1
|
Cass SH, Tobin JWD, Seo YD, Gener-Ricos G, Keung EZ, Burton EM, Davies MA, McQuade JL, Lazar AJ, Mason R, Millward M, Sandhu S, Khoo C, Warburton L, Guerra V, Haydon A, Dearden H, Menzies AM, Carlino MS, Smith JL, Mollee P, Burgess M, Mapp S, Keane C, Atkinson V, Parikh SA, Markovic SN, Ding W, Call TG, Hampel PJ, Long GV, Wargo JA, Ferrajoli A. Efficacy of immune checkpoint inhibitors for the treatment of advanced melanoma in patients with concomitant chronic lymphocytic leukemia. Ann Oncol 2023; 34:796-805. [PMID: 37414216 DOI: 10.1016/j.annonc.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/25/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have revolutionized the management of advanced melanoma (AM). However, data on ICI effectiveness have largely been restricted to clinical trials, thereby excluding patients with co-existing malignancies. Chronic lymphocytic leukemia (CLL) is the most prevalent adult leukemia and is associated with increased risk of melanoma. CLL alters systemic immunity and can induce T-cell exhaustion, which may limit the efficacy of ICIs in patients with CLL. We, therefore, sought to examine the efficacy of ICI in patients with these co-occurring diagnoses. PATIENTS AND METHODS In this international multicenter study, a retrospective review of clinical databases identified patients with concomitant diagnoses of CLL and AM treated with ICI (US-MD Anderson Cancer Center, N = 24; US-Mayo Clinic, N = 15; AUS, N = 19). Objective response rates (ORRs), assessed by RECIST v1.1, and survival outcomes [overall survival (OS) and progression-free survival (PFS)] among patients with CLL and AM were assessed. Clinical factors associated with improved ORR and survival were explored. Additionally, ORR and survival outcomes were compared between the Australian CLL/AM cohort and a control cohort of 148 Australian patients with AM alone. RESULTS Between 1997 and 2020, 58 patients with concomitant CLL and AM were treated with ICI. ORRs were comparable between AUS-CLL/AM and AM control cohorts (53% versus 48%, P = 0.81). PFS and OS from ICI initiation were also comparable between cohorts. Among CLL/AM patients, a majority were untreated for their CLL (64%) at the time of ICI. Patients with prior history of chemoimmunotherapy treatment for CLL (19%) had significantly reduced ORRs, PFS, and OS. CONCLUSIONS Our case series of patients with concomitant CLL and melanoma demonstrate frequent, durable clinical responses to ICI. However, those with prior chemoimmunotherapy treatment for CLL had significantly worse outcomes. We found that CLL disease course is largely unchanged by treatment with ICI.
Collapse
Affiliation(s)
- S H Cass
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - J W D Tobin
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - Y D Seo
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - G Gener-Ricos
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston
| | - E Z Keung
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - E M Burton
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - M A Davies
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - J L McQuade
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - A J Lazar
- Departments of Pathology and Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Mason
- Gold Coast University Hospital, Southport
| | | | - S Sandhu
- Peter Macallum Cancer Centre, Melbourne
| | - C Khoo
- Peter Macallum Cancer Centre, Melbourne
| | - L Warburton
- Fiona Stanley Hospital, Perth; Edith Cowan University, Joondalup; Future Health Research and Innovation Fund/Raine Clinician Research Fellowship
| | - V Guerra
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston
| | | | - H Dearden
- Melanoma Institute Australia, The University of Sydney, Sydney
| | - A M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney; Faculty of Medicine and Health, The University of Sydney, Sydney; The University of Sydney Charles Perkins Centre, Sydney; The University of Sydney Royal North Shore and Mater Hospitals, Sydney
| | - M S Carlino
- Melanoma Institute Australia, The University of Sydney, Sydney; Westmead Hospital, Sydney, Australia
| | - J L Smith
- Westmead Hospital, Sydney, Australia
| | - P Mollee
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - M Burgess
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - S Mapp
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - C Keane
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - V Atkinson
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | | | | | - W Ding
- Mayo Clinic, Rochester, USA
| | | | | | - G V Long
- Melanoma Institute Australia, The University of Sydney, Sydney; Faculty of Medicine and Health, The University of Sydney, Sydney; The University of Sydney Charles Perkins Centre, Sydney; The University of Sydney Royal North Shore and Mater Hospitals, Sydney
| | - J A Wargo
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
| | - A Ferrajoli
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston
| |
Collapse
|
2
|
Zhang M, Fergusson DA, Sharma R, Khoo C, Mendelson AA, McDonald B, Macala KF, Sharma N, Gill SE, Fiest KM, Lehmann C, Shorr R, Jahandideh F, Bourque SL, Liaw PC, Fox-Robichaud A, Lalu MM. Sex-based analysis of treatment responses in animal models of sepsis: a preclinical systematic review protocol. Syst Rev 2023; 12:50. [PMID: 36945012 PMCID: PMC10029211 DOI: 10.1186/s13643-023-02189-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 02/06/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The importance of investigating sex- and gender-dependent differences has been recently emphasized by major funding agencies. Notably, the influence of biological sex on clinical outcomes in sepsis is unclear, and observational studies suffer from the effect of confounding factors. The controlled experimental environment afforded by preclinical studies allows for clarification and mechanistic evaluation of sex-dependent differences. We propose a systematic review to assess the impact of biological sex on baseline responses to disease induction as well as treatment responses in animal models of sepsis. Given the lack of guidance surrounding sex-based analyses in preclinical systematic reviews, careful consideration of various factors is needed to understand how best to conduct analyses and communicate findings. METHODS MEDLINE and Embase will be searched (2011-present) to identify preclinical studies of sepsis in which any intervention was administered and sex-stratified data reported. The primary outcome will be mortality. Secondary outcomes will include organ dysfunction, bacterial load, and IL-6 levels. Study selection will be conducted independently and in duplicate by two reviewers. Data extraction will be conducted by one reviewer and audited by a second independent reviewer. Data extracted from included studies will be pooled, and meta-analysis will be conducted using random effects modeling. Primary analyses will be stratified by animal age and will assess the impact of sex at the following time points: pre-intervention, in response to treatment, and post-intervention. Risk of bias will be assessed using the SYRCLE's risk-of-bias tool. Illustrative examples of potential methods to analyze sex-based differences are provided in this protocol. DISCUSSION Our systematic review will summarize the current state of knowledge on sex-dependent differences in sepsis. This will identify current knowledge gaps that future studies can address. Finally, this review will provide a framework for sex-based analysis in future preclinical systematic reviews. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022367726.
Collapse
Affiliation(s)
- MengQi Zhang
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON, K1H 8M5, Canada
- Clinical Epidemiology Program, Blueprint Translational Group, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada
| | - Dean A Fergusson
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON, K1H 8M5, Canada.
- Clinical Epidemiology Program, Blueprint Translational Group, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada.
| | - Rahul Sharma
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON, K1H 8M5, Canada
| | - Ciel Khoo
- Clinical Epidemiology Program, Blueprint Translational Group, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada
| | - Asher A Mendelson
- Department of Internal Medicine, Section of Critical Care Medicine, Rady Faculty of Health Sciences, University of Manitoba, 820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada
| | - Braedon McDonald
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
- Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Kimberly F Macala
- Department of Critical Care Medicine, Royal Alexandra Hospital, University of Alberta, 2-214 Clinical Science Building, 8440-112Th Street, Edmonton, AB, T6G 2B7, Canada
| | - Neha Sharma
- Department of Medical Sciences and Thrombosis and Atherosclerosis Research Institute, McMaster University, 237 Barton St East, Hamilton, ON, L8L 2X2, Canada
| | - Sean E Gill
- Centre for Critical Illness Research, Lawson Health Research Institutes, Victoria Research Labs, A6-134, 800 Commissioners Road Ease, London, ON, N6A 5W9, Canada
- Division of Respirology, Department of Medicine, Western University, London, ON, Canada
| | - Kirsten M Fiest
- Department of Critical Care Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada
| | - Christian Lehmann
- Department of Anesthesia, Pain Management and Perioperative Medicine, II Health Sciences Centre, 5850 College Street, Halifax, NS, B3H 1X5, Canada
| | - Risa Shorr
- Learning Services, The Ottawa Hospital, Ottawa, ON, Canada
| | - Forough Jahandideh
- Clinical Epidemiology Program, Blueprint Translational Group, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada
- Department of Anesthesiology & Pain Medicine, Katz Group Centre for Pharmacy and Health Research, University of Alberta, 3-020H, Edmonton, AB, T6G 2E1, Canada
| | - Stephane L Bourque
- Department of Anesthesiology & Pain Medicine, Katz Group Centre for Pharmacy and Health Research, University of Alberta, 3-020H, Edmonton, AB, T6G 2E1, Canada
| | - Patricia C Liaw
- Department of Medicine and Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, 237 Barton St East, Hamilton, ON, L8L 2X2, Canada
| | - Alison Fox-Robichaud
- Department of Medicine and Thrombosis and Atherosclerosis Research Institute, McMaster University and Hamilton Health Sciences, 237 Barton St East, Hamilton, ON, L8L 2X2, Canada
| | - Manoj M Lalu
- Clinical Epidemiology Program, Blueprint Translational Group, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada.
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Room B307, 1053 Carling Avenue, Mail Stop 249, Ottawa, ON, K1Y 4E9, Canada.
- Regenerative Medicine Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada.
| | | |
Collapse
|
3
|
Uthman A, Khoo C, Taylor N, Bolton E. Urachal cancer: Experience of a high-volume bladder cancer centre. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01129-6] [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: 02/12/2023]
|
4
|
Uthman A, Connor M, Khoo C, Rai A, Bass E, Agarwal S, Dasgupta R, Winkler M, Abboudi H, El-Husseiny T, Ahmed H. Rezum thermotherapy for large prostate volumes (>/= 80 cc): 2-year clinical outcomes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00282-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
|
5
|
Reddy D, Eldred-Evans D, Connor M, Hosking-Jervis F, Bertoncelli Tanaka M, Bhola-Stewart H, Maynard W, Khoo C, Shah T, Bass E, Lee H, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Assessing the regional variability of a pre-biopsy mpMRI and targeted prostate cancer diagnostic pathway. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00532-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
6
|
Connor M, Rai A, Khoo C, Bass E, Eldred-Evans D, Agarwal S, Winkler M, Abboudi H, Dasgupta R, El-Husseiny T, Ahmed H. Patient-reported outcome measures and surgical retreatment rates from 181 patients treated with water vapor thermal therapy (Rezūm™). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00802-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
7
|
Ho C, Palaniappan V, Ting A, Khoo C, Forster L, Kondjin-Smith M, Abboudi H, Hanna M, El-Husseiny T, Dasgupta R. 746 Single-Centre Experience with Three Metallic Ureteric Stents (Allium URS, Memokath-051 and Resonance) for Chronic Ureteric Obstruction. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Aim
To evaluate efficacy of Allium URS, Memokath 051 and Resonance metallic ureteric stents as an alternative to polymer stents/nephrostomy in managing chronic ureteric obstruction (CUO).
Method
Retrospective analysis of consecutive patients with CUO managed with Allium URS, Memokath-051 or Resonance (September 2015/July 2020). Baseline patient variables (age, gender, underlying aetiology, ASA) and stricture characteristics (length, level, continuity) were recorded. Intra- and post-operative clinical and radiological follow-up assessments at 6 weeks, 3 months and then every 6 months, as well as any emergency attendances, were reviewed for placement success, stent complications, serum creatinine, and mortality. Outcomes included placement success rate, functional stent survival, and mean renal function.
Results
Overall, 129 stent insertion episodes (SIEs) (Allium URS: 23, Memokath 051: 48, Resonance: 58) occurred in 76 patients (Allium URS: 16; Memokath-051: 31; Resonance: 29). Placement success was high (Allium URS: 95.7%; Memokath-051 and Resonance: both 100%). Median functional stent survival was 11.4 months for Allium URS, 5.5 months for Memokath-051 and 11.7 months for Resonance. 47.8% of Allium URS SIEs (11/23), 64.6% of Memokath-051 SIEs (31/48) and 19% of Resonance SIEs (11/58) experienced complication (most frequently obstruction followed by migration and infection). There were no complications for Resonance SIEs for benign indication. In the first year following SIE, serum creatinine ranged from +21.3% to + 46.7% for Allium URS, -7.8% to + 8.9% for Memokath-051, and -9.4% to + 27.3% for Resonance.
Conclusions
Allium URS, Memokath 051 and Resonance metallic ureteric stents are all viable management options of CUO. Resonance was particularly efficacious for patients with benign aetiology.
Collapse
Affiliation(s)
- C Ho
- Imperial College London, London, United Kingdom
| | | | - A Ting
- Imperial College London, London, United Kingdom
| | - C Khoo
- Imperial Endourology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom, London, United Kingdom
| | - L Forster
- Imperial Endourology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom, London, United Kingdom
| | - M Kondjin-Smith
- Imperial Endourology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom, London, United Kingdom
| | - H Abboudi
- Imperial Endourology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom, London, United Kingdom
| | - M Hanna
- Imperial Endourology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom, London, United Kingdom
| | - T El-Husseiny
- Imperial Endourology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom, London, United Kingdom
| | - R Dasgupta
- Imperial Endourology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom, London, United Kingdom
| |
Collapse
|
8
|
Ting A, Shanmugathas N, Khoo C, Dasgupta R, El-Husseiny T, Abboudi H. 525 Minimally Invasive Surgical Treatment of Benign Prostatic Hyperplasia: A Systematic Review. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Minimally invasive surgical treatments (MISTs) of benign prostatic hyperplasia (BPH) have evolved to offer men daycase care with preservation of urinary continence and sexual function. This systematic review evaluates trends in minimally invasive BPH surgery over the last decade
Method
Systematic review (PRISMA) of Embase/MEDLINE databases (2010-2020). MISTs included Rezum, Urolift, Prostatic Artery Embolisation (PAE), Temporary Implantable Nitinol Device (TIND), Intraprostatic Injection, Transurethral Microwave Therapy (TUMT) and Transurethral Needle Ablation (TUNA). Primary outcome: urinary functional change (International Prostate Symptom Score (IPSS)/maximum flow (Qmax)). Secondary outcomes: sexual functional change (International Index of Erectile Function-5 (IIEF-5)), technical failures and complications.
Results
74 studies were included (total: 8,917 patients). Primary: all interventions offered improvement in IPSS and Qmax (intervention (no. studies): range IPSS change, range Qmax change, range months follow-up; Rezum (4): -46.7% to -62.7%, +17.6% to + 55.6%, 6-48; Urolift (11): -35.2% to -64.2%, +16.7% to + 89.6%, 1-60; PAE (36): -36.8% to -85.2%, +17.4% to + 155.2%, 3-38; TIND (2): -36.8% to -59.6%, +32.9% to + 95.9%, 12-36; Intraprostatic Injection (14): -24.3% to -62%, +8.7% to + 98.4%, 3-24; TUMT (4): -56.1% to -58.7%, +12.9% to + 60.2%, 6-60; TUNA (3): -17.6% to -63.2%, +3.9% to + 39%, 1-120). Secondary: 33 studies of all interventions bar TIND and TUMT reported IIEF-5 change; sexual function was largely preserved. Technical failures and Clavien-Dindo ≥3 complications were rare.
Conclusions
MISTs for BPH are efficacious and safe. Randomised comparisons with long-term urinary and sexual follow-up are needed to guide choice; until then, patients should be carefully counselled based on individual priorities and circumstances.
Collapse
Affiliation(s)
- A Ting
- Imperial College London, London, United Kingdom
| | - N Shanmugathas
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom
| | - C Khoo
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom
| | - R Dasgupta
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom
| | - T El-Husseiny
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom
| | - H Abboudi
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, United Kingdom
| |
Collapse
|
9
|
Barker M, Mehran R, Wong G, Nair P, Chou A, Butler C, Chen-Tournoux A, Coverett K, Essadiqi B, Froeschl M, Hazra S, Huitema A, Kavanagh K, Khoo C, Korley V, Ly H, Moeller A, Morin J, Teefy P, Sibbald M, Gin K, Sathananthan J. THE CURRENT LANDSCAPE OF CARDIAC CATHETERIZATION TRAINING IN CANADA: A NATIONWIDE SURVEY OF CORE CARDIOLOGY TRAINEES. Can J Cardiol 2021. [DOI: 10.1016/j.cjca.2021.07.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
10
|
Connor M, Eldred-Evans D, Hosking-Jervis F, Bass E, Reddy D, Bertoncelli Tanaka M, Bhola-Stewart H, Khoo C, Maynard W, Shah T, Lee J, Sri D, Powell L, Ahmad S, Joshi S, Pegers E, Kathie W, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Carton J, Ahmed H. Direct and marginal cost analysis of not aiming for the target in a MRI-targeted prostate biopsy pathway. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34162-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
11
|
Eldred-Evans D, Peters M, Bertoncelli Tanaka M, Hosking-Jervis F, Connor M, Reddy D, Shah T, Khoo C, Maynard W, Bass E, Lee J, Sri D, Bhola-Stewart H, Powell L, Ahmad S, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Qazi H, Gordon S, Ahmed H. The RAPID risk model: A novel risk score to predict significant prostate cancer in men with an mpMRI lesion. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33766-6] [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: 11/17/2022] Open
|
12
|
Reddy D, Eldred-Evans D, Connor M, Hosking-Jervis F, Bertoncelli-Tanaka M, Bhola-Stewart H, Maynard W, Khoo C, Shah T, Bass E, Lee J, Sri D, Powell L, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Indeterminate mpMRI lesions: Evaluating the optimal PSA density threshold for prostate biopsy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33741-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
13
|
Connor M, Eldred-Evans D, Hosking-Jervis F, Bass E, Reddy D, Bertoncelli Tanaka M, Bhola-Stewart H, Maynard W, Khoo C, Shah T, Lee J, Sri D, Powell L, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Which men should undergo non-targeted systematic sampling in an mpMRI-targeted pathway – an analysis from 1,719 pre-biopsy mpMRI cases? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32674-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
14
|
Maynard W, Eldred-Evans D, Connor M, Reddy D, Bertoncelli Tanaka M, Bhola-Stewart H, Khoo C, Bass E, Shah T, Lee J, Sri D, Powell L, Ahmad S, Noureldin M, Joshi S, Pegers E, Wong K, Tam H, Hrouda D, Winkler M, Gordon S, Qazi H, Ahmed H. Local anaesthetic transperineal prostate biopsy: Optimising patient selection. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34178-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
15
|
Chew KL, Tan SS, Saw S, Pajarillaga A, Zaine S, Khoo C, Wang W, Tambyah P, Jureen R, Sethi SK. Clinical evaluation of serological IgG antibody response on the Abbott Architect for established SARS-CoV-2 infection. Clin Microbiol Infect 2020; 26:1256.e9-1256.e11. [PMID: 32531475 PMCID: PMC7282795 DOI: 10.1016/j.cmi.2020.05.036] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/30/2020] [Accepted: 05/31/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This study aimed to evaluate the diagnostic performance of the Abbott Architect SARS-CoV-2 IgG assay in COVID-19 patients. METHODS Residual sera from 177 symptomatic SARS-CoV-2-positive patients and 163 non-COVID-19 patients were tested for antibody with the Abbott SARS-CoV-2 IgG assay (Abbott Diagnostics, Chicago, USA). Clinical records for COVID-19 patients were reviewed to determine the time from onset of clinical illness to testing. RESULTS Specificity of the assay was 100.0% (95%CI: 97.1-100.0%). The clinical sensitivity of the assay varied depending on time from onset of symptoms, increasing with longer periods from the onset of clinical illness. The clinical sensitivity at ≤6 days was 8.6% (7/81; 95%CI: 3.8-17.5%), at 7-13 days 43.6% (17/39; 95%CI: 28.2-60.2%), at 14-20 days 84.0% (21/25; 95%CI: 63.1-94.7%), and at ≥21 days 84.4% (27/32; 95%CI: 66.5-94.1%). Clinical sensitivity was higher in the ≥14-day group compared to <14 days. There were no differences between the 14-20-day and ≥21-days groups; the combined clinical sensitivity for these groups (≥14 days) was 84.2% (49/57; 71.6-92.1%). CONCLUSION The Abbott SARS-CoV-2 IgG test has high specificity. Clinical sensitivity was limited in the early stages of disease but improved from 14 days after the onset of clinical symptoms.
Collapse
Affiliation(s)
- K L Chew
- Department of Laboratory Medicine, National University Hospital, Singapore.
| | - S S Tan
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - S Saw
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - A Pajarillaga
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - S Zaine
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - C Khoo
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - W Wang
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - P Tambyah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - R Jureen
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - S K Sethi
- Department of Laboratory Medicine, National University Hospital, Singapore
| |
Collapse
|
16
|
Kanwar M, Khoo C, Lohmueller L, Bailey S, Murali S, Antaki J. Predicting Post LVAD Acute Severe Right Heart Failure Using Bayesian Analysis. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
17
|
Hadi A, Alpert C, Murali S, Khoo C, Williams G, Benza R, Raina A, Lander M, Kanwar M. Intra-Aortic Balloon Pump Use before Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1159] [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: 11/17/2022] Open
|
18
|
Gao C, McCormack C, van der Weyden C, Goh M, Campbell B, Twigger R, Buelens O, Harrison S, Khoo C, Lade S, Prince H. A review of 65 patients with mycosis fungoides/Sezary syndrome treated with extracorporeal photopheresis: our experience at Peter MacCallum Cancer Centre. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30590-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
19
|
Gao C, McCormack C, van der Weyden C, Twigger R, Buelens O, Lade S, Khoo C, Campbell B, Goh M, McKelvie P, Prince H. A retrospective analysis of patients with co-existent mycosis fungoides and primary cutaneous anaplastic large cell lymphoma from the Australian Cutaneous Lymphoma Network database. Eur J Cancer 2019. [DOI: 10.1016/s0959-8049(19)30521-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
20
|
Lai-Kwon J, Khoo C, Lo S, Milne D, Mohamed M, Raleigh J, Smith K, Lisy K, Sandhu S, Jefford M. The survivorship experience of patients with metastatic melanoma on long-term immune checkpoint inhibitors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy439] [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] Open
|
21
|
Khoo C, Markar S, Nott D. A novel method of 'hands-free' laparoscopic retraction. Ann R Coll Surg Engl 2018; 101:304-305. [PMID: 30286639 DOI: 10.1308/rcsann.2018.0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- C Khoo
- Department of General Surgery, Chelsea and Westminster NHS Foundation Trust, Chelsea and Westminster Hospital , London , UK
| | - S Markar
- Department of General Surgery, Chelsea and Westminster NHS Foundation Trust, Chelsea and Westminster Hospital , London , UK
| | - D Nott
- Department of General Surgery, Chelsea and Westminster NHS Foundation Trust, Chelsea and Westminster Hospital , London , UK
| |
Collapse
|
22
|
Christie S, Hiebert B, Seifer C, Khoo C. COMPARING CLINICAL OUTCOMES OF CRT-P VS CRT-D IN ELDERLY PATIENTS WITH HEART FAILURE. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
23
|
Abstract
A 44-year-old woman was admitted to our hospital with dengue fever. She developed a haematoma in the right arm at the site of a previous arterial line insertion. Due to coexisting thrombocytopenia, the bleeding was severe enough to cause compartment syndrome. An emergency fasciotomy was performed and her limb salvaged. The case illustrates one important potential complication of this common infectious disease.
Collapse
Affiliation(s)
- C Khoo
- CS Khoo, Department of Internal Medicine, Ampang Hospital, Jalan Mewah Utara, 68000 Ampang, Selangor, Malaysia. E-mail
| | | | | | | |
Collapse
|
24
|
Li J, Koh LY, Yang JH, Khoo C, Ter T, Tan BH. Quality improvement project to optimize enteral nutrition in a tertiary hospital's surgical ICU. Crit Care 2015. [PMCID: PMC4470434 DOI: 10.1186/cc14475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
|
25
|
Khoo C, Tung S. Utilisation of a Right Ventricular Apical Lead for Pacing Backup in Patients With a His-Bundle Lead. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
26
|
Khoo C, Lauck S, Kutcher S, Barr S, Furlan B, Galte C, Redman K, McIlroy C, Shalansky S, Tung S, Yeung-Lai-Wah A, Kerr C, Chakrabarti S. 069 Improving Atrial Fibrillation Outcomes Through an Interdisciplinary Atrial Fibrillation Clinic: Incidence of Cerebrovascular Events and Emergency Room Visits. Can J Cardiol 2012. [DOI: 10.1016/j.cjca.2012.07.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
|
27
|
|
28
|
Khoo C, Thevarayan S, Rengsen P, Deepak AS. Septic Arthritis of Lumbar Facet Joint with Co-Existing Spondylolisthesis – A Case Report. Malays Orthop J 2010. [DOI: 10.5704/moj.1007.009] [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: 11/05/2022] Open
|
29
|
Krishnamoorty S, Khoo C, Lim H, Lip G. P65 ARTERIAL STIFFNESS IN PAROXYSMAL ATRIAL FIBRILLATION: RELATIONSHIP WITH MICRO- AND MACROVASCULAR ENDOTHELIAL DYSFUNCTION AND CARDIOVASCULAR DISEASE. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70132-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
30
|
|
31
|
Abstract
We undertook an audit of the practice of antenatal steroid prescribing. Data were collected over a prospective 12-week period in an initial audit (2002). Deviations from compliance with guidelines published by the Royal College of Obstetricians and Gynaecologists were identified and a report highlighting the audit findings was disseminated to all maternity units in Glasgow. A repeat audit (2004) was performed over a further prospective 12-week period. A total of 111 women in the initial and 188 women in the repeat audits received corticosteroids. Steroid courses per eventual delivery between 24-36 weeks' gestation increased from 0.64 to 1.18. Repeat courses of steroid decreased from 5% to <1%. Potentially effective courses of steroid increased from 24% to 35%. The proportion of potentially effective steroid courses varied according to the indication. Few steroid courses were potentially effective where the indication was pre-term labour. The findings of this audit are generally encouraging but continuing education regarding the appropriate prescription of antenatal corticosteroids is necessary to maintain and possibly improve upon the findings of this audit.
Collapse
Affiliation(s)
- C Khoo
- Princess Royal Maternity Hospital, Glasgow, UK
| | | | | |
Collapse
|
32
|
Zheng C, Khoo C, Furtado J, Sacks F. Abstract: P937 SHIFT FROM APOE TO APOCIII IN TRIGLYCERIDE-RICH LIPOPROTEIN METABOLISM ESTABLISHES HYPERTRIGLYCERIDEMIA. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)71058-x] [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: 11/15/2022]
|
33
|
Tansley AP, Baildam A, Rainsbury R, Khoo C, Smith BM. Interspecialty fellowships in oncoplastic surgery and breast reconstruction – the innovative training scheme in the United Kingdom. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-4141] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #4141
Improved survival rates for breast cancer have evolved with specialist multidisciplinary care and adjuvant treatment regimes. Surgical options for breast cancer are increasingly complex comprising adequate oncological resection with improved aesthetic outcome, quality of life and psychosexual function for cancer survivors. Such surgery requires oncoplastic skills and innovative techniques and is an integral part of delivering a modern surgical breast service.
 In 2002, an innovative interspecialty training program was established for senior trainees in breast and plastic surgery, initiated by senior breast specialist surgeons and funded by the Department of Health. Nine breast centres in the UK were selected for their high volume high quality specialist care in breast disease with dual training in breast and plastic surgery. Competitive application to the training program selected the highest quality trainees for a year of interspecialty Fellowship training. The demand for these posts has required a highly competitive curriculum vitae and a higher academic degree.
 Since 2004, detailed prospective data has been collected on the qualitative and quantitative experience of the Fellowship scheme. This has been questionnaire based using logbook data for quantitative technical experience and comparative qualitative data for Fellowship satisfaction and outcome in specialty training.
 53 fellows have to 2008 completed interspecialty training. 43 have been in their penultimate or last year in higher surgical training, the majority (42) are breast trainees in general surgery, 11 are trainees in plastic and reconstructive surgery. The Fellowship maximises exposure to operative planning and surgical techniques. 62% of oncology surgery (including breast reconing procedures), 49% of (immediate and delayed) reconstructive procedures, and 49% of breast symmetrization and aesthetic surgery is performed by the trainee under direct supervision. Overall expectations and quality of the Fellowships scored 'high' to 'excellent' and this was reflected in the confidence of fellows to take up NHS Consultant posts and continue to use the skills acquired within a multidisciplinary specialised breast team.
 The interspecialty training program has been successful for both breast and plastics trainees. It has given senior surgical trainees the opportunity to focus and direct their own training requirements into an intense clinical year of surgical oncology and breast reconstruction. Key components to the success of this year include working in high volume, specialist breast and plastic reconstructive units with direct supervision from dedicated trainers, supernumerary training status and an elective surgical practice. It succeeds as a pioneering program designed to increase the number of trained surgeons offering seamless oncoplastic surgery for the benefit of the patients.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4141.
Collapse
Affiliation(s)
- AP Tansley
- 1 Training Interface Group in Breast Surgery, The Royal College of Surgeons of England, London, United Kingdom
| | - A Baildam
- 1 Training Interface Group in Breast Surgery, The Royal College of Surgeons of England, London, United Kingdom
| | - R Rainsbury
- 1 Training Interface Group in Breast Surgery, The Royal College of Surgeons of England, London, United Kingdom
| | - C Khoo
- 1 Training Interface Group in Breast Surgery, The Royal College of Surgeons of England, London, United Kingdom
| | - BM Smith
- 1 Training Interface Group in Breast Surgery, The Royal College of Surgeons of England, London, United Kingdom
| |
Collapse
|
34
|
Inness VL, McCartney AL, Khoo C, Gross KL, Gibson GR. Molecular characterisation of the gut microflora of healthy and inflammatory bowel disease cats using fluorescence in situ hybridisation with special reference to Desulfovibrio spp. J Anim Physiol Anim Nutr (Berl) 2007; 91:48-53. [PMID: 17217390 DOI: 10.1111/j.1439-0396.2006.00640.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Inflammatory bowel disease (IBD) is a common cause of chronic large bowel diarrhoea in cats. Although the aetiology of IBD is unknown, an immune-mediated response to a luminal antigen is thought to be involved. As knowledge concerning the colonic microflora of cats is limited and requires further investigation, the purpose of this study was to determine the presence of specific bacterial groups in normal and IBD cats, and the potential role they play in the health of the host. Total bacterial populations, Bacteroides spp., Bifidobacterium spp., Clostridium histolyticum subgp., Lactobacillus-Enterococcus subgp. and Desulfovibrio spp. were enumerated in 34 healthy cats and 11 IBD cats using fluorescence in situ hybridisation. The study is one of the first to show the presence of Desulfovibrio in cats. Total bacteria, Bifidobacterium spp. and Bacteroides spp. counts were all significantly higher in healthy cats when compared with IBD cats, whereas Desulfovibrio spp. (producers of toxic sulphides) numbers were found to be significantly higher in colitic cats. The information obtained from this study suggests that modulation of bacterial flora by increasing bifidobacteria and decreasing Desulfovibrio spp. may be beneficial to cats with IBD. Dietary intervention may be an important aspect of their treatment.
Collapse
Affiliation(s)
- V L Inness
- Food Microbial Sciences Unit, School of Food Biosciences, The University of Reading, Reading, UK
| | | | | | | | | |
Collapse
|
35
|
|
36
|
Choi HB, Khoo C, Ryu JK, van Breemen E, Kim SU, McLarnon JG. Inhibition of lipopolysaccharide-induced cyclooxygenase-2, tumor necrosis factor-alpha and [Ca2+]i responses in human microglia by the peripheral benzodiazepine receptor ligand PK11195. J Neurochem 2002; 83:546-55. [PMID: 12390516 DOI: 10.1046/j.1471-4159.2002.01122.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The anti-inflammatory actions of the mitochondrial peripheral benzodiazepine receptor (PBR) agonist PK11195 [1-(2-chloro- phenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinoline-carboxamide] were investigated in human microglia. Application of the microglial inflammatory stimulus lipopolysaccharide (LPS, at 100 ng/mL for 3 h), induced enhancement of the expressions of the inducible enzyme, cyclooxygenase-2 (COX-2) and the pro-inflammatory cytokine, tumor necrosis factor-alpha (TNF-alpha). PK11195 (at 50 microm) significantly inhibited the LPS-induced up-regulation of both inflammatory factors; at a lower concentration of PK11195 (2 microm) expression of TNF-alpha, but not COX-2, was reduced. Production of both factors, using immunocytochemistry for COX-2 and ELISA for TNF-alpha, was markedly reduced with 50 microm of PK11195 added to LPS solution. Acute application of LPS induced a transient increase in intracellular Ca2+[Ca2+]i exhibiting both a slow development and recovery in kinetic behavior. This increase in [Ca2+]i consisted primarily of a Ca2+ influx component accompanied by a smaller mobilization from intracellular Ca2+ stores. In the presence of PK11195, the amplitude of the [Ca2+]i response induced by LPS was reduced by 54%. Another mitochondrial agent cyclosporin A (CsA), which also acts at the permeability transition pore (PTP) of mitochondrial membrane but at a site different from the PBR, was ineffective in reducing either the LPS-induced expression of COX-2 and TNF-alpha or the endotoxin increase in [Ca2+]i. These results indicate that the mitochondrial effector PK11195 is a specific and effective agent for inhibiting LPS-induced microglial expressions of COX-2 and TNF-alpha and that modulation of Ca2+-mediated signaling pathways could be involved in the anti-inflammatory actions.
Collapse
Affiliation(s)
- Hyan B Choi
- Department of Pharmacology and Therapeutics, Division of Neurology, Faculty of Medicine, The University of British Columbia, 2176 Health Sciences Mall, Vancouver, British Columbia, Canada V6T 1Z3
| | | | | | | | | | | |
Collapse
|
37
|
Abstract
The effects of extracellular acidification on Ca(2+)-dependent signaling pathways in human microglia were investigated using Ca(2+)-sensitive fluorescence microscopy. Adenosine triphosphate (ATP) was used to elicit Ca(2+) responses primarily dependent on the depletion of intracellular endoplasmic reticulum (ER) stores, while platelet-activating factor (PAF) was used to elicit responses primarily dependent on store-operated channel (SOC) influx of Ca(2+). The duration of transient responses induced by ATP was not significantly different in standard physiological pH 7.4 (mean duration 30.2 +/- 2.5 s) or acidified pH 6.2 (mean duration 31.7 +/- 2.8 s) extracellular solutions. However, the time course of the PAF response at pH 7.4 was significantly reduced by 87% with external pH at 6.2. These results suggest that acidification of extracellular solutions inhibits SOC entry of Ca(2+) with little or no effect on depletion of ER stores. Changes of extracellular pH over the range from 8.6 to 6.2 during the development of a sustained SOC influx induced by PAF resulted in instantaneous modulation of SOC amplitude indicating a rapidly reversible effect of pH on this Ca(2+) pathway. Whole-cell patch clamp recordings showed external acidification blocked depolarization-activated outward K(+) current indicating cellular depolarization may be involved in the acid pH inhibition. Since SOC mediated influx of Ca(2+) is strongly modulated by membrane potential, the electrophysiological data suggest that acidification may act to inhibit SOC by cellular depolarization. These results suggest that acidification observed during cerebral ischemia may alter microglial responses and functions.
Collapse
Affiliation(s)
- C Khoo
- Department of Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | | | | | | |
Collapse
|
38
|
Campos H, Perlov D, Khoo C, Sacks FM. Distinct patterns of lipoproteins with apoB defined by presence of apoE or apoC-III in hypercholesterolemia and hypertriglyceridemia. J Lipid Res 2001; 42:1239-49. [PMID: 11483625] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Apolipoprotein (apo) E and apoC-III concentrations in VLDL and LDL are associated with coronary heart disease. We studied the relationship between apoE and apoC-III and the abnormal concentrations and distribution of apoB lipoproteins in 10 hypercholesterolemic and 13 hypertriglyceridemic patients compared with 12 normolipidemic subjects (mean age, 45 years). Sixteen distinct types of apoB lipoprotein particles were separated by first using anti-apoE and anti-apoC-III immunoaffinity chromatography in sequence and then ultracentrifugation [light VLDL, dense VLDL, IDL, and LDL, with apoE with or without apoC-III (E(+)C-III(+), E(+)C-III(-)) or without apoE with or without apoC-III (E(-)C-III(+), E(-)C-III(-))]. The concentrations of VLDL particles with apoC-III (E(+)C-III(+), E(-)C-III(+)) were increased in the hypertriglyceridemic group compared with the hypercholesterolemic and normolipidemic groups. These particles were the most triglyceride rich of the particle types, and their triglyceride content was twice as high in hypertriglyceridemics compared with the other two groups. Hypertriglyceridemics had a similar concentration of total E(-)C-III(-) particles compared with normolipidemics, but the E(-)C-III(-) particles were distributed more to VLDL and IDL than to LDL. Hypercholesterolemics, in contrast, were distinguished from the normolipidemic group by 2-fold higher concentrations of apoB lipoproteins without apoE or apoC-III (E(-)C-III(-)), mainly LDL, which had high cholesterol content. Nonetheless, both normolipidemics and hypercholesterolemics had apoC-III-containing VLDL, which comprised 68% and 43% of their total VLDL particles. E(+)C-III(-) particles were a minor type, comprising <10% of particles in all lipoproteins and patient groups. Therefore, VLDL particles with apoC-III may play a central role in identifying the high risk of coronary heart disease in hypertriglyceridemia, but their substantial prevalence in normolipidemics may be of clinical significance as well.
Collapse
Affiliation(s)
- H Campos
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.
| | | | | | | |
Collapse
|
39
|
Broman E, Khoo C, Taylor LS. A comparison of alternative polymer excipients and processing methods for making solid dispersions of a poorly water soluble drug. Int J Pharm 2001; 222:139-51. [PMID: 11404040 DOI: 10.1016/s0378-5173(01)00709-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Solid dispersions were prepared with the extremely poorly water soluble drug, probucol and the water soluble polymers, polyvinyl pyrrolidone (PVP), polyacrylic acid (PAA) or polyethylene oxide (PEO) and blends of these polymers. The solid dispersions were prepared either by the solvent evaporation method, or by compression moulding into films. The materials were characterised by a combination of thermal analysis and FT-Raman spectroscopy. The physical state of the drug was observed to be dependent on the carrier, thus the PVP solid dispersions contained amorphous probucol, whilst the PAA and PEO systems contained the crystalline polymorph II. The method of production was not found to greatly influence the state of the drug in the solid dispersion. The greatest extent of release into solution was observed for the binary blend of drug and PEO, and the blending of polymers was not found to have any advantageous effects in this study.
Collapse
Affiliation(s)
- E Broman
- Department of Pharmaceutics, Uppsala University, Uppsala, Sweden
| | | | | |
Collapse
|
40
|
Abstract
Human carcinomas are intimately linked to advancing age. These cancers have complex cytogenetic profiles, including aneuploidy and chromosomal structural aberrations. While aged humans sustain a high rate of carcinomas, mice bearing common tumor suppressor gene mutations typically develop soft tissue sarcomas and lymphomas. One marked species distinction between human and mouse that bears on the predisposition to carcinogenesis lies in the radical differences in length and regulation of the telomere, nucleoprotein complexes that cap the ends of eukaryotic chromosomes. Recent cancer modeling studies in the telomerase knockout p53 mutant mice revealed that telomere dynamics might be relevant to carcinogenesis. In these mice, there is a shift in the tumor spectrum towards epithelial carcinomas, and these cancers emerge with complex cytogenetic profiles classical for human carcinomas. In this review, we suggest that the mechanism of fusion-bridge-breakage-translocation, triggered by critically short telomeres, may be one of the generators of genomic instability commonly seen in human carcinomas.
Collapse
Affiliation(s)
- S Chang
- Department of Adult Oncology, Dana-Farber Cancer Institute, 44 Binney St., Boston, MA 02115, USA
| | | | | |
Collapse
|
41
|
Kishi S, Zhou XZ, Ziv Y, Khoo C, Hill DE, Shiloh Y, Lu KP. Telomeric protein Pin2/TRF1 as an important ATM target in response to double strand DNA breaks. J Biol Chem 2001; 276:29282-91. [PMID: 11375976 DOI: 10.1074/jbc.m011534200] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
ATM mutations are responsible for the genetic disease ataxia-telangiectasia (A-T). ATM encodes a protein kinase that is activated by ionizing radiation-induced double strand DNA breaks. Cells derived from A-T patients show many abnormalities, including accelerated telomere loss and hypersensitivity to ionizing radiation; they enter into mitosis and apoptosis after DNA damage. Pin2 was originally identified as a protein involved in G(2)/M regulation and is almost identical to TRF1, a telomeric protein that negatively regulates telomere elongation. Pin2 and TRF1, probably encoded by the same gene, PIN2/TRF1, are regulated during the cell cycle. Furthermore, up-regulation of Pin2 or TRF1 induces mitotic entry and apoptosis, a phenotype similar to that of A-T cells after DNA damage. These results suggest that ATM may regulate the function of Pin2/TRF1, but their exact relationship remains unknown. Here we show that Pin2/TRF1 coimmunoprecipitated with ATM, and its phosphorylation was increased in an ATM-dependent manner by ionizing DNA damage. Furthermore, activated ATM directly phosphorylated Pin2/TRF1 preferentially on the conserved Ser(219)-Gln site in vitro and in vivo. The biological significance of this phosphorylation is substantiated by functional analyses of the phosphorylation site mutants. Although expression of Pin2 and its mutants has no detectable effect on telomere length in transient transfection, a Pin2 mutant refractory to ATM phosphorylation on Ser(219) potently induces mitotic entry and apoptosis and increases radiation hypersensitivity of A-T cells. In contrast, Pin2 mutants mimicking ATM phosphorylation on Ser(219) completely fail to induce apoptosis and also reduce radiation hypersensitivity of A-T cells. Interestingly, the phenotype of the phosphorylation-mimicking mutants is the same as that which resulted from inhibition of endogenous Pin2/TRF1 in A-T cells by its dominant-negative mutants. These results demonstrate for the first time that ATM interacts with and phosphorylates Pin2/TRF1 and suggest that Pin2/TRF1 may be involved in the cellular response to double strand DNA breaks.
Collapse
Affiliation(s)
- S Kishi
- Cancer Biology Program, Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA
| | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
This work demonstrates the presence of hyoscyamine and scopolamine at different stages of shoot regeneration from non-organogenic and organogenic calli. The 11-week-old non-organogenic calli contained 0.41+/-0.03 and 0.23+/-0.02 microg g(-1) dry wt hyoscyamine and scopolamine respectively. However, no root meristem was found in the calli. The alkaloids were absent in 2-week-old organogenic calli. The shoot-buds induced on the non-organogenic and organogenic calli did not contain these alkaloids. Hyoscyamine and scopolamine contents of the 6-week-old non-rooted shoots regenerated from non-organogenic calli were 7.8+/-0.1 and 6.5+/-0.4 microg g(-1) dry wt respectively and those in the 9-week-old non-rooted shoot regenerated from organogenic calli were 38.5+/-0.4 and 3.6+/-0.1 microg g(-1) dry wt respectively. Hyoscyamine and scopolamine contents of the 4-week-old roots regenerated from non-organogenic and organogenic calli were higher than those in the non-rooted shoots. Since the presence of hyoscyamine and scopolamine in the non-rooted shoot depends on the stage of differentiation, manipulation of culture environment may improve hyoscyamine and scopolamine contents of the non-rooted shoots.
Collapse
Affiliation(s)
- N Khanam
- Department of Biological Sciences, University of Western Sydney, Campbelltown, NSW, Australia.
| | | | | | | |
Collapse
|
43
|
Campos H, Perlov D, Khoo C, Sacks F. Distinct patterns of apo B lipoproteins defined by apo CIII or E in hyperlipidemias. Atherosclerosis 2000. [DOI: 10.1016/s0021-9150(00)80780-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
44
|
Khoo C, Campos H, Judge H, Sacks FM. Effects of estrogenic oral contraceptives on the lipoprotein B particle system defined by apolipoproteins E and C-III content. J Lipid Res 1999; 40:202-12. [PMID: 9925648] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
Apolipoproteins E and C-III are modulators of lipoprotein metabolism that could affect development of atherosclerosis. The prevalence in plasma of apoB-containing particles (LpB) that contain either apoE or apoC-III, both or neither, and the effect of estrogen on these lipoproteins are unknown. The LpB particle system, defined by the presence or absence of apoE or C-III, was studied in 13 normolipidemic women, 7 nonusers and 6 users of oral contraceptives. Fasting plasma was separated by anti-apoE and C-III affinity chromatography and ultracentrifugation into four types of VLDL, IDL, and LDL particles: with apoE but not apoC-III (E+C-), apoC-III but not apoE (E-C+), both (E+C+) or neither (E-C-). The predominant VLDL particles were E-C- (42% in nonusers, 56% in users) and E+C+ (39% in nonusers, 24% in users), suggesting that apoE and apoC-III mainly exist together in VLDL. In IDL, E-C- was the major fraction (74% nonusers, 81% users), and in LDL, it was 99% in both groups. The triglycerides in VLDL and IDL were mainly contained in C+ particles (79% and 66% of the total VLDL and IDL triglycerides, respectively). Within VLDL, IDL, and LDL, E-C- particles had the smallest size and E+C+ or E-C+ the largest. Users had higher concentrations of VLDL E-C- (280%) and IDL E-C- (90%) particles than nonusers. They also had higher free cholesterol and cholesteryl ester concentrations associated with these fractions and with VLDL E-C+. The triglyceride contents of VLDL E-C- particles were lower in users of oral contraceptives than in nonusers. This study demonstrates that the elevated VLDL TG concentrations in users of estrogen-dominant oral contraceptives is mainly caused by an increased concentration of small VLDL particles that have reduced TG content, and that do not have apoE and C-III. These particles may have lower atherogenicity than particles enriched with apoE and C-III.-Khoo, C., H. Campos, H. Judge, and F. M. Sacks. Effects of estrogenic oral contraceptives on the lipoprotein B particle system defined by apolipoproteins E and C-III content.
Collapse
Affiliation(s)
- C Khoo
- Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA
| | | | | | | |
Collapse
|
45
|
Sacks F, Khoo C, Judge H, Campos H. 4.P.279 The human lipoprotein B particle system defined by apolipoproteins E and CIII content: Metabolic pathways in women and effect of oral contraceptives. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)89809-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
46
|
Khoo C, Blanchard RK, Sullivan VK, Cousins RJ. Human cysteine-rich intestinal protein: cDNA cloning and expression of recombinant protein and identification in human peripheral blood mononuclear cells. Protein Expr Purif 1997; 9:379-87. [PMID: 9126610 DOI: 10.1006/prep.1996.0709] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Cysteine-rich intestinal protein (CRIP) is a small, 8.5-kDa protein with one double zinc-finger motif called a LIM domain. It is very abundant in intestine and some immune cells in rodents, and expression is influenced by development and the immune response. We have cloned a human CRIP cDNA from human small intestine poly(A)+ RNA by RT-PCR. Through sequencing, we found that the human intestinal CRIP protein (hCRIP) differed from the previously cloned rat CRIP by two amino acids (residues 8 and 58). hCRIP was expressed with the pET vector/bacterial system and isolated by gel filtration and ion-exchange chromatography. The protein was purified to homogeneity as confirmed by PAGE, Western blotting, and immunodetection. Recombinant hCRIP has a molecular mass of 8390 Da based on mass spectrum analysis. Southern analysis suggests that there are three copies of the CRIP gene in the human genome. hCRIP mRNA was detected by RT-PCR in human monocytes purified from peripheral blood and THP-1 cells, a human monocytic cell line. Incubation of THP-1 cells with 65Zn and chromatography of the cytosol show that a significant amount of the radioactivity is associated with CRIP as was shown previously for rat intestine. The results are consistent with a functional role for CRIP in proliferation/differentiation of specific cell types, particularly those associated with host defense.
Collapse
Affiliation(s)
- C Khoo
- Food Science and Human Nutrition Department, University of Florida, Gainesville 32611, USA
| | | | | | | |
Collapse
|
47
|
Li YH, Toh CL, Khoo C, Low YP. Necrotising fasciitis--an old enemy or a new foe. Ann Acad Med Singap 1997; 26:175-8. [PMID: 9208069] [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: 02/04/2023]
Abstract
Necrotising fasciitis when described by Meleney was caused predominantly by Streptococcus pyogenes. Since then, there were several reports which confirmed streptococcus as the main organism identified in this disease entity. However, recently there were reports of necrotising fasciitis caused by organisms other than Streptococcus. We analysed 19 cases of necrotising fasciitis seen in the Department of Orthopaedic Surgery over a period of 24 months to see if this disease entity has changed significantly. The patients in our series were between the ages of 19 to 85 years with an average age of 57.2 years. Males were more often affected (16 out of 19). The majority of the patients have some form of underlying disease (16 out of 19 cases). There was a trend towards polymicrobial infection and many were resistant to standard antimicrobial therapy. The mortality rate was 21.1%. Our results are comparable to many earlier series.
Collapse
Affiliation(s)
- Y H Li
- Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore
| | | | | | | |
Collapse
|
48
|
Khoo C, Hallquist NA, Samuelson DA, Cousins RJ. Differential expression of cysteine-rich intestinal protein in liver and intestine in CCl4-induced inflammation. Am J Physiol 1996; 270:G613-8. [PMID: 8928791 DOI: 10.1152/ajpgi.1996.270.4.g613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cysteine-rich intestinal protein (CRIP) is a double zinc finger (LIM domain) protein that is developmentally regulated but has an unknown function. CRIP is highly expressed in the intestine, but expression is low in liver. To determine if CRIP expression is regulated under altered physiological status, we used CCl4-induced injury as a model to produce hepatic injury and systemic effects associated with inflammation. Since CRIP is a zinc finger protein and zinc decreases the hepatic response to CCl4, the effect of supplemental dietary zinc (300 mg/kg diet) was also examined. Our results show that this supplemental level of dietary zinc did not affect the index of hepatic injury (plasma alanine aminotransferase), indicating zinc did not have a protective effect. Liver CRIP mRNA increased with CCl4 and CRIP protein was shown by immunohistochemistry to be localized in hepatocytes near the vascular supply. In the intestine, CCl4 caused a transient decrease in CRIP mRNA, but supplemental dietary zinc treatment prevented this decrease. These current results show that CRIP expression changes in response to cellular damage due to acute hepatic injury and are consistent with a functional role for CRIP in proliferation, differentiation, or turnover.
Collapse
Affiliation(s)
- C Khoo
- Food Science and Human Nutrition Department, University of Florida, Gainesville 32611, USA
| | | | | | | |
Collapse
|
49
|
Hallquist NA, Khoo C, Cousins RJ. Lipopolysaccharide regulates cysteine-rich intestinal protein, a zinc-finger protein, in immune cells and plasma. J Leukoc Biol 1996; 59:172-7. [PMID: 8603989 DOI: 10.1002/jlb.59.2.172] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [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: 01/31/2023] Open
Abstract
Cysteine-rich intestinal protein (CRIP), a double zinc-finger LIM protein, is expressed in great abundance in the intestine. We have found comparable levels of CRIP mRNA in peritoneal macrophages, peripheral blood mononuclear cells (PBMC), and lesser amounts in thymus and spleen. Because CRIP expression was high in immune cells, rats were challenged with lipopolysaccharide (LPS) to determine whether expression was altered during the acute-phase immune response. Immunocytochemistry showed that, in adherent mononuclear cells, CRIP protein was localized in the cytoplasm. CRIP mRNA levels increased over time after LPS injection in peritoneal macrophages, PBMC, spleen, and intestine. No changes in CRIP mRNA level were seen in either liver or thymus. In PBMC, the level of CRIP mRNA decreased before increasing later in the acute-phase immune response. CRIP protein was found in the plasma. Shortly after LPS administration plasma CRIP decreased, suggesting that CRIP was either passively diffused out of capillaries or was actively shunted into tissues to execute its function. Increased CRIP expression seen in response to LPS suggests that CRIP may play a role in immune cell activation or differentiation or in processes associated with cellular repair.
Collapse
Affiliation(s)
- N A Hallquist
- Food Science and Human Nutrition Department, University of Florida, Gainesville 32611, USA
| | | | | |
Collapse
|
50
|
Abstract
Cysteine-rich intestinal protein (CRIP) is a zinc-binding protein where the binding domain is in the so-called LIM double zinc finger motif. Methods are described for the preparation of CRIP from rat small intestine. Gel-filtration and ion-exchange chromatography and preparative PAGE gave homogeneous CRIP, based upon analytical PAGE, mass spectrometry and microsequencing. Initial localization of CRIP during chromatography was based on binding of 65Zn radioisotope introduced into the intestine. The stoichiometry of binding by CRIP is less than 2 atoms of zinc per molecule. The metal-binding affinity in vitro is zinc > cadmium > copper > iron, at low metal concentrations. Zinc is the predominant metal bound when these metals are taken up from the intestinal lumen. Zinc binding was not influenced by pH between values of 4.5 to 7.5. Metallothionein has a much greater zinc-binding affinity than CRIP. The tissue concentration of CRIP is of the order of 15-20 micrograms/g of mucosal tissue, suggesting that the protein is more abundant than zinc-finger-containing transcription factors. The metal-binding properties of CRIP are consistent with proposed zinc-related functions for this cytoplasmic protein, which is expressed in the small intestine during the postnatal period.
Collapse
Affiliation(s)
- C Khoo
- Food Science and Human Nutrition Department, University of Florida, Gainesville 32611
| | | |
Collapse
|