1
|
McPhee M, Lee J, Salsman J, Pinelli M, Di Cara F, Rosen K, Dellaire G, Ridgway ND. Nuclear lipid droplets in Caco2 cells originate from nascent precursors and in situ at the nuclear envelope. J Lipid Res 2024; 65:100540. [PMID: 38570093 PMCID: PMC11077042 DOI: 10.1016/j.jlr.2024.100540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/05/2024] Open
Abstract
Intestinal epithelial cells convert excess fatty acids into triglyceride (TAG) for storage in cytoplasmic lipid droplets and secretion in chylomicrons. Nuclear lipid droplets (nLDs) are present in intestinal cells but their origin and relationship to cytoplasmic TAG synthesis and secretion is unknown. nLDs and related lipid-associated promyelocytic leukemia structures (LAPS) were abundant in oleate-treated Caco2 but less frequent in other human colorectal cancer cell lines and mouse intestinal organoids. nLDs and LAPS in undifferentiated oleate-treated Caco2 cells harbored the phosphatidate phosphatase Lipin1, its product diacylglycerol, and CTP:phosphocholine cytidylyltransferase (CCT)α. CCTα knockout Caco2 cells had fewer but larger nLDs, indicating a reliance on de novo PC synthesis for assembly. Differentiation of Caco2 cells caused large nLDs and LAPS to form regardless of oleate treatment or CCTα expression. nLDs and LAPS in Caco2 cells did not associate with apoCIII and apoAI and formed dependently of microsomal triglyceride transfer protein expression and activity, indicating they are not derived from endoplasmic reticulum luminal LDs precursors. Instead, undifferentiated Caco2 cells harbored a constitutive pool of nLDs and LAPS in proximity to the nuclear envelope that expanded in size and number with oleate treatment. Inhibition of TAG synthesis did affect the number of nascent nLDs and LAPS but prevented their association with promyelocytic leukemia protein, Lipin1α, and diacylglycerol, which instead accumulated on the nuclear membranes. Thus, nLD and LAPS biogenesis in Caco2 cells is not linked to lipoprotein secretion but involves biogenesis and/or expansion of nascent nLDs by de novo lipid synthesis.
Collapse
Affiliation(s)
- Michael McPhee
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jonghwa Lee
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jayme Salsman
- Depts of Pathology and Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marinella Pinelli
- Dept of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Francesca Di Cara
- Dept of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kirill Rosen
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Graham Dellaire
- Depts of Pathology and Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Neale D Ridgway
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
| |
Collapse
|
2
|
Soman RR, Fabiszak MM, McPhee M, Schade P, Freiwald W, Brivanlou AH. High resolution dynamic ultrasound atlas of embryonic and fetal development of the common marmoset. J Assist Reprod Genet 2024:10.1007/s10815-024-03072-2. [PMID: 38446290 DOI: 10.1007/s10815-024-03072-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/12/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE The common marmoset (Callithrix jacchus) provides an ideal model to study early development of primates, and an in vivo platform to validate conclusions from in vitro studies of human embryos and embryo models. Currently, however, no established staging atlas of marmoset embryonic development exists. Using high-resolution, longitudinal ultrasound scans on live pregnant marmosets, we present the first dynamic in vivo imaging of entire primate gestation beginning with attachment until the last day before birth. METHODS Our study unveils the first dynamic images of an in vivo attached mammalian embryo developing in utero, and the intricacies of the delayed development period unique to the common marmoset amongst primates, revealing a window for somatic interventions. RESULTS Established obstetric and embryologic measurements for each scan were used comparatively with the standardized Carnegie staging of human development to highlight similarities and differences. Our study also allows for tracking the development of major organs. We focus on the ontogeny of the primate heart and brain. Finally, input ultrasound images were used to train deep neural networks to accurately determine the gestational age. All our ultrasounds and staging data recording are posted online so that the atlas can be used as a community resource toward monitoring and managing marmoset breeding colonies. CONCLUSION The temporal and spatial resolution of ultrasound achieved in this study demonstrates the promise of noninvasive imaging in the marmoset for the in vivo study of primate-specific aspects of embryonic and fetal development.
Collapse
Affiliation(s)
- Rohan R Soman
- Tri-Institutional MD-PhD Program, Weill Cornell Medical College, New York, NY, USA
- Laboratory of Synthetic Embryology, Rockefeller University, New York, NY, USA
| | - Margaret M Fabiszak
- Tri-Institutional MD-PhD Program, Weill Cornell Medical College, New York, NY, USA
- Laboratory of Neural Systems, Rockefeller University, New York, NY, USA
| | - Michael McPhee
- Laboratory of Neural Systems, Rockefeller University, New York, NY, USA
| | - Peter Schade
- Laboratory of Neural Systems, Rockefeller University, New York, NY, USA
| | - Winrich Freiwald
- Laboratory of Neural Systems, Rockefeller University, New York, NY, USA
| | - Ali H Brivanlou
- Laboratory of Synthetic Embryology, Rockefeller University, New York, NY, USA.
| |
Collapse
|
3
|
Foster J, McPhee M, Yue L, Dellaire G, Pelech S, Ridgway ND. Lipid- and phospho-regulation of CTP:Phosphocholine Cytidylyltransferase α association with nuclear lipid droplets. Mol Biol Cell 2024; 35:ar33. [PMID: 38170618 PMCID: PMC10916874 DOI: 10.1091/mbc.e23-09-0354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
Fatty acids stored in triacylglycerol-rich lipid droplets are assembled with a surface monolayer composed primarily of phosphatidylcholine (PC). Fatty acids stimulate PC synthesis by translocating CTP:phosphocholine cytidylyltransferase (CCT) α to the inner nuclear membrane, nuclear lipid droplets (nLD) and lipid associated promyelocytic leukemia (PML) structures (LAPS). Huh7 cells were used to identify how CCTα translocation onto these nuclear structures are regulated by fatty acids and phosphorylation of its serine-rich P-domain. Oleate treatment of Huh7 cells increased nLDs and LAPS that became progressively enriched in CCTα. In cells expressing the phosphatidic acid phosphatase Lipin1α or 1β, the expanded pool of nLDs and LAPS had a proportional increase in associated CCTα. In contrast, palmitate induced few nLDs and LAPS and inhibited the oleate-dependent translocation of CCTα without affecting total nLDs. Phospho-memetic or phospho-null mutations in the P-domain revealed that a 70% phosphorylation threshold, rather than site-specific phosphorylation, regulated CCTα association with nLDs and LAPS. In vitro candidate kinase and inhibitor studies in Huh7 cells identified cyclin-dependent kinase (CDK) 1 and 2 as putative P-domain kinases. In conclusion, CCTα translocation onto nLDs and LAPS is dependent on available surface area and fatty acid composition, as well as threshold phosphorylation of the P-domain potentially involving CDKs.
Collapse
Affiliation(s)
- Jason Foster
- Departments of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, and
| | - Michael McPhee
- Departments of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, and
| | - Lambert Yue
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 2B5
| | - Graham Dellaire
- Departments of Pathology and Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada B3H4R2
| | - Steven Pelech
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada V6T 2B5
- Kinexus Bioinformatics Corporation, Vancouver, BC, Canada V6P 6T3
| | - Neale D. Ridgway
- Departments of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, and
| |
Collapse
|
4
|
Cannas A, Cabrera VE, Dougherty HC, Ellis JL, Gallo A, Huhtanen P, Kyriazakis I, McPhee M, Reed KF, Sakomura NK, van Milgen J. Editorial: The 10th international Workshop on Modelling Nutrient Digestion and Utilization in Farm Animals (MODNUT). Animal 2023; 17 Suppl 5:101067. [PMID: 38286524 DOI: 10.1016/j.animal.2023.101067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/31/2024] Open
Affiliation(s)
- A Cannas
- Department of Agricultural Sciences, University of Sassari, Italy.
| | - V E Cabrera
- Department of Animal and Dairy Sciences, University of Wisconsin, Madison, Madison, WI, United States
| | - H C Dougherty
- Department of Animal Science, University of New England, Armidale, NSW, Australia
| | - J L Ellis
- Centre for Nutrition Modelling, Department of Animal Biosciences, University of Guelph, Ontario, Canada
| | - A Gallo
- Dipartimento di Scienze animali, della nutrizione e degli alimenti (DIANA), Facoltà di Scienze Agrarie, Alimentari e Ambientali, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | - P Huhtanen
- Natural Resources Institute Finland (LUKE), Production Systems, Jokioinen, Finland
| | - I Kyriazakis
- Institute for Global Food Security, Queen's University, Belfast, United Kingdom
| | - M McPhee
- NSW Department of Primary Industries, Armidale Livestock Industries Centre, University of New England, Armidale, Australia
| | - K F Reed
- Department of Animal Science, Cornell University, Ithaca, NY, United States
| | - N K Sakomura
- Department of Animal Science, School of Agricultural and Veterinary Sciences, São Paulo State University (UNESP), Jaboticabal, São Paulo, Brazil
| | - J van Milgen
- Pegase, INRAE, Institut Agro, Le Clos, Saint Gilles 35590, France
| |
Collapse
|
5
|
Dorighello G, McPhee M, Halliday K, Dellaire G, Ridgway N. Differential contributions of phosphotransferases CEPT1 and CHPT1 to phosphatidylcholine homeostasis and lipid droplet biogenesis. J Biol Chem 2023; 299:104578. [PMID: 36871755 PMCID: PMC10166788 DOI: 10.1016/j.jbc.2023.104578] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/21/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
The CDP-choline (Kennedy) pathway culminates with the synthesis of phosphatidylcholine (PC) and phosphatidylethanolamine (PE) by choline/ethanolamine phosphotransferase 1 (CEPT1) in the endoplasmic reticulum (ER), and PC synthesis by choline phosphotransferase 1 (CHPT1) in the Golgi apparatus. Whether the PC and PE synthesized by CEPT1 and CHPT1 in the ER and Golgi apparatus has different cellular functions has not been formally addressed. Here we used CRISPR editing to generate CEPT1-and CHPT1-knockout (KO) U2OS cells to assess the differential contribution of the enzymes to feed-back regulation of nuclear CTP:phosphocholine cytidylyltransferase (CCT)α, the rate-limiting enzyme in PC synthesis, and lipid droplet (LD) biogenesis. We found that CEPT1-KO cells had a 50% and 80% reduction in PC and PE synthesis, respectively, while PC synthesis in CHPT1-KO cells was also reduced by 50%. CEPT1 knockout caused the post-transcriptional induction of CCTα protein expression as well as its dephosphorylation and constitutive localization on the inner nuclear membrane and nucleoplasmic reticulum. This activated CCTα phenotype was prevented by incubating CEPT1-KO cells with PC liposomes to restore end-product inhibition. Additionally, we determined that CEPT1 was in close proximity to cytoplasmic LDs, and CEPT1 knockout resulted in the accumulation of small cytoplasmic LDs, as well as increased nuclear LDs enriched in CCTα. In contrast, CHPT1 knockout had no effect on CCTα regulation or LD biogenesis. Thus, CEPT1 and CHPT1 contribute equally to PC synthesis; however, only PC synthesized by CEPT1 in the ER regulates CCTα and the biogenesis of cytoplasmic and nuclear LDs.
Collapse
Affiliation(s)
- Gabriel Dorighello
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia Canada B3H4R2
| | - Michael McPhee
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia Canada B3H4R2
| | - Katie Halliday
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia Canada B3H4R2
| | - Graham Dellaire
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia Canada B3H4R2; Depts of Pathology and Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia Canada B3H4R2
| | - NealeD Ridgway
- Depts of Pediatrics and Biochemistry & Molecular Biology, Atlantic Research Centre, Dalhousie University, Halifax, Nova Scotia Canada B3H4R2.
| |
Collapse
|
6
|
Mas-Herrero E, Singer N, Ferreri L, McPhee M, Zatorre RJ, Ripollés P. Music engagement is negatively correlated with depressive symptoms during the COVID-19 pandemic via reward-related mechanisms. Ann N Y Acad Sci 2023; 1519:186-198. [PMID: 36401802 DOI: 10.1111/nyas.14931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic has deeply affected the mental health of millions of people. We assessed which of many leisure activities correlated with positive mental health outputs, with particular attention to music, which has been reported to be important for coping with the psychological burden of the pandemic. Questionnaire data from about 1000 individuals primarily from Italy, Spain, and the United States during May-June 2020 show that people picked music activities (listening to, playing, singing, etc.) most often as the leisure experiences that helped them the most to cope with psychological distress related with the pandemic. During the pandemic, hours of engagement in music and food-related activities were associated with lower depressive symptoms. The negative correlation between music and depression was mediated by individual differences in sensitivity to reward, whereas the correlation between food-related activities and improved mental health outputs was explained by differences in emotion suppression strategies. Our results, while correlational, suggest that engaging in music activities could be related to improved well-being with the underlying mechanism being related to reward, consistent with neuroscience findings. Our data have practical significance in pointing to effective strategies to cope with mental health issues beyond those related to the COVID-19 pandemic.
Collapse
Affiliation(s)
- Ernest Mas-Herrero
- Department of Cognition, Development and Education Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Cognition and Brain Plasticity Unit, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Neomi Singer
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,International Laboratory for Brain, Music and Sound Research (BRAMS) and Center for Research in Brain, Language and Music (CRBLM), Montreal, Quebec, Canada.,Sagol Brain Institute and Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Laura Ferreri
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Laboratoire d'Étude des Mécanismes Cognitifs, Université Lumière Lyon 2, Lyon, France
| | - Michael McPhee
- Department of Psychology, New York University, New York, New York, USA.,Music and Auditory Research Laboratory (MARL), New York University, New York, New York, USA.,Center for Language, Music, and Emotion (CLaME), New York University, New York, New York, USA
| | - Robert J Zatorre
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,International Laboratory for Brain, Music and Sound Research (BRAMS) and Center for Research in Brain, Language and Music (CRBLM), Montreal, Quebec, Canada
| | - Pablo Ripollés
- Department of Psychology, New York University, New York, New York, USA.,Music and Auditory Research Laboratory (MARL), New York University, New York, New York, USA.,Center for Language, Music, and Emotion (CLaME), New York University, New York, New York, USA
| |
Collapse
|
7
|
Liu X, Chipurupalli S, Jiang P, Tavasoli M, Yoo BH, McPhee M, Mazinani S, Francia G, Kerbel RS, Rosen KV. ErbB2/Her2-dependent downregulation of a cell death-promoting protein BLNK in breast cancer cells is required for 3D breast tumor growth. Cell Death Dis 2022; 13:687. [PMID: 35933456 PMCID: PMC9357009 DOI: 10.1038/s41419-022-05117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 01/21/2023]
Abstract
A significant proportion of breast cancers are driven by ErbB2/Her2 oncoprotein that they overexpress. These malignancies are typically treated with various ErbB2-targeted drugs, but many such cancers develop resistance to these agents and become incurable. Conceivably, treatment of ErbB2-positive cancers could be facilitated by use of agents blocking oncogenic signaling mechanisms downstream of ErbB2. However, current understanding of these mechanisms is limited. The ability of solid tumor cells to resist anoikis, cell death triggered by cell detachment from the extracellular matrix (ECM), is thought to be critical for 3D tumor growth. In an effort to understand the mechanisms of ErbB2-driven breast cancer cell anoikis resistance we found that detachment of non-malignant breast epithelial cells from the ECM upregulates a cell death-promoting tumor suppressor adapter protein BLNK and that ErbB2 blocks this upregulation by reducing tumor cell levels of transcription factor IRF6. We further observed that trastuzumab, a therapeutic anti-ErbB2 antibody, upregulates BLNK in human trastuzumab-sensitive but not trastuzumab-resistant ErbB2-positive breast cancer cells. Moreover, we established that BLNK promotes anoikis by activating p38 MAP kinase and that ErbB2-dependent BLNK downregulation blocks breast cancer cell anoikis. In search for pharmacological approaches allowing to upregulate BLNK in tumor cells we found that clinically approved proteasome inhibitor bortezomib upregulates IRF6 and BLNK in human breast cancer cells and inhibits their 3D growth in a BLNK-dependent manner. In addition, we found that BLNK upregulation in human ErbB2-positive breast cancer cells blocks their ability to form tumors in mice. Furthermore, we used publicly available data on mRNA levels in multiple breast cancers to demonstrate that increased BLNK mRNA levels correlate with increased relapse-free survival in a cohort of approximately 400 patients with ErbB2-positive breast cancer. In summary, we discovered a novel mechanism of ErbB2-driven 3D breast tumor growth mediated by ErbB2-dependent BLNK downregulation.
Collapse
Affiliation(s)
- Xiaoyang Liu
- grid.55602.340000 0004 1936 8200Departments of Pediatrics & Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS Canada
| | - Sandhya Chipurupalli
- grid.55602.340000 0004 1936 8200Departments of Pediatrics & Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS Canada
| | - Peijia Jiang
- grid.55602.340000 0004 1936 8200Departments of Pediatrics & Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS Canada
| | - Mahtab Tavasoli
- grid.55602.340000 0004 1936 8200Department of Pharmacology, Department of Pediatrics, Dalhousie University, Halifax, NS Canada
| | - Byong Hoon Yoo
- grid.55602.340000 0004 1936 8200Departments of Pediatrics & Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS Canada
| | - Michael McPhee
- grid.55602.340000 0004 1936 8200Departments of Pediatrics & Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS Canada
| | - Sina Mazinani
- grid.55602.340000 0004 1936 8200Departments of Pediatrics & Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS Canada
| | - Giulio Francia
- grid.267324.60000 0001 0668 0420Border Biomedical Research Center, University of Texas at El Paso (UTEP), El Paso, TX USA
| | - Robert S. Kerbel
- grid.17063.330000 0001 2157 2938Biological Sciences Platform, Sunnybrook Research Institute, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938University of Toronto Department of Medical Biophysics, Toronto, ON Canada
| | - Kirill V. Rosen
- grid.55602.340000 0004 1936 8200Departments of Pediatrics & Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS Canada
| |
Collapse
|
8
|
Dillon LD, McPhee M, Davidson RS, Quick AP, Martin B, Covington KR, Zolochevska O, Cook RW, Vetto JT, Jarell AD, Fleming MD. Expanded evidence that the 31-gene expression profile test provides clinical utility for melanoma management in a multicenter study. Curr Med Res Opin 2022; 38:1267-1274. [PMID: 35081854 DOI: 10.1080/03007995.2022.2033560] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE National Comprehensive Cancer Network (NCCN) guidelines for cutaneous melanoma (CM) recommend physicians consider increased surveillance for patients who typically have lower melanoma survival rates (stages IIB-IV as determined by the American Joint Committee on Cancer (AJCC), 8th edition). However, up to 15% of patients identified as having a low recurrence risk (stages I-IIA) experience disease recurrence, and some patients identified as having a high recurrence risk will not experience any recurrence. The 31-gene expression profile test (31-GEP) stratifies patient recurrence risk into low (Class 1) and high (Class 2) and has demonstrated risk-appropriate impact on disease management and clinical decisions. METHODS Five-year plans for lab work, frequency of clinical visits, and imaging pre- and post-31-GEP test results were assessed for a cohort of 509 stage I-III patients following an interim subset analysis of 247 patients. RESULTS After receiving 31-GEP results, 50.6% of patients had a change in management plans in at least one of the following categories-clinical visits, lab work, or surveillance imaging. The changes aligned with the risk predicted by the 31-GEP for 76.1% of patients with a Class 1 result and 78.7% of patients with a Class 2 result. A Class 1 31-GEP result was associated with changes toward low-intensity management recommendations, while a Class 2 result was associated with changes toward high-intensity management recommendations. CONCLUSION The 31-GEP can stratify patient recurrence risk in patients with CM, and clinicians understand and apply the prognostic ability of the 31-GEP test to alter patient management in risk-appropriate directions.
Collapse
Affiliation(s)
- Larry D Dillon
- Larry D. Dillon Surgical Oncology and General Surgery, Colorado Springs, CO, USA
| | - Michael McPhee
- Breast Cancer Program, Advent Health Cancer Institute, Orlando, FL, USA
| | - Robert S Davidson
- Department of Surgical Oncology, Morton Plant Mease Healthcare, FL, USA
| | - Ann P Quick
- Castle Biosciences, Inc, Friendswood, TX, USA
| | | | | | | | | | - John T Vetto
- Department of Neurology, Surgical Oncology, Oregon Health & Science University, Portland, OR, USA
| | - Abel D Jarell
- Department of Dermatology, Northeast Dermatology Associates, P.C., Portsmouth, NH, USA
| | - Martin D Fleming
- Department of Surgical Oncology, The University of Tennessee Health Science Center, Memphis, TN, USA
| |
Collapse
|
9
|
Law JW, BuAli H, Costa S, Mullane MP, Hendawi M, McPhee M, Collini B, Teka M, Coutinho F, Broome R, Wolf FM, Toland L, Weber T, Berry A, Brown TD, Ali H. Abstract P3-14-17: Exploring racial disparities in BRCA testing for triple negative breast cancer patients: A real-world data analysis. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p3-14-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background and Objective: BRCA testing for patients (pts) with triple negative breast cancer (TNBC) is important because it has secondary prevention implications for patients and multigenerational implications allowing for earlier detection of BRCA gene carriers in the family and enabling primary prevention. And with the advent of PARP inhibitors it also has treatment implications. The NCCN guidelines recommended in January 2015 that BRCA testing be performed for all pts with TNBC diagnosed at age 60 or younger regardless of race, ethnicity or family history. To understand disparities in BRCA testing among TNBC pts we analyzed the proportion tested, explored barriers to testing, and made comparisons by race, ethnicity, and socioeconomic status (SES). Methods: Adult pts with TNBC diagnosed at or under age 60 between January 1, 2015 and December 31, 2020 were identified in the Syapse Learning Health Network, a real-world database with clinical and genomic data from community health systems. Study end was June 1, 2021, allowing for a minimum follow up of 5 months. Electronic health records were reviewed to calculate proportion tested and barriers to testing. SES was estimated using zip code level median household income from the 2010 census and stratified based on the national poverty level (low <150%, middle 150-299%, high 300%+). χ;2 statistics were used to assess differences between groups. Results: 577 pts with a median age at TNBC of 50 and median follow up of 18 months were included. 65.2% self-identified as white, 27.9% as Black or African American (AA), 1.4% Asian, 1.4% American Indian or Alaska Native, and 4.2% other. 8% identified as Hispanic/Latino. Due to relative size of racial/ethnic groups, the stratified analyses focused on comparisons between white and AA pts. Overall, 459 (79.5%) pts received a test, but with 83% of white pts receiving tests as compared to 72.7% of AA pts (p=0.009). 71.4% of pts with low SES received a test vs. 81.8% for middle and 79.4% with high SES (p=0.068). Among the 118 pts with no test, 48 (40.7%) did not have documentation of a test referral or evidence of testing offered in clinician notes. This differed by race with white pts less likely to have test offer documented vs. AA pts (53.1% vs. 72.7%, p=0.064). Among the 48 pts with no evidence of test offer, additional details were often not documented. However some clinician notes cited a perceived ineligibility due to lack of family history, transferring out or move to hospice, and pt refusal. Among the 70 (59.3%) pts who were offered a test but did not receive it, reasons included 37.1% choosing not to be tested, 11.4% due to early death, loss to follow up or transferring away, and 7.1% lacked adequate health insurance. These reasons varied by race, with 59.4% of AA pts choosing not to be tested vs. 20.6% of white pts (p=0.003) (Table 1). Conclusions: Real-world data provides insight into BRCA testing patterns in routine clinical practice where racial disparities are well documented and persistent. While the overall proportion of pts who received BRCA testing was high, AA pts experienced more barriers. Despite AA pts having greater evidence of a test offer vs. white pts, there was a significant gap in testing favoring white pts, with the most notable reason for lack of testing being pt choice. The clinical significance of BRCA testing in TNBC indicates a need to create targeted strategies to close gaps in education, confidence and access among patients and providers to improve testing levels.
Table 1.BRCA testing barriers among patients who were offered a test but did not receive it (N=70)Total (n=70)White (n=34)Black or African American (n=32)Low SES (n=19)Middle SES (n=43)High SES (n=8)Lack of adequate health insurance, n (%)5 (7.1)3 (8.8)1 (3.1)3 (15.8)1 (2.3)1 (12.5)Patient chose not to be tested, n (%)26 (37.1)7 (20.6)19 (59.4)8 (42.1)14 (32.6)4 (50.0)Deceased before testing occurred, n (%)5 (7.1)3 (8.8)2 (6.3)1 (5.3)4 (9.3)0 (0)LTFU/Transferred, n (%)3 (4.3)2 (5.9)1 (3.1)1 (5.3)1 (2.3)1 (12.5)Other, n (%)7 (10.0)6 (17.6)1 (3.1)1 (5.3)6 (14.0)0 (0)Unknown, n (%)24 (34.3)13 (38.2)8 (25.0)5(26.3)17 (39.5)2 (25.0)
Citation Format: Jeanna Wallenta Law, Hanadi BuAli, Sherri Costa, Michael P. Mullane, Mohamed Hendawi, Michael McPhee, Bryanne Collini, Mahder Teka, Francesca Coutinho, Ronda Broome, Frank M. Wolf, Liz Toland, Trista Weber, Anna Berry, Thomas D. Brown, Haythem Ali. Exploring racial disparities in BRCA testing for triple negative breast cancer patients: A real-world data analysis [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-14-17.
Collapse
|
10
|
Whitman ED, Koshenkov VP, Gastman BR, Lewis D, Hsueh EC, Pak H, Trezona TP, Davidson RS, McPhee M, Guenther JM, Toomey P, Smith FO, Beitsch PD, Lewis JM, Ward A, Young SE, Shah PK, Quick AP, Martin BJ, Zolochevska O, Covington KR, Monzon FA, Goldberg MS, Cook RW, Fleming MD, Hyams DM, Vetto JT. Integrating 31-Gene Expression Profiling With Clinicopathologic Features to Optimize Cutaneous Melanoma Sentinel Lymph Node Metastasis Prediction. JCO Precis Oncol 2021; 5:PO.21.00162. [PMID: 34568719 PMCID: PMC8457832 DOI: 10.1200/po.21.00162] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/22/2021] [Accepted: 08/04/2021] [Indexed: 11/30/2022] Open
Abstract
National guidelines recommend sentinel lymph node biopsy (SLNB) be offered to patients with > 10% likelihood of sentinel lymph node (SLN) positivity. On the other hand, guidelines do not recommend SLNB for patients with T1a tumors without high-risk features who have < 5% likelihood of a positive SLN. However, the decision to perform SLNB is less certain for patients with higher-risk T1 melanomas in which a positive node is expected 5%-10% of the time. We hypothesized that integrating clinicopathologic features with the 31-gene expression profile (31-GEP) score using advanced artificial intelligence techniques would provide more precise SLN risk prediction.
Collapse
Affiliation(s)
- Eric D Whitman
- Carol G. Simon Cancer at Morristown Medical Center, Atlantic Health System, Morristown, NJ
| | | | | | - Deri Lewis
- Medical City Dallas Hospital, Dallas, TX
| | - Eddy C Hsueh
- Department of Surgery, St Louis University, St Louis, MO
| | - Ho Pak
- General Surgery Abington Memorial Hospital, Abington, PA
| | | | | | | | | | - Paul Toomey
- Florida State University College of Medicine, Bradenton, FL
| | | | | | - James M Lewis
- University of Tennessee Graduate School of Medicine, Knoxville, TN
| | - Andrew Ward
- University of Tennessee Graduate School of Medicine, Knoxville, TN
| | | | | | | | | | | | | | | | | | | | - Martin D Fleming
- Division of Surgical Oncology, The University of Tennessee Health Science Center, Memphis, TN
| | | | - John T Vetto
- Oregon Health & Science University, Portland, OR
| |
Collapse
|
11
|
Ferreri L, Singer N, McPhee M, Ripollés P, Zatorre RJ, Mas-Herrero E. Engagement in Music-Related Activities During the COVID-19 Pandemic as a Mirror of Individual Differences in Musical Reward and Coping Strategies. Front Psychol 2021; 12:673772. [PMID: 34262511 PMCID: PMC8273332 DOI: 10.3389/fpsyg.2021.673772] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 02/28/2021] [Accepted: 05/31/2021] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 pandemic and the measures taken to mitigate its impact (e.g., confinement orders) have affected people's lives in profound ways that would have been unimagable only months before the pandemic began. Media reports from the height of the pandemic's initial international surge frequently highlighted that many people were engaging in music-related activities (from singing and dancing to playing music from balconies and attending virtual concerts) to help them cope with the strain of the pandemic. Our first goal in this study was to investigate changes in music-related habits due to the pandemic. We also investigated whether engagement in distinct music-related activities (singing, listening, dancing, etc.) was associated with individual differences in musical reward, music perception, musical training, or emotional regulation strategies. To do so, we collected detailed (~1 h-long) surveys during the initial peak of shelter-in-place order implementation (May-June 2020) from over a thousand individuals across different Countries in which the pandemic was especially devastating at that time: the USA, Spain, and Italy. Our findings indicate that, on average, people spent more time in music-related activities while under confinement than they had before the pandemic. Notably, this change in behavior was dependent on individual differences in music reward sensitivity, and in emotional regulation strategies. Finally, the type of musical activity with which individuals engaged was further associated with the degree to which they used music as a way to regulate stress, to address the lack of social interaction (especially the individuals more concerned about the risk of contracting the virus), or to cheer themselves up (especially those who were more worried about the pandemic consequences). Identifying which music-related activities have been particularly sought for by the population as a means for coping with such heightened uncertainty and stress, and understanding the individual differences that underlie said propensities are crucial to implementing personalized music-based interventions that aim to reduce stress, anxiety, and depression symptoms.
Collapse
Affiliation(s)
- Laura Ferreri
- Laboratoire d'Étude des Mécanismes Cognitifs, Université Lumière Lyon 2, Lyon, France
| | - Neomi Singer
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Michael McPhee
- Department of Psychology, New York University, New York, NY, United States
- Music and Auditory Research Laboratory (MARL), New York University, New York, NY, United States
| | - Pablo Ripollés
- Department of Psychology, New York University, New York, NY, United States
- Music and Auditory Research Laboratory (MARL), New York University, New York, NY, United States
- Center for Language, Music and Emotion (CLaME), New York University, New York, NY, United States
| | - Robert J. Zatorre
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- International Laboratory for Brain, Music and Sound Research, Montreal, QC, Canada
| | - Ernest Mas-Herrero
- Department of Cognition, Development and Education Psychology, Universitat de Barcelona, Barcelona, Spain
| |
Collapse
|
12
|
Howells L, Lancaster N, McPhee M, Bundy C, Ingram JR, Leighton P, Henaghan-Sykes K, Thomas KS. Thematic synthesis of the experiences of people with hidradenitis suppurativa: a systematic review. Br J Dermatol 2021; 185:921-934. [PMID: 34050935 DOI: 10.1111/bjd.20523] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Although hidradenitis suppurativa (HS) is known to affect quality of life, little summative knowledge exists on how HS impacts people living with the condition. OBJECTIVES To synthesize experiences of people with HS within published qualitative research. METHODS Searches on databases MEDLINE, PsycINFO, Embase and CINAHL were conducted on 17 April 2020. Two independent reviewers screened 5512 publications. Study quality was assessed using the National Institute for Health and Care Excellence quality appraisal checklist for qualitative studies. Thematic synthesis generated descriptive and analytic themes. RESULTS Fourteen studies were included: four studies fulfilled most quality criteria, eight fulfilled some quality criteria, and two fulfilled few quality criteria. There were three final themes. (i) Putting the brakes on life. The physical, psychological and social consequences of HS resulted in people missing out on multiple life events. This could have a cumulative effect that influences the trajectory of someone's life. (ii) A stigmatized identity: concealed and revealed. People try to conceal their HS, visually and verbally, but this results in anticipation and fear of exposure. Social support and psychological acceptance helped people cope. Connecting to others with HS may have a specific role in preserving a positive self-identity. (iii) Falling through the cracks. Delayed diagnosis, misdiagnosis and lack of access to care were reported. People felt unheard and misunderstood by healthcare professionals, and healthcare interactions could enhance feelings of shame. CONCLUSIONS There need to be improvements to clinical care to allow people with HS to live their life more fully.
Collapse
Affiliation(s)
- L Howells
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - N Lancaster
- Barnsley Hospital NHS Foundation Trust, Barnsley, UK
| | - M McPhee
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - C Bundy
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - J R Ingram
- Division of Infection & Immunity, Cardiff University, Cardiff, UK
| | - P Leighton
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - K S Thomas
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| |
Collapse
|
13
|
Ismail D, McAteer H, Majeed-Ariss R, McPhee M, Griffiths CEM, Young HS. Research priorities and identification of a health-service delivery model for psoriasis from the UK Psoriasis Priority Setting Partnership. Clin Exp Dermatol 2020; 46:276-285. [PMID: 32748405 DOI: 10.1111/ced.14407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Psoriasis impacts the health and psychosocial functioning of patients, conferring a significant economic burden on healthcare systems. There remain unmet needs in psoriasis care, which if addressed by research, could improve clinical outcomes. AIM To research priorities and identify a health service delivery model from the UK Psoriasis Priority Setting Partnership (PsPSP). METHODS Between July 2017 and November 2018, we invited people with lived experience of psoriasis and healthcare professionals to (i) identify unmet needs, and (ii) prioritize the order in which these should be addressed by research. We collaborated with the Psoriasis Association and used methodology established by the James Lind Alliance, which pioneers the joint setting of research priorities by patients and clinicians worldwide. RESULTS In our initial harvesting survey (Survey 1), 2133 questions were submitted by 805 individuals. Submissions that had not been answered by research (true uncertainties) were supplemented with evidence gaps from systematic reviews/guidelines published in the previous 5 years and refined to produce 55 indicative questions. Voting in Survey 2, by 1154 individuals, enabled a shortlist of questions, which were prioritized during the final workshop to produce a top 20 list of research questions. Submissions on health service delivery (5.8% of the total submissions), which were analysed separately, described a blueprint for psoriasis care. CONCLUSIONS The PsPSP will inform the translational research agenda, ensuring that future research is relevant for the needs of people with psoriasis and those who manage the disease. Submissions on health service delivery describe a model of holistic, patient-focused care providing high-quality, effective management for patients with psoriasis.
Collapse
Affiliation(s)
- D Ismail
- Department of Dermatology, Salford Royal Hospital, Stott Lane, Manchester, UK
| | - H McAteer
- Psoriasis Association, Northampton, UK
| | - R Majeed-Ariss
- Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre The University of Manchester, Manchester, UK
| | - M McPhee
- Centre of Evidence Based Dermatology, King's Meadow Campus, University of Nottingham, Nottingham, UK
| | - C E M Griffiths
- Department of Dermatology, Salford Royal Hospital, Stott Lane, Manchester, UK.,Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre The University of Manchester, Manchester, UK
| | - H S Young
- Department of Dermatology, Salford Royal Hospital, Stott Lane, Manchester, UK.,Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre The University of Manchester, Manchester, UK
| |
Collapse
|
14
|
Majeed-Ariss R, McPhee M, McAteer H, Griffiths CEM, Young HS. 'Mind the gap': what patients and clinicians believe is 'unknown' about psoriasis. Br J Dermatol 2020; 183:399-400. [PMID: 32149385 PMCID: PMC7496380 DOI: 10.1111/bjd.19023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R Majeed-Ariss
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, UK
| | - M McPhee
- Centre of Evidence Based Dermatology, University of Nottingham, King's Meadow Campus, Nottingham, UK
| | - H McAteer
- Psoriasis Association, Dick Coles House, Northampton, UK
| | - C E M Griffiths
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, UK
| | - H S Young
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, UK
| |
Collapse
|
15
|
Villar M, Hegarty R, Nolan J, Godwin I, McPhee M. The effect of dietary nitrate and canola oil alone or in combination on fermentation, digesta kinetics and methane emissions from cattle. Anim Feed Sci Technol 2020. [DOI: 10.1016/j.anifeedsci.2019.114294] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
16
|
Majeed-Ariss R, McPhee M, McAteer H, Griffiths CEM, Young H. The top 10 research priorities for psoriasis in the U.K.: results of a James Lind Alliance psoriasis Priority Setting Partnership. Br J Dermatol 2019; 181:871-873. [PMID: 31162641 PMCID: PMC6973084 DOI: 10.1111/bjd.18209] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R Majeed-Ariss
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, U.K
| | - M McPhee
- Centre of Evidence Based Dermatology, University of Nottingham, King's Meadow Campus, Nottingham, U.K
| | - H McAteer
- Psoriasis Association, Dick Coles House, 2 Queensbridge, Northampton, U.K
| | - C E M Griffiths
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, U.K
| | - H Young
- Department of Dermatology, The University of Manchester, Oxford Road, Manchester, U.K
| |
Collapse
|
17
|
Simpson RC, Cooper SM, Kirtschig G, Larsen S, Lawton S, McPhee M, Murphy R, Nunns D, Rees S, Tarpey M, Thomas KS. Future research priorities for lichen sclerosus - results of a James Lind Alliance Priority Setting Partnership. Br J Dermatol 2019; 180:1236-1237. [PMID: 30472735 PMCID: PMC6850137 DOI: 10.1111/bjd.17447] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R C Simpson
- Centre of Evidence Based Dermatology, University of Nottingham, King's Meadow Campus, Lenton Lane, Nottingham, NG7 2NR, U.K
| | - S M Cooper
- Department of Dermatology, Oxford University Hospitals, Oxford, U.K
| | | | | | - S Lawton
- Rotherham NHS Foundation Trust, Rotherham, U.K
| | - M McPhee
- Centre of Evidence Based Dermatology, University of Nottingham, King's Meadow Campus, Lenton Lane, Nottingham, NG7 2NR, U.K
| | - R Murphy
- Department of Dermatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, U.K
| | - D Nunns
- Department of Gynaecology, Nottingham University Hospitals NHS Trust, Nottingham, U.K
| | - S Rees
- University of Warwick, Warwick, U.K
| | - M Tarpey
- James Lind Alliance, National Institute for Health Research Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, U.K
| | - K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, King's Meadow Campus, Lenton Lane, Nottingham, NG7 2NR, U.K
| | | |
Collapse
|
18
|
Majeed-Ariss R, McPhee M, Bundy C, Griffiths C, Young H. 制定方案以识别银屑病研究问题,并对其进行优先级排序:James Lind联盟优先级设立合作伙伴关系. Br J Dermatol 2018. [DOI: 10.1111/bjd.16759] [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]
|
19
|
Majeed-Ariss R, McPhee M, Bundy C, Griffiths C, Young H. Developing a protocol to identify and prioritize research questions for psoriasis: a James Lind Alliance Priority Setting Partnership. Br J Dermatol 2018. [DOI: 10.1111/bjd.16747] [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
|
Majeed-Ariss R, McPhee M, Bundy C, Griffiths C, Young H. Developing a protocol to identify and prioritize research questions for psoriasis: a James Lind Alliance Priority Setting Partnership. Br J Dermatol 2018; 178:1383-1387. [DOI: 10.1111/bjd.15992] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2017] [Indexed: 11/30/2022]
Affiliation(s)
- R. Majeed-Ariss
- Department of Dermatology; The University of Manchester; Manchester Academic Health Science Centre; Manchester U.K
| | - M. McPhee
- Centre of Evidence Based Dermatology; University of Nottingham; King's Meadow Campus; Nottingham U.K
| | - C. Bundy
- School of Healthcare Sciences; College of Biomedical and Life Sciences; Cardiff University; Cardiff U.K
| | - C.E.M. Griffiths
- Department of Dermatology; The University of Manchester; Manchester Academic Health Science Centre; Manchester U.K
| | - H. Young
- Department of Dermatology; The University of Manchester; Manchester Academic Health Science Centre; Manchester U.K
| | | |
Collapse
|
21
|
Dillon LD, Gadzia JE, Davidson RS, McPhee M, Covington KR, Cook RW, Johnson C, Monzon FA, Milanese ED, Vetto J, Jarell AD, Fleming MD. Prospective, Multicenter Clinical Impact Evaluation of a 31-Gene Expression Profile Test for Management of Melanoma Patients. ACTA ACUST UNITED AC 2018. [DOI: 10.25251/skin.2.2.3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Objective: A 31-gene expression profile (GEP) test that has been clinically validated identifies melanoma patients with low (Class 1) or high (Class 2) risk of metastasis based on primary tumor biology. This study aimed to prospectively evaluate the test impact on clinical management of melanoma patients.Methods: Physicians at 16 dermatology, surgical or medical oncology centers examined patients to assess clinical features of the primary melanoma. Recommendations for clinical follow-up and surveillance were collected. Following consent of the patient and performance of the GEP test, recommendations for management were again collected, and pre- and post-test recommendations were assessed to determine changes in management resulting from the addition of GEP testing to traditional clinicopathologic risk factors. Results: Post-test management plans changed for 49% (122 of 247) of cases in the study when compared to pre-test plans. Thirty-six percent (66 of 181) of Class 1 cases had a management change, compared to 85% (56 of 66) of Class 2 cases. GEP class was a significant factor for change in care during the study (p<0.001), with Class 1 accounting for 91% (39 of 43) of cases with decreased management intensity, and Class 2 accounting for 72% (49 of 68) of cases with increases.Conclusions: The reported study show that the 31-gene GEP test improves net health outcomes in the management of cutaneous melanoma. Physicians used test results to guide risk-appropriate changes that match the biological risk of the tumor, including directing more frequent and intense surveillance to high-risk, Class 2 patients.
Collapse
|
22
|
Tanifuji G, Cenci U, Moog D, Dean S, Nakayama T, David V, Fiala I, Curtis BA, Sibbald SJ, Onodera NT, Colp M, Flegontov P, Johnson-MacKinnon J, McPhee M, Inagaki Y, Hashimoto T, Kelly S, Gull K, Lukeš J, Archibald JM. Genome sequencing reveals metabolic and cellular interdependence in an amoeba-kinetoplastid symbiosis. Sci Rep 2017; 7:11688. [PMID: 28916813 PMCID: PMC5601477 DOI: 10.1038/s41598-017-11866-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 08/31/2017] [Indexed: 01/12/2023] Open
Abstract
Endosymbiotic relationships between eukaryotic and prokaryotic cells are common in nature. Endosymbioses between two eukaryotes are also known; cyanobacterium-derived plastids have spread horizontally when one eukaryote assimilated another. A unique instance of a non-photosynthetic, eukaryotic endosymbiont involves members of the genus Paramoeba, amoebozoans that infect marine animals such as farmed fish and sea urchins. Paramoeba species harbor endosymbionts belonging to the Kinetoplastea, a diverse group of flagellate protists including some that cause devastating diseases. To elucidate the nature of this eukaryote-eukaryote association, we sequenced the genomes and transcriptomes of Paramoeba pemaquidensis and its endosymbiont Perkinsela sp. The endosymbiont nuclear genome is ~9.5 Mbp in size, the smallest of a kinetoplastid thus far discovered. Genomic analyses show that Perkinsela sp. has lost the ability to make a flagellum but retains hallmark features of kinetoplastid biology, including polycistronic transcription, trans-splicing, and a glycosome-like organelle. Mosaic biochemical pathways suggest extensive ‘cross-talk’ between the two organisms, and electron microscopy shows that the endosymbiont ingests amoeba cytoplasm, a novel form of endosymbiont-host communication. Our data reveal the cell biological and biochemical basis of the obligate relationship between Perkinsela sp. and its amoeba host, and provide a foundation for understanding pathogenicity determinants in economically important Paramoeba.
Collapse
Affiliation(s)
- Goro Tanifuji
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Zoology, National Museum of Nature and Science, Tsukuba, Japan
| | - Ugo Cenci
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Moog
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada.,Laboratory for Cell Biology, Philipps University, Marburg, Germany
| | - Samuel Dean
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Takuro Nakayama
- Center for Computational Sciences, University of Tsukuba, Tsukuba, Japan.,Graduate School of Life Sciences, Tohoku University, Tohoku, Japan
| | - Vojtěch David
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada.,Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Ivan Fiala
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic
| | - Bruce A Curtis
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shannon J Sibbald
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Naoko T Onodera
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada.,National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
| | - Morgan Colp
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pavel Flegontov
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic.,Life Science Research Centre, Faculty of Science, University of Ostrava, Ostrava, Czech Republic
| | - Jessica Johnson-MacKinnon
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada.,Institute for Marine and Antarctic Sciences, University of Tasmania, Launceston, Australia
| | - Michael McPhee
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada.,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yuji Inagaki
- Center for Computational Sciences, University of Tsukuba, Tsukuba, Japan.,Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tetsuo Hashimoto
- Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
| | - Steven Kelly
- Department of Plant Sciences, University of Oxford, Oxford, United Kingdom
| | - Keith Gull
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - Julius Lukeš
- Institute of Parasitology, Biology Centre, Czech Academy of Sciences, České Budějovice, Czech Republic.,Faculty of Sciences, University of South Bohemia, České Budějovice, Czech Republic.,Canadian Institute for Advanced Research, Program in Integrated Microbial Biodiversity, Toronto, Canada
| | - John M Archibald
- Department of Biochemistry & Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada. .,Centre for Comparative Genomics and Evolutionary Bioinformatics, Dalhousie University, Halifax, Nova Scotia, Canada. .,Canadian Institute for Advanced Research, Program in Integrated Microbial Biodiversity, Toronto, Canada.
| |
Collapse
|
23
|
Thomas K, Brindle R, Chalmers J, Gamble B, Francis N, Hardy D, Hooper J, Keeley V, Levell N, McPhee M, Metcalf L, Santer M, Tarpey M, Smart P, Wallace A, Wilkes S. Identifying priority areas for research into the diagnosis, treatment and prevention of cellulitis (erysipelas): results of a James Lind Alliance Priority Setting Partnership. Br J Dermatol 2017; 177:541-543. [DOI: 10.1111/bjd.15634] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- K.S. Thomas
- Centre of Evidence Based Dermatology; The University of Nottingham; Nottingham U.K
| | - R. Brindle
- School of Clinical Sciences; University of Bristol; Bristol U.K
| | - J.R. Chalmers
- Centre of Evidence Based Dermatology; The University of Nottingham; Nottingham U.K
| | | | - N.A. Francis
- Division of Population Medicine; School of Medicine; Cardiff University; Cardiff U.K
| | - D. Hardy
- Kendal Lymphology Centre; Kendal U.K
| | - J. Hooper
- Patient participant
- Primary Care and Population Sciences; University of Southampton; Southampton U.K
| | - V. Keeley
- Derby Teaching Hospitals NHS Foundation Trust; Derby U.K
| | - N.J. Levell
- Norfolk and Norwich University Hospitals NHS Foundation Trust; Norwich U.K
| | - M. McPhee
- Centre of Evidence Based Dermatology; The University of Nottingham; Nottingham U.K
| | - L. Metcalf
- James Lind Alliance, National Institute for Health Research Evaluation; Trials and Studies Coordinating Centre; University of Southampton; Southampton U.K
| | - M. Santer
- Primary Care and Population Sciences; University of Southampton; Southampton U.K
| | - M. Tarpey
- James Lind Alliance, National Institute for Health Research Evaluation; Trials and Studies Coordinating Centre; University of Southampton; Southampton U.K
| | | | - A. Wallace
- Patient participant
- Lymphoedema Support Network; London U.K
| | - S. Wilkes
- Centre of Evidence Based Dermatology; The University of Nottingham; Nottingham U.K
| |
Collapse
|
24
|
Rowbotham N, Smith S, McPhee M, Elliott Z, Rayner O, Leighton P, Daniels T, Collins S, Duff A, Nash E, Tabberner M, Chandran S, Peaple U, Morley R, Smyth A. EPS1.9 Question CF: a James Lind Alliance Priority Setting Partnership in cystic fibrosis. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30282-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
25
|
McPhee M, Arumainayagam N, Clark M, Burfitt N, DasGupta R. Renal injury management in an urban trauma centre and implications for urological training. Ann R Coll Surg Engl 2015; 97:194-7. [PMID: 26263803 DOI: 10.1308/003588414x14055925061117] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of this study was to analyse the treatment and management of renal injury patients presenting to our major trauma unit to determine the likelihood of patients needing immediate nephrectomy. METHODS The Trauma Audit and Research Network (TARN) database was used to review trauma cases presenting to our department between February 2009 and September 2013. Demographic data, mechanism and severity of injury, grade of renal trauma, management and 30-day outcome were determined from TARN data, electronic patient records and imaging. RESULTS There were a total of 1,856 trauma cases, of which 36 patients (1.9%) had a renal injury. In this group, the median age was 28 years (range: 16-92 years), with 28 patients (78%) having blunt renal trauma and 8 (22%) penetrating renal trauma. The most common cause for blunt renal trauma was road traffic accidents. Renal trauma cases were stratified into American Association for the Surgery of Trauma (AAST) grades (grade I: 19%, grade II: 22%, grade III: 28%, grade IV: 28%, grade V: 0%). All patients with grade I and II injuries were treated conservatively. There were three patients (1 with grade III and 2 with grade IV renal injuries) who underwent radiological embolisation. One of these patients went on to have a delayed nephrectomy owing to unsuccessful embolisation. CONCLUSIONS Trauma patients rarely require emergency nephrectomy. Radiological selective embolisation provides a good interventional option in cases of active bleeding from renal injury in haemodynamically stable patients. This has implications for trauma care and how surgical cover is provided for the rare event of nephrectomy.
Collapse
Affiliation(s)
| | | | - M Clark
- Imperial College Healthcare NHS Trust , UK
| | - N Burfitt
- Imperial College Healthcare NHS Trust , UK
| | - R DasGupta
- Imperial College Healthcare NHS Trust , UK
| |
Collapse
|
26
|
Affiliation(s)
- J.R. Ingram
- Department of Dermatology and Wound Healing; Institute of Infection and Immunity; University Hospital of Wales; Heath Park Cardiff CF14 4XW U.K
| | - M. McPhee
- Centre of Evidence-Based Dermatology; University of Nottingham; King's Meadow Campus, Lenton Lane Nottingham NG7 2NR U.K
| |
Collapse
|
27
|
Ingram JR, Abbott R, Ghazavi M, Alexandroff AB, McPhee M, Burton T, Clarke T. The Hidradenitis Suppurativa Priority Setting Partnership. Br J Dermatol 2014; 171:1422-7. [PMID: 24903313 DOI: 10.1111/bjd.13163] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) has been neglected by medical researchers and society in general, despite being a relatively common, painful, chronic skin disease. OBJECTIVES To generate a top 10 list of HS research priorities, from the perspectives of patients with HS, carers and clinicians, to take to funding bodies. METHODS A priority setting partnership was established between patients with HS, carers and clinicians, following the James Lind Alliance process. Survey 1 requested submission of HS uncertainties, which were grouped into 'indicative uncertainties' for prioritization in survey 2. The 30 highest-ranked indicative uncertainties were reduced to a 'top 10' list using nominal group technique at a prioritization workshop attended by all relevant HS stakeholders. RESULTS In total 1495 potential uncertainties were submitted in survey 1, including 57% from patients with HS and carers, and grouped into 55 indicative uncertainties. Ranking in survey 2 was completed by 371 participants, 50% of whom were patients and carers. The final workshop was attended by 22 HS stakeholders and four facilitators and produced a top 10 list, the three highest priorities in descending order being (i) What is the most effective and safe group of oral treatments in treating HS? (ii) What is the best management of an acute flare? (iii)What is the impact of HS and its treatment on people with HS? CONCLUSIONS The top 10 HS research priorities have been directly disseminated to funders to raise awareness of HS. The next step is to generate research questions that will provide the evidence needed to improve care for patients with HS.
Collapse
Affiliation(s)
- J R Ingram
- Department of Dermatology & Wound Healing, Institute of Infection & Immunity, Heath Park, Cardiff, CF14 4XW, U.K
| | | | | | | | | | | | | |
Collapse
|
28
|
Batchelor J, Ridd M, Clarke T, Ahmed A, Cox M, Crowe S, Howard M, Lawton S, McPhee M, Rani A, Ravenscroft J, Roberts A, Thomas K. The Eczema Priority Setting Partnership: a collaboration between patients, carers, clinicians and researchers to identify and prioritize important research questions for the treatment of eczema. Br J Dermatol 2013; 168:577-82. [DOI: 10.1111/bjd.12040] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
29
|
Giudici N, McPhee M. Diagnosis and Treatment of Malignant Melanoma in Pregnancy. J Gynecol Surg 2011. [DOI: 10.1089/gyn.2010.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Michael McPhee
- Department of Surgical Oncology, ProMedica Health System, Toledo, OH
| |
Collapse
|
30
|
Kirby M, McPhee M, Monk I, Whitfield A. Soluble medications mixed with enteral feeding solutions may block a nasogastric tube. Aust Crit Care 2010. [DOI: 10.1016/j.aucc.2009.12.027] [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: 10/19/2022] Open
|
31
|
|
32
|
Rubino CM, McPhee M, Vo M, Jungbluth GL. Application of real-time data assembly (RTDA) to a pivotal phase III pediatric trial: A proactive approach to population pharmacokinetic/pharmacodynamic (PK/PD) dataset creation. Clin Pharmacol Ther 2003. [DOI: 10.1016/s0009-9236(03)90595-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
33
|
Abstract
A retrospective review of our institute's tumor registry from January 1972 to January 1996 revealed 24 patients with a diagnosis of primary soft tissue sarcoma of the hand, from a total of 570 extremity soft tissue sarcomas (4%). The most frequent histologic type was malignant fibrous histiocytoma, which occurred in 9 (38%) of the 24 patients. The second most common histologic type was epithelioid sarcoma, which occurred in 6 (25%) patients. There was a statistically significant difference in the rate of local recurrence based on the type of treatment in which amputation was superior to the other forms of treatment. There was no statistically significant difference in the rate of distant failures between treatment groups. The estimated cumulative 5- and 10-year overall survival rates for all patients were 59% and 53%, respectively. Stage II patients had estimated cumulative 5- and 10-year survival rates of 68% and 59%, respectively. Stage III patients had a cumulative 5-year survival rate of 20%. Factors that were statistically significant in predicting survival were the size of the primary tumor, with tumors smaller than 5 cm having a better prognosis, and stage of the tumor at presentation, with stage I and II tumors having the highest survival rate. In selected patients with a primary hand sarcoma, aggressive limb-sparing surgery with adjuvant therapy offered equivalent survival compared with amputation.
Collapse
Affiliation(s)
- M McPhee
- Division of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | | | | | | | | | | |
Collapse
|
34
|
Katsifis A, Mardon K, McPhee M, Mattner F, Dikic B, Ridley D. Synthesis and evaluation of [123I]labelled analogues of the partial inverse agonist Ro 15-4513 for the study of diazepam-insensitive benzodiazepine receptors. Nucl Med Biol 1999; 26:641-9. [PMID: 10587102 DOI: 10.1016/s0969-8051(99)00030-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/27/2022]
Abstract
The imidazobenzodiazepines ethyl 8-iodo-5,6 dihydro-5-methyl-6-oxo-4H-imidazo[1,5a][1,4] benzodiazepine-3-carboxylate 1 and tert-butyl 8-iodo-5,6 dihydro-5-methyl-6-oxo-4H-imidazo [1,5a][1,4] benzodiazepine-3-carboxylate 2 were prepared to study the diazepam-insensitive (DI) benzodiazepine receptor (BZR) subtype. The [123I] analogues were prepared via iododestannylation reactions in radiochemical yields of 70-80% and a specific activity >2,500 Ci/mmol. The tert-butyl analogue [123I]-2 exhibited nanomolar affinity for BZRs in homogenate membranes of rat cerebellum with Kd values for the diazepam-sensitive (DS) and DI receptors of 3.18 +/- 0.58 and 13.55 +/- 2.72 nM, respectively. The Bmax for cerebellar DS and DI receptors were 1,276 +/- 195 and 518 +/- 26 fmol/mg protein, respectively.
Collapse
Affiliation(s)
- A Katsifis
- Radiopharmaceutical Division R&D, Australian Nuclear Science and Technology Organisation, NSW, Sydney.
| | | | | | | | | | | |
Collapse
|
35
|
North JH, McPhee M, Arredondo M, Edge SB. Sarcoma of the breast: implications of the extent of local therapy. Am Surg 1998; 64:1059-61. [PMID: 9798768] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Although the majority of breast neoplasms will be of epithelial origin, tumors of the stromal elements of the breast may occur. A retrospective review of the medical records and tumor registry data of 25 patients with breast sarcoma treated at Roswell Park Cancer Institute from 1964 to 1995 was performed. There were 24 females and 1 male, with a median age of 55 years. Delay in seeking medical attention was common. Angiosarcoma was the most common histologic type of breast sarcoma (n = 10). Mastectomy was the predominant form of local therapy (21 patients). Overall survival was 61 per cent at 5 years and 36 per cent at 10 years. There was no difference in survival or local control rates for those patients treated with local excision when compared with patients treated with mastectomy. Sarcoma is an unusual form of breast tumor. Survival and local control are similar when comparing local excision and mastectomy. When local excision is performed, attention must be directed to achieving clear margins of resection. The benefit of adjuvant therapy remains undefined.
Collapse
Affiliation(s)
- J H North
- Department of Breast Surgery, Division of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York, USA
| | | | | | | |
Collapse
|
36
|
Rozenblit G, Del Guercio LR, Savino J, Cerabona T, Policastro A, McPhee M. Splenic venous hypertension presenting as variceal hemorrhage caused by portal hypertension. J Am Coll Surg 1996; 182:63-8. [PMID: 8542092] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Splenic venous hypertension (SVH) may cause variceal hemorrhage that is clinically indistinguishable from similar bleeding caused by portal hypertension (PH). This may lead to erroneous treatment, including inappropriate portosystemic shunt placement. STUDY DESIGN A retrospective review of 58 cases of variceal hemorrhage referred for transmesenteric variceal sclerotherapy and transvenous intrahepatic portosystemic shunt (TIPS) placement revealed that seven patients had SVH as a cause of bleeding, and required treatment other than TIPS. The role of medical imaging in the diagnosis and management of SVH was analyzed. RESULTS Clinical data did not permit a differential diagnosis between PH and SVH as the cause of bleeding in all cases. Splenic venous hypertension was suspected and then confirmed exclusively by contrast-enhanced computed tomography (CT) and angiography, which are essential for correct patient management. CONCLUSIONS Computed tomography should be routinely performed to exclude SVH before TIPS placement. In instances in which CT fails to establish the diagnosis or splenic artery occlusion is considered for patient management, angiography may be used.
Collapse
Affiliation(s)
- G Rozenblit
- Department of Radiology, Westchester County Medical Center, New York Medical College, Valhalla 10595, USA
| | | | | | | | | | | |
Collapse
|
37
|
Abstract
In photodynamic therapy (PDT) the uniform distribution of intratumor or externally applied light is desirable but often difficult to achieve. An optical fiber tip producing cylindrical or lateral light emission can facilitate the application of laser energy by direct implantation of the tip into solid tumors or within tubular cavities of the body such as the bronchus or esophagus. A procedure is described for fabricating such a fiber tip, the main component of which is a hollow glass cylinder containing a light-scattering material. Light distributions emitted from the tip in air are documented. Useful properties of the tip include good light distribution, durability, heat resistance, and simplicity of construction.
Collapse
|
38
|
|
39
|
Lingwood BE, Hardy KJ, Long JG, McPhee M, Wintour EM. Amniotic fluid volume and composition following experimental manipulations in sheep. Obstet Gynecol 1980; 56:451-8. [PMID: 6775256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Twenty to thirty percent of amniotic fluid volume was replaced by isotonic solutions of saline, mannitol, or dextrose in chronically cannulated ovine fetuses. In all cases the sodium, potassium, and chloride concentrations returned to control values in 3 to 6 hours. Urea and creatinine behaved similarly in the saline and mannitol experiments, but rose above control values within 1 hour of dextrose replacement. Amniotic fluid volume increased with return of solute. Fetal urine drainage to the exterior abolished the rapid return of urea and creatinine concentrations in the dextrose experiments, although no changes in renal function occurred in any experiments. It was concluded that dextrose inhibited the exit of urea and creatinine from the amniotic compartment.
Collapse
|
40
|
Abstract
A retrospective review of 218 consecutive nephrostomies done on uremic cancer patients has revealed an alarming incidence of postoperative morbidity and mortality. This review has raised legitimate questions regarding the value of palliative urinary diversion. We present a rationale to assist physicians in the management of this clinical problem.
Collapse
|
41
|
|
42
|
Burkel WE, McPhee M. Effect of phenol injection into peripheral nerve of rat: electron microscope studies. Arch Phys Med Rehabil 1970; 51:391-7. [PMID: 5433603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|