated mechanism. Cotreatment with pevonedistat and cisplatin yielded dramatic HNSCC tumor regression and long-term animal survival in 100% of treated mice. Importantly, the combination decreased nephrotoxicity induced by cisplatin monotherapy as evidenced by the blockade of kidney injury molecule-1 (KIM-1) and TXNIP expression, a reduction in collapsed glomeruli and necrotic cast formation, and inhibition of cisplatin-mediated animal weight loss. Inhibition of NEDDylation represents a novel strategy to prevent cisplatin-induced nephrotoxicity while simultaneously enhancing its anticancer activity through a redox-mediated mechanism. Significance Cisplatin therapy is associated with significant nephrotoxicity, which limits its clinical use. Here we demonstrate that NEDDylation inhibition with pevonedistat is a novel approach to selectively prevent cisplatin-induced oxidative damage to the kidneys while simultaneously enhancing its anticancer efficacy. Clinical evaluation of the combination of pevonedistat and cisplatin is warranted.
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Affiliation(s)
- Trace M. Jones
- Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona
| | - Claudia M. Espitia
- Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona
| | - Juan Chipollini
- Department of Urology, University of Arizona, Tucson, Arizona
| | - Benjamin R. Lee
- Department of Urology, University of Arizona, Tucson, Arizona
| | - Jason A. Wertheim
- Departments of Surgery and Biomedical Engineering, University of Arizona, Tucson, Arizona
| | - Jennifer S. Carew
- Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona
| | - Steffan T. Nawrocki
- Division of Hematology and Oncology, Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona
- Department of Urology, University of Arizona, Tucson, Arizona
- Corresponding Author: Steffan T. Nawrocki, University of Arizona Cancer Center, 1515 N. Campbell Ave, Tucson, AZ 85724. Phone: 520-626-7395; Fax: 520-626-2272; E-mail:
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Lee BR, Batai K. EDITORIAL COMMENT. Urology 2022; 165:96-97. [PMID: 35843703 DOI: 10.1016/j.urology.2021.08.073] [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] [Received: 04/08/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Benjamin R Lee
- Department of Urology, University of Arizona, Tucson, AZ
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Batai K, Chen Y, Rheinheimer B, Heimark R, Ellis N, Lee BR. Abstract 3665: Clear cell renal cell carcinoma molecular characteristics in Hispanic Americans compared to European Americans. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-3665] [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: Hispanic Americans (HAs) have higher incidence and mortality rates of renal cell carcinoma (RCC) than European Americans (EAs). Despite the disparate burden of RCC, tumor molecular characteristics among HAs are unknown. This study explored clear cell RCC (ccRCC) molecular difference between HAs and EAs.
Methods: Paraffin embedded surgical specimens of ccRCC patients who underwent nephrectomy for a treatment of RCC were obtained. Three exons of VHL gene were screened for somatic mutations in a total of 150 patients. 96 patients were included for TempO-Seq analysis. A centroid-based approach with 34 gene set was used to assign molecular subtype (ccA or ccB). DESeq2 was used for differential gene expressional analysis.
Results: HAs were younger (mean age of 55.7 vs. 61.2) and had slightly higher mean Body Mass Index (BMI, 32.1 vs. 30.3). More HAs reported that they never smoked (71%) compared to EAs (46%). 73 somatic mutations in coding regions of VHL were found in 56 patients (37.3%), and 11 patients had more than 2 somatic mutations in coding regions. Mutations in coding regions were more common in EAs (41.5%) than HAs (35.5%), but the difference was not statistically significant (p=0.49). When we focused on moderate or high impact mutations, EAs had mutations at higher frequency than HAs (40.2 vs. 27.4%; p=0.07 after adjusting for age and sex). Frequency of somatic mutations was also higher for former (30.3%) and current smokers (40.0%) compared to non-smokers (24.3%). After including smoking history in the regression model, HA ethnicity was not associated with presence of high/moderate impact somatic mutations. HAs had a higher frequency of ccA subtype than EAs (61.9% vs 45.8%). ccA subtype was also more common in patients with BMI>35 (65.2%) than patients with BMI<25 (45.0%). In the adjusted model, HAs had significantly increased odds of having ccA (OR 3.34, 95%CI: 1.17-9.52). Haptoglobin (HP) gene was most significantly over-expressed in high-grade compared to low-grade ccRCC in an analysis including all samples (log2 fold change 4.0, adjusted-p=1.7x10-12). HP was highly over-expressed in high-grade compared to low-grade ccRCC in EAs (log2 fold change 5.2, adjusted-p=4.9x10-9), but not in HA tumors (log2 fold change 2.5, adjusted-p=0.06).
Conclusion: HA and EA tumors have different molecular characteristics potentially due to differences in prevalence of behavioral risk factors.
Impact: Different molecular characteristics in racial/ethnic groups may impact clinical treatment in diverse patient populations.
Citation Format: Ken Batai, Yuliang Chen, Brenna Rheinheimer, Ron Heimark, Nathan Ellis, Benjamin R. Lee. Clear cell renal cell carcinoma molecular characteristics in Hispanic Americans compared to European Americans [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3665.
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Cruz A, Dickerson F, Pulling KR, Garcia K, Gachupin FC, Hsu CH, Chipollini J, Lee BR, Batai K. Impacts of Neighborhood Characteristics and Surgical Treatment Disparities on Overall Mortality in Stage I Renal Cell Carcinoma Patients. Int J Environ Res Public Health 2022; 19:2050. [PMID: 35206240 PMCID: PMC8872003 DOI: 10.3390/ijerph19042050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/15/2022] [Accepted: 02/09/2022] [Indexed: 12/20/2022]
Abstract
Racial/ethnic minority groups in the United States have high renal cell carcinoma (RCC) mortality rates. This study assessed surgical treatment disparities across racial/ethnic groups and impacts of neighborhood socioeconomic characteristics on surgical treatments and overall mortality. Stage I RCC patients diagnosed between 2004 and 2016 from National Cancer Database were included (n = 238,141). We assessed differences in associations between race/ethnicity and treatment patterns using logistic regression and between race/ethnicity and overall mortality using Cox regression with and without neighborhood characteristics in the regression models. When compared to non-Hispanic Whites (NHWs), American Indians/Alaska Natives and non-Hispanic Blacks (NHBs) were more likely not to receive surgical care and all racial/ethnic minority groups had significantly increased odds of undergoing radical rather than partial nephrectomy, even after adjusting for neighborhood characteristics. Including surgical treatment and neighborhood factors in the models slightly attenuated the association, but NHBs had a significantly increased risk of overall mortality. NHBs who underwent radical nephrectomy had an increased risk of mortality (HR 1.15, 95% CI: 1.08-1.23), but not for NHBs who underwent partial nephrectomy (HR 0.92, 95% CI: 0.84-1.02). Neighborhood factors were associated with surgical treatment patterns and overall mortality in both NHBs and NHWs. Neighborhood socioeconomic factors may only partly explain RCC disparities.
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Affiliation(s)
- Alejandro Cruz
- Department of Urology, University of Arizona, Tucson, AZ 85724, USA; (A.C.); (F.D.); (K.R.P.); (K.G.); (J.C.); (B.R.L.)
| | - Faith Dickerson
- Department of Urology, University of Arizona, Tucson, AZ 85724, USA; (A.C.); (F.D.); (K.R.P.); (K.G.); (J.C.); (B.R.L.)
| | - Kathryn R. Pulling
- Department of Urology, University of Arizona, Tucson, AZ 85724, USA; (A.C.); (F.D.); (K.R.P.); (K.G.); (J.C.); (B.R.L.)
| | - Kyle Garcia
- Department of Urology, University of Arizona, Tucson, AZ 85724, USA; (A.C.); (F.D.); (K.R.P.); (K.G.); (J.C.); (B.R.L.)
| | - Francine C. Gachupin
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ 85711, USA;
| | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ 85724, USA;
| | - Juan Chipollini
- Department of Urology, University of Arizona, Tucson, AZ 85724, USA; (A.C.); (F.D.); (K.R.P.); (K.G.); (J.C.); (B.R.L.)
| | - Benjamin R. Lee
- Department of Urology, University of Arizona, Tucson, AZ 85724, USA; (A.C.); (F.D.); (K.R.P.); (K.G.); (J.C.); (B.R.L.)
| | - Ken Batai
- Department of Urology, University of Arizona, Tucson, AZ 85724, USA; (A.C.); (F.D.); (K.R.P.); (K.G.); (J.C.); (B.R.L.)
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Gachupin FC, Lee BR, Chipollini J, Pulling KR, Cruz A, Wong AC, Valencia CI, Hsu CH, Batai K. Renal Cell Carcinoma Surgical Treatment Disparities in American Indian/Alaska Natives and Hispanic Americans in Arizona. Int J Environ Res Public Health 2022; 19:1185. [PMID: 35162208 PMCID: PMC8834853 DOI: 10.3390/ijerph19031185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/04/2022]
Abstract
American Indians/Alaska Natives (AI/AN) and Hispanic Americans (HA) have higher kidney cancer incidence and mortality rates compared to non-Hispanic Whites (NHW). Herein, we describe the disparity in renal cell carcinoma (RCC) surgical treatment for AI/AN and HA and the potential association with mortality in Arizona. A total of 5111 stage I RCC cases diagnosed between 2007 and 2016 from the Arizona Cancer Registry were included. Statistical analyses were performed to test the association of race/ethnicity with surgical treatment pattern and overall mortality, adjusting for patients' demographic, healthcare access, and socioeconomic factors. AI/AN were diagnosed 6 years younger than NHW and were more likely to receive radical rather than partial nephrectomy (OR 1.49 95% CI: 1.07-2.07) compared to NHW. Mexican Americans had increased odds of not undergoing surgical treatment (OR 1.66, 95% CI: 1.08-2.53). Analysis showed that not undergoing surgical treatment and undergoing radical nephrectomy were statistically significantly associated with higher overall mortality (HR 1.82 95% CI: 1.21-2.76 and HR 1.59 95% CI: 1.30-1.95 respectively). Mexican Americans, particularly U.S.-born Mexican Americans, had an increased risk for overall mortality and RCC-specific mortality even after adjusting for neighborhood socioeconomic factors and surgical treatment patterns. Although statistically not significant after adjusting for neighborhood-level socioeconomic factors and surgical treatment patterns, AI/AN had an elevated risk of mortality.
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Affiliation(s)
- Francine C. Gachupin
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85711, USA;
| | - Benjamin R. Lee
- Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (B.R.L.); (J.C.); (K.R.P.); (A.C.); (A.C.W.); (K.B.)
| | - Juan Chipollini
- Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (B.R.L.); (J.C.); (K.R.P.); (A.C.); (A.C.W.); (K.B.)
| | - Kathryn R. Pulling
- Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (B.R.L.); (J.C.); (K.R.P.); (A.C.); (A.C.W.); (K.B.)
| | - Alejandro Cruz
- Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (B.R.L.); (J.C.); (K.R.P.); (A.C.); (A.C.W.); (K.B.)
| | - Ava C. Wong
- Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (B.R.L.); (J.C.); (K.R.P.); (A.C.); (A.C.W.); (K.B.)
| | - Celina I. Valencia
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ 85711, USA;
| | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Ken Batai
- Department of Urology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA; (B.R.L.); (J.C.); (K.R.P.); (A.C.); (A.C.W.); (K.B.)
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Cruz A, Dickerson F, Pulling KR, Garcia K, Gachupin FC, Hsu CH, Chipollini J, Lee BR, Batai K. Abstract PO-169: Impacts of neighborhood characteristics and surgical treatment disparities on overall mortality in stage I renal cell carcinoma patients. Cancer Epidemiol Biomarkers Prev 2022. [DOI: 10.1158/1538-7755.disp21-po-169] [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] Open
Abstract
Abstract
Background Racial/ethnic minority groups in the United States have high kidney cancer mortality rates. Disparities in treatments may contribute to higher mortality in racial/ethnic minority groups, but the relationship between treatment disparities and kidney cancer mortality is not well understood. In this study, we assessed if there are differences in surgical treatments across racial/ethnic groups and surgical treatments influence disparities in overall mortality. Methods Stage I renal cell carcinoma patients who were diagnosed between 2004 and 2016 from National Cancer Database were included. Logistic regression was performed to assess associations between race/ethnicity and treatment patterns adjusting for neighborhood socioeconomic (SES) and other factors. Cox regression analysis was performed to assess associations between race/ethnicity and overall mortality. Results A total of 238,141 patients were included in the analysis. Compared to non-Hispanic Whites, American Indians/Alaska Natives, and non-Hispanic Blacks (NHBs) were more likely not to receive surgical care even after adjusting for neighborhood SES (OR 1.85, 95% CI: 1.28-2.70 and OR 1.32 95% CI: 1.20-1.45 respectively). Although all racial/ethnic groups had significantly increased odds of undergoing radical nephrectomy rather than partial nephrectomy,. NHBs had the greatest odds of receiving radical rather than partial nephrectomy (OR 1.38, 95% CI: 1.33-1.44).. The associations were slightly attenuated after including healthcare access and neighborhood SESNHBs had an elevated risk of overall mortality, while Asian Americans and Hispanic Americans had reduced risk. Including surgical treatment, health access and neighborhood factors slightly attenuated the association for NHBs, but the associations between race/ethnicity and overall mortality remained significant. Analysis was performed stratifying samples based on surgical treatment to further assess effects of surgical treatment disparities on associations between race/ethnicity and overall mortality. NHBs who had surgical treatment had increased risk of mortality (HR 1.11, 95% CI:1.06-1.17).. Among patients who underwent nephrectomy, NHBs who underwent radical nephrectomy had increased risk of mortality (HR 1.15, 95% CI: 1.08-1.23), but not NHBs who underwent partial nephrectomy (HR 0.92, 95% CI:0.84-1.02). Conclusion Racial/ethnic minority patients were more likely not to receive surgical treatment. When they do, they are likely to have less optimal surgical treatment (radical rather than partial nephrectomy). Surgical treatment disparities account for high kidney cancer mortality in NHBs.
Citation Format: Alejandro Cruz, Faith Dickerson, Kathryn R. Pulling, Kyle Garcia, Francine C. Gachupin, Chiu-Hsieh Hsu, Juan Chipollini, Benjamin R. Lee, Ken Batai. Impacts of neighborhood characteristics and surgical treatment disparities on overall mortality in stage I renal cell carcinoma patients [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-169.
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Marr KD, Ignatenko NA, Warfel NA, Batai K, Cress AE, Pollock GR, Wong AC, Lee BR. Digital image analysis using video microscopy of human-derived prostate cancer vs normal prostate organoids to assess migratory behavior on extracellular matrix proteins. Front Oncol 2022; 12:1083150. [PMID: 36727054 PMCID: PMC9885251 DOI: 10.3389/fonc.2022.1083150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/28/2022] [Indexed: 01/17/2023] Open
Abstract
The advent of perpetuating living organoids derived from patient tissue is a promising avenue for cancer research but is limited by difficulties with precise characterization. In this brief communication, we demonstrate via time-lapse imaging distinct phenotypes of prostate organoids derived from patient material- without confirmation of cellular identity. We show that organoids derived from histologically normal tissue more readily spread on a physiologic extracellular matrix (ECM) than on pathologic ECM (p<0.0001), while tumor-derived organoids spread equally on either substrate (p=0.2406). This study is an important proof-of-concept to defer precise characterization of organoids and still glean information into disease pathology.
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Affiliation(s)
- Kendra D. Marr
- Cancer Biology, University of Arizona, Tucson, AZ, United States
- MD/PhD Program, College of Medicine Tucson, University of Arizona, Tucson, AZ, United States
| | | | - Noel A. Warfel
- Cancer Biology, University of Arizona, Tucson, AZ, United States
- Cellular & Molecular Medicine, University of Arizona, Tucson, AZ, United States
| | - Ken Batai
- Cancer Prevention & Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Anne E. Cress
- Cancer Biology, University of Arizona, Tucson, AZ, United States
- Cellular & Molecular Medicine, University of Arizona, Tucson, AZ, United States
| | - Grant R. Pollock
- Urology, College of Medicine Tucson, University of Arizona, Tucson, AZ, United States
| | - Ava C. Wong
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - Benjamin R. Lee
- Urology, College of Medicine Tucson, University of Arizona, Tucson, AZ, United States
- *Correspondence: Benjamin R. Lee,
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Kamal Rodin NS, Ismail NA, Abdul Wahid SF, Jamil A, Syed Zakaria SZ, Syed Abd Kadir SS, Lee BR, Bakrin IH, Wan Jamaludin WF. Epidemiology and clinical profiles of cutaneous graft versus host disease in allogeneic peripheral blood stem cell transplantation. Malays J Pathol 2021; 43:361-373. [PMID: 34958057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The epidemiology of cutaneous graft versus host disease (GVHD) in allogeneic peripheral blood stem cell transplantation (PBSCT) in Malaysia has not been described. MATERIALS AND METHODS We retrospectively analysed 691 allogeneic PBSCT patients between 2010-2017 in two centers. RESULTS The prevalence of cutaneous GVHD was 31.4% (217/691). No associations were detected with race, age or gender of donor and recipients. Cutaneous GVHD was associated with host cytomegalovirus (CMV) seropositivity (p<0.01), conditioning (p<0.01), GVHD prophylaxis (p=0.046) and survival (p<0.01). Majority developed the acute form (58.1%;126/217). Biopsies in 20.7% (45/217) showed 55.6% positivity for GVHD. Overall, involvement was non-severe. A majority demonstrated complete response (CR) to first-line corticosteroids (70.0%;152/217). Secondline therapies (extracorporeal phototherapy (ECP), psolaren ultraviolet A (PUVA), mycophenolate, tumour necrosis factor (TNF) inhibitors, interleukins inhibitors, or CD20 monoclonal antibodies) were required in 65/217, with 38.5% CR. Second-line therapy was associated with gender (p=0.042), extra-cutaneous GVHD (p=0.021), treatment outcomes (p=0.026) and survival (p=0.048). Mortality in cutaneous GVHD was 24.0% with severe sepsis being the leading cause at Day 100 (7.8%) and 5-years (7.8%), and relapsed disease at 2-years (32.7%). In steroid refractoriness, severe GVHD caused 30.8% mortality. In cutaneous GVHD, survival at Day 100 was 95.4%; 80.2% at 2-years and 73.1% at 5-years. The median survival in cutaneous GVHD was significantly shorter at 55 months, compared to those without GVHD at 69 months (p=0.001). CONCLUSION Cutaneous involvement is the commonest clinical manifestation of GVHD. A larger national study is warranted to further analyse severity and outcome of multiorgan GVHD, and factors associated with steroid refractoriness.
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Affiliation(s)
- N S Kamal Rodin
- Universiti Kebangsaan Malaysia Medical Centre, Department of Medicine, Kuala Lumpur, Malaysia
| | - N A Ismail
- Universiti Kebangsaan Malaysia Medical Centre, Cell Therapy Centre, Kuala Lumpur, Malaysia
| | - S F Abdul Wahid
- Universiti Kebangsaan Malaysia Medical Centre, Cell Therapy Centre, Kuala Lumpur, Malaysia
| | - A Jamil
- Universiti Kebangsaan Malaysia Medical Centre, Department of Medicine, Kuala Lumpur, Malaysia
| | - S Z Syed Zakaria
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pediatric & Community Health, Kuala Lumpur, Malaysia
| | - S S Syed Abd Kadir
- Hospital Ampang, Department of Hematology, 68000 Ampang, Selangor, Malaysia
| | - B R Lee
- Hospital Gleneagles, Department of Dermatopathology, 50450 Kuala Lumpur, Malaysia
| | - I H Bakrin
- Universiti Putra Malaysia, Faculty of Medicine and Health Sciences, Department of Pathology
| | - W F Wan Jamaludin
- Universiti Kebangsaan Malaysia Medical Centre, Cell Therapy Centre, Kuala Lumpur, Malaysia.
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Chipollini J, Pollock G, Hsu C, Batai K, Recio‐Boiles A, Lee BR. National trends and survival outcomes of penile squamous cell carcinoma based on human papillomavirus status. Cancer Med 2021; 10:7466-7474. [PMID: 34632731 PMCID: PMC8559500 DOI: 10.1002/cam4.4258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/09/2021] [Accepted: 08/11/2021] [Indexed: 12/14/2022] Open
Abstract
Background There are no series evaluating penile squamous cell carcinoma (pSCC) based on human papillomavirus (HPV) infection. Herein, we present national registry data on clinical and survival outcomes for pSCC based on HPV status. Methods We performed a retrospective review of 1224 pSCC patients with known HPV staining from the National Cancer Database. Patients with cM1 disease, those who did not receive treatment, or had missing follow‐up data were excluded. Logistic regression identified factors associated with locally aggressive disease. Univariable, multivariable, and inverse probability of treatment weighting (IPTW)‐Cox proportional hazard modeling were used to assess hazard ratios (HR) associated with overall survival (OS). Results After exclusion criteria, we identified 825 cases of which 321 (38.9%) were HPV positive. The HPV‐positivity rate did not significantly change by year. HPV‐positive patients were younger, had lower Charlson‐Deyo performance score, and resided in areas with both lower median household income and lower school education completion. HPV‐positive tumors presented with lower American Joint Committee on Cancer clinical T‐stage (cT), poorer differentiation, lower rates of lymphovascular invasion (LVI), but more node‐positive disease (cN+). For those who underwent lymph node surgery, there were no differences in final pathologic stage, upstaging, or presence of extranodal extension. Only tumor differentiation, LVI, and performance score were independent predictors for locally aggressive disease. HPV status was not a predictor of OS (IPTW‐HR:0.89, p = 0.13). Conclusions In the largest series evaluating pSCC based on HPV status, HPV‐positive tumors were associated with lower cT stages, less LVI, but more cN + disease. More studies on prognostic factors are needed, and time may still be immature to use HPV information for risk stratification.
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Affiliation(s)
| | - Grant Pollock
- Department of UrologyUniversity of ArizonaTucsonArizonaUSA
| | - Chiu‐Hsieh Hsu
- Department of Epidemiology and BiostatisticsUniversity of ArizonaTucsonArizonaUSA
| | - Ken Batai
- Department of UrologyUniversity of ArizonaTucsonArizonaUSA
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Lee BR, Ibáñez I. Improved phenological escape can help temperate tree seedlings maintain demographic performance under climate change conditions. Glob Chang Biol 2021; 27:3883-3897. [PMID: 33977598 DOI: 10.1111/gcb.15678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 06/12/2023]
Abstract
Phenological escape, a strategy that deciduous understory plants use to access direct light in spring by leafing out before the canopy closes, plays an important role in shaping the recruitment of temperate tree seedlings. Previous studies have investigated how climate change will alter these dynamics for herbaceous species, but there is a knowledge gap related to how woody species such as tree seedlings will be affected. Here, we modeled temperate tree seedling leaf-out phenology and canopy close phenology in response to environmental drivers and used climate change projections to forecast changes to the duration of spring phenological escape. We then used these predictions to estimate changes in annual carbon assimilation while accounting for reduced carbon assimilation rates associated with hotter and drier summers. Lastly, we applied these estimates to previously published models of seedling growth and survival to investigate the net effect on seedling demographic performance. Our models predict that temperate tree seedlings will experience improved phenological escape and, therefore, increased spring carbon assimilation under climate change conditions. However, increased summer respiration costs will offset the gains in spring under extreme climate change leading to a net loss in annual carbon assimilation and demographic performance. Furthermore, we found that annual carbon assimilation predictions depend strongly on the species of nearby canopy tree that seedlings were planted near, with all seedlings projected to assimilate less carbon (and therefore experience worse demographic performance) when planted near Quercus rubra canopy trees as opposed to Acer saccharum canopy trees. We conclude that changes to spring phenological escape will have important effects on how tree seedling recruitment is affected by climate change, with the magnitude of these effects dependent upon climate change severity and biological interactions with neighboring adults. Thus, future studies of temperate forest recruitment should account for phenological escape dynamics in their models.
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Affiliation(s)
- Benjamin R Lee
- School for Environment and Sustainability, University of Michigan, Ann Arbor, MI, USA
| | - Inés Ibáñez
- School for Environment and Sustainability, University of Michigan, Ann Arbor, MI, USA
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Chen Y, Meiklejohn KM, Ellis N, Bracamonte ER, Lee BR, Batai K. Abstract 2191: Clear cell renal cell carcinoma molecular differences between Hispanic Americans and European Americans. Cancer Res 2021. [DOI: 10.1158/1538-7445.am2021-2191] [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: Hispanic Americans (HAs) in Arizona have a heavy burden of renal cell carcinoma (RCC) presenting at a younger age at diagnosis with higher incidence and mortality rates than European Americans (EAs). However, HAs are underrepresented in RCC research, and tumor molecular characteristics in this population are unknown. We report preliminary findings from a study of molecular differences between HAs and EAs exploring the molecular basis of early-onset clear cell RCC (ccRCC).
Methods: Clinical records of patients who underwent surgical treatment for RCC between 2011 and 2020 at the University of Arizona Department of Urology was reviewed. A total of 539 patients were identified, and paraffin embedded surgical specimens of a subset of patients with ccRCC were selected for this study. Three exons of VHL gene, the most commonly altered gene in ccRCC, were screened for somatic mutations in a total of 117 patients. Thirty-three patients were included for TempO-Seq analysis to correlate molecular subtype with demographic and clinicopathologic characteristics.
Results: Among 117 patients, 55 somatic mutations in coding regions of VHL were found in 42 patients (35.9%). Nine patients had more than 2 somatic mutations. There were 37 substitutions, 14 deletions, and 4 insertions. There was one patient with a mutation of an intron variant that was a splice acceptor. Mutations in the coding regions were more common in EAs (40.9%) than HAs (31%), but the difference was not statistically significant (P=0.32). For moderate or high impact mutations, EAs had mutations at a significantly higher frequency than HAs (39.4% vs. 20.5%, P=0.04). Patients with high impact mutations tend to be diagnosed before the age of 50 (37.5%) compared to patients without high impact mutations (23.9%). We were able to assign 32 out of 33 patients into molecular subtypes (ccA and ccB). Molecular subtype could not be assigned to one HA patient with high grade and advanced stage ccRCC. Compared to patients with ccB subtype, patients who had ccA subtype were younger (mean age of 52.2 vs. 61.4) and tend to be obese (55.6% vs. 28.6% body mass index ≥30). Molecular subtype, ccA, was more common in HAs than EAs (64.3% vs. 41.2%), but this difference was not statistically significant.
Conclusion: Somatic mutations within the VHL gene often altered in early during ccRCC pathogenesis were less common in HAs, but ccA associated with early age of diagnosis and obesity was more common in HAs.
Impact: HAs and EAs have different molecular basis of early-onset ccRCC which may impact clinical managements.
Citation Format: Yuliang Chen, Karleen M. Meiklejohn, Nathan Ellis, Erika R. Bracamonte, Benjamin R. Lee, Ken Batai. Clear cell renal cell carcinoma molecular differences between Hispanic Americans and European Americans [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 2191.
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Liu RL, Yang YB, Lee BR, Liu G, Zhang WG, Chen XY, Song XJ, Kang JQ, Zhu ZH. The dispersal-related traits of an invasive plant Galinsoga quadriradiata correlate with elevation during range expansion into mountain ranges. AoB Plants 2021; 13:plab008. [PMID: 34194688 PMCID: PMC8237851 DOI: 10.1093/aobpla/plab008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 06/14/2021] [Indexed: 06/13/2023]
Abstract
Detecting shifts in trait values among populations of an invasive plant is important for assessing invasion risks and predicting future spread. Although a growing number of studies suggest that the dispersal propensity of invasive plants increases during range expansion, there has been relatively little attention paid to dispersal patterns along elevational gradients. In this study, we tested the differentiation of dispersal-related traits in an invasive plant, Galinsoga quadriradiata, across populations at different elevations in the Qinling and Bashan Mountains in central China. Seed mass-area ratio (MAR), an important seed dispersal-related trait, of 45 populations from along an elevational gradient was measured, and genetic variation of 23 populations was quantified using inter-simple sequence repeat (ISSR) markers. Individuals from four populations were then planted in a greenhouse to compare their performance under shared conditions. Changing patterns of seed dispersal-related traits and populations genetic diversity along elevation were tested using linear regression. Mass-area ratio of G. quadriradiata increased, while genetic diversity decreased with elevation in the field survey. In the greenhouse, populations of G. quadriradiata sourced from different elevations showed a difference response of MAR. These results suggest that although rapid evolution may contribute to the range expansion of G. quadriradiata in mountain ranges, dispersal-related traits will also likely be affected by phenotypic plasticity. This challenges the common argument that dispersal ability of invasive plants increases along dispersal routes. Furthermore, our results suggest that high-altitude populations would be more effective at seed dispersal once they continue to expand their range downslope on the other side. Our experiment provides novel evidence that the spread of these high-altitude populations may be more likely than previously theorized and that they should thus be cautiously monitored.
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Affiliation(s)
- Rui-Ling Liu
- College of Life Sciences, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
| | - Ying-Bo Yang
- College of Life Sciences, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
| | - Benjamin R Lee
- School for Environment and Sustainability, University of Michigan, Ann Arbor, MI 48109, USA
| | - Gang Liu
- College of Life Sciences, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
- National Engineering Laboratory for Resource Development of Endangered Crude Drugs in Northwest China, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
| | - Wen-Gang Zhang
- College of Life Sciences, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
| | - Xiao-Yan Chen
- College of Life Sciences, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
| | - Xing-Jiang Song
- College of Life Sciences, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
| | - Ju-Qing Kang
- College of Life Sciences, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
| | - Zhi-Hong Zhu
- College of Life Sciences, Shaanxi Normal University, 710119 Xi’an, People’s Republic of China
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Affiliation(s)
- Benjamin R. Lee
- School for Environment and Sustainability University of Michigan Ann Arbor MI USA
| | - Inés Ibáñez
- School for Environment and Sustainability University of Michigan Ann Arbor MI USA
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Pollock G, Hsu CH, Batai K, Lee BR, Chipollini J. Postoperative and Survival Outcomes After Cytoreductive Surgery in the Treatment of Metastatic Upper Tract Urothelial Carcinoma. Urology 2021; 153:244-249. [PMID: 33482133 DOI: 10.1016/j.urology.2021.01.017] [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] [Received: 10/12/2020] [Revised: 12/16/2020] [Accepted: 01/11/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To analyze utilization and outcomes of cytoreductive surgery (CRS) after systemic chemotherapy in select patients with metastatic upper tract urothelial carcinoma (UTUC). MATERIAL AND METHODS We identified 1,73 patients with cM1 UTUC from the National Cancer Database who were treated with first-line multiagent chemotherapy from 2004 to 2015. Patients considered surgical candidates based on Charlon-Deyo performance score were stratified into nonsurgical versus surgical arms based on receipt of CRS after systemic therapy. Those receiving radiation, immunotherapy, or other types of treatment were excluded. Cox proportional hazard models were used to analyze prognostic factors for overall survival (OS). Propensity-score matching and inverse probability of treatment weighting-adjusted regression models were used to compare OS. RESULTS A total of 1182 patients were included of which 349 (29.5%) were treated with definitive surgery. Median follow-up was 64 months (95% confidence interval:49.8-79.4) for chemotherapy+surgery versus 61.2 (52.2-78.7) for the chemotherapy-alone arms (P = .09). Patients treated with surgery were younger and more commonly treated at academic facilities. Patients who received CRS had improved median-OS versus those treated with chemotherapy alone (13.7 vs 10.8 months, log-rank P-value <.001). Predictors of OS were performance score, treatment at academic facility, and performance of CRS. Furthermore, in propensity-score and inverse probability of treatment weighting-adjusted Cox regression analyses, CRS was associated with significant OS benefit (hazard ratios = 0.61, 95% confidence interval:0.49-0.77, and 0.63;0.55-0.72; respectively). CONCLUSION We provide a contemporary report on the survival benefit of CRS after treatment with systemic therapy for M1 UTUC patients. Longitudinal studies are needed to evaluate the role of surgery, when feasible, within multidisciplinary approaches for this relatively, rare disease.
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Affiliation(s)
- Grant Pollock
- University of Arizona, Department of Urology, Tucson, AZ
| | - Chiu-Hsieh Hsu
- University of Arizona, Department of Epidemiology and Biostatistics, Tucson, AZ
| | - Ken Batai
- University of Arizona, Department of Urology, Tucson, AZ
| | - Benjamin R Lee
- University of Arizona, Department of Urology, Tucson, AZ
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Valencia CI, Gachupin FC, Hsu CH, Chipollini J, Lee BR, Batai K. Abstract PO-165: Renal cell carcinoma health disparities in American Indians/Alaska Natives and Hispanic Americans. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp20-po-165] [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] Open
Abstract
Abstract
Background: American Indians/Alaska Natives (AIs/ANs) and United States (U.S.)- born Hispanic Americans (HAs) have higher kidney cancer mortality rates compared to non-Hispanic Whites (NHWs). However, causes for the disparities have not been well understood. The aim of our study was to assess if socioeconomic factors and residence pattern (urban vs. rural) account for renal cell carcinoma (RCC) health disparities in AIs/ANs and HAs focusing on advanced stage (stage III/IV) diagnosis and survival. Methods: RCC patients diagnosed between 2004 and 2015 (n=405, 073) in National Cancer Database (NCDB) and between 2007 and 2016 (n=9,982) in Arizona Cancer Registry (ACR) were analyzed. Logistic regression and Cox regression analysis were performed to ascertain the effect of race/ethnicity on stage at diagnosis and overall survival adjusting for patient’s characteristics, including census tract socioeconomic status (SES), Rural-Urban Continuum Codes (RUCC), and other relevant factors. High school graduate rate, median income (or poverty rate), and unemployment rate was used to measure socioeconomic status. In ACR data, sub- distribution Cox proportional hazards regression was performed to study time to death due to RCC accounting for competing risks. Results: There were a total of 405,073 cases in NCDB and 9,982 cases in ACR. In both NCDB and ACR data, AIs/ANs had significantly increased odds of having advanced stage at diagnosis in unadjusted model (OR 1.20, 95% CI: 1.08-1.33 and OR 1.29, 95% CI: 1.06-1.56 respectively in NCDB and ACR), but the association was not significant after adjusting for patient’s characteristics. In both datasets, Mexican Americans had higher odds of having advanced stage diagnosis compared to NHWs (OR 1.22, 95% CI: 1.11-1.35 and OR 2.02, 95% CI: 1.58-2.58 respectively) even after adjusting for patient’s characteristics, including SES and RUCC. In ACR, advanced stage diagnosis was particularly common in U.S.-born Mexican Americans (49.1%) compared to NHWs (26.4%). AIs/ANs showed increased mortality risk in unadjusted model in both datasets (HR 1.10, 95% CI:1.01-1.20 and HR 1.20, 95% CI: 1.05-1.37 respectively in NCDB and ACR). The association was no longer significant in NCDB after adjusting for patient’s characteristics, while it remained significant in ACR (HR 1.33, 95% CI: 1.03-1.72). In Arizona, Mexican Americans had significantly higher risk of mortality compared to NHWs in both unadjusted and adjusted models (HR 2.46, 95% CI: 2.23-2.72 and HR 2.34, 95% CI: 1.93-2.90). The greatest risk of all-cause and RCC-specific mortality was observed in U.S.-born Mexican Americans (HR 3.21, 95% CI: 2.61-3.98 and sub- distribution HR 2.79, 95% CI: 2.05-3.81). Conclusion: RCC disparities in AIs/ANs is partially explained by neighborhood socioeconomic and residence characteristics, but the neighborhood characteristics did not affect the associations for HAs. Greater RCC health disparities were observed among Mexican Americans in Arizona than the national level.
Citation Format: Celina I. Valencia, Francine C. Gachupin, Chiu-Hsieh Hsu, Juan Chipollini, Benjamin R. Lee, Ken Batai. Renal cell carcinoma health disparities in American Indians/Alaska Natives and Hispanic Americans [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-165.
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Batai K, Harb de la Rosa A, Gachupin F, Imlaer E, Bracamonte ER, Seligmann B, Lee BR. Abstract C059: Clinical and molecular profile of renal cell carcinoma in Hispanic Americans, Native Americans, and European Americans. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp18-c059] [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] Open
Abstract
Abstract
Background: Racial/ethnic minority groups, including Hispanic Americans (HAs) and Native Americans (NAs), have a heavier burden of kidney cancer with a higher incidence and mortality than European Americans (EAs). However, HAs and NAs are under-represented in clinical and molecular genomic studies of renal cell carcinoma (RCC), the most common type of kidney cancer, and clinical and molecular characteristics of RCC among them are also unknown. We investigated variations in clinical and molecular characteristics of RCC patients.
Methods: A total of 284 patients, including 90 HAs (31.6%) and 22 NAs (7.7%), who were diagnosed with RCC and without prior diagnosis of cancer were included to understand the patients' clinical characteristics. A subset of 51 samples were selected to screen for somatic mutations on the VHL gene, and 33 samples were selected for whole-transcriptome sequencing analysis.
Results: Compared to EAs, HA and NA patients were diagnosed with RCC at younger ages (P<0.001). HA had about 5 years younger average age at diagnosis than EAs (55.2 vs. 60.6) and an over 2-fold increased odds of diagnosis before age 60 years (OR 2.50, 95% C.I.: 1.36-4.60). Mean age of diagnosis among NAs was 48.9, and NAs had more than 4-fold higher odds of diagnosis at a younger age (OR 4.12, 95% C.I.: 1.31-12.95). NA patients had higher body mass index than EA patients with 77.3% of NA obese patients. Diabetes was more common in HA (45.6%) and NA (50.0%) patients compared to EA (19.6%) patients. An RCC histologic subtype, clear cell RCC (ccRCC), was more common in HAs and NAs than EAs. Over 90% of HA patients had ccRCC, while only 77.6% of EA patients had ccRCC. HAs had increased odds of diagnosis with ccRCC compared to EAs (OR 2.39, 95% C.I.: 1.01-5.67). Among HAs, older patients were more likely to have advanced-stage RCC diagnosis (OR 7.06, 95% C.I.: 1.46-34.11). HAs who used Spanish as their primary language were more likely to have radical nephrectomy rather than partial nephrectomy (OR 5.13, 95% C.I.: 1.23-21.33). We detected pathogenic somatic mutations on the VHL gene, which is known to cause von Hippel-Lindau syndrome, in 4 patients, and these patients were younger than the patients without these mutations (45.5 vs. 57.1). We were able to assign 32 out of 33 patients into molecular subtypes (ccA and ccB). Molecular subtype could not be assigned to one HA patient with high-grade and advanced-stage ccRCC. Molecular subtype, ccA, was more common in HAs than EAs (64.3% vs. 41.2%), but this difference was not statistically significant. One gene, HABP2, showed evidence of differential expression between HA and EA tumors (PADJ<0.05) and was downregulated in HA tumors with log2 fold change <-2.0.
Conclusion: HA and NA RCC patients had different clinical and molecular characteristics from EA patients.
Impact: As we move toward a precision medicine approach for RCC care, it is necessary to better understand the clinical and molecular characteristics of these underserved HA and NA populations with high kidney cancer burden.
Citation Format: Ken Batai, Alfredo Harb de la Rosa, Francine Gachupin, Elliot Imlaer, Erika R. Bracamonte, Bruce Seligmann, Benjamin R. Lee. Clinical and molecular profile of renal cell carcinoma in Hispanic Americans, Native Americans, and European Americans [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C059.
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Chipollini J, Wright JR, Nwanosike H, Kepler CY, Batai K, Lee BR, Spiess PE, Stewart DB, Lamendella R. Characterization of urinary microbiome in patients with bladder cancer: Results from a single-institution, feasibility study. Urol Oncol 2020; 38:615-621. [PMID: 32414567 DOI: 10.1016/j.urolonc.2020.04.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 03/26/2020] [Accepted: 04/02/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The human microbiome has been linked to the development of several malignancies, but there is scarcity of data on the microbiome of bladder cancer patients. In this study, we analyzed microbial composition and diversity among patients with and without bladder cancer. MATERIAL AND METHODS Samples were collected from 38 urothelial carcinoma (UC) patients and 10 noncancer controls from August 2018 to May 2019. DNA was extracted and processed for 16 S ribosomal RNA sequencing. Alpha diversity community characteristics including evenness and richness as well as beta diversity metrics were obtained. Linear discriminant analysis effect size was used to identify microbial components whose sequences were more abundant. Pairwise statistics provided quantitative assessment of significant distributions among groups. RESULTS Thirty seven total samples contained high quality sequence data for subsequent analyses and divided into 3 cohorts: control (n = 10), muscle-invasive (n = 15) and superficial UC (n = 12). Control samples had significantly higher species evenness when compared to invasive (P = 0.031) and superficial tumors (P = 0.002). In addition, higher species richness was observed in noncancer versus cancer samples (Faith phylogenetic diversity, P < 0.05). Significantly enriched taxa were found in both control (Bacteroides, Lachnoclostridium, Burkholderiaceae) and cancer samples (Bacteroides and Faecalbacterium). CONCLUSION Significantly decreased microbial community diversity was seen in the urine of patients with bladder cancer when compared to a noncancer group. Distinct taxa were noted suggesting unique microbial communities in the urine of bladder cancer patients.
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Affiliation(s)
| | - Justin R Wright
- Department of Biology, Juniata College, Huntingdon, PA; Wright Labs, LLC, Huntingdon, PA
| | - Hephzibah Nwanosike
- Department of Biology, Juniata College, Huntingdon, PA; Wright Labs, LLC, Huntingdon, PA
| | - Carole Y Kepler
- University of Arizona Cancer Center Biospecimen Repository, Tucson, AZ
| | - Ken Batai
- Department of Urology, University of Arizona, Tucson, AZ
| | - Benjamin R Lee
- Department of Urology, University of Arizona, Tucson, AZ
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL
| | - David B Stewart
- Division of Colorectal Surgery, Department of Surgery, University of Arizona, Tucson, AZ
| | - Regina Lamendella
- Department of Biology, Juniata College, Huntingdon, PA; Wright Labs, LLC, Huntingdon, PA
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Zeng J, Lee BR. Editorial Comment on: "Magnetic-Assisted Robotic and Laparoscopic Renal Surgery: Initial Clinical Experience with the Levita Magnetic Surgical System" by Fulla et al. J Endourol 2020; 34:1247. [PMID: 32390470 DOI: 10.1089/end.2020.0423] [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)
- Jiping Zeng
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Benjamin R Lee
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona, USA
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Harb-De la Rosa A, Garcia-Castaneda J, Hsu CH, Zeng J, Batai K, Lee BR, Chipollini J. Perioperative outcomes of open vs. robotic radical cystectomy: a nationwide comparative analysis (2008–2014). Cent European J Urol 2020; 73:427-431. [PMID: 33552567 PMCID: PMC7848836 DOI: 10.5173/ceju.2020.0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Radical cystectomy (RC) is a complex procedure with high perioperative morbidity. In an effort to reduce complications, robotic-assisted RC (RARC) has been adopted as a minimally invasive alternative to the open approach (ORC). Herein, we examine post-operative outcomes of the two surgical approaches in the United States (US) using a large all-payer database. Material and methods Using International Classification of Disease, ninth revision (ICD-9) codes, patient who underwent RC were captured from National Inpatient Sample (2008–2014). ICD-9 diagnosis and procedure codes were used to identify post-operative complications. Trends in the utilization of RARC were analyzed. Logistic and log-linear regression accounting for hospital sample weights and sampling years were performed to analyze outcomes after adjustment of pertinent covariates. Results Of 11,189 patients, 14% underwent RARC. RARC was performed in more teaching hospitals, male patients, those with private insurance, and lower comorbidity score. Performance of RARC steadily increased over the study period (p <0.01). In the last year of the study, 22.8% of cases performed robotically. The weighted average length-of-stay were 10.4 and 8.79 days for ORC and RARC, respectively (p <0.01). In multivariable analyses, RARC was associated with decreased blood transfusion, parenteral nutrition, pneumonia, surgical-site infection, wound and respiratory complications (all, p <0.05). No significant differences were found for in-hospital mortality, cardiac, genitourinary, and vascular complications. Conclusions Performance of RARC has significantly increased in recent years. RARC appears safe and feasible for select patients. Earlier discharge and lower complications were noted for those undergoing RARC across different hospital systems nationwide.
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Affiliation(s)
| | | | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, University of Arizona College of Public Health, Arizona, USA
| | - Jiping Zeng
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Ken Batai
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Benjamin R. Lee
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Juan Chipollini
- Department of Urology, University of Arizona College of Medicine, Tucson, Arizona, USA
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Phung MC, Rouse AR, Pangilinan J, Bell RC, Bracamonte ER, Mashi S, Gmitro AF, Lee BR. Investigation of confocal microscopy for differentiation of renal cell carcinoma versus benign tissue. Can an optical biopsy be performed? Asian J Urol 2019; 7:363-368. [PMID: 32995282 PMCID: PMC7498942 DOI: 10.1016/j.ajur.2019.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/23/2018] [Revised: 02/12/2019] [Accepted: 07/17/2019] [Indexed: 01/20/2023] Open
Abstract
Objective Novel optical imaging modalities are under development with the goal of obtaining an “optical biopsy” to efficiently provide pathologic details. One such modality is confocal microscopy which allows in situ visualization of cells within a layer of tissue and imaging of cellular-level structures. The goal of this study is to validate the ability of confocal microscopy to quickly and accurately differentiate between normal renal tissue and cancer. Methods Specimens were obtained from patients who underwent robotic partial nephrectomy for renal mass. Samples of suspected normal and tumor tissue were extracted from the excised portion of the kidney and stained with acridine orange. The stained samples were imaged on a Nikon E600 C1 Confocal Microscope. The samples were then submitted for hematoxylin and eosin processing and read by an expert pathologist to provide a gold-standard diagnosis that can later be compared to the confocal images. Results This study included 11 patients, 17 tissue samples, and 118 confocal images. Of the 17 tissue samples, 10 had a gold-standard diagnosis of cancer and seven were benign. Of 118 confocal images, 66 had a gold-standard diagnosis of cancer and 52 were benign. Six confocal images were used as a training set to train eight observers. The observers were asked to rate the test images on a six point scale and the results were analyzed using a web based receiver operating characteristic curve calculator. The average accuracy, sensitivity, specificity, and area under the empirical receiver operating characteristic curve for this study were 91%, 98%, 81%, and 0.94 respectively. Conclusion This preliminary study suggest that confocal microscopy can be used to distinguish cancer from normal tissue with high sensitivity and specificity. The observers in this study were trained quickly and on only six images. We expect even higher performance as observers become more familiar with the confocal images.
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Affiliation(s)
- Michael C Phung
- Department of Urology, University of Arizona College of Medicine, Arizona, USA
| | - Andrew R Rouse
- Department of Medical Imaging, University of Arizona College of Medicine, Arizona, USA
| | - Jayce Pangilinan
- Department of Pathology, University of Arizona College of Medicine, Arizona, USA
| | - Robert C Bell
- Department of Pathology, University of Arizona College of Medicine, Arizona, USA
| | - Erika R Bracamonte
- Department of Pathology, University of Arizona College of Medicine, Arizona, USA
| | - Sharfuddeen Mashi
- Ringgold Standard Institution, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Arthur F Gmitro
- Biomedical Engineering, University of Arizona College of Medicine, Arizona, USA
| | - Benjamin R Lee
- Department of Urology, University of Arizona College of Medicine, Arizona, USA
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Chaus FM, Craig M, Bracamonte E, Sundararajan S, Lee BR. Primary Malignant Melanoma of the Bladder Treated by Robotic Partial Cystectomy and Immunotherapy. J Endourol Case Rep 2019; 5:151-153. [PMID: 32775650 DOI: 10.1089/cren.2019.0031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/13/2022] Open
Abstract
Background: Primary malignant melanoma (PMM) of the urinary tract is a rare entity, with only 28 cases reported in the literature. We present an interesting case of a 27-year-old Caucasian woman, with family history of melanoma, who initially presented with gross hematuria, and was subsequently found to have PMM of the bladder. Case Presentation: Initially diagnosis was made through transurethral resection of the bladder tumor with clinical suspicion of residual disease in the patient. Subsequently, she underwent robotic partial cystectomy with pelvic lymph node dissection followed by 1 year of pembrolizumab, a PD-1 checkpoint inhibitor. Subsequent imaging demonstrated no evidence of metastatic disease or local recurrence. Conclusion: This case report presents a unique management of a rare pathological diagnosis with the use of robotic partial cystectomy, and a PD-1 checkpoint inhibitor therapy that ultimately has led to a 2-year recurrence-free survival period for this young patient.
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Affiliation(s)
- Fahad M Chaus
- Division of Urology, University of Arizona College of Medicine Tucson, Tucson, Arizona
| | - Miguel Craig
- Department of Medical Imaging, University of Arizona College of Medicine Tucson, Tucson, Arizona
| | - Erika Bracamonte
- Department of Pathology, University of Arizona College of Medicine, Tucson, Arizona
| | - Srinath Sundararajan
- Division of Hematology-Oncology, University of Arizona College of Medicine, Tucson, Arizona
| | - Benjamin R Lee
- Division of Urology, University of Arizona College of Medicine Tucson, Tucson, Arizona
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Abstract
Historically, the gold standard for management of ureteropelvic junction obstruction (UPJO) has been open pyeloplasty. However, continued technological and surgical advances have ultimately led to the robotic approach. Continued advances in minimally invasive surgery have led to shorter hospital stays and hastened recovery. Here we present our step by step guide and video to robotic-assisted laparoscopic pyeloplasty.
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Affiliation(s)
- Andrew Bergersen
- 1 Division of Urology, University of Arizona College of Medicine , Tucson, Arizona
| | - Raju Thomas
- 2 Department of Urology, Tulane University School of Medicine , New Orleans, Louisiana
| | - Benjamin R Lee
- 1 Division of Urology, University of Arizona College of Medicine , Tucson, Arizona
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Ibáñez I, Acharya K, Juno E, Karounos C, Lee BR, McCollum C, Schaffer-Morrison S, Tourville J. Forest resilience under global environmental change: Do we have the information we need? A systematic review. PLoS One 2019; 14:e0222207. [PMID: 31513607 PMCID: PMC6742408 DOI: 10.1371/journal.pone.0222207] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/23/2019] [Indexed: 12/28/2022] Open
Abstract
The capacity of forests to recover after disturbance, i.e., their resilience, determines their ability to persist and function over time. Many variables, natural and managerial, affect forest resilience. Thus, understanding their effects is critical for the development of sound forest conservation and management strategies, especially in the context of ongoing global environmental changes. We conducted a representative review, meta-analysis, of the forest literature in this topic (search terms “forest AND resilience”). We aimed to identify natural conditions that promote or jeopardize resilience, assess the efficacy of post-disturbance management practices on forest recovery, and evaluate forest resilience under current environmental changes. We surveyed more than 2,500 articles and selected the 156 studies (724 observations) that compared and quantified forest recovery after disturbance under different contexts. Context of recovery included: resource gradients (moisture and fertility), post-disturbance biomass reduction treatments, species richness gradients, incidence of a second disturbance, and disturbance severity. Metrics of recovery varied from individual tree growth and reproduction, to population abundance, to species richness and cover. Analyses show management practices only favored recovery through increased reproduction (seed production) and abundance of recruitment stages. Higher moisture conditions favored recovery, particularly in dry temperate regions; and in boreal forests, this positive effect increased with regional humidity. Biomass reduction treatments were only effective in increasing resilience after a drought. Early recruiting plant stages benefited from increased severity, while disturbance severity was associated with lower recovery of remaining adult trees. This quantitative review provides insight into the natural conditions and management practices under which forest resilience is enhanced and highlights conditions that could jeopardize future resilience. We also identified important knowledge gaps, such as the role of diversity in determining forest resilience and the lack of data in many regions.
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Affiliation(s)
- Inés Ibáñez
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, United States of America
- * E-mail:
| | - Kirk Acharya
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Edith Juno
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Christopher Karounos
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Benjamin R. Lee
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Caleb McCollum
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Samuel Schaffer-Morrison
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jordon Tourville
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, United States of America
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Batai K, Harb-De la Rosa A, Zeng J, Chipollini JJ, Gachupin FC, Lee BR. Racial/ethnic disparities in renal cell carcinoma: Increased risk of early-onset and variation in histologic subtypes. Cancer Med 2019; 8:6780-6788. [PMID: 31509346 PMCID: PMC6826053 DOI: 10.1002/cam4.2552] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 05/13/2019] [Revised: 08/23/2019] [Accepted: 08/28/2019] [Indexed: 12/23/2022] Open
Abstract
Background Racial/ethnic minority groups have a higher burden of renal cell carcinoma (RCC), but RCC among Hispanic Americans (HAs) and American Indians and Alaska Natives (AIs/ANs) are clinically not well characterized. We explored variations in age at diagnosis and frequencies of RCC histologic subtypes across racial/ethnic groups and Hispanic subgroups using National Cancer Database (NCDB) and Arizona Cancer Registry Data. Methods Adult RCC cases with known race/ethnicity were included. Logistic regression analysis was performed to estimate odds and 95% confidence interval (CI) of early‐onset (age at diagnosis <50 years) and diagnosis with clear cell RCC (ccRCC) or papillary RCC. Results A total of 405 073 RCC cases from NCDB and 9751 cases from ACR were identified and included. In both datasets, patients from racial/ethnic minority groups had a younger age at diagnosis than non‐Hispanic White (NHW) patients. In the NCDB, AIs/ANs had twofold increased odds (OR, 2.21; 95% CI, 1.88‐2.59) of early‐onset RCC compared with NHWs. HAs also had twofold increased odds of early‐onset RCC (OR, 2.14; 95% CI, 1.79‐2.55) in the ACR. In NCDB, ccRCC was more prevalent in AIs (86.3%) and Mexican Americans (83.5%) than NHWs (72.5%). AIs/ANs had twofold increased odds of diagnosis with ccRCC (OR, 2.18; 95% CI, 1.85‐2.58) in the NCDB, but the association was stronger in the ACR (OR, 2.83; 95% CI, 2.08‐3.85). Similarly, Mexican Americans had significantly increased odds of diagnosis with ccRCC (OR, 2.00; 95% CI, 1.78‐2.23) in the NCDB. Conclusions This study reports younger age at diagnosis and higher frequencies of ccRCC histologic subtype in AIs/ANs and Hispanic subgroups. These variations across racial/ethnic groups and Hispanic subgroups may have potential clinical implications.
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Affiliation(s)
- Ken Batai
- Department of Urology, University of Arizona, Tucson, Arizona
| | | | - Jiping Zeng
- Department of Urology, University of Arizona, Tucson, Arizona
| | | | - Francine C Gachupin
- Department of Family and Community Medicine, University of Arizona, Tucson, Arizona
| | - Benjamin R Lee
- Department of Urology, University of Arizona, Tucson, Arizona
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Batai K, Imler E, Pangilinan J, Bell R, Lwin A, Price E, Milinic T, Arora A, Ellis NA, Bracamonte E, Seligmann B, Lee BR. Whole-transcriptome sequencing identified gene expression signatures associated with aggressive clear cell renal cell carcinoma. Genes Cancer 2018; 9:247-256. [PMID: 30603059 PMCID: PMC6305109 DOI: 10.18632/genesandcancer.183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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] [Indexed: 01/20/2023] Open
Abstract
Clear cell renal cell carcinoma (ccRCC) is the most prevalent subtype of kidney cancer, yet molecular biomarkers have not been used for the prognosis of ccRCC to aide clinical decision making. This study aimed to identify genes associated with ccRCC aggressiveness and overall survival (OS). Samples of ccRCC tumor tissue were obtained from 33 patients who underwent nephrectomy. Gene expression was determined using whole-transcriptome sequencing. The Cancer Genome Atlas Kidney Renal Clear Cell Carcinoma (TCGA-KIRC) RNA-seq data was used to test association with OS. 290 genes were differentially expressed between tumors with high and low stage, size, grade, and necrosis (SSIGN) score (≥7 vs. ≤3) with PADJ<0.05. Four genes, G6PD, APLP1, GCNT3, and PLPP2, were also over-expressed in advanced stage (III and IV) and high grade (3 and 4) ccRCC and tumor with necrosis (PADJ<0.05). Investigation stratifying by stage found that APLP1 and PLPP2 overexpression were significantly associated with poorer OS in the early stage (Quartile 1 vs. Quartile 4, HR = 3.87, 95% CI:1.25-11.97, P = 0.02 and HR = 4.77, 95% CI:1.37-16.57, P = 0.04 respectively). These genes are potential biomarkers of ccRCC aggressiveness and prognosis that direct clinical and surgical management.
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Affiliation(s)
- Ken Batai
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ, USA
| | | | - Jayce Pangilinan
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ, USA
| | - Robert Bell
- Department of Pathology, University of Arizona, Tucson, AZ, USA
| | - Aye Lwin
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ, USA
| | - Elinora Price
- Department of Surgery, University of Arizona, Tucson, AZ, USA
| | - Tijana Milinic
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ, USA
| | - Amit Arora
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Nathan A Ellis
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ, USA
| | | | | | - Benjamin R Lee
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ, USA
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Abstract
Surgical management of renal cell carcinoma has undergone a transformation in recent decades, especially with the dissemination of the robotic platform. Increasingly, larger and more complex renal lesions are now being treated in a minimally invasive fashion. The purpose of this article is to review advances in the use of the robotic approach for treatment of renal cell carcinoma, including nephron-sparing surgery, radical nephrectomy, and cytoreductive nephrectomy.
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Affiliation(s)
- Michael C Phung
- Division of Urology, Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona, USA
| | - Benjamin R Lee
- Division of Urology, Department of Surgery, University of Arizona College of Medicine, Tucson, Arizona, USA
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Batai K, Harb-De la Rosa A, Lwin A, Chaus F, Gachupin FC, Price E, Lee BR. Racial and Ethnic Disparities in Renal Cell Carcinoma: An Analysis of Clinical Characteristics. Clin Genitourin Cancer 2018; 17:e195-e202. [PMID: 30459061 DOI: 10.1016/j.clgc.2018.10.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [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: 08/24/2018] [Revised: 10/09/2018] [Accepted: 10/21/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Racial/ethnic minority groups, including Hispanic Americans (HAs) and Native Americans (NAs), have a heavier burden of kidney cancer than European Americans (EAs). We investigated variations in clinical characteristics of HA and NA patients with renal cell carcinoma (RCC) who were previously underrepresented. MATERIALS AND METHODS Clinical records of 294 patients with RCC (151 EAs, 95 HAs, 22 NAs, and 26 others) without prior diagnosis of cancer were reviewed. Logistic regression analysis was performed to understand patients' clinical characteristics. RESULTS HAs had about 5 years younger average age at diagnosis than EAs (55.8 vs. 60.5 years) and an almost 3-fold increased odds of diagnosis before age 50 years (odds ratio [OR], 2.77; 95% confidence interval [CI], 1.39-5.54). The mean age of diagnosis among NAs was 49.7 years, and NAs had an over 6-fold higher odds of diagnosis at a younger age (OR, 6.23; 95% CI, 2.00-19.46). Clear-cell RCC (ccRCC) was more common in HAs and NAs than EAs. Over 90% of HA patients had ccRCC, whereas only 78.8% of EA patients had ccRCC. HAs had increased odds of diagnosis with ccRCC compared with EAs (OR, 2.79; 95% CI, 1.15-6.80). Among HAs, older patients and patients who spoke Spanish as their primary language were more likely to have advanced stage RCC at diagnosis (OR, 10.48; 95% CI, 1.69-64.89 and OR, 4.61; 95% CI, 1.38-15.40). CONCLUSION HA and NA patients with RCC had different clinical characteristics than EA patients. It is necessary to better understand the clinical characteristics of these underserved HA and NA populations with high kidney cancer burden.
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Affiliation(s)
- Ken Batai
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ.
| | | | - Aye Lwin
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ
| | - Fahad Chaus
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ
| | - Francine C Gachupin
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ
| | - Elinora Price
- Department of Surgery, University of Arizona, Tucson, AZ
| | - Benjamin R Lee
- Division of Urology, Department of Surgery, University of Arizona, Tucson, AZ
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Wang M, Tulman DB, Sholl AB, Mandava SH, Maddox MM, Lee BR, Brown JQ. Partial nephrectomy margin imaging using structured illumination microscopy. J Biophotonics 2018; 11:10.1002/jbio.201600328. [PMID: 28834287 PMCID: PMC5821599 DOI: 10.1002/jbio.201600328] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 05/19/2017] [Accepted: 08/17/2017] [Indexed: 06/07/2023]
Abstract
Partial nephrectomy (PN) is the recommended procedure over radical nephrectomy (RN) for patients with renal masses less than 4 cm in diameter (Stage T1a). Patients with less than 4 cm renal masses can also be treated with PN, but have a higher risk for positive surgical margins (PSM). PSM, when present, are indicative of poor clinical outcomes. The current gold-standard histopathology method is not well-suited for the identification of PSM intraoperatively due to processing time and destructive nature. Here, video-rate structured illumination microscopy (VR-SIM) was investigated as a potential tool for PSM detection during PN. A clinical image atlas assembled from ex vivo renal biopsies provided diagnostically useful images of benign and malignant kidney, similar to permanent histopathology. VR-SIM was then used to image entire parenchymal margins of tumor resection covering up to >1800× more margin surface area than standard histology. Aided by the image atlas, the study pathologist correctly classified all parenchymal margins as negative for PSM with VR-SIM, compared to standard postoperative pathology. The ability to evaluate large surgical margins in a short time frame with VR-SIM may allow it to be used intraoperatively as a "safety net" for PSM detection, allowing more patients to undergo PN over RN.
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Affiliation(s)
- Mei Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118
| | - David B. Tulman
- Bioinnovation Program, Tulane University, New Orleans, LA 70118
| | - Andrew B. Sholl
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA 70112
| | - Sree H. Mandava
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112
| | - Michael M. Maddox
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112
| | - Benjamin R. Lee
- Division of Urology, University of Arizona College of Medicine, Tucson, AZ 85724
| | - J. Quincy Brown
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118
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Batai K, Bergersen A, Price E, Hynes K, Ellis NA, Lee BR. Clinical and Molecular Characteristics and Burden of Kidney Cancer Among Hispanics and Native Americans: Steps Toward Precision Medicine. Clin Genitourin Cancer 2018; 16:e535-e541. [PMID: 29449090 DOI: 10.1016/j.clgc.2018.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 10/25/2017] [Accepted: 01/16/2018] [Indexed: 01/20/2023]
Abstract
Cancer disparities in Native Americans (NAs) and Hispanic Americans (HAs) vary significantly in terms of cancer incidence and mortality rates across geographic regions. This review reports that kidney and renal pelvis cancers are unevenly affecting HAs and NAs compared to European Americans of non-Hispanic origin, and that currently there is significant need for improved data and reporting to be able to advance toward genomic-based precision medicine for the assessment of such cancers in these medically underserved populations. More specifically, in states along the US-Mexico border, HAs and NAs have higher kidney cancer incidence rates as well as a higher prevalence of kidney cancer risk factors, including obesity and chronic kidney disease. They are also more likely to receive suboptimal care compared to European Americans. Furthermore, they are underrepresented in epidemiologic, clinical, and molecular genomic studies of kidney cancer. Therefore, we maintain that progress in precision medicine for kidney cancer care requires an understanding of various factors among HAs and NAs, including the real kidney cancer burden, variations in clinical care, issues related to access to care, and specific clinical and molecular characteristics.
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Affiliation(s)
- Ken Batai
- Department of Surgery, Division of Urology, University of Arizona, Tucson, AZ.
| | - Andrew Bergersen
- Department of Surgery, Division of Urology, University of Arizona, Tucson, AZ
| | - Elinora Price
- Department of Surgery, Division of Urology, University of Arizona, Tucson, AZ
| | - Kieran Hynes
- Department of Surgery, Division of Urology, University of Arizona, Tucson, AZ
| | - Nathan A Ellis
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ
| | - Benjamin R Lee
- Department of Surgery, Division of Urology, University of Arizona, Tucson, AZ
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Phung MC, Lee BR, Funk JT. Percutaneous Management of a Pyocystic Fistulizing Continent Urinary Diversion. J Endourol Case Rep 2017; 3:162-164. [PMID: 29177193 PMCID: PMC5689115 DOI: 10.1089/cren.2017.0083] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Continent diversions have since been performed with increasing frequency since the 1950s, with some providers espousing the use of orthotopic diversions as being the new gold standard. However, patients must be counseled to take great care in the maintenance of their diversions because of complications such as metabolic abnormalities, pouch stones, and mucus retention. Case Report: A 21-year-old male with a history of posterior urethral valves underwent a continent catheterizable diversion as a child. He is undocumented and without health insurance and as a result unable to follow-up with an urologist for >10 years. He subsequently develops pyocystis with cutaneous fistulization and pouch stones necessitating percutaneous management. Conclusion: Patients may benefit greatly from a continent urinary diversion, however, selection must include patients who are able to maintain their pouch and follow-up with their providers to avoid major complications that may occur up to years following the procedure.
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Affiliation(s)
- Michael C. Phung
- Division of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | - Benjamin R. Lee
- Division of Urology, University of Arizona College of Medicine, Tucson, Arizona
| | - Joel T. Funk
- Division of Urology, University of Arizona College of Medicine, Tucson, Arizona
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Kim HM, Lee BR, Lee ES, Kwon MH, Huh JH, Kwon BE, Park EK, Chang SY, Kweon MN, Kim PH, Ko HJ, Chung CH. iNKT cells prevent obesity-induced hepatic steatosis in mice in a C-C chemokine receptor 7-dependent manner. Int J Obes (Lond) 2017; 42:270-279. [PMID: 28811651 PMCID: PMC5803573 DOI: 10.1038/ijo.2017.200] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 06/19/2017] [Accepted: 07/21/2017] [Indexed: 02/08/2023]
Abstract
Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis are characterized by an increase in hepatic triglyceride content with infiltration of immune cells, which can cause steatohepatitis and hepatic insulin resistance. C-C chemokine receptor 7 (CCR7) is primarily expressed in immune cells, and CCR7 deficiency leads to the development of multi-organ autoimmunity, chronic renal disease and autoimmune diabetes. Here, we investigated the effect of CCR7 on hepatic steatosis in a mouse model and its underlying mechanism. Our results demonstrated that body and liver weights were higher in the CCR7−/− mice than in the wild-type (WT) mice when they were fed a high-fat diet. Further, glucose tolerance and insulin sensitivity were markedly diminished in CCR7−/− mice. The number of invariant natural killer T (iNKT) cells was reduced in the livers of the CCR7−/− mice. Moreover, liver inflammation was detected in obese CCR7−/− mice, which was ameliorated by the adoptive transfer of hepatic mononuclear cells from WT mice, but not through the transfer of hepatic mononuclear cells from CD1d−/− or interleukin-10-deficient (IL-10−/−) mice. Overall, these results suggest that CCR7+ mononuclear cells in the liver could regulate obesity-induced hepatic steatosis via induction of IL-10-expressing iNKT cells.
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Affiliation(s)
- H M Kim
- Department of Global Medical Science, Yonsei University Wonju College of Medicine, Wonju, Korea.,Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - B R Lee
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, Korea
| | - E S Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - M H Kwon
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - J H Huh
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - B-E Kwon
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, Korea
| | - E-K Park
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, Korea
| | - S-Y Chang
- College of Pharmacy, Ajou University, Suwon, Korea
| | - M-N Kweon
- Mucosal Immunology Laboratory, Department of Convergence Medicine, University of Ulsan College of Medicine/Asan Medical Center, Seoul, Korea
| | - P-H Kim
- Department of Molecular Bioscience, School of Biomedical Science, Kangwon National University, Chuncheon, Korea
| | - H-J Ko
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, Korea
| | - C H Chung
- Department of Global Medical Science, Yonsei University Wonju College of Medicine, Wonju, Korea.,Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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Ibáñez I, Katz DSW, Lee BR. The contrasting effects of short-term climate change on the early recruitment of tree species. Oecologia 2017; 184:701-713. [PMID: 28573380 DOI: 10.1007/s00442-017-3889-1] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 05/23/2017] [Indexed: 11/26/2022]
Abstract
Predictions of plant responses to climate change are frequently based on organisms' presence in warmer locations, which are then assumed to reflect future performance in cooler areas. However, as plant life stages may be affected differently by environmental changes, there is little empirical evidence that this approach provides reliable estimates of short-term responses to global warming. Under this premise, we analyzed 8 years of early recruitment data, seed production and seedling establishment and survival, collected for two tree species at two latitudes. We quantified recruitment to a wide range of environmental conditions, temperature, soil moisture and light, and simulated recruitment under two forecasted climatic scenarios. Annual demographic transitions were affected by the particular conditions taking place during their onset, but the effects of similar environmental shifts differed among the recruitment stages; seed production was higher in warmer years, while seedling establishment and survival peaked during cold years. Within a species, these effects also varied between latitudes; increasing temperatures at the southern location will have stronger detrimental effects on recruitment than similar changes at the northern locations. Our simulations illustrate that warmer temperatures may increase seed production, but they will have a negative effect on establishment and survival. When the three early recruitment processes were simultaneously considered, simulations showed little change in recruitment dynamics at the northern site and a slight decrease at the southern site. It is only when we considered these three stages that we were able to assess likely changes in early recruitment under the predicted conditions.
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Affiliation(s)
- Inés Ibáñez
- School of Natural Resources and Environment, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Daniel S W Katz
- School of Natural Resources and Environment, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Benjamin R Lee
- School of Natural Resources and Environment, University of Michigan, Ann Arbor, MI, 48109, USA
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40
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Abshire C, Murad HY, Arora JS, Liu J, Mandava SH, John VT, Khismatullin DB, Lee BR. Focused Ultrasound-Triggered Release of Tyrosine Kinase Inhibitor From Thermosensitive Liposomes for Treatment of Renal Cell Carcinoma. J Pharm Sci 2017; 106:1355-1362. [PMID: 28159640 DOI: 10.1016/j.xphs.2017.01.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 12/16/2016] [Accepted: 01/24/2017] [Indexed: 12/29/2022]
Abstract
This study reports, for the first time, development of tyrosine kinase inhibitor-loaded, thermosensitive liposomes (TKI/TSLs) and their efficacy for treatment of renal cell carcinoma when triggered by focused ultrasound (FUS). Uptake of these nanoparticles into renal cancer cells was visualized with confocal and fluorescent imaging of rhodamine B-loaded liposomes. The combination of TKI/TSLs and FUS was tested in an in vitro tumor model of renal cell carcinoma. According to MTT cytotoxic assay and flow cytometric analysis, the combined treatment led to the least viability (23.4% ± 2.49%, p < 0.001), significantly lower than that observed from treatment with FUS (97.6% ± 0.67%, not significant) or TKI/TSL (71.0% ± 3.65%, p < 0.001) at 96 h compared to control. The importance of this unique, synergistic combination was demonstrated in viability experiments with non-thermosensitive liposomes (TKI/NTSL + FUS: 58.8% ± 1.5% vs. TKI/TSL + FUS: 36.2% ± 1.4%, p < 0.001) and heated water immersion (TKI/TSL + WB43°: 59.3% ± 2.91% vs. TKI/TSL + FUS: 36.4% ± 1.55%, p < 0.001). Our findings coupled with the existing use of FUS in clinical practice make the proposed combination of targeted chemotherapy, nanotechnology, and FUS a promising platform for enhanced drug delivery and cancer treatment.
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Affiliation(s)
- Caleb Abshire
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana 70112
| | - Hakm Y Murad
- Department of Biomedical Engineering, School of Science and Engineering, Tulane University, New Orleans, Louisiana 70118; Tulane Institute for Integrative Engineering for Health and Medicine, Tulane University, New Orleans, Louisiana 70112
| | - Jaspreet S Arora
- Department of Chemical and Bimolecular Engineering, School of Science and Engineering, Tulane University, New Orleans, Louisiana 70118; Vector-Borne Infectious Disease Research Center, Tulane University, New Orleans, Louisiana 70112
| | - James Liu
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana 70112
| | - Sree Harsha Mandava
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana 70112
| | - Vijay T John
- Department of Chemical and Bimolecular Engineering, School of Science and Engineering, Tulane University, New Orleans, Louisiana 70118; Vector-Borne Infectious Disease Research Center, Tulane University, New Orleans, Louisiana 70112
| | - Damir B Khismatullin
- Department of Biomedical Engineering, School of Science and Engineering, Tulane University, New Orleans, Louisiana 70118; Tulane Institute for Integrative Engineering for Health and Medicine, Tulane University, New Orleans, Louisiana 70112; Division of Urology, University of Arizona College of Medicine, Tucson, Arizona 85724
| | - Benjamin R Lee
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana 70112; Division of Urology, University of Arizona College of Medicine, Tucson, Arizona 85724.
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Golan S, Johnson SC, Maurice MJ, Kaouk JH, Lai WR, Lee BR, Kheyfets SV, Sundaram CP, Cahn DB, Uzzo RG, Shalhav AL. Safety and early effectiveness of robot-assisted partial nephrectomy for large angiomyolipomas. BJU Int 2017; 119:755-760. [DOI: 10.1111/bju.13747] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Shay Golan
- Section of Urology; University of Chicago; Chicago IL USA
| | | | - Matthew J. Maurice
- The Glickman Urological & Kidney Institute; Cleveland Clinic; Cleveland OH USA
| | - Jihad H. Kaouk
- The Glickman Urological & Kidney Institute; Cleveland Clinic; Cleveland OH USA
| | - Weil R. Lai
- Department of Urology; Tulane University; New Orleans LA USA
| | - Benjamin R. Lee
- Department of Urology; Tulane University; New Orleans LA USA
| | | | | | - David B. Cahn
- Division of Urologic Oncology and Urology; Fox Chase Cancer Center; Philadelphia PA USA
| | - Robert G. Uzzo
- Division of Urologic Oncology and Urology; Fox Chase Cancer Center; Philadelphia PA USA
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Ettinger AK, Lee BR, Montgomery S. Seed limitation and lack of downed wood, not invasive species, threaten conifer regeneration in an urban forest. Urban Ecosyst 2017. [DOI: 10.1007/s11252-016-0640-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Elfer KN, Sholl AB, Wang M, Tulman DB, Mandava SH, Lee BR, Brown JQ. DRAQ5 and Eosin ('D&E') as an Analog to Hematoxylin and Eosin for Rapid Fluorescence Histology of Fresh Tissues. PLoS One 2016; 11:e0165530. [PMID: 27788264 PMCID: PMC5082869 DOI: 10.1371/journal.pone.0165530] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [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: 04/27/2016] [Accepted: 10/13/2016] [Indexed: 01/17/2023] Open
Abstract
Real-time on-site histopathology review of biopsy tissues at the point-of-procedure has great potential for significant clinical value and improved patient care. For instance, on-site review can aid in rapid screening of diagnostic biopsies to reduce false-negative results, or in quantitative assessment of biospecimen quality to increase the efficacy of downstream laboratory and histopathology analysis. However, the only currently available rapid pathology method, frozen section analysis (FSA), is too time- and labor-intensive for use in screening large quantities of biopsy tissues and is too destructive for maximum tissue conservation in multiple small needle core biopsies. In this work we demonstrate the spectrally-compatible combination of the nuclear stain DRAQ5 and the anionic counterstain eosin as a dual-component fluorescent staining analog to hematoxylin and eosin intended for use on fresh, unsectioned tissues. Combined with optical sectioning fluorescence microscopy and pseudo-coloring algorithms, DRAQ5 and eosin (“D&E”) enables very fast, non-destructive psuedohistological imaging of tissues at the point-of-acquisition with minimal tissue handling and processing. D&E was validated against H&E on a one-to-one basis on formalin-fixed paraffin-embedded and frozen section tissues of various human organs using standard epi-fluorescence microscopy, demonstrating high fidelity of the staining mechanism as an H&E analog. The method was then applied to fresh, whole 18G renal needle core biopsies and large needle core prostate biospecimen biopsies using fluorescence structured illumination optical sectioning microscopy. We demonstrate the ability to obtain high-resolution histology-like images of unsectioned, fresh tissues similar to subsequent H&E staining of the tissue. The application of D&E does not interfere with subsequent standard-of-care H&E staining and imaging, preserving the integrity of the tissue for thorough downstream analysis. These results indicate that this dual-stain pseudocoloring method could provide a real-time histology-like image at the time of acquisition and valuable objective tissue analysis for the clinician at the time of service.
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Affiliation(s)
- Katherine N. Elfer
- Dept. of Biomedical Engineering, Tulane University, New Orleans, Louisiana, United States of America
| | - Andrew B. Sholl
- Dept. of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Mei Wang
- Dept. of Biomedical Engineering, Tulane University, New Orleans, Louisiana, United States of America
| | - David B. Tulman
- Dept. of Biomedical Engineering, Tulane University, New Orleans, Louisiana, United States of America
| | - Sree H. Mandava
- Dept. of Urology, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - Benjamin R. Lee
- Dept. of Urology, Tulane University School of Medicine, New Orleans, Louisiana, United States of America
| | - J. Quincy Brown
- Dept. of Biomedical Engineering, Tulane University, New Orleans, Louisiana, United States of America
- * E-mail:
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Liu J, Abshire C, Carry C, Sholl AB, Mandava SH, Datta A, Ranjan M, Callaghan C, Peralta DV, Williams KS, Lai WR, Abdel-Mageed AB, Tarr M, Lee BR. Nanotechnology combined therapy: tyrosine kinase-bound gold nanorod and laser thermal ablation produce a synergistic higher treatment response of renal cell carcinoma in a murine model. BJU Int 2016; 119:342-348. [PMID: 27431021 DOI: 10.1111/bju.13590] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 01/17/2023]
Abstract
OBJECTIVE To investigate tyrosine kinase inhibitors (TKI) and gold nanorods (AuNRs) paired with photothermal ablation in a human metastatic clear cell renal cell carcinoma (RCC) mouse model. Nanoparticles have been successful as a platform for targeted drug delivery in the treatment of urological cancers. Likewise, the use of nanoparticles in photothermal tumour ablation, although early in its development, has provided promising results. Our previous in vitro studies of nanoparticles loaded with both TKI and AuNRs and activated with photothermal ablation have shown significant synergistic cell kill greater than each individual arm alone. This study is a translation of our initial findings to an in vivo model. MATERIALS AND METHODS Immunologically naïve nude mice (athymic nude-Foxn1nu ) were injected subcutaneously bilaterally in both flanks (n = 36) with 2.5 × 106 cells of a human metastatic renal cell carcinoma cell line (RCC 786-O). Subcutaneous xenograft tumours developed into 1-cm palpable nodules. AuNRs encapsulated in human serum albumin protein (HSA) nanoparticles were synthesised with or without a TKI and injected directly into the tumour nodule. Irradiation was administered with an 808-nm light-emitting diode laser for 6 min. Mice were humanely killed 14 days after irradiation; tumours were excised, formalin fixed, paraffin embedded, and evaluated for size and the percentage of necrosis by a genitourinary pathologist. The untreated contralateral flank tumours were used as controls. RESULTS In mice that did not receive irradiation, TKI alone yielded 4.2% tumour necrosis on the injected side and administration of HSA-AuNR-TKI alone yielded 11.1% necrosis. In the laser-ablation models, laser ablation alone yielded 62% necrosis and when paired with HSA-AuNR there was 63.4% necrosis. The combination of laser irradiation and HSA-AuNR-TKI had cell kill rate of 100%. CONCLUSIONS In the absence of laser irradiation, TKI treatment alone or when delivered via nanoparticles produced moderate necrosis. Irradiation with and without gold particles alone also improves tumour necrosis. However, when irradiation is paired with gold particles and drug-loaded nanoparticles, the combined therapy showed the most significant and synergistic complete tumour necrosis of 100% (P < 0.05). This study illustrates the potential of combination nanotechnology as a new approach in the treatment of urological cancers.
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Affiliation(s)
- James Liu
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Caleb Abshire
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Connor Carry
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Andrew B Sholl
- Department of Pathology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Sree Harsha Mandava
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Amrita Datta
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Manish Ranjan
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Cameron Callaghan
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Donna V Peralta
- Department of Chemistry, University of New Orleans, New Orleans, LA, USA
| | - Kristen S Williams
- Department of Chemistry, University of New Orleans, New Orleans, LA, USA
| | - Weil R Lai
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Asim B Abdel-Mageed
- Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA
| | - Matthew Tarr
- Department of Chemistry, University of New Orleans, New Orleans, LA, USA
| | - Benjamin R Lee
- Division of Urology, University of Arizona College of Medicine, Tucson, AZ, USA
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Viriyasiripong S, Lopez A, Mandava SH, Lai WR, Mitchell GC, Boonjindasup A, Powers MK, Silberstein JL, Lee BR. Accelerometer Measurement of Head Movement During Laparoscopic Surgery as a Tool to Evaluate Skill Development of Surgeons. J Surg Educ 2016; 73:589-594. [PMID: 26923103 DOI: 10.1016/j.jsurg.2016.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/14/2016] [Accepted: 01/16/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To detect and measure surgeons' head movement during laparoscopic simulator performance to determine whether expert surgeons have economy of motion in their head movement, including change of direction, compared with intermediate and novice surgeons. We investigated head movement as an objective tool for assessment of laparoscopic surgical skill and its potential use for assessing novice surgeons' progress on the learning curve. DESIGN After obtaining institutional review board approval, medical students, urology residents, and attending staff surgeons from an academic institution were recruited. Participants were grouped by level of experience and performed tasks on the Electronic Data Generation for Evaluation laparoscopic simulator. Surgeons wore a commercially available wireless electroencephalogram monitor as a flexible, adjustable, and lightweight headband with 7 sensors-2 forehead sensors, 2 ear sensors, and 3 reference sensors. The headband incorporates a 3-axis accelerometer enabling head movement quantification. A variance analysis was used to compare the average head movement acceleration data between each group. SETTING Tulane University Medical Center, New Orleans, LA, an academic medical center and the principal teaching hospital for Tulane University School of Medicine. PARTICIPANTS A total of following 19 participants were recruited for the study and stratified by surgical experience into novice (n = 6), intermediate (n = 9), and expert (n = 4) laparoscopy groups: 6 medical students, 9 urology residents (postgraduate years 1 to5), and 4 attending urologists, respectively. RESULTS Analysis of the average acceleration rate of head movement showed statistically significant differences among groups on both the vertical axis (p = 0.006) and horizontal axis (p = 0.018) in the laparoscopic suturing task. This demonstrated the ability to distinguish between experts and novice laparoscopic surgeons. The average acceleration among groups did not demonstrate statistical significance on the vertical axis (p = 0.078) and horizontal axis (p = 0.077) in the peg transfer task. This may be in response to the ease of the task. The analysis of the forward-backward axis or depth perception also showed no significant differences between groups. CONCLUSION Accelerometer-based motion analysis of head movement appears to be a useful tool to evaluate laparoscopic skill development of surgeons in terms of their economy of motion, and it could potentially be used for ergonomic assessment of training in the future, and progression on the learning curve.
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Affiliation(s)
| | - Asis Lopez
- Interdisciplinary PhD Program, Tulane University, New Orleans, Louisiana
| | - Sree Harsha Mandava
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Weil R Lai
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Gregory C Mitchell
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Aaron Boonjindasup
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana
| | - Mary K Powers
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana
| | | | - Benjamin R Lee
- Division of Urology, University of Arizona, Tucson, Arizona.
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Lee WJ, Lee JH, Lee BR. Fundus autofluorescence imaging patterns in central serous chorioretinopathy according to chronicity. Eye (Lond) 2016; 30:1336-1342. [PMID: 27285318 DOI: 10.1038/eye.2016.113] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 04/14/2016] [Indexed: 01/29/2023] Open
Abstract
PurposeTo investigate the time-period characteristics associated with morphologic changes in central serous chorioretinopathy (CSC) using fundus autofluorescence (FAF).Patients and methodsRetrospective, cross-sectional observational case series. Patients were classified into three groups: acute and chronic according to the onset of subjective symptoms of 6 weeks and sequelae patients who have history and symptoms but no serous retinal detachment (SRD). We compared FAF images to obtain characteristic findings according to the chronicity.ResultsA total of 52 eyes were included in this study. Acute CSC eyes were characterized by decreased FAF intensity at the leakage point in 13/22 eyes (56.5%) and staining patterns with various levels of fluorescence signal (hyperautofluorescent (10 eyes, 43.5%), hypoautofluorescent (1 eye, 4.3%), and minimal changes (12 eyes, 52.2%)) in the area of SRD. In chronic CSC eyes, hyperautofluorescent (14 eyes, 63.6%) or minimal changes (8 eyes, 36.4%) were observed in the area of SRD. Discrete dots with increased FAF intensity were observed in chronic CSC eyes (P<0.001). Eyes with sequelae of CSC had mixed FAF patterns over areas of retinal pigment epithelium (RPE) atrophy in seven eyes (100%, P<0.001)) and descending tracts which showed various FAF intensities according to the RPE and photoreceptor status (P<0.001).ConclusionFAF imaging patterns in CSC eyes differ according to the course of the disease, reflecting RPE and outer retinal changes. Detailed investigation using FAF could help to estimate the duration of CSC and determine the proper treatment modality.
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Affiliation(s)
- W J Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - J-H Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
| | - B R Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea
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Wang M, Tulman DB, Sholl AB, Kimbrell HZ, Mandava SH, Elfer KN, Luethy S, Maddox MM, Lai W, Lee BR, Brown JQ. Gigapixel surface imaging of radical prostatectomy specimens for comprehensive detection of cancer-positive surgical margins using structured illumination microscopy. Sci Rep 2016; 6:27419. [PMID: 27257084 PMCID: PMC4891779 DOI: 10.1038/srep27419] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [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: 03/11/2016] [Accepted: 05/18/2016] [Indexed: 01/07/2023] Open
Abstract
Achieving cancer-free surgical margins in oncologic surgery is critical to reduce the need for additional adjuvant treatments and minimize tumor recurrence; however, there is a delicate balance between completeness of tumor removal and preservation of adjacent tissues critical for normal post-operative function. We sought to establish the feasibility of video-rate structured illumination microscopy (VR-SIM) of the intact removed tumor surface as a practical and non-destructive alternative to intra-operative frozen section pathology, using prostate cancer as an initial target. We present the first images of the intact human prostate surface obtained with pathologically-relevant contrast and subcellular detail, obtained in 24 radical prostatectomy specimens immediately after excision. We demonstrate that it is feasible to routinely image the full prostate circumference, generating gigapixel panorama images of the surface that are readily interpreted by pathologists. VR-SIM confirmed detection of positive surgical margins in 3 out of 4 prostates with pathology-confirmed adenocarcinoma at the circumferential surgical margin, and furthermore detected extensive residual cancer at the circumferential margin in a case post-operatively classified by histopathology as having negative surgical margins. Our results suggest that the increased surface coverage of VR-SIM could also provide added value for detection and characterization of positive surgical margins over traditional histopathology.
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Affiliation(s)
- Mei Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118, USA
| | - David B Tulman
- Bioinnovation Program, Tulane University, New Orleans, LA 70118, USA
| | - Andrew B Sholl
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Hillary Z Kimbrell
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Sree H Mandava
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Katherine N Elfer
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118, USA
| | - Samuel Luethy
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118, USA
| | - Michael M Maddox
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Weil Lai
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Benjamin R Lee
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - J Quincy Brown
- Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118, USA
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Upadhaya SD, Lee BR, Park JW, Kim IH. Effects of Supplementation of Ionized or Chelated Water-Soluble Mineral Mixture on the Live Performance, Nutrient Digestibility, Blood Profile, Egg Quality, and Excreta Microbiota of Laying Hens. Rev Bras Cienc Avic 2016. [DOI: 10.1590/1806-9061-2015-0023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - BR Lee
- Dankook University, Brazil
| | | | - IH Kim
- Dankook University, Brazil
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Ellimoottil C, Skolarus T, Gettman M, Boxer R, Kutikov A, Lee BR, Shelton J, Morgan T. Telemedicine in Urology: State of the Art. Urology 2016; 94:10-6. [PMID: 27109596 DOI: 10.1016/j.urology.2016.02.061] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/11/2016] [Accepted: 02/02/2016] [Indexed: 11/26/2022]
Abstract
Whereas telemedicine is recognized as one of the fastest-growing components of the healthcare system, the status of telemedicine use in urology is largely unknown. In this narrative review, we detail studies that investigate the use of televisits and teleconsultations for urologic conditions. Moreover, we discuss current regulatory and reimbursement policies. Finally, we discuss the significant barriers to widespread dissemination and implementation of telemedicine and reasons why the field of urology may be positioned to become a leader in the provision of telemedicine services.
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Affiliation(s)
- Chandy Ellimoottil
- Department of Urology, University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI.
| | - Ted Skolarus
- Department of Urology, University of Michigan, Ann Arbor, MI; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
| | - Matthew Gettman
- Department of Urology, Mayo Clinic College of Medicine, Rochester, MN
| | - Richard Boxer
- Department of Urology, University of California, Los Angeles, CA
| | - Alexander Kutikov
- Division of Urologic Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, PA
| | - Benjamin R Lee
- Department of Urology, University of Arizona, Tucson, AZ
| | - Jeremy Shelton
- Department of Urology, University of California, Los Angeles, CA; Veterans Affairs Greater Los Angeles, Los Angeles, CA
| | - Todd Morgan
- Department of Urology, University of Michigan, Ann Arbor, MI
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Callaghan C, Peralta D, Liu J, Mandava SH, Maddox M, Dash S, Tarr MA, Lee BR. Combined Treatment of Tyrosine Kinase Inhibitor–Labeled Gold Nanorod Encapsulated Albumin With Laser Thermal Ablation in a Renal Cell Carcinoma Model. J Pharm Sci 2016; 105:284-92. [DOI: 10.1016/j.xphs.2015.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/27/2015] [Accepted: 11/06/2015] [Indexed: 12/14/2022]
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