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Chung C, Choi S, Bae J, Jeong H, Lee J, Lee H. Developing and Validating a Korean Version of the Assessment of Children's Emotional Skills. Child Psychiatry Hum Dev 2024; 55:819-830. [PMID: 36229629 PMCID: PMC11061020 DOI: 10.1007/s10578-022-01452-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2022] [Indexed: 11/24/2022]
Abstract
In this study, a Korean Assessment of Children's Emotional Skills (ACES) was developed by modifying the original ACES which was initially introduced in the United States. Specifically, the original ACES was translated into Korean and revised to better fit the Korean cultural context. The content validity of the revised Korean ACES was established via expert reviews. To test its reliability, the revised Korean ACES was conducted on 286 six-year-old children. A confirmatory factor analysis indicated that our newly developed Korean ACES can be used as an appropriate tool to measure Korean children's emotional skills. The Korean ACES can stimulate further studies on these emotional skills and contribute to various international collaborative studies that seek to compare the emotional skills of children from diverse cultural backgrounds.
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Affiliation(s)
- C Chung
- School of Child Studies, Kyungpook National University, Daegu, South Korea
| | - S Choi
- Department of English Education, Kyungpook National University, Daegu, South Korea
| | - J Bae
- Department of English Education, Kyungpook National University, Daegu, South Korea
| | - H Jeong
- Department of Early Childhood Education, Keimyung College University, Daegu, South Korea
| | - J Lee
- School of Child Studies, Kyungpook National University, Daegu, South Korea
| | - H Lee
- Department of Home Economics Education, Kyungpook National University, Daegu, South Korea.
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2
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Diestro JDB, Adeeb N, Musmar B, Salim H, Aslan A, Cancelliere NM, McLellan RM, Algin O, Ghozy S, Lay SV, Guenego A, Renieri L, Carnevale J, Saliou G, Mastorakos P, El Naamani K, Shotar E, Premat K, Möhlenbruch M, Kral M, Bernstock JD, Doron O, Chung C, Salem MM, Lylyk I, Foreman PM, Vachhani JA, Shaikh H, Župančić V, Hafeez MU, Catapano J, Waqas M, Ibrahim MK, Mohammed MA, Imamoglu C, Bayrak A, Rabinov JD, Ren Y, Schirmer CM, Piano M, Kühn AL, Michelozzi C, Elens S, Starke RM, Hassan AE, Ogilvie M, Nguyen A, Jones J, Brinjikji W, Nawka MT, Psychogios M, Ulfert C, Pukenas B, Burkhardt JK, Huynh T, Martinez-Gutierrez JC, Essibayi MA, Sheth SA, Spiegel G, Tawk RG, Lubicz B, Panni P, Puri AS, Pero G, Nossek E, Raz E, Killer-Oberpfalzer M, Griessenauer CJ, Asadi H, Siddiqui A, Brook AL, Altschul D, Spears J, Marotta TR, Ducruet AF, Albuquerque FC, Regenhardt RW, Stapleton CJ, Kan P, Kalousek V, Lylyk P, Boddu S, Knopman J, Aziz-Sultan MA, Tjoumakaris SI, Jabbour PM, Clarençon F, Limbucci N, Cuellar-Saenz HH, Mendes Pereira V, Patel AB, Dmytriw AA. Association of preprocedural antiplatelet use with decreased thromboembolic complications for intracranial aneurysms undergoing intrasaccular flow disruption. J Neurosurg 2024:1-8. [PMID: 38701528 DOI: 10.3171/2024.2.jns232918] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/23/2024] [Indexed: 05/05/2024]
Abstract
OBJECTIVE This study was conducted to investigate the impact of antiplatelet administration in the periprocedural period on the occurrence of thromboembolic complications (TECs) in patients undergoing treatment using the Woven EndoBridge (WEB) device for intracranial wide-necked bifurcation aneurysms. The primary objective was to assess whether the use of antiplatelets in the pre- and postprocedural phases reduces the likelihood of developing TECs, considering various covariates. METHODS A retrospective multicenter observational study was conducted within the WorldWideWEB Consortium and comprised 38 academic centers with endovascular treatment capabilities. Univariable and multivariable logistic regression analyses were performed to determine the association between antiplatelet use and TECs, adjusting for covariates. Missing predictor data were addressed using multiple imputation. RESULTS The study comprised two cohorts: one addressing general thromboembolic events and consisting of 1412 patients, among whom 103 experienced TECs, and another focusing on symptomatic thromboembolic events and comprising 1395 patients, of whom 50 experienced symptomatic TECs. Preprocedural antiplatelet use was associated with a reduced likelihood of overall TECs (OR 0.32, 95% CI 0.19-0.53, p < 0.001) and symptomatic TECs (OR 0.49, 95% CI 0.25-0.95, p = 0.036), whereas postprocedural antiplatelet use showed no significant association with TECs. The study also revealed additional predictors of TECs, including stent use (overall: OR 4.96, 95% CI 2.38-10.3, p < 0.001; symptomatic: OR 3.24, 95% CI 1.26-8.36, p = 0.015), WEB single-layer sphere (SLS) type (overall: OR 0.18, 95% CI 0.04-0.74, p = 0.017), and posterior circulation aneurysm location (symptomatic: OR 18.43, 95% CI 1.48-230, p = 0.024). CONCLUSIONS The findings of this study suggest that the preprocedural administration of antiplatelets is associated with a reduced likelihood of TECs in patients undergoing treatment with the WEB device for wide-necked bifurcation aneurysms. However, postprocedural antiplatelet use did not show a significant impact on TEC occurrence.
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Affiliation(s)
- Jose Danilo Bengzon Diestro
- 1Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Nimer Adeeb
- 2Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana
| | - Basel Musmar
- 2Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana
| | - Hamza Salim
- 2Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana
| | - Assala Aslan
- 2Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana
| | - Nicole M Cancelliere
- 1Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Rachel M McLellan
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Oktay Algin
- 4Ankara University, Medical Faculty, Department of Radiology, Ankara, Turkey
| | | | - Sovann V Lay
- 6Service de Neuroradiologie Diagnostique et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France
| | - Adrien Guenego
- 7Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Bruxelles, Belgique
| | - Leonardo Renieri
- 8Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy
| | - Joseph Carnevale
- 9Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York
| | - Guillaume Saliou
- 10Service de radiodiagnostic et radiologie interventionnelle, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Panagiotis Mastorakos
- 11Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kareem El Naamani
- 11Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Eimad Shotar
- 12Département de Neuroradiologie, Hôpital Pitié-Salpêtrière, Université Sorbonne, Paris, France
| | - Kevin Premat
- 12Département de Neuroradiologie, Hôpital Pitié-Salpêtrière, Université Sorbonne, Paris, France
| | - Markus Möhlenbruch
- 13Sektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Germany
| | - Michael Kral
- 14Department of Neurosurgery, Christian Doppler University Hospital and Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Joshua D Bernstock
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Omer Doron
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Charlotte Chung
- Departments of15Radiology and
- 39Neurosurgery, NYU Langone Health Center, New York, New York
| | - Mohamed M Salem
- 16Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Ivan Lylyk
- 17Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Paul M Foreman
- 18Department of Neurosurgery, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida
| | - Jay A Vachhani
- 18Department of Neurosurgery, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida
| | - Hamza Shaikh
- Departments of19Radiology and
- 40Neurosurgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, New Jersey
| | - Vedran Župančić
- 20Department of Radiology, Subdivision of Interventional Neuroradiology, Clinical Hospital Center Sisters of Mercy, Zagreb, Croatia
| | - Muhammad U Hafeez
- 21Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, Texas
| | - Joshua Catapano
- 22Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
| | - Muhammad Waqas
- 23Department of Neurosurgery, State University of New York at Buffalo, New York
| | - Mohamed K Ibrahim
- Departments of5Radiology and
- 38Neurosurgery, Mayo Clinic, Rochester, Minnesota
| | - Marwa A Mohammed
- Departments of5Radiology and
- 38Neurosurgery, Mayo Clinic, Rochester, Minnesota
| | - Cetin Imamoglu
- 37Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey
| | - Ahmet Bayrak
- 37Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey
| | - James D Rabinov
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Yifan Ren
- 24Department of Radiology, Interventional Radiology and Neurointerventional Services, Austin Health, Melbourne, Victoria, Australia
| | - Clemens M Schirmer
- Departments of25Neurosurgery and
- 41Radiology, Geisinger Hospital, Danville, Pennsylvania
| | - Mariangela Piano
- 26Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milano, Italy
| | - Anna L Kühn
- 27Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, Massachusetts
| | | | - Stéphanie Elens
- 8Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy
| | | | - Ameer E Hassan
- 30Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, Texas
| | - Mark Ogilvie
- Departments of31Neurosurgery and
- 42Radiology, University of Alabama at Birmingham, Alabama
| | - Anh Nguyen
- 32Department of Neuroradiology, University Hospital of Basel, Switzerland
| | - Jesse Jones
- Departments of31Neurosurgery and
- 42Radiology, University of Alabama at Birmingham, Alabama
| | - Waleed Brinjikji
- Departments of5Radiology and
- 38Neurosurgery, Mayo Clinic, Rochester, Minnesota
| | - Marie T Nawka
- 33Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marios Psychogios
- 32Department of Neuroradiology, University Hospital of Basel, Switzerland
| | - Christian Ulfert
- 13Sektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Germany
| | - Bryan Pukenas
- 16Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Jan-Karl Burkhardt
- 16Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania
| | - Thien Huynh
- Departments of34Radiology and
- 43Neurosurgery, Mayo Clinic, Jacksonville, Florida
| | | | - Muhammed Amir Essibayi
- 36Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; and
| | - Sunil A Sheth
- Departments of35Radiology
- 44Neurology, and
- 45Neurosurgery, University of Texas Health Science Center at Houston, Texas
| | - Gary Spiegel
- Departments of35Radiology
- 44Neurology, and
- 45Neurosurgery, University of Texas Health Science Center at Houston, Texas
| | - Rabih G Tawk
- Departments of34Radiology and
- 43Neurosurgery, Mayo Clinic, Jacksonville, Florida
| | - Boris Lubicz
- 8Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy
| | - Pietro Panni
- 28Interventistica Neurovascolare, Ospedale San Raffaele, Milano, Italy
| | - Ajit S Puri
- 27Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, Massachusetts
| | - Guglielmo Pero
- 26Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milano, Italy
| | - Erez Nossek
- Departments of15Radiology and
- 39Neurosurgery, NYU Langone Health Center, New York, New York
| | - Eytan Raz
- Departments of15Radiology and
- 39Neurosurgery, NYU Langone Health Center, New York, New York
| | - Monika Killer-Oberpfalzer
- 14Department of Neurosurgery, Christian Doppler University Hospital and Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Christoph J Griessenauer
- 14Department of Neurosurgery, Christian Doppler University Hospital and Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Hamed Asadi
- Departments of15Radiology and
- 39Neurosurgery, NYU Langone Health Center, New York, New York
| | - Adnan Siddiqui
- 23Department of Neurosurgery, State University of New York at Buffalo, New York
| | - Allan L Brook
- 36Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; and
| | - David Altschul
- 36Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York; and
| | - Julian Spears
- 1Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Thomas R Marotta
- 1Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Andrew F Ducruet
- 22Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona
| | | | - Robert W Regenhardt
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Christopher J Stapleton
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Peter Kan
- 21Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, Texas
| | - Vladimir Kalousek
- 20Department of Radiology, Subdivision of Interventional Neuroradiology, Clinical Hospital Center Sisters of Mercy, Zagreb, Croatia
| | - Pedro Lylyk
- 17Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Srikanth Boddu
- 10Service de radiodiagnostic et radiologie interventionnelle, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jared Knopman
- 9Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York
| | - Mohammad A Aziz-Sultan
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | | | - Pascal M Jabbour
- 11Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Frédéric Clarençon
- 12Département de Neuroradiologie, Hôpital Pitié-Salpêtrière, Université Sorbonne, Paris, France
| | - Nicola Limbucci
- 9Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York
| | - Hugo H Cuellar-Saenz
- 1Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Vitor Mendes Pereira
- 1Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Aman B Patel
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
| | - Adam A Dmytriw
- 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts
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Tang ASP, Tan C, Lim WH, Ng CH, Tan DJH, Zeng R, Xiao J, Ong EYH, Cho E, Chung C, Lim WS, Chee D, Nah B, Tseng M, Syn N, Bonney G, Liu K, Huang DQ, Muthiah M, Siddiqui MS, Tan EXX. Impact of Pretransplant Diabetes on Outcomes After Liver Transplantation: An Updated Meta-analysis With Systematic Review. Transplantation 2024; 108:1157-1165. [PMID: 37899382 DOI: 10.1097/tp.0000000000004840] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Preliver transplant diabetes mellitus (pre-LT DM) is a common comorbidity in LT recipients associated with poorer post-transplant survival. However, its relationship with other important outcomes, including cardiovascular and renal outcomes, remains unclear. This meta-analysis aims to provide an updated analysis of the impact of pre-LT DM on key post-LT outcomes. METHODS A search was conducted in Medline and Embase databases for articles comparing the post-transplant outcomes between patients with and without pre-LT DM. Pairwise analysis using random effects with hazard ratios (HRs) was used to assess the longitudinal post-LT impacts of pre-LT DM. In the absence of HR, pooled odds ratios analysis was conducted for secondary outcomes. RESULTS Forty-two studies involving 77,615 LT recipients were included in this analysis. The pooled prevalence of pre-LT DM amongst LT recipients was 24.79%. Pre-LT DM was associated with significantly lower overall survival (HR, 0.65; 95% confidence interval, 0.52-0.81; P <0.01) and significantly increased cardiovascular disease-related mortality (HR, 1.78; 95% confidence interval, 1.11-2.85; P =0.03). Meta-regression of other patient characteristics identified Asian ethnicity and hypertension to be significant predictors of worse overall survival, whereas African-American ethnicity was associated with significantly improved overall survival in patients with pre-LT DM. Further analysis of secondary outcomes revealed pre-LT DM to be a significant predictor of post-LT cardiovascular events and end-stage renal disease. CONCLUSIONS The present study illustrates the impact of pre-LT DM on post-LT survival, and cardiovascular and renal outcomes and provides a sound basis for revision of preoperative management of pre-LT DM.
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Affiliation(s)
- Ansel Shao Pin Tang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Caitlyn Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Darren Jun Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Rebecca Zeng
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jieling Xiao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elden Yen Hng Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elina Cho
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Charlotte Chung
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wei Shyann Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Douglas Chee
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Benjamin Nah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Michael Tseng
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Nicholas Syn
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Glenn Bonney
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
| | - Ken Liu
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Daniel Q Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
| | - Mark Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Eunice X X Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore, Singapore
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4
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Parker CC, Petersen PM, Cook AD, Clarke NW, Catton C, Cross WR, Kynaston H, Parulekar WR, Persad RA, Saad F, Bower L, Durkan GC, Logue J, Maniatis C, Noor D, Payne H, Anderson J, Bahl AK, Bashir F, Bottomley DM, Brasso K, Capaldi L, Cooke PW, Chung C, Donohue J, Eddy B, Heath CM, Henderson A, Henry A, Jaganathan R, Jakobsen H, James ND, Joseph J, Lees K, Lester J, Lindberg H, Makar A, Morris SL, Oommen N, Ostler P, Owen L, Patel P, Pope A, Popert R, Raman R, Ramani V, Røder A, Sayers I, Simms M, Srinivasan V, Sundaram S, Tarver KL, Tran A, Wells P, Wilson J, Zarkar AM, Parmar MKM, Sydes MR. Timing of Radiotherapy (RT) After Radical Prostatectomy (RP): Long-term outcomes in the RADICALS-RT trial [NCT00541047]. Ann Oncol 2024:S0923-7534(24)00105-4. [PMID: 38583574 DOI: 10.1016/j.annonc.2024.03.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024] Open
Abstract
BACKGROUND The optimal timing of radiotherapy (RT) after radical prostatectomy for prostate cancer has been uncertain. RADICALS-RT compared efficacy and safety of adjuvant RT versus an observation policy with salvage RT for PSA failure. METHODS RADICALS-RT was a randomised controlled trial enrolling patients with ≥1 risk factor (pT3/4, Gleason 7-10, positive margins, pre-op PSA≥10ng/ml) for recurrence after radical prostatectomy. Patients were randomised 1:1 to adjuvant RT ("Adjuvant-RT") or an observation policy with salvage RT for PSA failure ("Salvage-RT") defined as PSA≥0.1ng/ml or 3 consecutive rises. Stratification factors were Gleason score, margin status, planned RT schedule (52.5Gy/20 fractions or 66Gy/33 fractions) and treatment centre. The primary outcome measure was freedom-from-distant metastasis, designed with 80% power to detect an improvement from 90% with Salvage-RT (control) to 95% at 10yr with Adjuvant-RT. Secondary outcome measures were bPFS, freedom-from-non-protocol hormone therapy, safety and patient-reported outcomes. Standard survival analysis methods were used; HR<1 favours Adjuvant-RT. FINDINGS Between Oct-2007 and Dec-2016, 1396 participants from UK, Denmark, Canada and Ireland were randomised: 699 Salvage-RT, 697 Adjuvant-RT. Allocated groups were balanced with median age 65yr. 93% (649/697) Adjuvant-RT reported RT within 6m after randomisation; 39% (270/699) Salvage-RT reported RT during follow-up. Median follow-up was 7.8 years. With 80 distant metastasis events, 10yr FFDM was 93% for Adjuvant-RT and 90% for Salvage-RT: HR=0.68 (95%CI 0·43-1·07, p=0·095). Of 109 deaths, 17 were due to prostate cancer. Overall survival was not improved (HR=0.980, 95%CI 0.667-1.440, p=0.917). Adjuvant-RT reported worse urinary and faecal incontinence one year after randomisation (p=0.001); faecal incontinence remained significant after ten years (p=0.017). INTERPRETATION Long-term results from RADICALS-RT confirm adjuvant RT after radical prostatectomy increases the risk of urinary and bowel morbidity, but does not meaningfully improve disease control. An observation policy with salvage RT for PSA failure should be the current standard after radical prostatectomy.
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Affiliation(s)
- C C Parker
- Institute of Cancer Research, Royal Marsden NHS Foundation Trust, Sutton, UK
| | - P M Petersen
- Dept of Oncology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - A D Cook
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - N W Clarke
- Dept of Urology, The Christie and Salford Royal Hospitals, Manchester, UK; The University of Manchester, Manchester, UK
| | - C Catton
- Dept of Radiation Oncology, Princess Margaret Hospital, University Health Network, Toronto, ON, Canada
| | - W R Cross
- Dept of Urology, St James's University Hospital, Leeds, UK
| | - H Kynaston
- Division of Cancer and Genetics, Cardiff University, Cardiff, UK
| | - W R Parulekar
- Canadian Cancer Trials Group, Queen's University, Kingston, ON, Canada
| | - R A Persad
- Dept of Urology, Bristol Urological Institute, Bristol, UK
| | - F Saad
- Dept of Urology, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
| | - L Bower
- Guy's and St Thomas' NHS Foundation Trust, London, UK; Institute of Cancer Research, Royal Marsden NHS Foundation Trust, London, UK
| | - G C Durkan
- Dept of Urology, University Hospital Galway, Galway, Ireland
| | - J Logue
- Dept of Oncology, The Christie Hospital NHS FT, Wilmslow Road, Manchester, UK
| | - C Maniatis
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - D Noor
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - H Payne
- The Prostate Centre, London, UK
| | - J Anderson
- St James's Institute of Oncology, Leeds, UK
| | - A K Bahl
- Bristol Haematology and Oncology Centre, University Hospitals Bristol & Weston NHS Trust, Bristol, UK
| | - F Bashir
- Queen's Centre for Oncology, Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, Cottingham, UK
| | | | - K Brasso
- Dept of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Dept of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - L Capaldi
- Worcester Oncology Centre, Worcestershire Acute NHS Hospitals Trust, Worcester, UK
| | - P W Cooke
- Dept of Urology, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - C Chung
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - J Donohue
- Dept of Urology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - B Eddy
- East Kent University Hospitals Foundation Trust, Kent, UK
| | - C M Heath
- Dept of Clinical Oncology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Henderson
- Dept of Urology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - A Henry
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - R Jaganathan
- Dept of Urology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - H Jakobsen
- Dept of Urology, Herlev University Hospital, Herlev, Denmark
| | - N D James
- Institute of Cancer Research, Royal Marsden NHS Foundation Trust, London, UK
| | - J Joseph
- Leeds Teaching Hospitals, UK; York and Scarborough Teaching Hospitals, UK
| | - K Lees
- Dept of Oncology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - J Lester
- South West Wales Cancer Centre, Singleton Hospital, Swansea, UK
| | - H Lindberg
- Dept of Oncology, Herlev University Hospital, Herlev, Denmark
| | - A Makar
- Dept of Urology, Worcestershire Acute Hospitals Trust, Worcester, UK
| | - S L Morris
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - N Oommen
- Wrexham Maelor Hospital, Wrexham, UK
| | - P Ostler
- Mount Vernon Cancer Centre, Northwood, UK
| | - L Owen
- Bradford Royal Infirmary, Bradford, UK; Leeds Cancer Centre, Leeds, UK
| | - P Patel
- Dept of Urology, University College London Hospitals, London, UK
| | - A Pope
- Mount Vernon Cancer Centre, Northwood, UK
| | - R Popert
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R Raman
- Kent Oncology Centre, Kent & Canterbury Hospital, Canterbury, UK
| | - V Ramani
- Dept of Urology, The Christie and Salford Royal Hospitals, Manchester, UK
| | - A Røder
- Dept of Urology, Copenhagen Prostate Cancer Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - I Sayers
- Deanesly Centre, New Cross Hospital, Wolverhampton, UK
| | - M Simms
- Dept of Urology, Hull University Hospitals NHS Trust, UK
| | - V Srinivasan
- Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Rhyl, UK
| | - S Sundaram
- Dept of Urology, Mid Yorkshire Teaching Hospital, Pontefract, UK
| | - K L Tarver
- Dept of Oncology, Queen's Hospital, Romford, UK
| | - A Tran
- Dept of Oncology, The Christie Hospital NHS FT, Wilmslow Road, Manchester, UK
| | - P Wells
- St Bartholomews Hospital, London UK
| | - J Wilson
- Royal Gwent Hospital, Newport, UK
| | - A M Zarkar
- Dept of Oncology, University Hospitals Birmingham, Birmingham, UK
| | - M K M Parmar
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK
| | - M R Sydes
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials and Methodology, UCL, London, UK.
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5
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Dmytriw AA, Salim H, Musmar B, Aslan A, Cancelliere NM, McLellan RM, Algin O, Ghozy S, Dibas M, Lay SV, Guenego A, Renieri L, Carnevale J, Saliou G, Mastorakos P, Naamani KE, Shotar E, Premat K, Möhlenbruch M, Kral M, Doron O, Chung C, Salem MM, Lylyk I, Foreman PM, Vachhani JA, Shaikh H, Župančić V, Hafeez MU, Catapano J, Waqas M, Tutino VM, Ibrahim MK, Mohammed MA, Imamoglu C, Bayrak A, Rabinov JD, Ren Y, Schirmer CM, Piano M, Kühn AL, Michelozzi C, Elens S, Starke RM, Hassan AE, Ogilvie M, Sporns P, Jones J, Brinjikji W, Nawka MT, Psychogios M, Ulfert C, Diestro JDB, Pukenas B, Burkhardt JK, Huynh T, Martinez-Gutierrez JC, Essibayi MA, Sheth SA, Spiegel G, Tawk R, Lubicz B, Panni P, Puri AS, Pero G, Nossek E, Raz E, Killer-Oberfalzer M, Griessenauer CJ, Asadi H, Siddiqui A, Brook AL, Altschul D, Ducruet AF, Albuquerque FC, Regenhardt RW, Stapleton CJ, Kan P, Kalousek V, Lylyk P, Boddu S, Knopman J, Aziz-Sultan MA, Tjoumakaris SI, Clarençon F, Limbucci N, Cuellar-Saenz HH, Jabbour PM, Pereira VM, Patel AB, Adeeb N. Dual Layer vs Single Layer Woven EndoBridge Device in the Treatment of Intracranial Aneurysms: A Propensity Score-Matched Analysis. Neurosurg Rev 2024; 47:116. [PMID: 38483647 DOI: 10.1007/s10143-024-02341-z] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/26/2024] [Accepted: 03/03/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND The Woven EndoBridge (WEB) devices have been used for treating wide neck bifurcation aneurysms (WNBAs) with several generational enhancements to improve clinical outcomes. The original device dual-layer (WEB DL) was replaced by a single-layer (WEB SL) device in 2013. This study aimed to compare the effectiveness and safety of these devices in managing intracranial aneurysms. METHODS A multicenter cohort study was conducted, and data from 1,289 patients with intracranial aneurysms treated with either the WEB SL or WEB DL devices were retrospectively analyzed. Propensity score matching was utilized to balance the baseline characteristics between the two groups. Outcomes assessed included immediate occlusion rate, complete occlusion at last follow-up, retreatment rate, device compaction, and aneurysmal rupture. RESULTS Before propensity score matching, patients treated with the WEB SL had a significantly higher rate of complete occlusion at the last follow-up and a lower rate of retreatment. After matching, there was no significant difference in immediate occlusion rate, retreatment rate, or device compaction between the WEB SL and DL groups. However, the SL group maintained a higher rate of complete occlusion at the final follow-up. Regression analysis showed that SL was associated with higher rates of complete occlusion (OR: 0.19; CI: 0.04 to 0.8, p = 0.029) and lower rates of retreatment (OR: 0.12; CI: 0 to 4.12, p = 0.23). CONCLUSION The WEB SL and DL devices demonstrated similar performances in immediate occlusion rates and retreatment requirements for intracranial aneurysms. The SL device showed a higher rate of complete occlusion at the final follow-up.
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Affiliation(s)
- Adam A Dmytriw
- Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA.
| | - Hamza Salim
- Departement of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA
| | - Basel Musmar
- Departement of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA
| | - Assala Aslan
- Departement of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA
| | - Nicole M Cancelliere
- Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Rachel M McLellan
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA
| | - Oktay Algin
- Medical Faculty, Department of Radiology, Ankara University, Ankara, Turkey
| | - Sherief Ghozy
- Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Mahmoud Dibas
- Departement of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA
| | - Sovann V Lay
- Service de Neuroradiologie Diagnostique Et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France
| | - Adrien Guenego
- Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Brussels, Belgique
| | - Leonardo Renieri
- Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy
| | - Joseph Carnevale
- Neurosurgery & Interventional Neuroradiology, Weill Cornell School of Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Guillaume Saliou
- Service de Radiodiagnostic Et Radiologie Interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland
| | | | - Kareem El Naamani
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Eimad Shotar
- Department de Neuroradiologie, Hôpital Pitié-Salpêtrière. Université Sorbonne, Paris, France
| | - Kevin Premat
- Department de Neuroradiologie, Hôpital Pitié-Salpêtrière. Université Sorbonne, Paris, France
| | - Markus Möhlenbruch
- Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Michael Kral
- Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Omer Doron
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA
| | - Charlotte Chung
- Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA
| | - Mohamed M Salem
- Department of Neurosurgery, University of Pennsylvania Medical Center, Pennsylvania, PA, USA
| | - Ivan Lylyk
- Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Paul M Foreman
- Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA
| | - Jay A Vachhani
- Neurosurgery Department, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, FL, USA
| | - Hamza Shaikh
- Departments of Radiology & Neurosurgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Vedran Župančić
- Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia
| | - Muhammad U Hafeez
- Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA
| | - Joshua Catapano
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Muhammad Waqas
- Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA
| | - Vincent M Tutino
- Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA
| | - Mohamed K Ibrahim
- Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Marwa A Mohammed
- Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Cetin Imamoglu
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey
| | - Ahmet Bayrak
- Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey
| | - James D Rabinov
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA
| | - Yifan Ren
- Interventional Radiology and Neurointerventional Services, Department of Radiology, Austin Health, Melbourne, VIC, Australia
| | - Clemens M Schirmer
- Department of Neurosurgery and Radiology, Geisinger Health System, Danville, PA, USA
| | - Mariangela Piano
- Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milan, Italy
| | - Anna L Kühn
- Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, USA
| | | | - Stéphanie Elens
- Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy
| | - Robert M Starke
- Deparment of Neurosurgery, University of Miami, Miami, FL, USA
| | - Ameer E Hassan
- Deparment of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, TX, USA
| | - Mark Ogilvie
- Deparments of Neurosurgery and Radiology, University of Alabama, Birmingham, AL, USA
| | - Peter Sporns
- Department of Interventional Neuroradiology, Interventional Neuroradiology, University Hospital of Basel, Basel, Switzerland
| | - Jesse Jones
- Deparments of Neurosurgery and Radiology, University of Alabama, Birmingham, AL, USA
| | - Waleed Brinjikji
- Departments of Radiology and Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Marie T Nawka
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marios Psychogios
- Department of Interventional Neuroradiology, Interventional Neuroradiology, University Hospital of Basel, Basel, Switzerland
| | - Christian Ulfert
- Sektion Vaskuläre Und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Jose Danilo Bengzon Diestro
- Divisions of Therapeutic Neuroradiology and Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Bryan Pukenas
- Department of Neurosurgery, University of Pennsylvania Medical Center, Pennsylvania, PA, USA
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, University of Pennsylvania Medical Center, Pennsylvania, PA, USA
| | - Thien Huynh
- Departments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA
| | - Juan Carlos Martinez-Gutierrez
- Departments of Radiology, Neurology, and Neurosurgery, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Muhammed Amir Essibayi
- Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Sunil A Sheth
- Departments of Radiology, Neurology, and Neurosurgery, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Gary Spiegel
- Departments of Radiology, Neurology, and Neurosurgery, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Rabih Tawk
- Departments of Radiology and Neurosurgery, Mayo Clinic, Jacksonville, FL, USA
| | - Boris Lubicz
- Interventistica Neurovascolare, Ospedale Careggi Di Firenze, Florence, Italy
| | - Pietro Panni
- Interventistica Neurovascolare, Ospedale San Raffaele Milano, Milan, Italy
| | - Ajit S Puri
- Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, MA, USA
| | - Guglielmo Pero
- Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milan, Italy
| | - Erez Nossek
- Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA
| | - Eytan Raz
- Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA
| | - Monika Killer-Oberfalzer
- Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Christoph J Griessenauer
- Department of Neurosurgery, Christian Doppler University Hospital & Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria
| | - Hamed Asadi
- Departments of Radiology & Neurosurgery, NYU Langone Health Center, New York, NY, USA
| | - Adnan Siddiqui
- Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY, USA
| | - Allan L Brook
- Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David Altschul
- Department of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andrew F Ducruet
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA
| | | | - Robert W Regenhardt
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA
| | - Christopher J Stapleton
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA
| | - Peter Kan
- Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, TX, USA
| | - Vladimir Kalousek
- Subdivision of Interventional Neuroradiology, Department of Radiology, Clinical Hospital Center 'Sisters of Mercy', Zagreb, Croatia
| | - Pedro Lylyk
- Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina
| | - Srikanth Boddu
- Service de Radiodiagnostic Et Radiologie Interventionnelle, Centre Hospitalier Vaudois de Lausanne, Lausanne, Switzerland
| | - Jared Knopman
- Neurosurgery & Interventional Neuroradiology, Weill Cornell School of Medicine, New York Presbyterian Hospital, New York, NY, USA
| | | | | | - Frédéric Clarençon
- Department de Neuroradiologie, Hôpital Pitié-Salpêtrière. Université Sorbonne, Paris, France
| | - Nicola Limbucci
- Neurosurgery & Interventional Neuroradiology, Weill Cornell School of Medicine, New York Presbyterian Hospital, New York, NY, USA
| | - Hugo H Cuellar-Saenz
- Departement of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA
| | - Pascal M Jabbour
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Vitor Mendes Pereira
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA
| | - Aman B Patel
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard University, Boston, MA, 02114, USA
| | - Nimer Adeeb
- Departement of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, LA, USA
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6
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Lim WH, Ng CH, Tan DJH, Xiao J, Fu CE, Ong C, Koh B, Chung C, Tan SN, Wong ZY, Mitchell K, Joseph AA, Tseng M, Syn N, Mak LY, Fung J, Huang DQ, Muthiah M, Tan EXX, Siddiqui MS. Donor Diabetes and Steatosis Affects Recipient Survival Following Liver Transplantation Based on Etiology of Liver Cirrhosis. Transplantation 2024; 108:473-482. [PMID: 37439778 DOI: 10.1097/tp.0000000000004718] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
BACKGROUND Liver transplantation (LT) offers patients with decompensated cirrhosis the best chance at long-term survival. With the rising prevalence of diabetes, further clarity is needed on the impact of receiving a liver allograft from a donor with diabetes on post-LT outcomes. This study aims to evaluate the impact of donor diabetes on clinical outcomes after LT. METHODS This is a retrospective analysis of the United Network for Organ Sharing registry data of LT recipients from January 1, 2000, to December 31, 2021. Outcomes analysis was performed using Cox proportional model for all-cause mortality and graft failure. Confounding was reduced by coarsened exact matching causal inference analysis. RESULTS Of 66 960 donors identified, 7178 (10.7%) had diabetes. Trend analysis revealed a longitudinal increase in the prevalence of donor diabetes ( P < 0.001). Importantly, donor diabetes was associated with increased all-cause mortality (hazard ratio [HR]: 1.13; 95% confidence interval [CI], 1.07-1.19; P < 0.001) and graft failure (HR: 1.16; 95% CI, 1.11-1.22; P < 0.001). Receiving donor organ with diabetes reduced graft survival in patients who received LT for nonalcoholic steatohepatitis cirrhosis (HR: 1.26; 95% CI, 1.13-1.41; P < 0.001) but not other etiologies of cirrhosis. CONCLUSIONS Donor diabetes was associated with worse outcomes post-LT, particularly in patients receiving LT for nonalcoholic steatohepatitis cirrhosis. Future studies are needed to better understand the mechanism underlying this association to develop better risk stratification and clinical practice to improve the outcomes of the transplanted patients.
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Affiliation(s)
- Wen Hui Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cheng Han Ng
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - Darren Jun Hao Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jieling Xiao
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Clarissa Elysia Fu
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Christen Ong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Benjamin Koh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Charlotte Chung
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shi Ni Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Zhen Yu Wong
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
| | - Kimberly Mitchell
- Division of Transplant Surgery, Virginia Commonwealth University, Richmond, VA
| | | | - Michael Tseng
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
| | - Nicholas Syn
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lung Yi Mak
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - James Fung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Daniel Q Huang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Mark Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Eunice X X Tan
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Mohammad Shadab Siddiqui
- Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA
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7
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von Oiste GG, Sangwon KL, Chung C, Narayan V, Raz E, Shapiro M, Rutledge C, Nelson PK, Ishida K, Torres JL, Rostanski SK, Zhang C, Yaghi S, Riina H, Oermann EK, Nossek E. Use of Carotid Web Angioarchitecture for Stroke Risk Assessment. World Neurosurg 2024; 182:e245-e252. [PMID: 38006939 DOI: 10.1016/j.wneu.2023.11.091] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 11/19/2023] [Indexed: 11/27/2023]
Abstract
OBJECTIVE To examine the usefulness of carotid web (CW), carotid bifurcation and their combined angioarchitectural measurements in assessing stroke risk. METHODS Anatomic data on the internal carotid artery (ICA), common carotid artery (CCA), and the CW were gathered as part of a retrospective study from symptomatic (stroke) and asymptomatic (nonstroke) patients with CW. We built a model of stroke risk using principal-component analysis, Firth regression trained with 5-fold cross-validation, and heuristic binary cutoffs based on the Minimal Description Length principle. RESULTS The study included 22 patients, with a mean age of 55.9 ± 12.8 years; 72.9% were female. Eleven patients experienced an ischemic stroke. The first 2 principal components distinguished between patients with stroke and patients without stroke. The model showed that ICA-pouch tip angle (P = 0.036), CCA-pouch tip angle (P = 0.036), ICA web-pouch angle (P = 0.036), and CCA web-pouch angle (P = 0.036) are the most important features associated with stroke risk. Conversely, CCA and ICA anatomy (diameter and angle) were not found to be risk factors. CONCLUSIONS This pilot study shows that using data from computed tomography angiography, carotid bifurcation, and CW angioarchitecture may be used to assess stroke risk, allowing physicians to tailor care for each patient according to risk stratification.
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Affiliation(s)
- Grace G von Oiste
- Department of Neurosurgery, NYU Langone Health, New York, New York, USA
| | - Karl L Sangwon
- Department of Neurosurgery, NYU Langone Health, New York, New York, USA.
| | - Charlotte Chung
- Department of Neurosurgery, NYU Langone Health, New York, New York, USA
| | - Vinayak Narayan
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Eytan Raz
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Maksim Shapiro
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Caleb Rutledge
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Peter Kim Nelson
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Koto Ishida
- Department of Neurology, NYU Langone Health, New York, New York, USA
| | - Jose L Torres
- Department of Neurology, NYU Langone Health, New York, New York, USA
| | - Sara K Rostanski
- Department of Neurology, NYU Langone Health, New York, New York, USA
| | - Cen Zhang
- Department of Neurology, NYU Langone Health, New York, New York, USA
| | - Shadi Yaghi
- Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Howard Riina
- Department of Neurosurgery, NYU Langone Health, New York, New York, USA
| | - Eric K Oermann
- Department of Neurosurgery, NYU Langone Health, New York, New York, USA
| | - Erez Nossek
- Department of Neurosurgery, NYU Langone Health, New York, New York, USA
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8
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Chung C, Jeong D, Sohn H, Choi H, Kang YA. Low household income increases the risk of tuberculosis recurrence: a retrospective nationwide cohort study in South Korea. Public Health 2024; 226:228-236. [PMID: 38091811 DOI: 10.1016/j.puhe.2023.11.014] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/14/2023] [Accepted: 11/08/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES We assessed the impact of household income on tuberculosis (TB) recurrence and the long-term impact of TB on household income. STUDY DESIGN This was a retrospective nationwide cohort study of patients with drug-susceptible TB (DS-TB) and TB recurrence. METHODS Using the South Korean national TB cohort database, we identified a sub-set cohort of patients with newly diagnosed drug-susceptible TB between 2013 and 2016 and tracked their TB recurrence and longitudinal income data from 2007 to 2018. Income levels were evaluated as 'Medical aid' and quintile categories. To assess risk factors associated with TB recurrence, we used a sub-distribution hazard model, adjusting for the competing risks of death. RESULTS Of 66,690 patients successfully treated with DS-TB, 2095 (3.1 %) experienced recurrence during a median follow-up of 39 months. The incidence of TB recurrence was 982.1/100,000 person-years, with 50.3 % of the recurrences occurring within 1 year of treatment completion. The risk of TB recurrence increased with decreasing income levels, with the highest risk observed in the lowest income group. The effect of income on TB recurrence was prominent in males but not in females. Overall, patients with TB recurrence experienced a linear decline in income levels, compared with those without recurrence. CONCLUSIONS Household income during the initial TB episode was an important risk factor for TB recurrence, particularly in males.
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Affiliation(s)
- C Chung
- Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - D Jeong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H Sohn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H Choi
- Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Y A Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Karp J, Chung C, Bhagwanani A, Sailer A. Helping Medically Underserved Populations: Guide for U.S. Radiology Trainees to Get Involved at Home. Radiographics 2024; 44:e230119. [PMID: 38096109 DOI: 10.1148/rg.230119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- John Karp
- From the Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY 11203 (J.K.); Department of Radiology, NYU Langone Health, New York, NY (C.C.); Department of Radiology, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Frimley, England (A.B.); and Department of Interventional Radiology, Yale University, New Haven, Conn (A.S.)
| | - Charlotte Chung
- From the Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY 11203 (J.K.); Department of Radiology, NYU Langone Health, New York, NY (C.C.); Department of Radiology, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Frimley, England (A.B.); and Department of Interventional Radiology, Yale University, New Haven, Conn (A.S.)
| | - Anisha Bhagwanani
- From the Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY 11203 (J.K.); Department of Radiology, NYU Langone Health, New York, NY (C.C.); Department of Radiology, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Frimley, England (A.B.); and Department of Interventional Radiology, Yale University, New Haven, Conn (A.S.)
| | - Anne Sailer
- From the Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY 11203 (J.K.); Department of Radiology, NYU Langone Health, New York, NY (C.C.); Department of Radiology, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Frimley, England (A.B.); and Department of Interventional Radiology, Yale University, New Haven, Conn (A.S.)
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Bhatt AA, Vibhute P, Wu XC, Escott EJ, Chung C, Rhyner PA. Cervical Osteomyelitis and Diskitis as a Complication of Neopharyngeal Breakdown: A Multisite Case Series Review. AJNR Am J Neuroradiol 2023; 44:1418-1420. [PMID: 37945524 PMCID: PMC10714855 DOI: 10.3174/ajnr.a8042] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/27/2023] [Indexed: 11/12/2023]
Abstract
Laryngectomy and pharyngectomy are surgical options for advanced laryngeal or pharyngeal squamous cell carcinoma. Cervical osteomyelitis-diskitis, occurring when there is dehiscence of the posterior neopharyngeal wall, is an uncommon complication of laryngopharyngectomy. This case series describes imaging findings of pharyngoesophageal wall breakdown with subsequent cervical spine infection and demonstrates that most of these patients had undergone prior esophageal or neopharyngeal dilations for benign posttreatment stricture. Neck pain, fever, or serologic evidence of infection should prompt careful evaluation for osteomyelitis-diskitis and assessment for neopharyngeal breakdown and sinus tract formation, especially in the postdilation setting.
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Affiliation(s)
- Alok A Bhatt
- From the Department of Radiology (A.A.B., P.V., P.A.R.), Mayo Clinic, Jacksonville, Florida
| | - Prasanna Vibhute
- From the Department of Radiology (A.A.B., P.V., P.A.R.), Mayo Clinic, Jacksonville, Florida
| | - Xin Cynthia Wu
- Department of Radiology (X.C.W.), University of California, San Francisco, San Francisco, California
| | - Edward J Escott
- Department of Radiology (E.J.E.), University of Kentucky, Lexington, Kentucky
| | - Charlotte Chung
- Department of Radiology (C.C.), New York University Langone Health, New York, New York
| | - Patricia A Rhyner
- From the Department of Radiology (A.A.B., P.V., P.A.R.), Mayo Clinic, Jacksonville, Florida
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11
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Chung C, Jo KW, Shim TS. Treatment outcome, recurrence and safety of multidrug-resistant TB treated with low-dose linezolid. Int J Tuberc Lung Dis 2023; 27:918-924. [PMID: 38042970 DOI: 10.5588/ijtld.23.0068] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND: Linezolid (LZD) is a key treatment option for patients with multidrug-resistant/rifampicin-resistant TB (MDR/RR-TB). We investigated the long-term treatment outcomes and safety of MDR/RR-TB treatment using low-dose LZD.METHODS: Medical records of patients with MDR/RR-TB treated with LZD ≥4 weeks between 2004 and 2018 at the Asan Medical Center, Seoul, Republic of Korea, were reviewed. Standard-dose and low-dose LZD groups were defined as patients initially administered LZD ≥600 mg/day or 300 mg/day, respectively.RESULTS: Among 94 patients, 65 were included in the low-dose LZD group; mean age was 43.1 ± 15.6 years, 53 (56.4%) were men and 77 (83.7%) were resistant to fluoroquinolone. The low-dose LZD group showed features of less severe disease, such as limited MDR-TB history and less severe radiological findings. There was no difference in treatment outcomes, relapse and safety between groups. In the low-dose LZD group, 54 (83.1%) succeeded treatment, of whom 48 (88.9%) were followed-up for a median of 38 months; there was no recurrence. Adverse drug reactions were reported in 41 (63.1%); peripheral neuropathy was most frequently reported (n = 31, 47.7%), while myelosuppression was reported in 12 (18.5%).CONCLUSION: Low-dose LZD in selected patients with less severe disease is both effective in the long-term and safe for the treatment of MDR/RR-TB.
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Affiliation(s)
- C Chung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - K-W Jo
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
| | - T S Shim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul
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12
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Shapiro M, Sharashidze V, Nossek E, Sen C, Rutledge C, Chung C, Khawaja A, Kvint S, Riina H, Nelson PK, Raz E. Superior hypophyseal arteries: angiographic re-discovery, comprehensive assessment, and embryologic implications. J Neurointerv Surg 2023:jnis-2023-020922. [PMID: 37875341 DOI: 10.1136/jnis-2023-020922] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
The superior hypophyseal arteries (SHAs) are well known in anatomical and surgical literature, with a well-established role in supply of the anterior hypophysis and superjacent optic apparatus. However, due to small size and overlap with other vessels, in vivo imaging by any modality has been essentially non-existent. Advances in high resolution cone beam CT angiography (CBCTA) now enables this deficiency to be addressed. This paper presents, to the best of our knowledge, the first comprehensive in vivo imaging evaluation of the SHAs. METHODS Twenty-five CBCTA studies of common or internal carotid arteries were obtained for a variety of clinical reasons. Dedicated secondary reconstructions of the siphon were performed, recording the presence, number, and supply territory of SHAs. A spectrum approach, emphasizing balance with adjacent territories (inferior hypophyseal, ophthalmic, posterior and communicating region arteries) was investigated. RESULTS The SHAs were present in all cases. Supply of the anterior pituitary was nearly universal (96%) and almost half (44%) originated from the 'cave' region, in excellent agreement with surgical literature. Optic apparatus supply was more difficult to adjudicate, but appeared present in most cases. The relationship with superior hypophyseal aneurysms was consistent. Patency following flow diverter placement was typical, despite a presumably rich collateral network. Embryologic implications with respect to the ophthalmic artery and infraoptic course of the anterior cerebral artery are intriguing. CONCLUSIONS SHAs are consistently seen with CBCTA, allowing for correlation with existing anatomical and surgical literature, laying the groundwork for future in vivo investigation.
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Affiliation(s)
- Maksim Shapiro
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Neurology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Vera Sharashidze
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Neurology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Erez Nossek
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
- Neurosurgery, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Chandra Sen
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
| | - Caleb Rutledge
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Neurosurgery, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Charlotte Chung
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Ayaz Khawaja
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Svetlana Kvint
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Howard Riina
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Peter Kim Nelson
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
| | - Eytan Raz
- Neurosurgery, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYU Grossman School of Medicine, New York, NY, USA
- Radiology, NYC Health Hospitals Bellevue, New York, NY, USA
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13
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Dehkharghani S, Vogel A, Jandhyala N, Chung C, Shu L, Frontera J, Yaghi S. Continued Infarction Growth and Penumbral Consumption After Reperfusion in Vaccine-Naive Patients With COVID-19: A Case-Control Study. AJR Am J Roentgenol 2023; 221:517-525. [PMID: 37195793 DOI: 10.2214/ajr.23.29296] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND. Neurologic sequelae of SARS-CoV-2 include potentially malignant cerebrovascular events arising from complex hemodynamic, hematologic, and inflammatory processes occurring in concert. OBJECTIVE. This study concerns the hypothesis that despite angiographic reperfusion COVID-19 promotes continued consumption of at-risk tissue volumes after acute ischemic stroke (AIS), yielding critical insights into prognostication and monitoring paradigms in vaccine-naive patients experiencing AIS. METHODS. This retrospective study compared 100 consecutive COVID-19 patients with AIS presenting between March 2020 and April 2021 with a contemporaneous cohort of 282 AIS patients without COVID-19. Reperfusion classes were dichotomized into positive (extended thrombolysis in cerebral ischemia [eTICI] score = 2c-3) and negative (eTICI score < 2c) groups. All patients underwent endovascular therapy after initial CT perfusion imaging (CTP) to document infarction core and total hypoperfusion volumes. RESULTS. Ten COVID-positive (mean age ± SD, 67 ± 12 years; seven men, three women) and 144 COVID-negative patients (mean age, 71 ± 16 years; 76 men, 68 women) undergoing endovascular reperfusion, with antecedent CTP and follow-up imaging, comprised the final dataset. Initial infarction core and total hypoperfusion volumes (mean ± SD) were 1.5 ± 18 mL and 85 ± 100 mL in COVID-negative patients and 30.5 ± 34 mL and 117 ± 80.5 mL in COVID-positive patients, respectively. Final infarction volumes were significantly larger in patients with COVID-19, with median volumes of 77.8 mL versus 18.2 mL among control patients (p = .01), as were normalized measures of infarction growth relative to baseline infarction volume (p = .05). In adjusted logistic parametric regression models, COVID positivity emerged as a significant predictor for continued infarct growth (OR, 5.10 [95% CI, 1.00-25.95]; p = .05). CONCLUSION. These findings support the potentially aggressive clinical course of cerebrovascular events in patients with COVID-19, suggesting greater infarction growth and ongoing consumption of at-risk tissues, even after angiographic reperfusion. CLINICAL IMPACT. SARS-CoV-2 infection may promote continued infarction progression despite angiographic reperfusion in vaccine-naive patients with large-vessel occlusion AIS. The findings carry potential implications for prognostication, treatment selection, and surveillance for infarction growth among revascularized patients in future waves of infection by novel viral strains.
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Affiliation(s)
- Seena Dehkharghani
- Department of Radiology, New York University Langone Medical Center, Center for Biomedical Imaging, 660 1st Ave, 2nd Fl, New York, NY 10016
- Department of Neurology, New York University Langone Health, New York, NY
| | - Andre Vogel
- Department of Radiology, New York University Grossman School of Medicine, New York, NY
| | - Nora Jandhyala
- Department of Radiology, New York University Grossman School of Medicine, New York, NY
| | - Charlotte Chung
- Department of Radiology, New York University Langone Medical Center, Center for Biomedical Imaging, 660 1st Ave, 2nd Fl, New York, NY 10016
| | - Liqi Shu
- Department of Neurology, Brown University, Providence, RI
| | - Jennifer Frontera
- Department of Neurology, New York University Langone Health, New York, NY
| | - Shadi Yaghi
- Department of Neurology, Brown University, Providence, RI
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14
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Yaow CYL, Chong B, Chin YH, Kueh MTW, Ng CH, Chan KE, Tang ASP, Chung C, Goh R, Kong G, Muthiah M, Sukmawati I, Lukito AA, Chan MY, Khoo CM, Mehta A, Mamas MA, Dimitriadis GK, Chew NWS. Higher risk of adverse cardiovascular outcomes in females with type 2 diabetes Mellitus: an Umbrella review of systematic reviews. Eur J Prev Cardiol 2023; 30:1227-1235. [PMID: 37185913 DOI: 10.1093/eurjpc/zwad133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/20/2023] [Accepted: 04/15/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Previous studies have shown that females with type 2 diabetes mellitus (T2DM) may have excess mortality risk compared to their male counterparts. An important next step to address the high global burden of T2DM and cardiovascular disease (CVD) is an umbrella review to summarize data on sex differences in cardiovascular outcomes for patients with T2DM and assess the strength of the evidence observed. METHODS AND RESULTS Medline and Embase were searched from inception till 7 August 2022 for systematic reviews and meta-analyses studying the effects of sex on cardiovascular outcomes in T2DM patients. Results from reviews were synthesized with a narrative synthesis, with a tabular presentation of findings and forest plots for reviews that performed a meta-analysis. 27 review articles evaluating sex differences in cardiovascular outcomes were included. Females with T2DM had a higher risk of developing coronary heart disease (CHD; RRR: 1.52, 95%CI: 1.32-1.76, P < 0.001), acute coronary syndrome (ACS; RRR: 1.38, 95%CI: 1.25-1.52, P < 0.001), heart failure (RRR: 1.09, 95%CI: 1.05-1.13, P < 0.001) than males. Females had a higher risk of all-cause mortality (RRR: 1.13, 95%CI: 1.07-1.19, P < 0.001), cardiac mortality (RRR: 1.49, 95%CI: 1.11-2.00, P = 0.009) and CHD mortality (RRR: 1.44, 95%CI: 1.20-1.73, P < 0.001) as compared to males. CONCLUSIONS This umbrella review demonstrates that females with T2DM have a higher risk of cardiovascular outcomes than their male counterparts. Future research should address the basis of this heterogeneity and epidemiological factors for better quality of evidence, and identify actionable interventions that will narrow these sex disparities.
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Affiliation(s)
- Clyve Yu Leon Yaow
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Bryan Chong
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Yip Han Chin
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Martin Tze Wah Kueh
- Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, D02 YN77, Ireland
- University College Dublin Malaysia Campus, George Town, Malaysia
| | - Cheng Han Ng
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Kai En Chan
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Ansel Shao Pin Tang
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Charlotte Chung
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Rachel Goh
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Gwyneth Kong
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
| | - Mark Muthiah
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Indah Sukmawati
- Cardiovascular Department, Siloam Hospitals Lippo Village, Pelita Harapan University, Tangerang, Indonesia
| | - Antonia Anna Lukito
- National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Mark Y Chan
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Chin Meng Khoo
- Division of Endocrinology, Department of Medicine, National University Hospital, Singapore
| | - Anurag Mehta
- VCU Health Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Mamas A Mamas
- Institute of Population Health, University of Manchester, Manchester, UK
- Keele Cardiac Research Group, Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK
| | - Georgios K Dimitriadis
- Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK
- Obesity, Type 2 Diabetes and Immunometabolism Research Group, Department of Diabetes, Faculty of Cardiovascular Medicine & Sciences, School of Life Course Sciences, King's College London, London SE1 9RT, UK
| | - Nicholas W S Chew
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597
- Cardiovascular Department, Siloam Hospitals Lippo Village, Pelita Harapan University, Tangerang, Indonesia
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15
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Shapiro M, Nossek E, Sharashidze V, Tanaka M, Rutledge C, Chung C, Khawaja A, Riina H, Nelson PK, Raz E. Spinal dural and epidural fistulas: role of cone beam CT in diagnosis and treatment. J Neurointerv Surg 2023:jnis-2022-019950. [PMID: 37673678 DOI: 10.1136/jnis-2022-019950] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/14/2023] [Indexed: 09/08/2023]
Abstract
Understanding normal spinal arterial and venous anatomy, and spinal vascular disease, is impossible without flow-based methods. Development of practical spinal angiography led to site-specific categorization of spinal vascular conditions, defined by the 'seat of disease' in relation to the cord and its covers. This enabled identification of targets for highly successful surgical and endovascular treatments, and guided interpretation of later cross-sectional imaging.Spinal dural and epidural arteriovenous fistulas represent the most common types of spinal shunts. Although etiology is debated, anatomy provides excellent pathophysiologic correlation. A spectrum of fistulas, from foramen magnum to the sacrum, is now well-characterized.Most recently, use of cone beam CT angiography has yielded new insights into normal and pathologic anatomy, including venous outflow. It provides unrivaled visualization of the fistula and its relationship with spinal cord vessels, and is the first practical method to study normal and pathologic spinal veins in vivo-with multiple implications for both safety and efficacy of treatments. We advocate consistent use of cone beam CT imaging in modern spinal fistula evaluation.The role of open surgery is likely to remain undiminished, with increasing availability and use of hybrid operating rooms for practical intraoperative angiography enhancing safety and efficacy of complex surgery.
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Affiliation(s)
- Maksim Shapiro
- Department of Radiology, Neurosurgery, and Neurology, New York City Health and Hospitals Bellevue, New York, New York, USA
| | - Erez Nossek
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, New York, USA
- Department of Neurosurgery, NYC Health Hospitals Bellevue, New York, New York, USA
| | - Vera Sharashidze
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Radiology, NYC Health Hospitals Bellevue, New York, New York, USA
| | - Michihiro Tanaka
- Department of Neurosurgery, Kameda Medical Center, Kamogawa, Chiba, Japan
| | - Caleb Rutledge
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, New York, USA
- Department of Neurosurgery, NYC Health Hospitals Bellevue, New York, New York, USA
| | - Charlotte Chung
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Radiology, NYC Health Hospitals Bellevue, New York, New York, USA
| | - Ayaz Khawaja
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Radiology, NYC Health Hospitals Bellevue, New York, New York, USA
| | - Howard Riina
- Department of Neurosurgery, NYU Grossman School of Medicine, New York, New York, USA
| | - Peter Kim Nelson
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Radiology, NYC Health Hospitals Bellevue, New York, New York, USA
| | - Eytan Raz
- Department of Radiology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Radiology, NYC Health Hospitals Bellevue, New York, New York, USA
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16
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McGrath M, Hyde J, Nosewicz J, Kaffenberger B, Trinidad J, Chung C. Concordance of diagnostic modalities in atypical skin and soft tissue infections in hospitalized patients. Arch Dermatol Res 2023; 315:2139-2143. [PMID: 36369596 DOI: 10.1007/s00403-022-02437-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 08/19/2022] [Accepted: 10/13/2022] [Indexed: 11/13/2022]
Abstract
Skin and soft tissue infections (SSTIs) have high rates of morbidity and mortality worldwide but lack reliable standards for diagnostic workup. As a result, atypical infections, more prevalent among immunocompromised patients, can be missed due to deviance from classic features only to be revealed later through inconsistently performed ancillary studies. Our objectives included to evaluate the sensitivities of clinical impression, histopathology, tissue culture, and molecular and non-molecular ancillary tests in diagnosing inpatient SSTIs, as well as to qualitatively discuss the unusual features making a subset of infections "atypical." To do so, we retrospectively reviewed the histopathologic reports and charts of inpatient dermatologic consults at a single tertiary care institution over a 3-year period. We identified a total of 111 cases of SSTIs evaluated by the inpatient dermatology consultation service with concurrent skin or soft tissue biopsy, with 32.4% representing atypical infections. Among these, clinical impression suggested infection in 9(25.0%), routine histopathology in 21(58.3%), specialized stains for microorganisms in 22(68.8%), and tissue culture in 15(68.2%). Due to incomplete picture that each modality by itself creates, we conclude that clinicians and pathologists should carry a low threshold for including SSTIs in their differential diagnoses and should evaluate with skin biopsy, special stains for microorganisms, and ancillary studies, particularly in critically ill individuals who necessitate timely diagnoses.
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Affiliation(s)
- M McGrath
- The Ohio State University College of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - J Hyde
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA
| | - J Nosewicz
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA
| | - B Kaffenberger
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA
| | - J Trinidad
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA
| | - C Chung
- Department of Dermatology, Massachusetts General Hospital, Cambridge, MA, USA.
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Lakhani DA, Doo FX, Chung C. Developing a Comprehensive Resident-driven Research Training Pathway: A Chief Resident's Perspective. Curr Probl Diagn Radiol 2023; 52:93-96. [PMID: 36050135 DOI: 10.1067/j.cpradiol.2022.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 01/19/2022] [Revised: 07/09/2022] [Accepted: 07/27/2022] [Indexed: 02/05/2023]
Abstract
Wide variation exists in research training, experience, opportunities, and exposure across various radiology residency training programs, ranging from having a dedicated research track to no exposure to hypothesis driven projects. Studies conducted at different residency training programs with varied resources and National Institutes of Health funding have shown that resident-driven research initiatives and mentorship programs have the potential to improve research experience during residency training, engage more medical students in research, increase departmental peer-reviewed publications and increase peer-reviewed publications of early-career faculty physicians. In an attempt to standardize the research training during radiology residency, we propose a standardized resident-led program which institutions may adapt, as well as resources that the American Alliance of Academic Chief Residents in Radiology (A3CR2) might compile in collaboration with other national organizations to improve trainee's research experience during their radiology residency training.
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Affiliation(s)
- Dhairya A Lakhani
- Chief Resident, Department of Radiology, West Virginia University, Morgantown, WV.; American Alliance of Academic Chief Residents in Radiology (A³CR²), Association of University Radiologists; The William W. Olmsted Trainee Editorial Fellow, The Radiological Society of North America (RSNA), Oak Brook, IL.
| | - Florence X Doo
- American Alliance of Academic Chief Residents in Radiology (A³CR²), Association of University Radiologists; Chief Resident, Department of Radiology, Icahn School of Medicine at Mount Sinai West, New York, NY.; Department of Radiology, Stanford University, Stanford, CA
| | - Charlotte Chung
- American Alliance of Academic Chief Residents in Radiology (A³CR²), Association of University Radiologists; Chief Resident, Department of Radiology, Emory University, Atlanta, GA.; Department of Radiology, New York University Langone Health, New York, NY
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Chung C, Shin JE, Jeon D, Kang H, Yim JJ, Jo KW, Shim TS. Treatment outcomes and safety of bedaquiline, delamanid, and linezolid in multidrug-resistant TB. Int J Tuberc Lung Dis 2023; 27:151-153. [PMID: 36853109 DOI: 10.5588/ijtld.22.0466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- C Chung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J E Shin
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - D Jeon
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - H Kang
- Department of Chest Medicine, Masan National Tuberculosis Hospital, Masan, Republic of Korea
| | - J-J Yim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K-W Jo
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - T S Shim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Liu W, Paranjpe M, Holth J, Clarke B, Thompson J, Clement J, Knoll E, Chung C, Adeluyi A, Powers A, Kurella V, Kavanagh D, Ezell B, Fiore T, Grant K, Hou J, Bales KR, Paul SM, Carter T. Efficacy evaluation of a novel vectorized anti‐tau antibody, targeting a C‐terminal phospho‐tau epitope, using systemic dosing of a blood brain barrier penetrant AAV capsid in mouse models of tauopathies. Alzheimers Dement 2022. [DOI: 10.1002/alz.062924] [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: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jay Hou
- Voyager Therapeutics Cambridge MA USA
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Liu W, Kurella V, Liu L, Kavanagh D, Paranjpe M, Holth J, Chung C, Powers A, Ren X, Shu Y, Capili A, Hou J, Ghetti BF, Bales KR, Paul SM, Carter T. Identification and characterization of novel anti‐tau antibodies that inhibit tau‐seed mediated pathology in a P301S tauopathy mouse model Alzheimer’s Disease and tauopathies. Alzheimers Dement 2022. [DOI: 10.1002/alz.062878] [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: 12/24/2022]
Affiliation(s)
| | | | - Li Liu
- Voyager Therapeutics Cambridge MA USA
| | | | | | | | | | | | | | | | | | - Jay Hou
- Voyager Therapeutics Cambridge MA USA
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Raz E, Nossek E, Sahlein DH, Sharashidze V, Narayan V, Ali A, Esparza R, Peschillo S, Chung C, Diana F, Syed S, Nelson PK, Shapiro M. Principles, techniques and applications of high resolution cone beam CT angiography in the neuroangio suite. J Neurointerv Surg 2022; 15:600-607. [PMID: 35835462 DOI: 10.1136/jnis-2022-018722] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 05/04/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
The aim of this review is to describe the acquisition and reformatting of state of the art high resolution cone beam CT (HR-CBCT) and demonstrate its role in multiple neurovascular conditions as a tool to improve the understanding of disease and guide therapeutic decisions. First, we will review the basic principle of CBCT acquisition, followed by the injection protocols and the reformatting paradigms. Next, multiple applications in different pathological conditions such as aneurysms, arteriovenous malformations, dural arteriovenous fistulas, and stroke will be described. HR-CBCT angiography, widely available, is uniquely useful in certain clinical scenarios to improve the understanding of disease and guide therapeutic decisions. It rapidly is becoming an essential tool for the contemporary neurointerventionalist.AChoAho.
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Affiliation(s)
- Eytan Raz
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Erez Nossek
- Department of Neurosurgery, NYU Langone Health, New York, New York, USA
| | - Daniel H Sahlein
- Neuroendovascular, Goodman Campbell Brain and Spine, Carmel, Indiana, USA
| | - Vera Sharashidze
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Vinayak Narayan
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Aryan Ali
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Rogelio Esparza
- Department of Neurosurgery, NYU Langone Health, New York, New York, USA
| | - Simone Peschillo
- Department of Neurology and Psychiatry, Endovascular Neurosurgery, University of Catania, Catania, Italy
| | - Charlotte Chung
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Francesco Diana
- Department of Neuroradiology, Azienda Ospedaliera Universitaria 'San Giovanni di Dio e Ruggi d'Aragona', Salerno, Italy
| | - Safia Syed
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Peter Kim Nelson
- Department of Radiology, NYU Langone Health, New York, New York, USA.,Department of Neurosurgery, NYU Langone Health, New York, New York, USA
| | - Maksim Shapiro
- Department of Radiology, NYU Langone Health, New York, New York, USA
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Fang C, Chen H, Bick A, Chung C, Tao R, Katalin S, Huffman J, Robinson-Cohen C, Siew E, Hung A. POS-437 Understanding Genetic and Clinical Determinants of Acquire Nephrotic Syndrome in Veterans (NephVA) in the Million Veteran Program (NephVA-MVP). Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Liu W, Holth J, Paranjpe M, Ren X, Shu Y, Murlidharan G, Chung C, Powers A, Peterson E, Ecker A, Hameedi U, Grant K, Kurella V, Kavanagh D, Khwaja O, Hou J, Paul SM, Bales KR, Carter T. Efficacy of a vectorized anti‐tau antibody using systemic dosing of a blood brain barrier penetrant AAV capsid in mouse models of tauopathies. Alzheimers Dement 2021. [DOI: 10.1002/alz.053341] [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: 11/10/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jay Hou
- Voyager Therapeutics Cambridge MA USA
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Echevarria M, Chung C, Kirtane K, Kish J, Muzaffar J, Caudell J. Outcomes of Phase I Trial of Patients With Recurrent Head and Neck Squamous Cell Carcinoma Treated With Re-Irradiation With Stereotactic Body Radiation Therapy and Concurrent Cisplatin. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tawbi H, Forsyth P, Hodi F, Algazi A, Hamid O, Lao C, Moschos S, Atkins M, Lewis K, Postow M, Thomas R, Khushalani N, Pavlick A, Ernstoff M, Reardon D, Chung C, Lee CW, Bas T, Askelson M, Margolin K. 1039MO CheckMate 204: 3-year outcomes of treatment with combination nivolumab (NIVO) plus ipilimumab (IPI) for patients (pts) with active melanoma brain metastases (MBM). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Cortellini A, Roldán E, Garcia MC, Berardi R, Sánchez A, Martinez C, Parisi A, Jones E, Bertulli R, Rizzo G, Guida A, Chung C, Bower M, Betti M, Vincenzi B, Mirallas O, Biello F, Queirolo P, Gennari A, Pinato D. 1560O Prevalence and impact of COVID-19 sequelae on treatment pathways and survival of cancer patients who recovered from SARS-CoV-2 infection. Ann Oncol 2021. [PMCID: PMC8454394 DOI: 10.1016/j.annonc.2021.08.1553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Javed F, Chung C, Fayyaz H, Jeffery R. AB0853 IGG4-RELATED DISEASE CAUSING OCULAR NERVE PALSIES AND ORBITAL APEX SYNDROME: CASE REPORT AND LITERATURE REVIEW. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:IgG4-Related Disease (IgG4-RD) is a systemic immune-mediated fibroinflammatory condition. The epidemiology is not well defined: it usually affects adults from middle-age onwards, predominantly male. Both B and T-cells are central in IgG4-RD pathogenesis, as demonstrated by the efficacy of B-cell depletion therapy.IgG4-RD can affect multiple organs including the central and peripheral nervous system, producing a constellation of clinical symptoms and signs, depending on the organ structures involved.IgG4-related orbital disease is relatively rare can implicate all extra-ocular muscles, structures emerging from the Orbital apex, optic canal, or superior and inferior orbital fissure. Depending on the structures involved, it can produce different or sometimes subtle clinical presentations, posing diagnostic challenge. There were case reports of IgG4-related ophthalmic disease misdiagnosed as intraocular tumour.Objectives:IgG4-RD is increasingly recognised as an entity affecting the head and neck region. However, it rarely involves skull base and presents with orbital apex syndrome. In this current case report, we describe an interesting case of IgG-related orbital disease presenting with ocular nerve palsies and orbital apex syndrome.Methods:Case report.Results:A 36-year-old gentleman with cocaine and alcohol misuse presented with a 2-month history of left sided headache, diplopia, recurrent ear infections, otalgia and hearing loss. Initial imaging suggested left otomastoiditis and intravenous antibiotics were commenced. Contralateral partial third nerve palsy with pupil sparing was elicited. 2 months later, there was worsening right eye ptosis, proptosis, right relative afferent pupillary defect, reduced visual acuity and colour vision as well as a near-complete ophthalmoplegia. Subsequent imaging showed worsening soft tissue swelling centred on the upper left parapharyngeal and masticator space, with multiple perineural enhancement and lateral extension to right orbital apex and orbital fissures. Blood tests only revealed raised IgG4 subclass. Infectious aetiology was excluded. Left nasal mass biopsy performed showed no fungal organism or malignancy. There were lymphoplasmacytic proliferation but no storiform fibrosis or obliterative phlebitis. IgG4 immunostaining on two assessable fields revealed 22 and 17 positive plasma cells respectively, and an IgG4: IgG ratio of <10%, and 50% in the other. Significant improvement was seen clinically and radiologically with antibiotics and a tapering regime of oral Prednisolone. Patient was commenced on Azathioprine as long term immunosuppression.Conclusion:A high degree of clinical suspicion is necessary to diagnose IgG4-RD when presenting with orbital apex syndrome and ocular nerve palsies,IgG4-RD can mimic mastoiditis of infectious aetiology. Other differentials may include cocaine-induced midline destructive lesions and granulomatosis with polyangiitis. The diagnosis can be supported by elevated serum IgG, elevated IgG index and pathognomonic histopathological findings. . The diagnosis of IgG4-related orbital disease should be deliberated on by a multidisciplinary group, with every effort being made to exclude an infectious aetiology, before embarking on immunosuppressive therapy.Primary treatment is with steroids. However, immunotherapy using azathioprine can be utilised in recurrent disease or patients with steroid intolerance.References:[1]Goto H, Ueda S. Immunoglobulin G4-related ophthalmic disease involving the sclera misdiagnosed as intraocular tumor: report of one case. OculOncolPathol. 2016;2(4):285–8.[2]Ohyama K, Koike H, Iijima M, et al. IgG4-related neuropathy: a case report. JAMA Neurol. 2013;70(4):502–5.[3]AbdelRazek MA, Venna N, Stone JH. IgG4-related disease of the central and peripheral nervous systems. Lancet Neurol. 2018;17(2):183–92.[4]Kamekura R, Takahashi H, Ichimiya S. New insights into IgG4-related disease: emerging new CD4+ T-cell subsets. Curr Opin Rheumatol. 2019;31(1):9–15.Disclosure of Interests:None declared
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Goldenberg M, Ly N, Spaccarelli N, Korman A, Chung C, Kaffenberger B. 287 A retrospective study of cellulitis outcomes in Ohio hospitals with or without access to dermatology residency programs. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fritsch C, Gout JF, Haroon S, Towheed A, Chung C, LaGosh J, McGann E, Zhang X, Song Y, Simpson S, Danthi PS, Benayoun BA, Wallace D, Thomas K, Lynch M, Vermulst M. Genome-wide surveillance of transcription errors in response to genotoxic stress. Proc Natl Acad Sci U S A 2021; 118:e2004077118. [PMID: 33443141 PMCID: PMC7817157 DOI: 10.1073/pnas.2004077118] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Indexed: 11/18/2022] Open
Abstract
Mutagenic compounds are a potent source of human disease. By inducing genetic instability, they can accelerate the evolution of human cancers or lead to the development of genetically inherited diseases. Here, we show that in addition to genetic mutations, mutagens are also a powerful source of transcription errors. These errors arise in dividing and nondividing cells alike, affect every class of transcripts inside cells, and, in certain cases, greatly exceed the number of mutations that arise in the genome. In addition, we reveal the kinetics of transcription errors in response to mutagen exposure and find that DNA repair is required to mitigate transcriptional mutagenesis after exposure. Together, these observations have far-reaching consequences for our understanding of mutagenesis in human aging and disease, and suggest that the impact of DNA damage on human physiology has been greatly underestimated.
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Affiliation(s)
- C Fritsch
- Department of Cellular and Molecular Biology, University of Pennsylvania, Philadelphia, PA 19104
| | - J-F Gout
- School of Life Sciences, Biodesign Center for Mechanisms of Evolution, Arizona State University, Tempe, AZ 85287
- Department of Biological Sciences, Mississippi State University, Mississippi State, MS 39762
| | - S Haroon
- Department of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104
| | - A Towheed
- Touro College of Osteopathic Medicine, Middletown, NY 10940
| | - C Chung
- School of Gerontology, University of Southern California, Los Angeles, CA 90089
| | - J LaGosh
- School of Gerontology, University of Southern California, Los Angeles, CA 90089
| | - E McGann
- School of Gerontology, University of Southern California, Los Angeles, CA 90089
| | - X Zhang
- Bioinforx, Inc., Madison, WI 53719
| | - Y Song
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA 19104
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, University of Pennsylvania, Philadelphia, PA 19104
| | - S Simpson
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, NH 03824
| | - P S Danthi
- School of Gerontology, University of Southern California, Los Angeles, CA 90089
| | - B A Benayoun
- School of Gerontology, University of Southern California, Los Angeles, CA 90089
| | - D Wallace
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, University of Pennsylvania, Philadelphia, PA 19104
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104
| | - K Thomas
- Department of Molecular, Cellular and Biomedical Sciences, University of New Hampshire, Durham, NH 03824
| | - M Lynch
- School of Life Sciences, Biodesign Center for Mechanisms of Evolution, Arizona State University, Tempe, AZ 85287;
| | - M Vermulst
- School of Gerontology, University of Southern California, Los Angeles, CA 90089;
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104
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Anagnostou M, Chung C, McGann E, Verheijen B, Kou Y, Chen L, Vermulst M. Transcription errors in aging and disease. Translational Medicine of Aging 2021. [DOI: 10.1016/j.tma.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Palmer J, Klamer B, Ballman K, Brown P, Cerhan J, Anderson K, Whitton A, Greenspoon J, Chung C, Burri S, Parney I, Stieber V, Pollock B, Laack N, Ashman J, Bahary J, Barker F, Galanis E, Asher A, Roberge D. Effect of Stereotactic Radiosurgery Compared to Whole-brain Radiotherapy for Limited Brain Metastasis on Long Term Cognition and Quality of Life: A Pooled Analysis of NCCTG N107C/CEC.3 and N0574 (Alliance) Randomized Clinical Trials. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Li J, Ludmir E, Wang Y, Guha-Thakurta N, McAleer M, Settle S, Yeboa D, Ghia A, McGovern S, Chung C, Woodhouse K, Briere T, Sullaway C, Liu D, Rao G, Chang E, Mahajan A, Sulman E, Brown P, Wefel J. Stereotactic Radiosurgery versus Whole-brain Radiation Therapy for Patients with 4-15 Brain Metastases: A Phase III Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2108] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thrower S, Al Feghali K, Luo D, Paddick I, Brock K, Chung C. MR Slice Thickness Impacts Detection and Delineation of Brain Metastases for Treatment Determination, Radiosurgery Treatment Planning and Follow-Up. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Augustyn A, Ludmir E, Patel R, Maldonado A, Bishop A, Chung C, Ghia A, McAleer M, McGovern S, Woodhouse K, Yeboa D, Briere T, Haydu L, Ferguson S, Guha-Thakurta N, Glitza I, Li J. Concurrent Immunotherapy and Stereotactic Radiosurgery for Patients with Melanoma Brain Metastases is not Associated with Increased Risk of Brain Radionecrosis. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Li J, Wang Y, Tang C, Welsh J, Guha-Thakurta N, Carter B, Wefel J, Ghia A, Yeboa D, McAleer M, Chung C, Woodhouse K, Elamin Y, Le X, Cascone T, Negrao M, Skoulidis F, Ferrarotto R, Heymach J, Altan M. Concurrent Nivolumab And Ipilimumab With Brain Stereotactic Radiosurgery For Brain Metastases From Non-Small Cell Lung Cancer: A Phase I Trial. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Johnson A, Zhao Q, Chung C, William B. 503 Outcomes of patients with cutaneous T-cell lymphoma (CTCL) treated with extracorporeal photopheresis (ECP): A single institution experience. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hwang S, Johnson A, Fabbro S, Hastings J, Haverkos B, Chung C, Porcu P, William B. Topical imiquimod monotherapy for indolent primary cutaneous B-cell lymphomas: a single-institution experience. Br J Dermatol 2020; 183:386-387. [PMID: 32078154 DOI: 10.1111/bjd.18961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Hwang
- Division of Hematology, Ohio State University, Columbus, OH, USA
| | - A Johnson
- Division of Hematology, Ohio State University, Columbus, OH, USA
| | - S Fabbro
- Division of Dermatology, Department of Medicine, Ohio State University, Columbus, OH, USA
| | - J Hastings
- Division of Dermatology, Department of Medicine, Ohio State University, Columbus, OH, USA
| | - B Haverkos
- Blood Cancer and BMT Program, University of Colorado School of Medicine, Aurora, CO, USA
| | - C Chung
- Division of Dermatology, Department of Medicine, Ohio State University, Columbus, OH, USA
| | - P Porcu
- Division of Hematologic Malignancies and Hematopoietic Stem Cell Transplantation, Department of Medical Oncology, Sidney Kimmel Cancer Center at Jefferson, Thomas Jefferson University, Philadelphia, PA, USA
| | - B William
- Division of Hematology, Ohio State University, Columbus, OH, USA
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El Mekabaty A, Gottschalk A, Moghekar A, Obusez E, Khan M, Chung C, Spiotta A, Luciano MG, Hui FK. General Anesthesia Alters Intracranial Venous Pressures During Transverse Sinus Stenting. World Neurosurg 2020; 138:e712-e717. [PMID: 32194272 DOI: 10.1016/j.wneu.2020.03.050] [Citation(s) in RCA: 3] [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] [Received: 12/06/2019] [Revised: 03/06/2020] [Accepted: 03/07/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Pressure gradients across venous stenosis are used as a marker for physiologically significant narrowing in idiopathic intracranial hypertension. Performing such measurements under conscious sedation (CS) more likely reflects physiologic conditions, but can be uncomfortable, leading some operators to perform measurement under general anesthesia (GA), though this may not be equivalent. METHODS We performed a retrospective analysis of patients who received endovascular transverse sinus stenting due to idiopathic intracranial hypertension between August 2013 and May 2017. Patients' demographics and anesthetic parameters were collected along with venous pressure measurements. RESULTS We identified 15 patients (14 women). The mean (SD) age was 30.5 (9.0) years and the mean body mass index (SD) was 39.5 (9.6) kg/m2. After measurements during CS, GA was induced with propofol and maintained with a volatile anesthetic. The median [IQR; range] transverse sinus pressure gradient under CS was 18 [12, 25; 6-38] mmHg compared with 14 [8, 21; 3-26] mm Hg under GA. The median [IQR; range] pressure gradient change after initiation of GA was -3 [-12, 0; -22 to 9] mm Hg (P = 0.014). After correction for increases in internal jugular vein pressures associated with assumption of GA, the median [IQR; range] gradient change was -11 [-12.5, -5; -22 to 0] mm Hg (P < 0.001). CONCLUSIONS The transition from CS to GA results in clinically meaningful reductions in transverse sinus gradients in idiopathic intracranial hypertension. Correction for increases in the internal jugular vein pressures reveals even more dramatic reductions in transverse sinus gradients.
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Affiliation(s)
- Amgad El Mekabaty
- Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Allan Gottschalk
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, Maryland, USA; Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Abhay Moghekar
- Department of Neurology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Emmanuel Obusez
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Majid Khan
- Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Charlotte Chung
- Department of Radiology, Emory University Hospital, Atlanta, Georgia, USA
| | - Alejandro Spiotta
- Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Mark G Luciano
- Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Ferdinand K Hui
- Department of Radiology, The Johns Hopkins Hospital, Baltimore, Maryland, USA.
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Tabaie A, Nemati S, Allen JW, Chung C, Queiroga F, Kuk WJ, Prater AB. Assessing Contribution of Higher Order Clinical Risk Factors to Prediction of Outcome in Aneurysmal Subarachnoid Hemorrhage Patients. AMIA Annu Symp Proc 2020; 2019:848-856. [PMID: 32308881 PMCID: PMC7153066] [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: 06/11/2023]
Abstract
The goal of this study was to investigate the application of machine learning models capable of capturing multiplica tive and temporal clinical risk factors for outcome prediction inpatients with aneurysmal subarachnoid hemorrhage (aSAH). We examined a cohort of 575 aSAH patients from Emory Healthcare, identified via digital subtraction angiog- raphy. The outcome measure was the modified Ranking Scale (mRS) after 90 days. Predictions were performed with longitudinal clinical and imaging risk factors as inputs into a regularized Logistic Regression, a feedforward Neural Network and a multivariate time-series prediction model known as the long short-term memory (LSTM) architecture. Through extraction of higher-order risk factors, the LSTM model achieved an AUC of 0.89 eight days into hospitaliza tion, outperforming other techniques. Our preliminary findings indicate the proposed model has the potential to aid treatment decisions and effective imaging resource utilization in high-risk patients by providing actionable predictions prior to the development of neurological deterioration.
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Affiliation(s)
- Azade Tabaie
- Department of Biomedical Informatics, Emory School of Medicine, Atlanta, GA, USA
| | - Shamim Nemati
- Department of Biomedical Informatics, Emory School of Medicine, Atlanta, GA, USA
| | - Jason W Allen
- Department of Biomedical Informatics, Emory School of Medicine, Atlanta, GA, USA
| | - Charlotte Chung
- Department of Biomedical Informatics, Emory School of Medicine, Atlanta, GA, USA
| | - Flavia Queiroga
- Department of Biomedical Informatics, Emory School of Medicine, Atlanta, GA, USA
| | - Won-Jun Kuk
- Department of Biomedical Informatics, Emory School of Medicine, Atlanta, GA, USA
| | - Adam B Prater
- Department of Biomedical Informatics, Emory School of Medicine, Atlanta, GA, USA
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Soliman M, Rosenblatt R, Joshi M, Chung C, Mitry M, Oh K, Talenfeld A, Samstein B, Brown R, Halazun K, Fortune B, Charalel R. 3:27 PM Abstract No. 130 Hospitalization and complication rates following radiation segmentectomy versus microwave ablation for small hepatocellular carcinoma. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Joshi M, Rosenblatt R, Chung C, Mitry M, Soliman M, Oh K, Askin G, Talenfeld A, Samstein B, Brown R, Halazun K, Fortune B, Charalel R. Abstract No. 532 Comparative efficacy of transarterial embolization versus transarterial embolization plus microwave ablation for hepatocellular carcinoma 3 to 5 cm in size. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Wahl GM, Ma Z, Chung C, Dravis C, Spike BT, Giraddi RT, Balcioglu O, Fan C, Hagos B, Heinz R, Herrera-Valdez J, Hou X, Hwang J, Lasken R, Luna G, Lytle NE, Mehrabad EM, Novotny M, Perou CM, Poirion O, Preissl S, Ren B, Reya T, Trejo CL, Varley KT. Abstract ES10-2: Understanding breast cancer using a developmental perspective. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-es10-2] [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
Parallels among embryonic development, stem cells, and cancer have long been recognized. We identified, isolated, and characterized stem cells that first become committed to a mammary fate during embryogenesis; we refer to these cells as fetal mammary stem cells (fMaSCs). Lineage tracing, in vitro sphere formation, and in vivo transplantation studies by our group and many others all confirm that cells in the embryo are the bipotent progenitors of the mammary gland. There is debate, however, on whether such bipotent cells persist into the adult, or whether the luminal and basal lineages are maintained by unipotent progenitors. To gain insight into the relationships between fMaSCs and breast cancer, and to investigate their potential persistence in the adult, we have applied bulk and single cell RNA-sequencing (sc-RNA-seq) and single nucleus ATAC-sequencing (snATAC-seq) throughout mammary development. The results to be discussed demonstrate that fMaSC transcriptomes are heterogeneous, but all share co-expression of genes associated with luminal and basal cell fates. This fits a model in which the bipotent state is created by a balance of lineage specifiers. We also find that the fMaSC transcriptome is highly enriched in basal-like human breast cancers and identify potential embryonic pathways that correlate with poor prognosis. We used a variety of computational tools to infer the gene expression programs that ensue when fMaSCs commit to luminal and basal states. The data from scRNA-seq and snATAC-seq demonstrate that the transitions are gradual, not precipitous, and that luminal and basal cells exhibit significant transcriptomic and epigenetic heterogeneity. This challenges the notion that the mammary gland consists of discrete cell types defined by rigid transcriptomic parameters, and reveals a potential for intrinsic phenotypic plasticity of normal mammary cells. Using the combined databases, we identified Sox10 as a significantly differentially expressed cell state regulator. We show that tumors are heterogeneous with regard to Sox10 expression, and that locally invasive cells tend to express high Sox10 levels. Elevated Sox10 correlates with acquisition of a neural-crest like, EMT-related state. Implications for interception of metastasis by targeting neural crest-like cells will be discussed. Finally, we have generated a web resource that is available to the scientific community to enable the transcription and epigenetic characteristics of any gene of interest to be tracked through mammary development (https://wahl-labsalk.shinyapps.io/Mammary_snATAC/).
Citation Format: GM Wahl, Z Ma, C Chung, C Dravis, BT Spike, RR Giraddi, O Balcioglu, C Fan, B Hagos, R Heinz, Herrera-Valdez J, X Hou, J Hwang, R Lasken, G Luna, NE Lytle, EM Mehrabad, M Novotny, CM Perou, O Poirion, S Preissl, B Ren, T Reya, CL Trejo, KT Varley. Understanding breast cancer using a developmental perspective [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr ES10-2.
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Affiliation(s)
- GM Wahl
- 1Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA
| | - Z Ma
- 1Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA
| | - C Chung
- 2Gene Expression Laboratory, Salk Institute for Biological Studies; Current address: Pfizer Inc., San Diego, CA 92121, La Jolla, CA
| | - C Dravis
- 1Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA
| | - BT Spike
- 3Huntsman Cancer Institute, Department of Oncological Sciences, University of Utah, Salt Lake City, UT
| | - RT Giraddi
- 2Gene Expression Laboratory, Salk Institute for Biological Studies; Current address: Pfizer Inc., San Diego, CA 92121, La Jolla, CA
| | - O Balcioglu
- 3Huntsman Cancer Institute, Department of Oncological Sciences, University of Utah, Salt Lake City, UT
| | - C Fan
- 4Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - B Hagos
- 3Huntsman Cancer Institute, Department of Oncological Sciences, University of Utah, Salt Lake City, UT
| | - R Heinz
- 5Huntsman Cancer Institute, Department of Oncological Sciences, University of Utah, Salt Lake Sity, UT
| | - J Herrera-Valdez
- 1Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA
| | - X Hou
- 6Center for Epigenomics, Department of Cellular and Molecular Medicine, University of California, San Diego, School of Medicine, La Jolla, CA
| | - J Hwang
- 3Huntsman Cancer Institute, Department of Oncological Sciences, University of Utah, Salt Lake City, UT
| | - R Lasken
- 7J. Craig Venter Institute, La Jolla, CA
| | - G Luna
- 1Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA
| | - NE Lytle
- 1Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA
| | - EM Mehrabad
- 3Huntsman Cancer Institute, Department of Oncological Sciences, University of Utah, Salt Lake City, UT
| | - M Novotny
- 7J. Craig Venter Institute, La Jolla, CA
| | - CM Perou
- 4Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - O Poirion
- 6Center for Epigenomics, Department of Cellular and Molecular Medicine, University of California, San Diego, School of Medicine, La Jolla, CA
| | - S Preissl
- 6Center for Epigenomics, Department of Cellular and Molecular Medicine, University of California, San Diego, School of Medicine, La Jolla, CA
| | - B Ren
- 8Center for Epigenomics, Department of Cellular and Molecular Medicine, University of California, San Diego, School of Medicine; Ludwig Institute for Cancer Research, La Jolla, CA
| | - T Reya
- 9Sanford Consortium for Regenerative Medicine; Departments of Pharmacology and Medicine, Moores Cancer Center, University of California San Diego School of Medicine, La Jolla, CA
| | - CL Trejo
- 1Gene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, CA
| | - KT Varley
- 3Huntsman Cancer Institute, Department of Oncological Sciences, University of Utah, Salt Lake City, UT
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Mohammaden M, Pisani L, Perry da Camara C, Rodrigues GM, Bousalma M, Barreira C, Chung C, Bhatt N, Belagaje S, Anderson A, Al-bayati A, Haussen DC, Frankel M, Nogueira RG. Abstract TP90: Advance: Automated Detection and Volumetric Assessment of Intracerebral Hemorrhage. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.tp90] [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
Introduction:
Intracerebral hemorrhages (ICHs) accounts for approximately 15% of all strokes but carry high rates of morbidity and mortality. The location and volume of hematoma are strongly associated with outcomes. As novel treatments become established, early detection and proper volume measurement are becoming increasingly important. We aim to evaluate an artificial intelligence-based algorithm (Viz-ICH® v1.4) for ICH detection, volume measurement, and its differentiation from intraventricular hemorrhage (IVH).
Methods:
We performed single center retrospective analysis of non-contrast CTs (NCCTs), randomly picked from prospective cohort of acute stroke patients, with and without parenchymal ICHs, admitted to our stroke center from 02/14-03/17. Experienced stroke neurologists graded NCCTs with a semi-automated tool (OsiriX MD v.9.0.1) for presence and volume of ICH, and also presence of intraventricular hemorrhage (IVH). AI- and human-based readings were compared.
Results:
A total of 211 NCCTs were evaluated including 163 ICHs and 48 controls. The ICH location was basal ganglionic in 55.8%, Lobar in 23.3% and posterior fossa in 12% of the cases and 51.5 % of patients had associated IVH with mean volume 41.94 cc. The AI algorithm demonstrated high accuracy for ICH detection and volumetric measurement (Table). The maximal running time of the algorithm was under 15s.
Conclusion:
The presence and volume of ICHs can be accurately detected by AI Viz-ICH Algorithm, with good differentiation from IVH which will help in early triage of these patients.
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Affiliation(s)
- Mahmoud Mohammaden
- Advance: Automated Detection And Volumetric Assessment Of Intracerebral Hemorrhage, Atlanta, GA
| | | | - Catarina Perry da Camara
- Cntr Hosp Uinversitario Lisbo CentralEmory Univ Sch of Medicime/Grady Memorial Hosp, Atlanta, GA
| | | | - Mehdi Bousalma
- Emory Univ Sch Of Medicine/Grady Memorial Hosp, Atlanta, GA
| | | | | | - Nirav Bhatt
- Emory Univ Sch Of Medicine/Grady Memorial Hosp, Atlanta, GA
| | - Samir Belagaje
- Emory Univ Sch Of Medicine/Grady Memorial Hosp, Atlanta, GA
| | - Aaron Anderson
- Emory Univ Sch Of Medicine/Grady Memorial Hosp, Atlanta, GA
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Perry da Câmara C, Rodrigues GM, Barreira C, Bouslama M, Pisani L, Mohammaden M, Alhamza AB, Haussen DC, Chung C, Bianchi N, Belagaje S, Liberato B, Bhatt NR, Anderson A, Frankel M, Nogueira R. Abstract WP61: Artificial Intelligence for Automated Detection of Large Vessel Occlusion Strokes. Stroke 2020. [DOI: 10.1161/str.51.suppl_1.wp61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Introduction:
Identification of Large Vessel Occlusion (LVO) in acute ischemic stroke (AIS) patients is critical for proper decision-making. Limited availability of trained experts and delays in LVO recognition can have a detrimental effect on outcomes. We sought to evaluate an artificial intelligence-based algorithm for LVO detection in AIS.
Methods:
A retrospective analysis of a prospectively-collected database of AIS patients admitted to a large volume stroke center between 2014-2018 was performed. Experienced vascular neurologists graded CTA for presence and site of LVO. Concurrently, studies were analyzed by the Viz-LVO Algorithm® version 1.4 (GA) - a convolutional neural network programmed to detect occlusions from the internal carotid artery terminus (ICA-T) to the sylvian fissure, which would include all MCA M1-segment and most M2-segment lesions. CTA readings were categorized as LVOs (ICA-T, MCA-M1, MCA-M2) versus non-LVOs/more distal occlusions. Comparisons between human and AI-based readings were done by accuracy analysis and calculating Cohen’s kappa.
Results:
A total of 610 CTAs were analyzed. The AI algorithm rejected 3.4% of the CTAs due to poor quality. Viz-LVO identified LVOs with an overall sensitivity of 81.3%, specificity of 87.8%, and accuracy of 83.2% (AUC 0.845 (95%CI:0.81-0.88, p<0.001). Table 1 shows the results per occlusion site. Accuracy was higher for ICA-T and M1 occlusions as compared to M2 occlusions. The mean run time of the algorithm was 2.78±0.5minutes.
Conclusion:
Our study demonstrates that automated AI reading allows for fast and accurate identification of LVO strokes. Future efforts should be made to improve the detection of the more distal occlusions.
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Affiliation(s)
- Catarina Perry da Câmara
- Emory Univ Sch of Medicine/ Grady Memorial Hosp/ Cntr Hospar Universitário Lisboa Central (Portugal), Atlanta, GA
| | | | - Clara Barreira
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | - Mehdi Bouslama
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | - Leonardo Pisani
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | | | | | - Diogo C Haussen
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | - Charlotte Chung
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | - Nicolas Bianchi
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | - Samir Belagaje
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | | | - Nirav R Bhatt
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | - Aaron Anderson
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | - Michael Frankel
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
| | - Raul Nogueira
- Emory Univ Sch of Medicine/ Grady Memorial Hosp, Atlanta, GA
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Yom S, Torres-Saavedra P, Caudell J, Waldron J, Gillison M, Truong M, Jordan R, Subramaniam R, Yao M, Chung C, Geiger J, Chan J, O'Sullivan B, Blakaj D, Mell L, Thorstad W, Jones C, Banerjee R, Lominska C, Le Q. NRG-HN002: A Randomized Phase II Trial for Patients With p16-Positive, Non-Smoking-Associated, Locoregionally Advanced Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.08.038] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Laceby JP, Kerr JG, Zhu D, Chung C, Situ Q, Abbasi S, Orwin JF. Chloride inputs to the North Saskatchewan River watershed: the role of road salts as a potential driver of salinization downstream of North America's northern most major city (Edmonton, Canada). Sci Total Environ 2019; 688:1056-1068. [PMID: 31726537 DOI: 10.1016/j.scitotenv.2019.06.208] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 05/27/2023]
Abstract
Multiple anthropogenic activities are driving the salinization of freshwater environments threatening water resources worldwide. Accordingly, this research will first examine the spatial and temporal variability of major ions (i.e. Ca2+, Mg2+, Na+, K+, SO42-, CO32-, and HCO3-) upstream and downstream of the northernmost major city in North America (Edmonton, Canada). Second, this research will estimate the relative contributions of the major sources of chloride (Cl), the main constituent of road deicers, to the sub-basin around Edmonton. Monthly water quality data was for three sites on the North Saskatchewan River (NSR): Rocky Mountain House (RMH - downstream of the Rocky Mountain headwaters), Devon Bridge (upstream of Edmonton) and Pakan Bridge (downstream of Edmonton). Change ratios investigate the downstream alterations of major ions at Pakan and Devon, relative to RMH. Seasonal Kendall tests examine temporal trends (1987-2017). A mass-balance approach then quantifies the major sources of Cl in the sub-basin of the NSR between Devon and Pakan. Progressing from the Rocky Mountain headwaters (at RMH) to downstream of Edmonton (at Pakan), Cl- increased by >5.5 times, Na+ by 4.8 times and K by 2.7 times. No significant temporal trends for Cl-, Na+ and K+ were evident at Devon (upstream of Edmonton), whereas all three significantly increased at Pakan (downstream of Edmonton). Deicers (54%), agriculture (20%), along with waste water treatment plant and industrial effluent (15%) were the largest Cl sources in the NSR Devon-Pakan sub-basin. In total, 77 Gg yr-1 of Cl (or 6 t km2 yr-1) is added to the Devon-Pakan sub-basin, of which, 43 Gg yr-1 is retained. Understanding and managing the major drivers of freshwater salinization will be of increasing importance in the 21st century owing to the potential salinization of freshwater resources in the context of a changing climate.
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Affiliation(s)
- J P Laceby
- Environmental Monitoring and Science Division, Alberta Environment and Parks, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada.
| | - J G Kerr
- Environmental Monitoring and Science Division, Alberta Environment and Parks, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada
| | - D Zhu
- Water Resources Branch, Environment, Government of Yukon, 419 Range Road, Whitehorse, Yukon, Y1A, 3V1, Canada
| | - C Chung
- Environmental Monitoring and Science Division, Alberta Environment and Parks, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada
| | - Q Situ
- Environmental Monitoring and Science Division, Alberta Environment and Parks, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada
| | - S Abbasi
- Environmental Monitoring and Science Division, Alberta Environment and Parks, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada
| | - J F Orwin
- Environmental Monitoring and Science Division, Alberta Environment and Parks, 3535 Research Rd NW, Calgary, Alberta T2L 2K8, Canada
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Kang D, Chung C, Lee J. EP1.04-08 Is Pseudoprogression Really Uncommon After Immunotherapy in Lung Cancer? J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jin Y, Randall J, Elhalawani H, Elliott A, Anderson B, Landry L, Mohamed A, Fuller C, Chung C. Evaluation of Serial Diffusion Tensor Imaging to Reveal Subclinical Tumor Prior to Detection on Anatomical Imaging in Patients with Glioblastoma. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Al Feghali K, Randall J, Wefel J, Guha-Thakurta N, Grosshans D, Dibej S, McAvoy S, Li J, McGovern S, McAleer M, Ghia A, Paulino A, Sulman E, Penas-Prado M, Wang J, deGroot J, Heimberger A, Armstrong T, Gilbert M, Mahajan A, Brown P, Chung C. Prospective Phase II Randomized Trial Comparing Proton Therapy vs. IMRT for Newly Diagnosed GBM: Secondary Analysis Comparison of Progression Free Survival between Clinical Radiological Assessment vs. Response Assessment in Neuro-Oncology (RANO). Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Awan O, Dey C, Salts H, Brian J, Fotos J, Royston E, Braileanu M, Ghobadi E, Powell J, Chung C, Auffermann W. Making Learning Fun: Gaming in Radiology Education. Acad Radiol 2019; 26:1127-1136. [PMID: 31005406 DOI: 10.1016/j.acra.2019.02.020] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [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: 12/17/2018] [Revised: 02/21/2019] [Accepted: 02/26/2019] [Indexed: 01/01/2023]
Abstract
With continued technologic advances, it is not surprising that gaming techniques are increasingly being used in radiology residency programs. This comprehensive review on gaming in radiology education offers insight into the importance of gaming, types of games and principles utilized in gaming, as well as applications that are inherent in artificial intelligence and continued medical education. The advantages and disadvantages of gaming will be considered, as well as barriers to successful adoption of gaming.
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Affiliation(s)
- Omer Awan
- University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201.
| | - Courtney Dey
- Eastern Virginia Medical School, Norfolk, Virginia.
| | - Hayden Salts
- Eastern Virginia Medical School, Norfolk, Virginia.
| | - James Brian
- Penn State Hershey Medical Center, Hershey, Pennsylvania.
| | - Joseph Fotos
- Penn State Hershey Medical Center, Hershey, Pennsylvania.
| | | | | | | | - Jason Powell
- Wake Forest Baptist Health, Winston-Salem, North Carolina.
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