1
|
Wong XK, Ng CS, Yeong KY. Shaping the future of antiviral Treatment: Spotlight on Nucleobase-Containing drugs and their revolutionary impact. Bioorg Chem 2024; 144:107150. [PMID: 38309002 DOI: 10.1016/j.bioorg.2024.107150] [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: 11/08/2023] [Revised: 12/28/2023] [Accepted: 01/22/2024] [Indexed: 02/05/2024]
Abstract
Nucleobases serve as essential molecular frameworks present in both natural and synthetic compounds that exhibit notable antiviral activity. Through molecular modifications, novel nucleobase-containing drugs (NCDs) have been developed, exhibiting enhanced antiviral activity against a wide range of viruses, including the recently emerged SARS‑CoV‑2. This article provides a detailed examination of the significant advancements in NCDs from 2015 till current, encompassing various aspects concerning their mechanisms of action, pharmacology and antiviral properties. Additionally, the article discusses antiviral prodrugs relevant to the scope of this review. It fills in the knowledge gap by examining the structure-activity relationship and trend of NCDs as therapeutics against a diverse range of viral diseases, either as approved drugs, clinical candidates or as early-stage development prospects. Moreover, the article highlights on the status of this field of study and addresses the prevailing limitations encountered.
Collapse
Affiliation(s)
- Xi Khai Wong
- School of Science, Monash University (Malaysia Campus), Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia
| | - Chen Seng Ng
- School of Science, Monash University (Malaysia Campus), Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia
| | - Keng Yoon Yeong
- School of Science, Monash University (Malaysia Campus), Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor, Malaysia.
| |
Collapse
|
2
|
Youn HM, Zhang Y, Liu A, Ng CS, Liang J, Lau GKK, Lee SF, Lok J, Lam CLK, Wan EYF, Quan J. Decline in Cancer Diagnoses during the 'Zero COVID' Policy in Hong Kong: Indirect Spillover Impact of the COVID-19 Pandemic. Clin Oncol (R Coll Radiol) 2024; 36:157-164. [PMID: 38262779 DOI: 10.1016/j.clon.2024.01.008] [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: 06/21/2023] [Revised: 11/26/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
AIMS Despite a largely successful 'zero COVID' policy in 2020, the COVID-19 pandemic disrupted routine cancer services in the city of Hong Kong. The aims of this study were to examine the trends in cancer incidence before and during the COVID-19 pandemic and estimate missed cancer diagnoses. MATERIALS AND METHODS We used population-based data from the Hong Kong Cancer Registry 1983-2020 to examine the trends of age- and sex-standardised cancer incidence before and during the COVID-19 pandemic. We applied: (i) the annual average percentage change (AAPC) calculated using the Joinpoint regression model and (ii) the autoregressive integrated moving average (ARIMA) model to forecast cancer incidence rates in 2020. Missed cancer diagnoses in 2020 were estimated by comparing forecasted incidence rates to reported rates. A subgroup analysis was conducted by sex, age and cancer site. RESULTS The cancer incidence in Hong Kong declined by 4.4% from 2019 to 2020 (male 8.1%; female 1.1%) compared with the long-term AAPC of 0.5% from 2005 to 2019 (95% confidence interval 0.3, 0.7). The gap between the reported and forecasted incidence for 2020 ranged from 5.1 to 5.7% (male 8.5%, 9.8%; female 2.3%, 3.5%). We estimated 1525-1596 missed cancer diagnoses (ARIMA estimate -98, 3148; AAPC 514, 1729) in 2020. Most missed diagnoses were in males (ARIMA 1361 [327, 2394]; AAPC 1401 [1353, 1460]), with an estimated 479-557 missed cases of colorectal cancer (ARIMA 112, 837; AAPC 518, 597) and 256-352 missed cases of prostate cancer (AAPC 231, 280; ARIMA 110, 594). CONCLUSION The incidence of new cancer diagnoses declined in 2020 contrary to the long-term increase over the previous decades. Significantly lower diagnoses than expected were observed in males, particularly for colorectal and prostate cancers. Fewer reported cancer cases indicate missed diagnoses and could lead to delayed treatment that could impact future health outcomes.
Collapse
Affiliation(s)
- H M Youn
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - Y Zhang
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - A Liu
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - C S Ng
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - J Liang
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - G K K Lau
- Department of Medicine, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - S F Lee
- Department of Radiation Oncology, National University Cancer Institute, Singapore
| | - J Lok
- Department of Pathology, United Christian Hospital, Hong Kong SAR, China
| | - C L K Lam
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - E Y F Wan
- Department of Family Medicine and Primary Care, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health (D(2)4H), Hong Kong Science and Technology Park, Hong Kong SAR, China
| | - J Quan
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China; HKU Business School, University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
3
|
Tan HY, Yong YK, Xue YC, Liu H, Furihata T, Shankar EM, Ng CS. cGAS and DDX41-STING mediated intrinsic immunity spreads intercellularly to promote neuroinflammation in SOD1 ALS model. iScience 2022; 25:104404. [PMID: 35712074 PMCID: PMC9194172 DOI: 10.1016/j.isci.2022.104404] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/22/2022] [Accepted: 05/10/2022] [Indexed: 11/25/2022] Open
Abstract
Neuroinflammation exacerbates the progression of SOD1-driven amyotrophic lateral sclerosis (ALS), although the underlying mechanisms remain largely unknown. Herein, we demonstrate that misfolded SOD1 (SOD1Mut)-causing ALS results in mitochondrial damage, thus triggering the release of mtDNA and an RNA:DNA hybrid into the cytosol in an mPTP-independent manner to activate IRF3- and IFNAR-dependent type I interferon (IFN-I) and interferon-stimulating genes. The neuronal hyper-IFN-I and pro-inflammatory responses triggered in ALS-SOD1Mut were sufficiently robust to cause a strong physiological outcome in vitro and in vivo. cGAS/DDX41-STING-signaling is amplified in bystander cells through inter-neuronal gap junctions. Our results highlight the importance of a common DNA-sensing pathway between SOD1 and TDP-43 in influencing the progression of ALS. Constitutive basal activation of IFN-I was found in the SOD1-ALS animal model SOD1-ALS damaged mitochondria to release mtDNA and RNA:DNA to activate the STING-pathway Blocking cGAS and STING diminishes neurodegeneration in vivo in the SOD1-ALS model Connexin and pannexin channels are required to propagate neuroinflammation in SOD1-ALS
Collapse
Affiliation(s)
- Hong Yien Tan
- Laboratory Centre, Xiamen University Malaysia, Sepang, Selangor, Malaysia.,School of Traditional Chinese Medicine, Xiamen University Malaysia, Sepang, Selangor, Malaysia
| | - Yean Kong Yong
- Laboratory Centre, Xiamen University Malaysia, Sepang, Selangor, Malaysia
| | - Yuan Chao Xue
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Department of Pathology and Laboratory of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Huitao Liu
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.,Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tomomi Furihata
- Laboratory of Clinical Pharmacy and Experimental Therapeutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Esaki Muthu Shankar
- Infection Biology, Department of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Chen Seng Ng
- China-ASEAN College of Marine Sciences, Xiamen University Malaysia, Sepang, Selangor, Malaysia
| |
Collapse
|
4
|
Tan TH, Wong TH, Khoo CH, Mahaletchumy T, Ng CS, Ghazali MW. Malaysian consensus statement on FDG PET-CT reporting format for lymphoma. Med J Malaysia 2021; 76:685-690. [PMID: 34508375] [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: 06/13/2023]
Abstract
Over the past decade, 18F-Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PETCT) has emerged as an important imaging modality in the management of lymphoma. Since the introduction of Deauville scoring system (2009) and the Lymphoma Response Assessment Criteria (2014), clinicians are now sharing a common language in the management of lymphoma. In Malaysia, nearly a third of PET-CT request is related to lymphoma imaging. Though there are extensive publications regarding these scoring systems and assessment criteria for lymphoma, there are hardly any literature on the reporting format for the 18F-FDG PET-CT in this disease. The variable reporting formats have on many occasions caused confusion not only to the referring clinicians but also to nuclear medicine physicians. Thus, a working committee comprising experienced nuclear medicine physicians and haematologists in Malaysia have agreed and made a joint recommendation on the standard reporting format for 18F-FDG PET-CT in Lymphoma. This recommendation will minimize inter-observer discrepancies in reporting, facilitate the understanding of the report of the referring clinicians as well as facilitate counseling between patients and clinicians in the management of the disease.
Collapse
Affiliation(s)
- T H Tan
- Sunway Medical Centre, Nuclear Medicine Centre, Selangor, Malaysia
| | - T H Wong
- Pantai Hospital Kuala Lumpur, Department of Nuclear Medicine, Kuala Lumpur, Malaysia.
| | - C H Khoo
- Penang Adventist Hospital, Nuclear Medicine Centre, Pulau Pinang, Malaysia
| | - T Mahaletchumy
- Universiti Kebangsaan Malaysia Medical Centre, Department of Molecular Imaging and Nuclear Medicine, Selangor, Malaysia
| | - C S Ng
- Pantai Hospital Kuala Lumpur, Department of Nuclear Medicine, Kuala Lumpur, Malaysia
| | - M W Ghazali
- Hospital Pulau Pinang, Department of Nuclear Medicine, Pulau Pinang, Malaysia
| |
Collapse
|
5
|
Kavita A, Abdul Onny MA, Suppiah S, Abdul Aziz AF, Hashim H, Raja Shariff RE, Ng CS. A challenging road to diagnosing transthyretin cardiac amyloidosis and using technetium-99m pyrophosphate bone scintigraphy in nuclear cardiology - A case report. Med J Malaysia 2021; 76:762-767. [PMID: 34508392] [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: 06/13/2023]
Abstract
Cardiac amyloidosis (CA) is a rare form of protein deposition disease, leading to restrictive cardiomyopathy that often presents with signs and symptoms of unexplained heart failure with preserved ejection fraction (HFpEF). There are two main subtypes of CA, namely light chain amyloidosis (AL) and transthyretin amyloidosis (ATTR), which are conventionally confirmed by endomyocardial biopsy (EMB). The prognosis and treatment of the subtypes differ extensively, making it crucial to distinguish between the two. Although echocardiography (ECHO) and cardiac magnetic resonance imaging (CMR) are useful to aid in the diagnosis, they are unable to differentiate between the subtypes. Advantageously, the transthyretin cardiac amyloidosis (ATTR-CA) subtype can be diagnosed based on nuclear medicine bone scintigraphy imaging using Technetiumlabelled bone-seeking radiotracers. We report a case of a previously well, elderly gentleman who presented with acute heart failure symptoms, whereby ECHO findings were suspicious for CA. Technetium-99m pyrophosphate (99mTc- PYP) bone scintigraphy performed with complementary single photon emission computed tomography/computed tomography (SPECT/CT) at three hours post-injection revealed radiotracer uptake in the myocardium that was higher than the skeletal bone uptake. This corresponded to Perugini score of 3 along with an increased heart to contralateral lung ratio (H:CL) of 1.69. The bone scintigraphy findings together with his symptoms, ECHO, CMR, and laboratory results enabled the diagnosis of ATTR-CA to be made. In summary, bone scintigraphy offers a reliable and non-invasive method for the diagnosis of ATTR-CA. We also highlight the diagnostic pitfalls and recommendations in reporting bone scintigraphy for the indication of typing cardiac amyloidosis.
Collapse
Affiliation(s)
- A Kavita
- Institut Kanser Negara, Department of Nuclear Medicine, Kementerian Kesihatan Malaysia, W.P. Putrajaya, Malaysia
| | - M A Abdul Onny
- Institut Kanser Negara, Department of Nuclear Medicine, Kementerian Kesihatan Malaysia, W.P. Putrajaya, Malaysia
| | - S Suppiah
- Institut Kanser Negara, Department of Nuclear Medicine, Kementerian Kesihatan Malaysia, W.P. Putrajaya, Malaysia.
| | - A F Abdul Aziz
- Institut Kanser Negara, Department of Nuclear Medicine, Kementerian Kesihatan Malaysia, W.P. Putrajaya, Malaysia
| | - H Hashim
- Advanced Medical & Dental Institute, Universiti Sains Malaysia, Bertam, Kepala Batas, Pulau Pinang, Malaysia
| | - R E Raja Shariff
- Universiti Teknologi Mara (UiTM), Faculty of Medicine, Department of Medicine, Sungai Buloh, Selangor, Malaysia
| | - C S Ng
- Institut Kanser Negara, Department of Nuclear Medicine, Kementerian Kesihatan Malaysia, W.P. Putrajaya, Malaysia
| |
Collapse
|
6
|
Mohamud Y, Xue YC, Liu H, Ng CS, Bahreyni A, Luo H. Autophagy Receptor Protein Tax1-Binding Protein 1/TRAF6-Binding Protein Is a Cellular Substrate of Enteroviral Proteinase. Front Microbiol 2021; 12:647410. [PMID: 34149637 PMCID: PMC8213198 DOI: 10.3389/fmicb.2021.647410] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/11/2021] [Indexed: 12/26/2022] Open
Abstract
Enteroviruses (EVs) usurp the host autophagy pathway for pro-viral functions; however, the consequence of EV-induced diversion of autophagy on organelle quality control is poorly defined. Using coxsackievirus B3 (CVB3) as a model EV, we explored the interplay between EV infection and selective autophagy receptors, i.e., Tax1-binding protein 1/TRAF6-binding protein (T6BP), optineurin (OPTN), and nuclear dot 10 protein 52 (NDP52), known to be involved in regulating the clearance of damaged mitochondria, a process termed as mitophagy. Following CVB3 infection, we showed significant perturbations of the mitochondrial network coincident with degradation of the autophagy receptor protein T6BP, similar phenomenon to what we previously observed on NDP52. Notably, protein levels of OPTN are not altered during early infection and slightly reduced upon late infection. Cell culture studies revealed that T6BP degradation occurs independent of the function of host caspases and viral proteinase 3C, but requires the proteolytic activity of viral proteinase 2A. Further investigation identified the cleavage site on T6BP after the amino acid 621 that separates the C-terminal ubiquitin-binding domain from the other functional domains at the N-terminus. Genetic silencing of T6BP and OPTN results in the attenuation of CVB3 replication, suggesting a pro-viral activity for these two proteins. Finally, functional assessment of cleaved fragments from NDP52 and T6BP revealed abnormal binding affinity and impaired capacity to be recruited to depolarized mitochondria. Collectively, these results suggest that CVB3 targets autophagy receptors to impair selective autophagy.
Collapse
Affiliation(s)
- Yasir Mohamud
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Yuan Chao Xue
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Huitao Liu
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chen Seng Ng
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Amirhossein Bahreyni
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Honglin Luo
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
7
|
Xue YC, Ng CS, Mohamud Y, Fung G, Liu H, Bahreyni A, Zhang J, Luo H. FUS/TLS Suppresses Enterovirus Replication and Promotes Antiviral Innate Immune Responses. J Virol 2021; 95:e00304-21. [PMID: 33827951 PMCID: PMC8316056 DOI: 10.1128/jvi.00304-21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/31/2021] [Indexed: 12/16/2022] Open
Abstract
During viral infection, the dynamic virus-host relationship is constantly in play. Many cellular proteins, such as RNA-binding proteins (RBPs), have been shown to mediate antiviral responses during viral infection. Here, we report that the RBP FUS/TLS (fused in sarcoma/translocated in liposarcoma) acts as a host-restricting factor against infection with coxsackievirus B3 (CVB3). Mechanistically, we found that deletion of FUS leads to increased viral RNA transcription and enhanced internal ribosome entry site (IRES)-driven translation, with no apparent impact on viral RNA stability. We further demonstrated that FUS physically interacts with the viral genome, which may contribute to direct inhibition of viral RNA transcription/translation. Moreover, we identified a novel function for FUS in regulating host innate immune response. We show that in the absence of FUS, gene expression of type I interferons and proinflammatory cytokines elicited by viral or bacterial infection is significantly impaired. Emerging evidence suggests a role for stress granules (SGs) in antiviral innate immunity. We further reveal that knockout of FUS abolishes the ability to form SGs upon CVB3 infection or poly(I·C) treatment. Finally, we show that, to avoid FUS-mediated antiviral response and innate immunity, CVB3 infection results in cytoplasmic mislocalization and cleavage of FUS through the enzymatic activity of viral proteases. Together, our findings in this study identify FUS as a novel host antiviral factor which restricts CVB3 replication through direct inhibition of viral RNA transcription and protein translation and through regulation of host antiviral innate immunity.IMPORTANCE Enteroviruses are common human pathogens, including those that cause myocarditis (coxsackievirus B3 [CVB3]), poliomyelitis (poliovirus), and hand, foot, and mouth disease (enterovirus 71). Understanding the virus-host interaction is crucial for developing means of treating and preventing diseases caused by these pathogens. In this study, we explored the interplay between the host RNA-binding protein FUS/TLS and CVB3 and found that FUS/TLS restricts CVB3 replication through direct inhibition of viral RNA transcription/translation and through regulation of cellular antiviral innate immunity. To impede the antiviral role of FUS, CVB3 targets FUS for mislocalization and cleavage. Findings from this study provide novel insights into interactions between CVB3 and FUS, which may lead to novel therapeutic interventions against enterovirus-induced diseases.
Collapse
Affiliation(s)
- Yuan Chao Xue
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chen Seng Ng
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yasir Mohamud
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Gabriel Fung
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Huitao Liu
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amirhossein Bahreyni
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jingchun Zhang
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Honglin Luo
- Centre for Heart and Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
8
|
Abstract
Coxsackievirus B3 (CVB3) is a prevalent etiological agent for viral myocarditis and neurological disorders, particularly in infants and young children. Virus-encoded proteinases have emerged as cytopathic factors that contribute to disease pathogenesis in part through targeting the cellular recycling machinery of autophagy. Although it is appreciated that CVB3 can usurp cellular macroautophagy/autophagy for pro-viral functions, the precise mechanisms by which viral proteinases disrupt autophagy remain incompletely understood. Here we identified TFEB (transcription factor EB), a master regulator of autophagy and lysosome biogenesis, as a novel target of CVB3 proteinase 3 C. Time-course infections uncovered a significant loss of full-length TFEB and the emergence of a lower-molecular mass (~63 kDa) fragment. Cellular and in vitro cleavage assays revealed the involvement of viral proteinase 3 C in the proteolytic processing of TFEB, while site-directed mutagenesis identified the site of cleavage after glutamine 60. Assessment of TFEB transcriptional activity using a reporter construct discovered a loss of function of the cleavage fragment despite nuclear localization and retaining of the ability of DNA and protein binding. Furthermore, we showed that CVB3 infection was also able to trigger cleavage-independent nuclear translocation of TFEB that relied on the serine-threonine phosphatase PPP3/calcineurin. Finally, we demonstrated that both TFEB and TFEB [Δ60] serve roles in viral egress albeit through differing mechanisms. Collectively, this study reveals that CVB3 targets TFEB for proteolytic processing to disrupt host lysosomal function and enhance viral infection. Abbreviations:ACTB: actin beta; CLEAR: coordinated lysosomal enhancement and regulation; CVB3: coxsackievirus B3; DAPI: 4′,6-diamidino-2-phenylindole; GFP: green fluorescent protein; LAMP1: lysosomal associated membrane protein 1; LTR: LysoTracker Red; PPP3/calcineurin: protein phosphatase 3; PPP3CA: protein phosphatase 3 catalytic subunit A; p-TFEB: phospho-Ser211 TFEB; si-CON: scramble control siRNA; TFEB: transcription factor EB; TFEB [Δ60]: TFEB cleavage fragment that lacks the first 60 amino acids; VP1: viral capsid protein 1
Collapse
Affiliation(s)
- Yasir Mohamud
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Hui Tang
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada.,Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yuan Chao Xue
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Huitao Liu
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada.,Department of Experimental Medicine, University of British Columbia, Vancouver, Canada
| | - Chen Seng Ng
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Amirhossein Bahreyni
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Honglin Luo
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
9
|
Liu H, Xue YC, Deng H, Mohamud Y, Ng CS, Chu A, Lim CJ, Lockwood WW, Jia WW, Luo H. Erratum: MicroRNA Modification of Coxsackievirus B3 Decreases Its Toxicity, while Retaining Oncolytic Potency against Lung Cancer. Mol Ther Oncolytics 2021; 20:1-2. [PMID: 33575465 PMCID: PMC7844118 DOI: 10.1016/j.omto.2020.12.002] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
[This corrects the article DOI: 10.1016/j.omto.2020.01.002.].
Collapse
|
10
|
Mohamud Y, Xue YC, Liu H, Ng CS, Bahreyni A, Jan E, Luo H. The papain-like protease of coronaviruses cleaves ULK1 to disrupt host autophagy. Biochem Biophys Res Commun 2021; 540:75-82. [PMID: 33450483 PMCID: PMC7836930 DOI: 10.1016/j.bbrc.2020.12.091] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 12/25/2020] [Indexed: 01/27/2023]
Abstract
The ongoing pandemic of COVID-19 alongside the outbreaks of SARS in 2003 and MERS in 2012 underscore the significance to understand betacoronaviruses as a global health challenge. SARS-CoV-2, the etiological agent for COVID-19, has infected over 50 million individuals' worldwide with more than ∼1 million fatalities. Autophagy modulators have emerged as potential therapeutic candidates against SARS-CoV-2 but recent clinical setbacks urge for better understanding of viral subversion of autophagy. Using MHV-A59 as a model betacoronavirus, time-course infections revealed significant loss in the protein level of ULK1, a canonical autophagy-regulating kinase, and the concomitant appearance of a possible cleavage fragment. To investigate whether virus-encoded proteases target ULK1, we conducted in-vitro and cellular cleavage assays and identified ULK1 as a novel bona fide substrate of SARS-CoV-2 papain-like protease (PLpro). Mutagenesis studies discovered that ULK1 is cleaved at a conserved PLpro recognition sequence (LGGG) after G499, separating its N-terminal kinase domain from a C-terminal substrate recognition region. Over-expression of SARS-CoV-2 PLpro is sufficient to impair starvation-induced autophagy and disrupt formation of ULK1-ATG13 complex. Finally, we demonstrated a dual role for ULK1 in MHV-A59 replication, serving a pro-viral functions during early replication that is inactivated at late stages of infection. In conclusion, our study identified a new mechanism by which PLpro of betacoronaviruses induces viral pathogenesis by targeting cellular autophagy.
Collapse
Affiliation(s)
- Yasir Mohamud
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Yuan Chao Xue
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Huitao Liu
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada; Experimental Medicine, University of British Columbia, Vancouver, Canada
| | - Chen Seng Ng
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Amirhossein Bahreyni
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Eric Jan
- Biochemistry and Molecular Biology, University of British Columbia, Vancouver, Canada
| | - Honglin Luo
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada; Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada.
| |
Collapse
|
11
|
Ng CS, Stobart CC, Luo H. Innate immune evasion mediated by picornaviral 3C protease: Possible lessons for coronaviral 3C-like protease? Rev Med Virol 2021; 31:1-22. [PMID: 33624382 PMCID: PMC7883238 DOI: 10.1002/rmv.2206] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 01/10/2023]
Abstract
Severe acute respiratory syndrome coronavirus-2 is the etiological agent of the ongoing pandemic of coronavirus disease-2019, a multi-organ disease that has triggered an unprecedented global health and economic crisis. The virally encoded 3C-like protease (3CLpro ), which is named after picornaviral 3C protease (3Cpro ) due to their similarities in substrate recognition and enzymatic activity, is essential for viral replication and has been considered as the primary drug target. However, information regarding the cellular substrates of 3CLpro and its interaction with the host remains scarce, though recent work has begun to shape our understanding more clearly. Here we summarized and compared the mechanisms by which picornaviruses and coronaviruses have evolved to evade innate immune surveillance, with a focus on the established role of 3Cpro in this process. Through this comparison, we hope to highlight the potential action and mechanisms that are conserved and shared between 3Cpro and 3CLpro . In this review, we also briefly discussed current advances in the development of broad-spectrum antivirals targeting both 3Cpro and 3CLpro .
Collapse
Affiliation(s)
- Chen Seng Ng
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, Canada.,Department of Pathology and Laboratory of Medicine, University of British Columbia, Vancouver, Canada
| | | | - Honglin Luo
- Centre for Heart Lung Innovation, St Paul's Hospital, University of British Columbia, Vancouver, Canada.,Department of Pathology and Laboratory of Medicine, University of British Columbia, Vancouver, Canada
| |
Collapse
|
12
|
Hong Yien T, Yean Kong Y, Ng CS, Vimali J, Mohamed R, Velu V, Larsson M, Esaki Muthu S. MAIT cells in hepatitis B virus infection – Diplomatic front-runners in the fight against HBV disease. Crit Rev Immunol 2021; 41:1-16. [DOI: 10.1615/critrevimmunol.2021041408] [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: 11/13/2022]
|
13
|
Ng CS, Kasumba DM, Fujita T, Luo H. Spatio-temporal characterization of the antiviral activity of the XRN1-DCP1/2 aggregation against cytoplasmic RNA viruses to prevent cell death. Cell Death Differ 2020; 27:2363-2382. [PMID: 32034313 PMCID: PMC7370233 DOI: 10.1038/s41418-020-0509-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/23/2020] [Accepted: 01/28/2020] [Indexed: 12/25/2022] Open
Abstract
Host nucleases are implicated in antiviral response through the processing of pathogen-derived nucleic acids. Among many host RNases, decapping enzymes DCP1 and 2, and 5'→3' exonuclease XRN1, which are components of the RNA decay machinery, have been extensively studied in prokaryotes, plants, and invertebrates but less so in mammalian systems. As a result, the implication of XRN1 and DCPs in viral replication, in particular, the spatio-temporal dynamics during RNA viral infections remains elusive. Here, we highlight that XRN1 and DCPs play a critical role in limiting several groups of RNA viral infections. This antiviral activity was not obvious in wild-type cells but clearly observed in type I interferon (IFN-I)-deficient cells. Mechanistically, infection with RNA viruses induced the enrichment of XRN1 and DCPs in viral replication complexes (vRCs), hence forming distinct cytoplasmic aggregates. These aggregates served as sites for direct interaction between XRN1, DCP1/2, and viral ribonucleoprotein that contains viral RNA (vRNA). Although these XRN1-DCP1/2-vRC-containing foci resemble antiviral stress granules (SGs) or P-body (PB), they did not colocalize with known SG markers and did not correlate with critical PB functions. Furthermore, the presence of 5' mono- and 5' triphosphate structures on vRNA was not required for the formation of XRN1-DCP1/2-vRC-containing foci. On the other hand, single-, double-stranded, and higher-ordered vRNA species play a role but are not deterministic for efficient formation of XRN1-DCP1/2 foci and consequent antiviral activity in a manner proportional to RNA length. These results highlight the mechanism behind the antiviral function of XRN1-DCP1/2 in RNA viral infections independent of IFN-I response, protein kinase R and PB function.
Collapse
Affiliation(s)
- Chen Seng Ng
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Dacquin M Kasumba
- Centre de Recherche du Centre Hospitalier de I'Université de Montréal, Université de Montréal, Montréal, QC, Canada
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Takashi Fujita
- Laboratory of Molecular Genetics, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan
- Laboratory of Molecular and Cellular Immunology, Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Honglin Luo
- Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
| |
Collapse
|
14
|
Swayne LA, Johnstone SR, Ng CS, Sanchez-Arias JC, Good ME, Penuela S, Lohman AW, Wolpe AG, Laubach VE, Koval M, Isakson BE. Consideration of Pannexin 1 channels in COVID-19 pathology and treatment. Am J Physiol Lung Cell Mol Physiol 2020; 319:L121-L125. [PMID: 32519892 PMCID: PMC7347959 DOI: 10.1152/ajplung.00146.2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Leigh Anne Swayne
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Scott R Johnstone
- Fralin Biomedical Research Institute at Virginia Tech Carilion Center for Heart and Reparative Medicine Research, Virginia Tech, Roanoke, Virginia.,Department of Biological Sciences, Virginia Tech, Roanoke, Virginia
| | - Chen Seng Ng
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Juan C Sanchez-Arias
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
| | - Miranda E Good
- Molecular Cardiology Research Institute, Tufts Medical Center, Boston, Massachusetts
| | - Silvia Penuela
- Department of Anatomy and Cell Biology, University of Western Ontario, London, Ontario, Canada
| | - Alexander W Lohman
- Department of Cell Biology and Anatomy, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Abigail G Wolpe
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia.,Department of Cell Biology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Victor E Laubach
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.,Department of Molecular Physiology and Biophysics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Michael Koval
- Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Brant E Isakson
- Robert M. Berne Cardiovascular Research Center, University of Virginia School of Medicine, Charlottesville, Virginia.,Department of Molecular Physiology and Biophysics, University of Virginia School of Medicine, Charlottesville, Virginia
| |
Collapse
|
15
|
Xue YC, Ng CS, Xiang P, Liu H, Zhang K, Mohamud Y, Luo H. Dysregulation of RNA-Binding Proteins in Amyotrophic Lateral Sclerosis. Front Mol Neurosci 2020; 13:78. [PMID: 32547363 PMCID: PMC7273501 DOI: 10.3389/fnmol.2020.00078] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/22/2020] [Indexed: 12/11/2022] Open
Abstract
Genetic analyses of patients with amyotrophic lateral sclerosis (ALS) have revealed a strong association between mutations in genes encoding many RNA-binding proteins (RBPs), including TARDBP, FUS, hnRNPA1, hnRNPA2B1, MATR3, ATXN2, TAF15, TIA-1, and EWSR1, and disease onset/progression. RBPs are a group of evolutionally conserved proteins that participate in multiple steps of RNA metabolism, including splicing, polyadenylation, mRNA stability, localization, and translation. Dysregulation of RBPs, as a consequence of gene mutations, impaired nucleocytoplasmic trafficking, posttranslational modification (PTM), aggregation, and sequestration by abnormal RNA foci, has been shown to be involved in neurodegeneration and the development of ALS. While the exact mechanism by which dysregulated RBPs contribute to ALS remains elusive, emerging evidence supports the notion that both a loss of function and/or a gain of toxic function of these ALS-linked RBPs play a significant role in disease pathogenesis through facilitating abnormal protein interaction, causing aberrant RNA metabolism, and by disturbing ribonucleoprotein granule dynamics and phase transition. In this review article, we summarize the current knowledge on the molecular mechanism by which RBPs are dysregulated and the influence of defective RBPs on cellular homeostasis during the development of ALS. The strategies of ongoing clinical trials targeting RBPs and/or relevant processes are also discussed in the present review.
Collapse
Affiliation(s)
- Yuan Chao Xue
- Centre for Heart and Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chen Seng Ng
- Centre for Heart and Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Pinhao Xiang
- Centre for Heart and Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Huitao Liu
- Centre for Heart and Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kevin Zhang
- Centre for Heart and Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Yasir Mohamud
- Centre for Heart and Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Honglin Luo
- Centre for Heart and Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
16
|
Liu H, Xue YC, Deng H, Mohamud Y, Ng CS, Chu A, Lim CJ, Lockwood WW, Jia WWG, Luo H. MicroRNA Modification of Coxsackievirus B3 Decreases Its Toxicity, while Retaining Oncolytic Potency against Lung Cancer. Mol Ther Oncolytics 2020; 16:207-218. [PMID: 32123721 PMCID: PMC7036525 DOI: 10.1016/j.omto.2020.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 01/07/2020] [Indexed: 12/17/2022]
Abstract
We recently discovered that coxsackievirus B3 (CVB3) is a potent oncolytic virus against KRAS mutant lung adenocarcinoma. Nevertheless, the evident toxicity restricts the use of wild-type (WT)-CVB3 for cancer therapy. The current study aims to engineer the CVB3 to decrease its toxicity and to extend our previous research to determine its safety and efficacy in treating TP53/RB1 mutant small-cell lung cancer (SCLC). A microRNA-modified CVB3 (miR-CVB3) was generated via inserting multiple copies of tumor-suppressive miR-145/miR-143 target sequences into the viral genome. In vitro experiments revealed that miR-CVB3 retained the ability to infect and lyse KRAS mutant lung adenocarcinoma and TP53/RB1-mutant SCLC cells, but with a markedly reduced cytotoxicity toward cardiomyocytes. In vivo study using a TP53/RB1-mutant SCLC xenograft model demonstrated that a single dose of miR-CVB3 via systemic administration resulted in a significant tumor regression. Most strikingly, mice treated with miR-CVB3 exhibited greatly attenuated cardiotoxicities and decreased viral titers compared to WT-CVB3-treated mice. Collectively, we generated a recombinant CVB3 that is powerful in destroying both KRAS mutant lung adenocarcinoma and TP53/RB1-mutant SCLC, with a negligible toxicity toward normal tissues. Future investigation is needed to address the issue of genome instability of miR-CVB3, which was observed in ~40% of mice after a prolonged treatment.
Collapse
Affiliation(s)
- Huitao Liu
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Yuan Chao Xue
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Haoyu Deng
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Vascular Surgery, RenJi Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yasir Mohamud
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chen Seng Ng
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Axel Chu
- Department of Pediatrics, University of British Columbia, BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Chinten James Lim
- Department of Pediatrics, University of British Columbia, BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - William W Lockwood
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - William W G Jia
- Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, BC, Canada
| | - Honglin Luo
- Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Experimental Medicine, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
17
|
Abstract
Glomus tumor can rarely arise in the central nervous system as a sella turcica mass. In this article, we report a case of sellar glomus tumor in a female patient who presented at the age of 8 years with visual impairment. The tumor recurred at 4 years and 26 years after initial excision and gamma knife therapy. Histologic examination showed a monotonous population of oval cells accompanied by delicate blood vessels, features mimicking pituitary adenoma. The tumor showed histologic progression at the second recurrence. Synaptophysin staining was positive, but chromogranin and CD56 were negative. The tumor cells were negative for epithelial markers but expressed actin and SMA. Awareness of the rare occurrence of glomus tumor at this region, careful analysis of morphology, and appropriate immunohistochemical workup are essential to solve this diagnostic challenge. The clinicopathologic features of all previously reported cases are reviewed.
Collapse
Affiliation(s)
| | - C S Ng
- St Teresa's Hospital, Hong Kong, SAR China
| | - C F Fung
- St Teresa's Hospital, Hong Kong, SAR China
| | | | - Wah Cheuk
- Queen Elizabeth Hospital, Hong Kong, SAR China
| |
Collapse
|
18
|
Deng H, Liu H, de Silva T, Xue Y, Mohamud Y, Ng CS, Qu J, Zhang J, Jia WW, Lockwood WW, Luo H. Coxsackievirus Type B3 Is a Potent Oncolytic Virus against KRAS-Mutant Lung Adenocarcinoma. Mol Ther Oncolytics 2019; 14:266-278. [PMID: 31463367 PMCID: PMC6709373 DOI: 10.1016/j.omto.2019.07.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 07/13/2019] [Indexed: 02/05/2023]
Abstract
KRAS mutant (KRASmut) lung adenocarcinoma is a refractory cancer without available targeted therapy. The current study explored the possibility to develop coxsackievirus type B3 (CVB3) as an oncolytic agent for the treatment of KRASmut lung adenocarcinoma. In cultured cells, we discovered that CVB3 selectively infects and lyses KRASmut lung adenocarcinoma cells (A549, H2030, and H23), while sparing normal lung epithelial cells (primary, BEAS2B, HPL1D, and 1HAEo) and EGFRmut lung adenocarcinoma cells (HCC4006, PC9, H3255, and H1975). Using stable cells expressing a single driver mutation of either KRASG12V or EGFRL858R in normal lung epithelial cells (HPL1D), we further showed that CVB3 specifically kills HPL1D-KRASG12V cells with minimal harm to HPL1D-EGFRL858R and control cells. Mechanistically, we demonstrated that aberrant activation of extracellular signal-regulated kinase 1/2 (ERK1/2) and compromised type I interferon immune response in KRASmut lung adenocarcinoma cells serve as key factors contributing to the sensitivity to CVB3-induced cytotoxicity. Lastly, we conducted in vivo xenograft studies using two immunocompromised mouse models. Our results revealed that intratumoral injection of CVB3 results in a marked tumor regression of KRASmut lung adenocarcinoma in both non-obese diabetic (NOD) severe combined immunodeficiency (SCID) gamma (NSG) and NOD-SCID xenograft models. Together, our findings suggest that CVB3 is an excellent candidate to be further developed as a targeted therapy for KRASmut lung adenocarcinoma.
Collapse
Affiliation(s)
- Haoyu Deng
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Vascular Surgery, RenJi Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Huitao Liu
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Tanya de Silva
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - YuanChao Xue
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Yasir Mohamud
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chen Seng Ng
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, BC, Canada
| | - Junyan Qu
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Centre for Infectious Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Jingchun Zhang
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - William W.G. Jia
- Department of Surgery, Division of Neurosurgery, University of British Columbia, Vancouver, BC, Canada
| | - William W. Lockwood
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Integrative Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
- Corresponding author: William W. Lockwood, Department of Integrative Oncology, British Columbia Cancer Research Centre, 675 West 10th Avenue, Vancouver, BC V5Z 1L3, Canada.
| | - Honglin Luo
- Centre for Heart Lung Innovation, St. Paul’s Hospital, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Corresponding author: Honglin Luo, Centre for Heart Lung Innovation, St. Paul’s Hospital, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada.
| |
Collapse
|
19
|
Ngim CF, Ibrahim H, Abdullah N, Lai NM, Tan RKM, Ng CS, Ramadas A. A web-based educational intervention module to improve knowledge and attitudes towards thalassaemia prevention in Malaysian young adults. Med J Malaysia 2019; 74:219-225. [PMID: 31256177] [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: 06/09/2023]
Abstract
BACKGROUND Thalassaemia is a public health burden in Malaysia and its prevention faces many challenges. In this study, we aimed to assess the effectiveness of a web-based educational module in improving knowledge and attitudes about thalassaemia prevention amongst Malaysian young adults. METHODS We designed an interactive web-based educational module in the Malay language wherein videos were combined with text and pictorial visual cues. Malaysians aged 18-40 years old who underwent the module had their knowledge and attitudes assessed at baseline, post-intervention and at 6-month follow-up using a selfadministered validated questionnaire. RESULTS Sixty-five participants: 47 Malays (72.3%), 15 Chinese (23.1%), three Indians (4.6%) underwent the module. Questionnaires were completed at baseline (n=65), postintervention (n=65) and at 6-month follow-up (n=60). Out of a total knowledge score of 21, significant changes were recorded across three time-points- median scores were 12 at pre-intervention, 19 at post-intervention and 16 at 6-month follow-up (p<0.001). Post-hoc testing comparing preintervention and 6-month follow-up scores showed significant retention of knowledge (p<0.001). Compared to baseline, attitudes at 6-month follow-up showed an increased acceptance for "marriage avoidance between carriers" (pre-intervention 20%, 6-month follow-up 48.3%, p<0.001) and "prenatal diagnosis" (pre-intervention 73.8%, 6-month follow-up 86.2%, p=0.008). Acceptance for selective termination however, remained low without significant change (pre-intervention 6.2%, 6-month follow-up 16.7%, p=0.109). CONCLUSION A web-based educational module appears effective in improving knowledge and attitudes towards thalassaemia prevention and its incorporation in thalassaemia prevention programs is potentially useful in Malaysia and countries with a high internet penetration rate.
Collapse
Affiliation(s)
- C F Ngim
- Monash University Malaysia, Jeffrey Cheah School of Medicine and Health Sciences, Malaysia.
| | - H Ibrahim
- Department of Paediatrics, Institut Pediatrik, Hospital Kuala Lumpur, Malaysia
| | - N Abdullah
- Hospital Sultanah Aminah, Department of Paediatrics, Johor Bahru, Malaysia
| | - N M Lai
- Taylor's University, School of Medicine, Subang Jaya, Selangor, Malaysia
| | - R K M Tan
- Monash University Malaysia, Jeffrey Cheah School of Medicine and Health Sciences, Malaysia
| | - C S Ng
- Hospital Sultanah Aminah, Department of Nuclear Medicine, Johor Bahru, Malaysia
| | - A Ramadas
- Monash University Malaysia, Jeffrey Cheah School of Medicine and Health Sciences, Malaysia
| |
Collapse
|
20
|
Ng CS, Kato H, Fujita T. Fueling Type I Interferonopathies: Regulation and Function of Type I Interferon Antiviral Responses. J Interferon Cytokine Res 2019; 39:383-392. [PMID: 30897023 DOI: 10.1089/jir.2019.0037] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In conjunction with the development of genome-wide technology, numerous studies have revealed the importance of regulatory mechanisms to avoid the onset of autoimmunity. In this, protein regulators and the newly identified low-abundant RNA species participate in the regulation of type I interferon (IFN-I) and proinflammatory genes induced by innate immune sensors. In this review, we briefly look into some of the autoimmune diseases profiled by dysregulations of IFN-I signaling and the regulatory mechanisms critical for immunological homeostasis.
Collapse
Affiliation(s)
- Chen Seng Ng
- 1 Institute for Quantitative and Computational Biosciences, Immunology and Molecular Genetics, University of California, Los Angeles, California.,2 Department of Microbiology, Immunology and Molecular Genetics, University of California, Los Angeles, California
| | - Hiroki Kato
- 3 Institute of Cardiovascular Immunology, University Hospitals, University of Bonn, Bonn, Germany
| | - Takashi Fujita
- 4 Laboratory of Molecular Genetics, Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto, Japan.,5 Laboratory of Molecular and Cellular Immunology, Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| |
Collapse
|
21
|
|
22
|
Ng CS, Luqman M, Wong ZQ, Ngiu CS, Raja Affendi RA. Gastrointestinal: Solitary fibrous tumor from lesser omentum: An elderly from Malaysia with an unusual huge painful intra-abdominal mass. J Gastroenterol Hepatol 2017; 32:1664. [PMID: 28948703 DOI: 10.1111/jgh.13721] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 12/09/2016] [Accepted: 01/01/2017] [Indexed: 12/09/2022]
Affiliation(s)
- C S Ng
- Gastroenterology Unit, Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - M Luqman
- Department of General Surgery, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Z Q Wong
- Gastroenterology Unit, Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - C S Ngiu
- Gastroenterology Unit, Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - R A Raja Affendi
- Gastroenterology Unit, Department of Internal Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| |
Collapse
|
23
|
Ng CS, Arulanantham S, Khoo JJ, Sabaratnam S, Lee YF, Ngim CF. Skill validation study on sentinel lymph node biopsy in breast cancer and the challenges of false-negative, in-transit and micrometastatic nodes. Med J Malaysia 2016; 71:275-281. [PMID: 28064295] [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: 06/06/2023]
Abstract
No abstract available.
Collapse
Affiliation(s)
- C S Ng
- Hospital Sultanah Aminah, Department of Nuclear Medicine, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia.
| | - S Arulanantham
- Hospital Sultanah Aminah, Department of Surgery, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia
| | - J J Khoo
- Monash University Malaysia, School of Medicine & Health Sciences, Johor Bahru Clinical School, Malaysia
| | - S Sabaratnam
- Monash University Malaysia, School of Medicine & Health Sciences, Johor Bahru Clinical School, Malaysia
| | - Y F Lee
- Hospital Sultanah Aminah, Department of Nuclear Medicine, Jalan Persiaran Abu Bakar Sultan, 80100 Johor Bahru, Johor, Malaysia
| | - C F Ngim
- Monash University Malaysia, School of Medicine & Health Sciences, Johor Bahru Clinical School, Malaysia
| |
Collapse
|
24
|
Teng CL, Zuhanariah MN, Ng CS, Goh CC. Bibliography of clinical research in malaysia: methods and brief results. Med J Malaysia 2014; 69 Suppl A:4-7. [PMID: 25417946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article describes the methodology of this bibliography. A search was conducted on the following: (1) bibliographic databases (PubMed, Scopus, and other databases) using search terms that maximize the retrieval of Malaysian publications; (2) Individual journal search of Malaysian healthrelated journals; (3) A targeted search of Google and Google Scholar; (4) Searching of Malaysian institutional repositories; (5) Searching of Ministry of Health and Clinical Research Centre website. The publication years were limited to 2000- 2013. The citations were imported or manually entered into bibliographic software Refworks. After removing duplicates, and correcting data entry errors, PubMed's Medical Subject Headings (MeSH terms) were added. Clinical research is coded using the definition "patient-oriented-research or research conducted with human subjects (or on material of human origin) for which the investigator directly interacts with the human subjects at some point during the study." A bibliography of citations [n=2056] that fit the criteria of clinical research in Malaysia in selected topics within five domains was generated: Cancers [589], Cardiovascular diseases [432], Infections [795], Injuries [142], and Mental Health [582]. This is done by retrieving citations with the appropriate MESH terms, as follow: For cancers (Breast Neoplasms; Colorectal Neoplasms; Uterine Cervical Neoplasms), for cardiovascular diseases (Coronary Disease; Hypertension; Stroke), for infections (Dengue; Enterovirus Infections, HIV Infections; Malaria; Nipah Virus; Tuberculosis), for injuries (Accidents, Occupational; Accidents, Traffic; Child Abuse; Occupational Injuries), for mental health (Depression; Depressive Disorder; Depressive Disorder, Major; Drug Users; Psychotic Disorders; Suicide; Suicide, Attempted; Suicidal Ideation; Substance- Related Disorders).
Collapse
Affiliation(s)
- C L Teng
- International Medical University, Jln Rasah, Seremban, Negeri Sembilan, Malaysia.
| | - M N Zuhanariah
- International Medical University, Jln Rasah, Seremban, Negeri Sembilan, Malaysia
| | - C S Ng
- International Medical University, Jln Rasah, Seremban, Negeri Sembilan, Malaysia
| | - C C Goh
- International Medical University, Jln Rasah, Seremban, Negeri Sembilan, Malaysia
| |
Collapse
|
25
|
Haygood TM, Liu MAQ, Galvan E, Bassett R, Murphy WA, Ng CS, Matamoros A, Marom EM. Consistency of response and image recognition, pulmonary nodules. Br J Radiol 2014; 87:20130767. [PMID: 24697724 DOI: 10.1259/bjr.20130767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the effect of recognition of a previously encountered radiograph on consistency of response in localized pulmonary nodules. METHODS 13 radiologists interpreted 40 radiographs each to locate pulmonary nodules. A few days later, they again interpreted 40 radiographs. Half of the images in the second set were new. We asked the radiologists whether each image had been in the first set. We used Fisher's exact test and Kruskal-Wallis test to evaluate the correlation between recognition of an image and consistency in its interpretation. We evaluated the data using all possible recognition levels-definitely, probably or possibly included vs definitely, probably or possibly not included by collapsing the recognition levels into two and by eliminating the "possibly included" and "possibly not included" scores. RESULTS With all but one of six methods of looking at the data, there was no significant correlation between consistency in interpretation and recognition of the image. When the possibly included and possibly not included scores were eliminated, there was a borderline statistical significance (p = 0.04) with slightly greater consistency in interpretation of recognized than that of non-recognized images. CONCLUSION We found no convincing evidence that radiologists' recognition of images in an observer performance study affects their interpretation on a second encounter. ADVANCES IN KNOWLEDGE Conscious recognition of chest radiographs did not result in a greater degree of consistency in the tested interpretation than that in the interpretation of images that were not recognized.
Collapse
Affiliation(s)
- T M Haygood
- 1 Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Yoo JS, Takahasi K, Ng CS, Ouda R, Onomoto K, Yoneyama M, Lai JC, Lattmann S, Nagamine Y, Matsui T, Iwabuchi K, Kato H, Fujita T. DHX36 enhances RIG-I signaling by facilitating PKR-mediated antiviral stress granule formation. PLoS Pathog 2014; 10:e1004012. [PMID: 24651521 PMCID: PMC3961341 DOI: 10.1371/journal.ppat.1004012] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 02/04/2014] [Indexed: 12/14/2022] Open
Abstract
RIG-I is a DExD/H-box RNA helicase and functions as a critical cytoplasmic sensor for RNA viruses to initiate antiviral interferon (IFN) responses. Here we demonstrate that another DExD/H-box RNA helicase DHX36 is a key molecule for RIG-I signaling by regulating double-stranded RNA (dsRNA)-dependent protein kinase (PKR) activation, which has been shown to be essential for the formation of antiviral stress granule (avSG). We found that DHX36 and PKR form a complex in a dsRNA-dependent manner. By forming this complex, DHX36 facilitates dsRNA binding and phosphorylation of PKR through its ATPase/helicase activity. Using DHX36 KO-inducible MEF cells, we demonstrated that DHX36 deficient cells showed defect in IFN production and higher susceptibility in RNA virus infection, indicating the physiological importance of this complex in host defense. In summary, we identify a novel function of DHX36 as a critical regulator of PKR-dependent avSG to facilitate viral RNA recognition by RIG-I-like receptor (RLR).
Collapse
Affiliation(s)
- Ji-Seung Yoo
- Laboratory of Molecular Genetics, Institute for Virus Research, Kyoto University, Kyoto, Japan
- Laboratory of Molecular Cell Biology, Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Kiyohiro Takahasi
- Laboratory of Molecular Genetics, Institute for Virus Research, Kyoto University, Kyoto, Japan
- Institute for Innovative NanoBio Drug Discovery and Development, Graduate School of Pharmaceutical Science, Kyoto University, Kyoto, Japan
| | - Chen Seng Ng
- Laboratory of Molecular Genetics, Institute for Virus Research, Kyoto University, Kyoto, Japan
- Laboratory of Molecular Cell Biology, Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Ryota Ouda
- Laboratory of Molecular Genetics, Institute for Virus Research, Kyoto University, Kyoto, Japan
- Laboratory of Molecular Cell Biology, Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Koji Onomoto
- Division of Molecular Immunology, Medical Mycology Research Center, Chiba University, Chuo-ku, Chiba, Japan
| | - Mitsutoshi Yoneyama
- Division of Molecular Immunology, Medical Mycology Research Center, Chiba University, Chuo-ku, Chiba, Japan
| | - Janice Ching Lai
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Simon Lattmann
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Yoshikuni Nagamine
- Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Tadashi Matsui
- Department of Biochemistry I, School of Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Kuniyoshi Iwabuchi
- Department of Biochemistry I, School of Medicine, Kanazawa Medical University, Uchinada, Ishikawa, Japan
| | - Hiroki Kato
- Laboratory of Molecular Genetics, Institute for Virus Research, Kyoto University, Kyoto, Japan
- Laboratory of Molecular Cell Biology, Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| | - Takashi Fujita
- Laboratory of Molecular Genetics, Institute for Virus Research, Kyoto University, Kyoto, Japan
- Laboratory of Molecular Cell Biology, Graduate School of Biostudies, Kyoto University, Kyoto, Japan
| |
Collapse
|
27
|
Chandler A, Wei W, Anderson EF, Herron DH, Ye Z, Ng CS. Validation of motion correction techniques for liver CT perfusion studies. Br J Radiol 2012; 85:e514-22. [PMID: 22374283 DOI: 10.1259/bjr/31999821] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Motion in images potentially compromises the evaluation of temporally acquired CT perfusion (CTp) data; image registration should mitigate this, but first requires validation. Our objective was to compare the relative performance of manual, rigid and non-rigid registration techniques to correct anatomical misalignment in acquired liver CTp data sets. METHODS 17 data sets in patients with liver tumours who had undergone a CTp protocol were evaluated. Each data set consisted of a cine acquisition during a breath-hold (Phase 1), followed by six further sets of cine scans (each containing 11 images) acquired during free breathing (Phase 2). Phase 2 images were registered to a reference image from Phase 1 cine using two semi-automated intensity-based registration techniques (rigid and non-rigid) and a manual technique (the only option available in the relevant vendor CTp software). The performance of each technique to align liver anatomy was assessed by four observers, independently and blindly, on two separate occasions, using a semi-quantitative visual validation study (employing a six-point score). The registration techniques were statistically compared using an ordinal probit regression model. RESULTS 306 registrations (2448 observer scores) were evaluated. The three registration techniques were significantly different from each other (p=0.03). On pairwise comparison, the semi-automated techniques were significantly superior to the manual technique, with non-rigid significantly superior to rigid (p<0.0001), which in turn was significantly superior to manual registration (p=0.04). CONCLUSION Semi-automated registration techniques achieved superior alignment of liver anatomy compared with the manual technique. We hope this will translate into more reliable CTp analyses.
Collapse
Affiliation(s)
- A Chandler
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | | | | | | | | |
Collapse
|
28
|
Ng CS. Systematic review and meta-analysis of randomized controlled trials comparing Chinese patent medicines Compound Danshen Dripping Pills and Di’ao Xinxuekang in treating angina pectoris. ACTA ACUST UNITED AC 2012; 10:25-34. [DOI: 10.3736/jcim20120105] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
29
|
Patnana M, Bronstein Y, Szklaruk J, Bedi DG, Hwu WJ, Gershenwald JE, Prieto VG, Ng CS. Multimethod imaging, staging, and spectrum of manifestations of metastatic melanoma. Clin Radiol 2011; 66:224-36. [PMID: 21295201 DOI: 10.1016/j.crad.2010.10.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 10/16/2010] [Accepted: 10/22/2010] [Indexed: 02/07/2023]
Abstract
The incidence of melanoma has been steadily increasing. Imaging plays an important role in tumour assessment as metastatic melanoma can involve multiple organs. Computed tomography (CT) is currently the most widely used technique for tumour staging, surveillance and assessment of therapeutic response, but ultrasound, magnetic resonance imaging (MRI) and positron-emission tomography (PET)-CT also play important roles in the imaging of this tumour. In this article, we review the pathways of spread, staging according to the recently updated TNM classification, pathology, typical and atypical imaging features at common and uncommon sites, and treatment of metastatic melanoma.
Collapse
Affiliation(s)
- M Patnana
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Ashcroft MW, Ng CS, Frost RA, Freeman AH. Biliary inflammatory pseudotumour: report of two cases and review of the literature. Clin Radiol 2009; 64:449-55. [PMID: 19264191 DOI: 10.1016/j.crad.2008.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Revised: 11/17/2008] [Accepted: 12/23/2008] [Indexed: 10/21/2022]
Affiliation(s)
- M W Ashcroft
- Department of Radiology, Salisbury District Hospital, Wiltshire, UK
| | | | | | | |
Collapse
|
31
|
Affiliation(s)
- K F Wong
- Institute of Pathology, Queen Elizabeth Hospital, Hong Kong
| | | | | | | |
Collapse
|
32
|
Abstract
Acute appendicitis is a diagnosis that can be made on clinical symptoms and signs but can often be extremely challenging. Difficulties arise particularly when the presentation is atypical, and this can lead to untoward sequelae. In this review, we present the range of presentations of atypical appendicitis, the variety of management options and the potential value of CT.
Collapse
Affiliation(s)
- T C See
- Department of Radiology, Adenbrooke's Hospital, Cambridge, UK
| | | | | | | |
Collapse
|
33
|
Ng CS, Wei W, Doyle TC, Courtney HM, Dixon AK, Freeman AH. Minimal-preparation abdomino-pelvic CT in frail and elderly patients: prognostic value of colonic and extracolonic findings. Clin Radiol 2008; 63:424-32. [PMID: 18325363 DOI: 10.1016/j.crad.2007.09.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 07/01/2007] [Revised: 09/22/2007] [Accepted: 09/24/2007] [Indexed: 11/20/2022]
Abstract
AIM To examine the overall survival of patients who had had been referred for minimal preparation abdomino-pelvic computed tomography (MPCT), and to assess the prognostic value of the colonic and extracolonic findings detected. METHODS AND MATERIALS The survival of a cohort of 1029 elderly and frail patients, with clinical symptoms and signs suspicious for colorectal cancer (CRC), who had undergone MPCT between 1995 and 1998 was investigated. Univariate and multivariate survival analyses were undertaken according to the presence of CRC and extracolonic abnormalities (ECA). RESULTS The median age of the 1029 patients was 79.4 years. The overall median survival following MPCT was 5.4 years; and 6.6 years if no abnormality was detected. On multivariate analysis, age, sex, CRC status, and number of ECAs were significant factors in overall survival. Median survival for those with confirmed CRC [n=91 (prevalence, 8.8%)] was 1.1 years, compared with 5.9 years without CRC (p<0.0001); and 2.4 years for those with one or more ECA [n=245 (prevalence, 23.8%)], compared with 6.1 years without ECA (p<0.0001). Survival was progressively shorter for increasing numbers of ECAs; and shorter for previously unknown non-CRC malignancies (n=24) compared with CRC (p<0.0001). CONCLUSIONS MPCT appears to have prognostic potential in this patient population, with significant reductions in survival if a CRC or ECA is detected. The detection of ECA would appear to have at least as important an impact on the usefulness of the examination as the detection of CRC.
Collapse
Affiliation(s)
- C S Ng
- Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA.
| | | | | | | | | | | |
Collapse
|
34
|
Abstract
Diagnostic confidence has been used as a measure of diagnostic efficacy, but this measure in isolation fails to take into account incorrect diagnoses. Conventional analytical approaches of diagnostic confidence ignore associated diagnostic accuracy. To address this limitation, we introduce a unifying framework which incorporates diagnostic confidence, changes in diagnoses and ultimate accuracy. The framework is illustrated using data from a study in which 62 patients with acute abdominal pain prospectively underwent CT. Admitting surgeons documented their diagnoses and graded their diagnostic confidences (on a 5-point scale) on admission and again after CT. Our approach, unlike conventional analyses, incorporates knowledge of final diagnoses, obtained from surgery or 6 months follow up, in assessing the impact of the test (on a 9-point scale). Changes in pre- and post-CT confidence scores were assessed by the one-sample t-test comparing against zero change, with the test statistic acting as a standardized quantity allowing comparison between our and conventional methodological approaches. Overall, 52% (32/62) of patients were misdiagnosed on admission and 19% (12/62) had incorrect post-CT diagnoses. Diagnostic confidence following CT increased significantly compared with pre-CT confidence on applying both analytical methods, although the level of statistical significance was less marked using our approach. Mean (95% confidence interval) increase in confidence under conventional analysis was 1.32 (1.03, 1.62), with standardized score t = 8.90 [p<0.0001], whereas our method yielded 0.69 (0.25, 1.13), with standardized score t = 3.12 [p = 0.003]. Although both analytical methods led to the same inference regarding the efficacy of CT in the illustrative case study presented, they differed somewhat in degree. It is conceivable that disparate conclusions may emerge in other studies and circumstances. Failure to take adequate account of incorrect diagnoses is potentially misleading. We suggest that a comprehensive analysis of diagnostic confidence requires the incorporation of diagnostic accuracy.
Collapse
Affiliation(s)
- C S Ng
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-4009, USA
| | | |
Collapse
|
35
|
Harvey JN, Craney L, Nagendran S, Ng CS. Towards comprehensive population-based screening for diabetic retinopathy: operation of the North Wales diabetic retinopathy screening programme using a central patient register and various screening methods. J Med Screen 2006; 13:87-92. [PMID: 16792832 DOI: 10.1258/096914106777589669] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 11/18/2022]
Abstract
OBJECTIVES To examine whether population-based retinopathy screening using a central diabetes register and employing various screening methods can achieve a high degree of population coverage to meet National Screening Committee (NSC) targets. To identify the main barriers to achieving comprehensive population coverage. To analyse referrals to ophthalmology and their outcome as a measure of previously unmet need. To assess the influence of modality of screening. SETTING Three local health board areas in North Wales. METHODS Establishment of a district diabetes register to hold records of all patients and subserve call-recall of general practitioner (GP) sole-care patients for screening by optometrists or digital photography. Hospital attenders were screened in diabetic clinic by direct ophthalmoscopy. Data were collected for years 1 and 2 of operation of the scheme. RESULTS The system held a screening record for 86% of diabetic patients after year 1 and 93% after year 2. Failure to attend was the major barrier to comprehensive population screening, but this improved in year 2 (P<0.001). Both optometrists and photography identified substantial unmet need: 1% of all GP sole-care patients required immediate laser treatment. Photography was more sensitive than optometrist screening, but the additional retinopathy identified was mostly minor not requiring treatment. CONCLUSIONS Lack of screening is much more important than modality of screening as a cause of missed sight-threatening retinopathy. A central, district-based patient register system identifies those patients not screened for further follow-up and can produce a high level of population coverage, close to NSC targets. Such schemes are needed, particularly to support primary care diabetes management.
Collapse
Affiliation(s)
- J N Harvey
- Endocrinology and Metabolism, University of Wales College of Medicine, Wrexham Academic Unit, Maelor Hospital, Wrexham, UK.
| | | | | | | |
Collapse
|
36
|
Koo BC, Ng CS, U-King-Im J, Prevost AT, Freeman AH. Minimal preparation CT for the diagnosis of suspected colorectal cancer in the frail and elderly patient. Clin Radiol 2006; 61:127-39. [PMID: 16439217 DOI: 10.1016/j.crad.2005.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 03/04/2005] [Revised: 06/29/2005] [Accepted: 07/07/2005] [Indexed: 12/30/2022]
Abstract
Colorectal cancer is a common malignancy with an increased incidence in the elderly population. Traditional methods of evaluating this disease have included double contrast barium enema and colonoscopy. Unfortunately, in the frail and elderly patient, these investigations can be difficult to perform and are often not tolerated. Minimal preparation computed tomography (MPCT) of the colon has been suggested as an alternative in this patient population. In this technique, no bowel preparation is used apart from the administration of oral contrast medium. The patient is imaged only in the supine position, without per rectal insufflation of gas or barium. This article reviews the experience to date of MPCT in detecting colonic tumours, and compares its efficacy to the traditional methods. A meta-analysis of the studies allowed estimation of the pooled sensitivity of MPCT to be 83% (95% confidence interval: 76-89%), and pooled specificity to be 90% (95% CI: 85-94%). An added advantage of MPCT is the ability to identify extra-colonic pathology, and this aspect is also reviewed. In addition, the common radiological features and pitfalls in identifying colonic tumours by MPCT are discussed.
Collapse
Affiliation(s)
- B C Koo
- Department of Radiology, Addenbrooke's NHS Trust, Cambridge, UK.
| | | | | | | | | |
Collapse
|
37
|
Lo WYF, Li JYW, Chan YK, Lai LSW, Yeung YW, Lo STH, Tsui WMS, Ng CS. Instability of clonality in gastric lymphoid infiltrates: a study with emphasis on serial biopsies. Am J Surg Pathol 2006; 29:1582-92. [PMID: 16327430 DOI: 10.1097/01.pas.0000188031.40836.00] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/25/2022]
Abstract
The evolution of low-grade B-cell mucosa-associated lymphoid-tissue (MALT) lymphoma of the stomach is a multistage process, reflected in the histologic continuum from Helicobacter pylori-chronic gastritis, to low-grade and high-grade lymphoma. Interestingly, in daily gastric biopsy sign-out, the authors observed that some biopsies showed monoclonality on polymerase chain reaction (PCR) even though there were no definite histologic features of malignancy and vice versa. To address the question, the authors studied the endoscopic gastric biopsies at first presentation of 46 patients to examine any clonality differences among various histologic patterns within the spectrum of MALT lymphoma evolution. The gastric biopsies were reviewed histologically and graded according to the Wotherspoon-Isaacson histologic scoring system from grade 0 (normal) to grade 5 (MALT lymphoma). The clonality of cases in each grade was determined by performing nested PCR for immunoglobulin heavy chain (IgH) gene rearrangement using FR2/JH and FR3/JH primer sets. The monoclonality rates among different grades were as follows: grade 2, 6.3% (1 of 16); grade 3, 27.3% (3 of 11); grade 4, 83.3% (5 of 6); grade 5, 69.2% (9 of 13). Statistically significant difference of monoclonality rate is demonstrated in histologic grade 4 versus grades 2 and 3, and grade 5 versus grade 2 (P < 0.05, Fisher exact test). The authors went on to examine the progress of disease by following up the clinical status, histologic changes, and clonality fluctuation of these cases. Four of the 8 patients with monoclonality on PCR, but no definite lymphoma at first presentation later progressed to frank MALT lymphoma. Our study shows that, during the progression to MALT lymphoma, there is an instability of clonality. Clonality can fluctuate between polyclonality, oligoclonality, and monoclonality, none of which defines an irreversible stage for progression to MALT lymphoma. Monoclonality is a risk factor for development of MALT lymphoma. Those cases with dense gastric mucosal lymphoid infiltrate (without definite MALT lymphoma) and monoclonality on PCR need to be closely monitored and Helicobacter infection promptly treated if present. In combination with clinicohistologic examination, PCR can serve as a complementary tool in arriving at a definite diagnosis of MALT lymphoma in cases with borderline histologic features.
Collapse
Affiliation(s)
- William Y F Lo
- Pathology Service, Caritas Medical Centre, Kowloon, Hong Kong, China.
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
Bernstein-Greene-Kruskal modes in a three-dimensional (3D) unmagnetized plasma are constructed. It is shown that 3D solutions that depend only on energy do not exist. However, 3D solutions that depend on energy and additional constants of motion (such as angular momentum) do exist. Exact analytical as well as numerical solutions are constructed assuming spherical symmetry, and their properties are contrasted with those of 1D solutions. Possible extensions to solutions with cylindrical symmetry with or without a finite magnetic guide field are discussed.
Collapse
Affiliation(s)
- C S Ng
- Space Science Center, Institute for the Study of Earth, Oceans, and Space, University of New Hampshire, Durham, New Hampshire 03824, USA
| | | |
Collapse
|
39
|
See TC, Davies SE, Appleton DS, Ng CS. CT and angiographic features of hepatic inflammatory myofibroblastic tumour. Clin Radiol 2005; 60:718-22. [PMID: 16038700 DOI: 10.1016/j.crad.2005.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2004] [Revised: 12/22/2004] [Accepted: 01/12/2005] [Indexed: 11/18/2022]
Affiliation(s)
- T C See
- Department of Radiology, Royal Free Hospital, London, UK
| | | | | | | |
Collapse
|
40
|
Affiliation(s)
- C S Ng
- Department of Radiology, Unit 57, MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030-4009, USA
| | | |
Collapse
|
41
|
Ng CS, Mohd MS. Lingual thyroid--a lesson to learn. Med J Malaysia 2005; 60:115. [PMID: 16250296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
|
42
|
Ng CS, Doyle TC, Courtney HM, Campbell GA, Freeman AH, Dixon AK. Extracolonic findings in patients undergoing abdomino-pelvic CT for suspected colorectal carcinoma in the frail and disabled patient. Clin Radiol 2004; 59:421-30. [PMID: 15081847 DOI: 10.1016/s0009-9260(03)00342-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [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: 03/25/2003] [Revised: 07/11/2003] [Accepted: 07/15/2003] [Indexed: 12/18/2022]
Abstract
AIM The aims of this study were to evaluate the extracolonic findings identified in patients undergoing minimal preparation abdomino-pelvic CT in place of barium enema or colonoscopy for the detection of possible colorectal carcinoma. MATERIALS AND METHODS The CT technique involved helical acquisition (10 mm collimation, 1.5 pitch) following 2 days of preparation with oral contrast medium only. Extracolonic findings were evaluated in the light of subsequent follow-up and accuracy. The evaluation included assessment of the potential contribution of the extracolonic finding(s) to staging the cancer in the subset of patients who had colorectal carcinoma, and to account for the patients' presenting symptoms and signs in the remaining patients. RESULTS A total of 344 extracolonic findings were detected in 261 CT examinations, from amongst a total of 1077 cases (24%). Extracolonic findings were potentially important in staging in 32 of the 98 (33%) cases subsequently found to have colorectal cancer. There were 284 extracolonic findings amongst the 221 cases who proved not have colorectal cancer. One hundred and twenty-four (44%) of these 284 findings were actively followed up by clinicians, and 33 (12%) ultimately had a surgical intervention. Fifty-six percent (160/284) of the findings were determined to be correct (by further investigation, autopsy, and/or clinical follow-up); the remainder were incorrect or indeterminate (n = 56) or had no follow-up (n = 68). The commonest extracolonic findings were focal liver lesions (found in 42/1077, 4%) and abdominal aortic aneurysms (31/1077, 3%). Twenty-four (24/1077, 2%) previously unknown extracolonic malignancies were detected. Ten percent (106/1077) of the patients had extracolonic findings that could potentially have accounted for their presenting symptoms. CONCLUSIONS CT has the added benefit, compared with colonoscopy and barium enema, of not just evaluating the colon but also of detecting extracolonic abnormalities. Such findings may be useful in staging the cancer, may explain the patient's presenting symptoms, and may detect other potentially serious disorders.
Collapse
Affiliation(s)
- C S Ng
- Department of Radiology, Addenbrooke's NHS Trust and the University of Cambridge, Cambridge, UK.
| | | | | | | | | | | |
Collapse
|
43
|
Abstract
In one department practicing critical review of indications for cesarean delivery, the overall LSCS rate was maintained at 12.3%, 11.1%, 11.2% and 11.4% for 1987, 1988, 1989 and 1990, respectively. A highly significant (P = 0.0013) reduction of 26.8% was observed in the LSCS rate for cephalo-pelvic disproportion between 1987 and 1990. Perinatal mortality rate per 1000 births remained low at 8.25, 7.05, 9.39 and 5.83 for infants weighing 500 g or more.
Collapse
Affiliation(s)
- S K Tay
- Department of Obstetrics and Gynecology, Singapore General Hospital
| | | | | |
Collapse
|
44
|
Ng CS, Bhattacharjee A, Skiff F. Complete spectrum of kinetic eigenmodes for plasma oscillations in a weakly collisional plasma. Phys Rev Lett 2004; 92:065002. [PMID: 14995245 DOI: 10.1103/physrevlett.92.065002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2003] [Indexed: 05/24/2023]
Abstract
Kinetic eigenmodes of plasma oscillations in a weakly collisional plasma, described by a collision operator of the Fokker-Planck type, are obtained in closed form for initial-value as well as for boundary-value problems. These eigenmodes, which are smooth and compose a complete discrete spectrum, play the same role for weakly collisional plasmas as the Case-Van Kampen modes do for collisionless plasmas.
Collapse
Affiliation(s)
- C S Ng
- Space Science Center, Institute for the Study of Earth, Oceans, and Space, University of New Hampshire, Durham, New Hampshire 03824, USA
| | | | | |
Collapse
|
45
|
Abstract
A 4-year-old girl had redness and swelling of the left upper eyelid of 1 week's duration. She had been treated with topical fusidic add and oral flucloxacillin without resolution. Ophthalmic examination showed a diffuse, erythematous, tender lesion affecting the entire upper eyelid. There was a central area of skin ulceration with marked bleeding and discharge. Also found were small vesicles under the left eyebrow. The child's mother had noticed a scaly rash on her own forearm. Examination under anesthesia was carried out to assess the globe and to obtain samples for microbiology investigation. Microbiology scrapings showed fungal hyphae of the Dermatophyte group. Treatment with Griseofulvin was commenced, and complete resolution of the lesion occurred. To our knowledge there is only one similar case reported in the literature describing ring-worm as a cause of preseptal cellulitis. This case highlights the importance of considering alternative diagnoses when standard antibiotic treatment has failed.
Collapse
Affiliation(s)
- P S Rajalekshmi
- Department of Ophthalmology, H. M. Stanley Hospital, St. Asaph, United Kingdom
| | | | | | | | | |
Collapse
|
46
|
Abstract
Computed tomography (CT) appearances in "colitis" are often non-specific, and include mural thickening and mesenteric fat stranding. In the western world, the majority of cases will have, or be subsequently diagnosed with, inflammatory bowel disease, pseudomembranous colitis or ischaemic colitis. However, other rare conditions may also produce these rather non-specific signs. We present a number of cases demonstrating colonic wall thickening on CT due to rarer diagnoses, which are correlated with the histopathological features. Some of these CT appearances have not been described previously in the literature.
Collapse
Affiliation(s)
- D R Turner
- Department of Diagnostic Imaging, Addenbrooke's Hospital NHS Trust, Cambridge, UK
| | | | | | | | | |
Collapse
|
47
|
Markose G, Ng CS, Freeman AH. The impact of helical computed tomography on the diagnosis of unsuspected inflammatory bowel disease in the large bowel. Eur Radiol 2003; 13:107-13. [PMID: 12541117 DOI: 10.1007/s00330-002-1415-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 09/28/2001] [Revised: 01/22/2002] [Accepted: 02/06/2002] [Indexed: 10/25/2022]
Abstract
Inflammatory bowel diseases (IBD) are diagnoses that can be easily overlooked clinically. The aim of this study was to investigate if CT is able to make a contribution to the identification of previously unsuspected cases of IBD. We retrospectively identified cases in which the possibility of an IBD was raised in CT reports (over a 4-year period), by utilising a keyword search of the radiology database. Cases with a previously known or suspected IBD were rigorously excluded by review of case notes, and endoscopic, radiological, histological and microbiological findings. The CT images of the identified cases were reviewed by a blinded observer to document the extent of bowel wall thickening, the location of lesion(s), and presence of peri-colic fat abnormality, ascites and/or collections. The observer also attempted to corroborate the presence, and to identify the type, of IBD based on the CT appearances alone. Thirty-five cases (out of approximately 19,000 body CTs performed) of clinically unsuspected IBD were identified, of which 27 underwent further investigation. An IBD was confirmed in 48% (13 of 27): Crohn's disease (n=6), ulcerative colitis (n=2), pseudomembranous colitis (n=3) and other (n=2), of which 70% (9 of 13) were correctly typed by the reviewer. Inflammatory bowel disease was not substantiated in the remainder (14 of 27), although 7 of these had other bowel pathologies: diverticular disease (n=4); and carcinoma (n=3). Prospectively determining the presence, and furthermore type, of IBD on CT is challenging largely because of the considerable overlap in the appearances of the individual IBDs and indeed of normality. Nevertheless, CT is able to identify clinically unsuspected cases and radiologists should be alert to this treatable and not infrequently elusive diagnosis.
Collapse
Affiliation(s)
- G Markose
- Department of Radiology, Addenbrooke's NHS Trust, Cambridge, UK
| | | | | |
Collapse
|
48
|
Ng CS, Doyle TC, Pinto EM, Courtney HM, Bull RK, Prevost AT, Campbell GA, Freeman AH, Dixon AK. Evaluation of CT in identifying colorectal carcinoma in the frail and disabled patient. Eur Radiol 2002; 12:2988-97. [PMID: 12439581 DOI: 10.1007/s00330-002-1367-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [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: 03/06/2001] [Revised: 12/14/2001] [Accepted: 01/04/2002] [Indexed: 10/25/2022]
Abstract
Frail and physically or mentally disabled patients frequently have difficulty in tolerating formal colonic investigations. The aims of this study were to evaluate the accuracy of minimal-preparation CT in identifying colorectal carcinoma in this population and to determine the clinical indications and radiological signs with the highest yield for tumour. The CT technique involved helical acquisition (10-mm collimation, 1.5 pitch) following 2 days of preparation with oral contrast medium only. The outcome of 4 years of experience was retrospectively reviewed. The gold standards were pathological and cancer registration records, together with colonoscopy and barium enema when undertaken, with a minimum of 15 months follow-up. One thousand seventy-seven CT studies in 1031 patients (median age 80 years) were evaluated. CT correctly identified 83 of the 98 colorectal carcinomas in this group but missed 15 cases; sensitivity and specificity (with 95% confidence interval) 85% (78-92%) and 91% (90-93%), respectively. Multivariate analysis identified: (a) a palpable abdominal mass and anaemia to be the strongest clinical indications, particularly in combination (p<0.0025); and (b) lesion width and blurring of the serosal margin of lesions to be associated with tumours (p<0.0001). Computed tomography has a valuable role in the investigation of frail and otherwise disabled patients with symptoms suspicious for a colonic neoplasm. Although interpretation can be difficult, the technique is able to exclude malignancy with good accuracy.
Collapse
Affiliation(s)
- C S Ng
- Department of Radiology, Addenbrooke's NHS Trust, University of Cambridge, UK.
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Chan JKC, Ng CS, Hui PK, Leung TW, Lo ESF, Lau WH, McGuire LJ. Anaplastic large cell Ki-1 lymphoma. Delineation of two morphological types. Histopathology 2002; 41:127-50. [PMID: 12405944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Affiliation(s)
- J K C Chan
- Institute of Pathology, Queen Elizabeth Hospital, Department of Pathology, Hong Kong
| | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
Acute appendicitis has extremely varied clinical presentations. A delayed or missed diagnosis may result in severe adverse consequences. Helical CT is evolving as an important diagnostic aid, but the CT signs can be varied and can easily be overlooked by the unwary. This pictorial review illustrates the spectrum of radiological signs and appearances of appendicitis on helical CT.
Collapse
Affiliation(s)
- T C See
- University Department of Radiology, Addenbrooke's NHS Trust and the University of Cambridge, Hills Road, Cambridge CB2 2QQ, UK
| | | | | | | |
Collapse
|