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Olkowicz M, Ramadan K, Rosales-Solano H, Yu M, Wang A, Cypel M, Pawliszyn J. Mapping the metabolic responses to oxaliplatin-based chemotherapy with in vivo spatiotemporal metabolomics. J Pharm Anal 2024; 14:196-210. [PMID: 38464782 PMCID: PMC10921245 DOI: 10.1016/j.jpha.2023.08.001] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/14/2023] [Accepted: 08/07/2023] [Indexed: 03/12/2024] Open
Abstract
Adjuvant chemotherapy improves the survival outlook for patients undergoing operations for lung metastases caused by colorectal cancer (CRC). However, a multidisciplinary approach that evaluates several factors related to patient and tumor characteristics is necessary for managing chemotherapy treatment in metastatic CRC patients with lung disease, as such factors dictate the timing and drug regimen, which may affect treatment response and prognosis. In this study, we explore the potential of spatial metabolomics for evaluating metabolic phenotypes and therapy outcomes during the local delivery of the anticancer drug, oxaliplatin, to the lung. 12 male Yorkshire pigs underwent a 3 h left lung in vivo lung perfusion (IVLP) with various doses of oxaliplatin (7.5, 10, 20, 40, and 80 mg/L), which were administered to the perfusion circuit reservoir as a bolus. Biocompatible solid-phase microextraction (SPME) microprobes were combined with global metabolite profiling to obtain spatiotemporal information about the activity of the drug, determine toxic doses that exceed therapeutic efficacy, and conduct a mechanistic exploration of associated lung injury. Mild and subclinical lung injury was observed at 40 mg/L of oxaliplatin, and significant compromise of the hemodynamic lung function was found at 80 mg/L. This result was associated with massive alterations in metabolic patterns of lung tissue and perfusate, resulting in a total of 139 discriminant compounds. Uncontrolled inflammatory response, abnormalities in energy metabolism, and mitochondrial dysfunction next to accelerated kynurenine and aldosterone production were recognized as distinct features of dysregulated metabolipidome. Spatial pharmacometabolomics may be a promising tool for identifying pathological responses to chemotherapy.
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Affiliation(s)
- Mariola Olkowicz
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada
- Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, Krakow, Poland
| | - Khaled Ramadan
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | | | - Miao Yu
- The Jackson Laboratory, JAX Genomic Medicine, Farmington, CT, USA
| | - Aizhou Wang
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Marcelo Cypel
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Division of Thoracic Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto Lung Transplant Program, Toronto, ON, Canada
| | - Janusz Pawliszyn
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada
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Khelifi RS, Huang SJ, Savage KJ, Villa D, Scott DW, Ramadan K, Connors JM, Sehn LH, Toze CL, Gerrie AS. Population-level impact of ibrutinib for chronic lymphocytic leukemia in British Columbia, Canada. Leuk Lymphoma 2023:1-10. [PMID: 37086469 DOI: 10.1080/10428194.2023.2199340] [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: 04/24/2023]
Abstract
Ibrutinib has dramatically changed the treatment landscape for chronic lymphocytic leukemia (CLL) since its availability in British Columbia (BC), Canada in 2014. We analyzed patterns of use and real-world survival outcomes in 370 patients who received ibrutinib for first-line (1 L, n = 35) and relapsed/refractory (R/R, n = 335) CLL between 2014-2018 in BC. Dose reductions and interruptions were frequent in 32% and 27%, respectively. With a median follow-up of 27.6 months, 35% of patients discontinued ibrutinib, primarily for adverse events (AEs) rather than progressive disease. Over the course of treatment, 87% of patients experienced at least one adverse event. The 2-year overall survival (OS) and event-free survival (EFS) were excellent at 83.9% and 76.1%, respectively, with medians not reached. However, patients who discontinued ibrutinib had a median OS of 32.5 months and median EFS of only 3.8 months from time of discontinuation, highlighting the need to minimize toxicity in the real-world.
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Affiliation(s)
- Rania S Khelifi
- Department of Experimental Medicine, University of British Columbia, Vancouver, Canada
| | - Steven J Huang
- Leukemia/Bone Marrow Transplant Program of British Columbia, Division of Hematology, Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver, Canada
| | - Kerry J Savage
- Centre for Lymphoid Cancer, BC Cancer, Division of Medical Oncology, University of British Columbia, Vancouver, Canada
| | - Diego Villa
- Centre for Lymphoid Cancer, BC Cancer, Division of Medical Oncology, University of British Columbia, Vancouver, Canada
| | - David W Scott
- Centre for Lymphoid Cancer, BC Cancer, Division of Medical Oncology, University of British Columbia, Vancouver, Canada
| | - Khaled Ramadan
- St. Paul's Hospital, Division of Hematology, University of British Columbia, Vancouver, Canada
| | - Joseph M Connors
- Centre for Lymphoid Cancer, BC Cancer, Division of Medical Oncology, University of British Columbia, Vancouver, Canada
| | - Laurie H Sehn
- Centre for Lymphoid Cancer, BC Cancer, Division of Medical Oncology, University of British Columbia, Vancouver, Canada
| | - Cynthia L Toze
- Leukemia/Bone Marrow Transplant Program of British Columbia, Division of Hematology, Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver, Canada
| | - Alina S Gerrie
- Department of Experimental Medicine, University of British Columbia, Vancouver, Canada
- Leukemia/Bone Marrow Transplant Program of British Columbia, Division of Hematology, Vancouver General Hospital, BC Cancer, University of British Columbia, Vancouver, Canada
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Ramadan K, Chaiton K, Burke J, Labrakos D, Maeda A, Okrainec A. Virtual fundamentals of laparoscopic surgery (FLS) boot-camp using telesimulation: an educational solution during the covid-19 pandemic. Surg Endosc 2023; 37:3926-3933. [PMID: 37067595 PMCID: PMC10108785 DOI: 10.1007/s00464-023-09995-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/23/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND The Fundamentals of Laparoscopic Surgery (FLS) is an internationally recognized educational and certification program designed to teach the knowledge and skills required for basic laparoscopic surgery. Previously, our institution has organized an FLS boot-camp to teach PGY1 residents the FLS manual skills. During the COVID-19 pandemic, in-person sessions were not possible. The purpose of this study was to utilize telesimulation as an education solution for teaching FLS technical skills to PGY1 residents during the COVID-19 pandemic. METHODS A virtual FLS program was established. A complete, easily portable FLS kit was distributed to participants and instructors to set up an FLS box and connect remotely using telesimulation. The program was delivered by three senior residents using the Zoom™ platform. Participants were split into groups of 3-4 individuals, each receiving three 1-h sessions. Sessions were structured with initial demonstration of tasks followed by individual coaching of participants in 'break-out' rooms. The official FLS exam was administered in-person on the 4th week. Pre- and post-course surveys were administered to participants gauging self-reported proficiency with FLS tasks and overall course feedback. Anonymized FLS exam results were collected. RESULTS A total of 14 residents participated, and 11 responded to the survey. Participants reported that their overall FLS skills proficiency significantly improved on a 5-point likert scale from 1.5 ± 0.5 pre-course to 4.0 ± 0.5 post-course (mean ± SD). Participants unanimously stated that having the FLS box at home was valuable and enabled them to practice more. On the FLS exam, 13 of 14 participants passed the manual skills component. CONCLUSIONS We developed a telesimulation hands-on FLS course as an alternative to in-person training. The course was practical and effective and was preferred to traditional methods by participants. With ever-expanding technological solutions, virtual telesimulation education is an attractive and underutilized tool, not only in the setting of COVID-19, but also more broadly across current educational programs.
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Affiliation(s)
- Khaled Ramadan
- Department of Surgery, Faculty of Medicine, University of Toronto, 149 College Street, Toronto, ON, M5T 1P5, Canada
| | - Karen Chaiton
- Temerty Advanced Surgical Education and Simulation Centre, The Michener Institute of Education, University Health Network, 222 St., Patrick St., Toronto, ON, M5T 1V4, Canada
| | - Jaime Burke
- Division of General Surgery, University Health Network, 190 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - Dimitra Labrakos
- Temerty Advanced Surgical Education and Simulation Centre, The Michener Institute of Education, University Health Network, 222 St., Patrick St., Toronto, ON, M5T 1V4, Canada
| | - Azusa Maeda
- Division of General Surgery, University Health Network, 190 Elizabeth St., Toronto, ON, M5G 2C4, Canada
| | - Allan Okrainec
- Department of Surgery, Faculty of Medicine, University of Toronto, 149 College Street, Toronto, ON, M5T 1P5, Canada.
- Temerty Advanced Surgical Education and Simulation Centre, The Michener Institute of Education, University Health Network, 222 St., Patrick St., Toronto, ON, M5T 1V4, Canada.
- Division of General Surgery, University Health Network, 190 Elizabeth St., Toronto, ON, M5G 2C4, Canada.
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Olkowicz M, Rosales-Solano H, Ramadan K, Wang A, Cypel M, Pawliszyn J. The metabolic fate of oxaliplatin in the biological milieu investigated during in vivo lung perfusion using a unique miniaturized sampling approach based on solid-phase microextraction coupled with liquid chromatography-mass spectrometry. Front Cell Dev Biol 2022; 10:928152. [PMID: 36092704 PMCID: PMC9453651 DOI: 10.3389/fcell.2022.928152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
Adjuvant chemotherapy after pulmonary metastasectomy for colorectal cancer may reduce recurrence and improve survival rates; however, the benefits of this treatment are limited by the significant side effects that accompany it. The development of a novel in vivo lung perfusion (IVLP) platform would permit the localized delivery of high doses of chemotherapeutic drugs to target residual micrometastatic disease. Nonetheless, it is critical to continuously monitor the levels of such drugs during IVLP administration, as lung injury can occur if tissue concentrations are not maintained within the therapeutic window. This paper presents a simple chemical-biopsy approach based on sampling with a small nitinol wire coated with a sorbent of biocompatible morphology and evaluates its applicability for the near-real-time in vivo determination of oxaliplatin (OxPt) in a 72-h porcine IVLP survival model. To this end, the pigs underwent a 3-h left lung IVLP with 3 doses of the tested drug (5, 7.5, and 40 mg/L), which were administered to the perfusion circuit reservoir as a bolus after a full perfusion flow had been established. Along with OxPt levels, the biocompatible solid-phase microextraction (SPME) probes were employed to profile other low-molecular-weight compounds to provide spatial and temporal information about the toxicity of chemotherapy or lung injury. The resultant measurements revealed a rather heterogeneous distribution of OxPt (over the course of IVLP) in the two sampled sections of the lung. In most cases, the OxPt concentration in the lung tissue peaked during the second hour of IVLP, with this trend being more evident in the upper section. In turn, OxPt in supernatant samples represented ∼25% of the entire drug after the first hour of perfusion, which may be attributable to the binding of OxPt to albumin, its sequestration into erythrocytes, or its rapid nonenzymatic biotransformation. Additionally, the Bio-SPME probes also facilitated the extraction of various endogenous molecules for the purpose of screening biochemical pathways affected during IVLP (i.e., lipid and amino acid metabolism, steroidogenesis, or purine metabolism). Overall, the results of this study demonstrate that the minimally invasive SPME-based sampling approach presented in this work can serve as (pre)clinical and precise bedside medical tool.
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Affiliation(s)
- Mariola Olkowicz
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada
| | | | - Khaled Ramadan
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Aizhou Wang
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | - Marcelo Cypel
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
- Division of Thoracic Surgery, Department of Surgery, University Health Network, University of Toronto, Toronto Lung Transplant Program, Toronto, ON, Canada
| | - Janusz Pawliszyn
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada
- *Correspondence: Janusz Pawliszyn,
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Ramadan K, Dessouky MI, El-Samie FEA. Equalization and Co-Carrier Frequency Offsets Compensations for UWA-OFDM Communication Systems. Wireless Pers Commun 2022; 124:2229-2245. [DOI: 10.1007/s11277-021-09453-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/06/2021] [Indexed: 09/02/2023]
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Ramadan R, Alzaki A, Leitch H, Ramadan K. PB1881: IBRUTINIB REDUCES THE RISK OF RICHTER’S TRANSFORMATION IN PREVIOUSLY TREATED CLL PATIENTS: A POPULATION-BASED STUDY IN BRITISH COLUMBIA. Hemasphere 2022. [PMCID: PMC9431738 DOI: 10.1097/01.hs9.0000850376.34769.f0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Ramadan K, Alturki A, Dessouky MI, Abd El-Samie FE. Equalization and CFO compensation for SISO-OFDM communication systems with chaotic interleaving. International Journal of Electronics 2021; 108:1590-1609. [DOI: 10.1080/00207217.2020.1870736] [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] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 10/03/2020] [Indexed: 09/02/2023]
Affiliation(s)
- K. Ramadan
- Department of Electronics and Electrical Communication Engineering, The Higher Institute of Engineering at Al-Shorouk City, Cairo, Egypt
| | - Abdulrahman Alturki
- Department of Electrical Engineering, Collage of Engineering, Qassim University, Buraydah, Saudi Arabia
| | - M. I. Dessouky
- Department of Electronics and Electrical Communication Engineering, Faculty of Electronic Engineering Menoufia University, Menouf, Egypt
| | - Fathi E. Abd El-Samie
- Department of Electronics and Electrical Communication Engineering, Faculty of Electronic Engineering Menoufia University, Menouf, Egypt
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Ali A, Pettenuzzo T, Ramadan K, Farrell A, Di Nardo M, Liu M, Keshavjee S, Fan E, Cypel M, Del Sorbo L. Surfactant therapy in lung transplantation: A systematic review and meta-analysis. Transplant Rev (Orlando) 2021; 35:100637. [PMID: 34224988 DOI: 10.1016/j.trre.2021.100637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Despite numerous reports demonstrating the efficacy of exogenous surfactant therapy during lung transplantation, this strategy remains absent in routine clinical use. Here, we systematically review and meta-analyze the effect of exogenous surfactant on respiratory pathophysiological variables during lung transplantation. METHODS To identify relevant clinical and pre-clinical studies, we performed an electronic search of MEDLINE, EMBASE, and Cochrane CENTRAL from inception to June 11, 2021. In addition, research-in-progress databases were searched. Randomized and non-randomized adult and pediatric clinical studies and animal experiments that compared the use of surfactant for lung transplantation with a control group were included. The primary outcome was the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2 ratio). RESULTS From 1,041 citations, we identified 35 studies, of which 6 were clinical studies and 29 were pre-clinical. Thirty-two studies were included in the quantitative analysis. The administration of surfactant therapy during clinical lung transplantation significantly improved PaO2/FiO2 ratio in recipients (mean difference [MD] 93 mmHg, 95% confidence interval [CI] 25-160 mmHg, p < 0.01). Similar results were seen in pre-clinical settings (MD 201 mmHg, 95% CI 145-256 mmHg, p < 0.01). Moreover, surfactant benefited a range of important physiologic and biologic outcomes after preclinical lung transplantation. The overall certainty of evidence was very low. CONCLUSIONS Exogenous surfactant therapy improves post-transplant lung function; however, its effects on clinical outcomes remain uncertain. High-quality randomized controlled trials are needed to determine whether the physiologic benefits of surfactant therapy affect patient-important outcomes in lung transplant recipients.
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Affiliation(s)
- Aadil Ali
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, MaRS Discovery District, 101 College St, Toronto, Ontario M5G 1L7, Canada.
| | - Tommaso Pettenuzzo
- Interdepartmental Division of Critical Care Medicine, University Health Network, University of Toronto, 204 Victoria Street, Toronto, Ontario M5B 1T8, Canada.
| | - Khaled Ramadan
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, MaRS Discovery District, 101 College St, Toronto, Ontario M5G 1L7, Canada.
| | - Ashley Farrell
- Library & Information Services, University Health Network, 101 College St, Toronto, Ontario M5G 1L7, Canada.
| | - Matteo Di Nardo
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, MaRS Discovery District, 101 College St, Toronto, Ontario M5G 1L7, Canada.
| | - Mingyao Liu
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, MaRS Discovery District, 101 College St, Toronto, Ontario M5G 1L7, Canada.
| | - Shaf Keshavjee
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, MaRS Discovery District, 101 College St, Toronto, Ontario M5G 1L7, Canada; Division of Thoracic Surgery, University Health Network, University of Toronto, 200 Elizabeth St, Toronto, Ontario, M5G 2C4, Canada.
| | - Eddy Fan
- Interdepartmental Division of Critical Care Medicine, University Health Network, University of Toronto, 204 Victoria Street, Toronto, Ontario M5B 1T8, Canada.
| | - Marcelo Cypel
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, MaRS Discovery District, 101 College St, Toronto, Ontario M5G 1L7, Canada; Division of Thoracic Surgery, University Health Network, University of Toronto, 200 Elizabeth St, Toronto, Ontario, M5G 2C4, Canada.
| | - Lorenzo Del Sorbo
- Latner Thoracic Surgery Research Laboratories, University Health Network, University of Toronto, MaRS Discovery District, 101 College St, Toronto, Ontario M5G 1L7, Canada; Interdepartmental Division of Critical Care Medicine, University Health Network, University of Toronto, 204 Victoria Street, Toronto, Ontario M5B 1T8, Canada.
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Ramadan K, Dessouky MI, Abd El-Samie FE. Non-linear equalisation and CFO compensation for MIMO-OFDM communication systems based on DWT. International Journal of Electronics 2021; 108:115-138. [DOI: 10.1080/00207217.2020.1756458] [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] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/22/2020] [Indexed: 09/02/2023]
Affiliation(s)
- K. Ramadan
- Department of Electronics and Electrical Communication Engineering, The Higher Institute of Engineering at Al-Shorouk City, Cairo, Egypt
| | - Moawad I. Dessouky
- Department of Electronics and Electrical Communication Engineering, Faculty of Electronic Engineering, Menoufia University, Menouf, Egypt
| | - Fathi E. Abd El-Samie
- Department of Electronics and Electrical Communication Engineering, Faculty of Electronic Engineering, Menoufia University, Menouf, Egypt
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Bojko B, Looby N, Olkowicz M, Roszkowska A, Kupcewicz B, Reck Dos Santos P, Ramadan K, Keshavjee S, Waddell TK, Gómez-Ríos G, Tascon M, Goryński K, Cypel M, Pawliszyn J. Solid phase microextraction chemical biopsy tool for monitoring of doxorubicin residue during in vivo lung chemo-perfusion. J Pharm Anal 2020; 11:37-47. [PMID: 33717610 PMCID: PMC7930785 DOI: 10.1016/j.jpha.2020.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 04/15/2020] [Revised: 08/24/2020] [Accepted: 08/24/2020] [Indexed: 12/24/2022] Open
Abstract
Development of a novel in vivo lung perfusion (IVLP) procedure allows localized delivery of high-dose doxorubicin (DOX) for targeting residual micrometastatic disease in the lungs. However, DOX delivery via IVLP requires careful monitoring of drug level to ensure tissue concentrations of this agent remain in the therapeutic window. A small dimension nitinol wire coated with a sorbent of biocompatible morphology (Bio-SPME) has been clinically evaluated for in vivo lung tissue extraction and determination of DOX and its key metabolites. The in vivo Bio-SPME-IVLP experiments were performed on pig model over various (150 and 225 mg/m2) drug doses, and during human clinical trial. Two patients with metastatic osteosarcoma were treated with a single 5 and 7 μg/mL (respectively) dose of DOX during a 3-h IVLP. In both pig and human cases, DOX tissue levels presented similar trends during IVLP. Human lung tissue concentrations of drug ranged between 15 and 293 μg/g over the course of the IVLP procedure. In addition to DOX levels, Bio-SPME followed by liquid chromatography-mass spectrometry analysis generated 64 metabolic features during endogenous metabolite screening, providing information about lung status during drug administration. Real-time monitoring of DOX levels in the lungs can be performed effectively throughout the IVLP procedure by in vivo Bio-SPME chemical biopsy approach. Bio-SPME also extracted various endogenous molecules, thus providing a real-time snapshot of the physiology of the cells, which might assist in the tailoring of personalized treatment strategy.
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Affiliation(s)
- Barbara Bojko
- Department of Chemistry, University of Waterloo, Waterloo, ON M1B 6G3, Canada.,Department of Pharmacodynamics and Molecular Pharmacology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-089, Bydgoszcz, Poland
| | - Nikita Looby
- Department of Chemistry, University of Waterloo, Waterloo, ON M1B 6G3, Canada
| | - Mariola Olkowicz
- Department of Chemistry, University of Waterloo, Waterloo, ON M1B 6G3, Canada.,Jagiellonian Centre for Experimental Therapeutics (JCET), Jagiellonian University, 30-348 Krakow, Poland
| | - Anna Roszkowska
- Department of Chemistry, University of Waterloo, Waterloo, ON M1B 6G3, Canada.,Department of Pharmaceutical Chemistry, Medical University of Gdansk, 80-416, Gdansk, Poland
| | - Bogumiła Kupcewicz
- Department of Inorganic and Analytical Chemistry, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-089, Bydgoszcz, Poland
| | | | - Khaled Ramadan
- University Health Network - TGH, Toronto, ON M5G 2C4, Canada
| | - Shaf Keshavjee
- University Health Network - TGH, Toronto, ON M5G 2C4, Canada
| | | | - German Gómez-Ríos
- Department of Chemistry, University of Waterloo, Waterloo, ON M1B 6G3, Canada
| | - Marcos Tascon
- Department of Chemistry, University of Waterloo, Waterloo, ON M1B 6G3, Canada
| | - Krzysztof Goryński
- Department of Chemistry, University of Waterloo, Waterloo, ON M1B 6G3, Canada.,Department of Pharmacodynamics and Molecular Pharmacology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, 85-089, Bydgoszcz, Poland
| | - Marcelo Cypel
- University Health Network - TGH, Toronto, ON M5G 2C4, Canada
| | - Janusz Pawliszyn
- Department of Chemistry, University of Waterloo, Waterloo, ON M1B 6G3, Canada
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Ramadan K, Dessouky MI, Abd El-Samie FE. Performance enhancement of OFDM systems with lower-complexity using DST based on successive interference cancellation. Digital Signal Processing 2020; 102:102739. [DOI: 10.1016/j.dsp.2020.102739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Ali A, Watanabe Y, Galasso M, Watanabe T, Chen M, Fan E, Brochard L, Ramadan K, Ribeiro RVP, Stansfield W, Gokhale H, Gazzalle A, Waddell T, Liu M, Keshavjee S, Cypel M. An extracellular oxygen carrier during prolonged pulmonary preservation improves post-transplant lung function. J Heart Lung Transplant 2020; 39:595-603. [PMID: 32334946 DOI: 10.1016/j.healun.2020.03.027] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 03/06/2020] [Accepted: 03/25/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The use of a novel extracellular oxygen carrier (EOC) preservation additive known as HEMO2Life has recently been shown to lead to a superior preservation of different types of solid organs. Our study aimed to investigate the effect of this EOC on extending lung preservation time and its mechanism of action. METHODS Donor pigs were randomly allocated to either of the following 2 groups (n = 6 per group): (1) 36 hours cold preservation or (2) 36 hours cold preservation with 1 g/liter of EOC. The lungs were evaluated through 12 hours of normothermic ex vivo lung perfusion (EVLP) followed by a left-single lung transplant into a recipient pig. Grafts were reperfused for 4 hours, followed by right pulmonary artery clamping to assess graft oxygenation function. RESULTS During EVLP assessment, EOC-treated lungs showed improvements in physiologic parameters, whereas the control lungs deteriorated. After a total of 48 hours of preservation (36 hours cold + 12 hours normothermic EVLP), transplanted grafts in the treatment group displayed significantly better oxygenation than in the controls (PaO2/FiO2: 437 ± 36 mm Hg vs 343 ± 27 mm Hg, p = 0.041). In addition, the use of EOC led to significantly less edema formation (wet-to-dry ratio: 4.95 ± 0.29 vs 6.05 ± 0.33, p = 0.026), less apoptotic cell death (p = 0.041), improved tight junction preservation (p = 0.002), and lower levels of circulating IL-6 within recipient plasma (p = 0.004) compared with non-use of EOC in the control group after transplantation. CONCLUSION The use of an EOC during an extended pulmonary preservation period led to significantly superior early post-transplant lung function.
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Affiliation(s)
- Aadil Ali
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Yui Watanabe
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Marcos Galasso
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Tatsuaki Watanabe
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Manyin Chen
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Eddy Fan
- Divisions of Respirology and Critical Care Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Laurent Brochard
- Divisions of Respirology and Critical Care Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Khaled Ramadan
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Rafaela Vanin Pinto Ribeiro
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - William Stansfield
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Hemant Gokhale
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Anajara Gazzalle
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Thomas Waddell
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Mingyao Liu
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Shaf Keshavjee
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada
| | - Marcelo Cypel
- Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, Toronto, Ontario, Canada.
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Ramadan K, Dessouky MI, Abd El‐Samie FE. Joint low‐complexity nonlinear equalization and carrier frequency offset compensation for multiple‐input multiple‐output orthogonal frequency division multiplexing communication systems. Trans Emerging Tel Tech 2020; 31. [DOI: 10.1002/ett.3874] [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] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 12/29/2019] [Indexed: 09/02/2023]
Abstract
AbstractThe conventional zero forcing (ZF) equalizer suffers from the noise enhancement problem and the increasing complexity with the increase of the number of subcarriers. On the other hand, the minimum mean square error (MMSE) equalizer mitigates the noise enhancement, but it needs estimation of the signal‐to‐noise ratio (SNR) to work properly. In addition, the Joint Low‐complexity Regularized ZF (JLRZF) equalization and carrier frequency offset compensation scheme mitigates the noise enhancement using a constant parameter called the regularization parameter without SNR estimation. In this paper, we present a JLRZF with successive iInterference cancelation (JLRZF‐SIC) scheme for multiple‐input multiple‐output (MIMO) discrete Fourier transform orthogonal frequency division multiplexing (DFT‐OFDM) system to cope with the above‐mentioned problems. The proposed JLRZF‐SIC scheme jointly performs the equalization and the carrier frequency offset (CFO) compensation processes in two steps. The coupling nature of the MIMO channel is canceled in the first step. A regularization term is added in the second step to avoid the inter‐symbol‐interference (ISI). Simulation results show that the proposed JLRZF‐SIC scheme improves the system performance with low complexity, especially in the presence of estimation errors.
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Affiliation(s)
- K. Ramadan
- Department of Electronics and Electrical Communication Engineering The Higher Institute of Engineering at Al‐Shorouk City Cairo Egypt
| | - Moawad I. Dessouky
- Department of Electronics and Electrical Communications Engineering, Faculty of Electronic Engineering Menoufia University Menouf 32952 Egypt
| | - Fathi E. Abd El‐Samie
- Department of Electronics and Electrical Communications Engineering, Faculty of Electronic Engineering Menoufia University Menouf 32952 Egypt
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VP Ribeiro R, Ku T, Ferreira V, Galasso M, Moshkelgosha S, Michaelsen V, Wang A, Ali A, Ramadan K, Gomes B, Pires L, Gokhale H, Gazzalle A, Sinclair J, Kledal T, Liu M, Keshavjee S, Humar A, Cypel M. Targeting Latent Human Cytomegalovirus (CMV) with a Novel Fusion Toxin Protein during Ex Vivo Lung Perfusion. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Michaelsen V, VP Ribeiro R, Wang A, Price C, Wannberg B, Zhang Y, Pires L, del Sorbo L, Ramadan K, Gomes B, Galasso M, Brambate E, Gazzalle A, Liu M, Keshavjee S, Cypel M. Gaseous Nitric Oxide (gNO) as a Potential Antimicrobial Therapy during Ex Vivo Lung Perfusion: An Efficacy and Safety Study. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Ramadan K, Ramadan KF, Fiky AS, Alam H, Dessouky MI, Abd El-Samie FE. Joint low-complexity equalization and CFO estimation and compensation for UWA-OFDM communication systems. Int J Commun Syst 2020; 33:e3972. [DOI: 10.1002/dac.3972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- Khaled Ramadan
- Department of Electronics and Electrical Communications Engineering; The Higher Institute of Engineering at Al-Shorouk City; Cairo Egypt
| | - Khalil F. Ramadan
- Department of Electronics and Electrical Communications Engineering, Faculty of Electronic Engineering; Menoufia University; Menouf Egypt
| | - Ahmed S. Fiky
- Department of Physics and Mathematical Engineering; The Higher Institute of Engineering at Al-Shorouk City; Cairo Egypt
| | - Hasna Alam
- Department of Electronics and Electrical Communications Engineering, Faculty of Electronic Engineering; Menoufia University; Menouf Egypt
| | - Moawad I. Dessouky
- Department of Electronics and Electrical Communications Engineering, Faculty of Electronic Engineering; Menoufia University; Menouf Egypt
| | - Fathi E. Abd El-Samie
- Department of Electronics and Electrical Communications Engineering, Faculty of Electronic Engineering; Menoufia University; Menouf Egypt
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17
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Ramadan K, Dessouky MI, Abd El-Samie FE, Fiky AS. Equalization and blind CFO estimation for performance enhancement of OFDM communication systems using discrete cosine transform. Int J Commun Syst 2020; 33:e3984. [DOI: 10.1002/dac.3984] [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] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
- Khaled Ramadan
- Department of Electronics and Electrical Communication Engineering; The Higher Institute of Engineering at Al-Shorouk City; Cairo Egypt
| | - Moawad I. Dessouky
- Department of Electronics and Electrical Communication Engineering; Faculty of Electronic Engineering Menoufia University; Menouf Egypt
| | - Fathi E. Abd El-Samie
- Department of Electronics and Electrical Communication Engineering; Faculty of Electronic Engineering Menoufia University; Menouf Egypt
| | - Ahmed S. Fiky
- Department of Physics and Mathematical Engineering Department; The Higher Institute of Engineering at Al-Shorouk City; Cairo Egypt
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18
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Watanabe Y, Galasso M, Watanabe T, Ali A, Qaqish R, Nakajima D, Taniguchi Y, Pipkin M, Caldarone L, Chen M, Kanou T, Summers C, Ramadan K, Zhang Y, Chan H, Waddell TK, Liu M, Keshavjee S, Del Sorbo L, Cypel M. Donor prone positioning protects lungs from injury during warm ischemia. Am J Transplant 2019; 19:2746-2755. [PMID: 30887696 DOI: 10.1111/ajt.15363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 01/25/2023]
Abstract
A large proportion of controlled donation after circulatory death (cDCD) donor lungs are declined because cardiac arrest does not occur within a suitable time after the withdrawal of life-sustaining therapy. Improved strategies to preserve lungs after asystole may allow the recovery team to arrive after death actually occurs and enable the recovery of lungs from more cDCD donors. The aim of this study was to determine the effect of donor positioning on the quality of lung preservation after cardiac arrest in a cDCD model. Cardiac arrest was induced by withdrawal of ventilation under anesthesia in pigs. After asystole, animals were divided into 2 groups based on body positioning (supine or prone). All animals were subjected to 3 hours of warm ischemia. After the observation period, donor lungs were explanted and preserved at 4°C for 6 hours, followed by 6 hours of physiologic and biological lung assessment under normothermic ex vivo lung perfusion. Donor lungs from the prone group displayed significantly greater quality as reflected by better function during ex vivo lung perfusion, less edema formation, less cell death, and decreased inflammation compared with the supine group. A simple maneuver of donor prone positioning after cardiac arrest significantly improves lung graft preservation and function.
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Affiliation(s)
- Yui Watanabe
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.,Toronto Lung Transplant Program, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Marcos Galasso
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Tatsuaki Watanabe
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Aadil Ali
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Robert Qaqish
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Daisuke Nakajima
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Yohei Taniguchi
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Mauricio Pipkin
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Lindsay Caldarone
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Manyin Chen
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Takashi Kanou
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Cara Summers
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Khaled Ramadan
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Yu Zhang
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Harley Chan
- Guided Therapeutics, TECHNA Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Thomas K Waddell
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.,Toronto Lung Transplant Program, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Mingyao Liu
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Shaf Keshavjee
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.,Toronto Lung Transplant Program, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Lorenzo Del Sorbo
- Interdepartmental Division of Critical Care Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Marcelo Cypel
- Latner Thoracic Surgery Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.,Toronto Lung Transplant Program, Division of Thoracic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
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Gomes B, Ribeiro R, Ramadan K, Galasso M, Ali A, Watanabe Y, Paradiso E, Meineri M, Chan H, Zhang Y, Hwang D, Slutsky A, Fan E, Liu M, Keshavjee S, Cypel M, del Sorbo L. Effect of PEEP-Induced Alveolar Recruitment on Lung Injury during Extracorporeal Membrane Oxygenation for ARDS. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.851] [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
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20
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Galasso M, Feld JJ, Watanabe Y, Pipkin M, Summers C, Ali A, Qaqish R, Chen M, Ribeiro RVP, Ramadan K, Pires L, Bagnato VS, Kurachi C, Cherepanov V, Moonen G, Gazzalle A, Waddell TK, Liu M, Keshavjee S, Wilson BC, Humar A, Cypel M. Inactivating hepatitis C virus in donor lungs using light therapies during normothermic ex vivo lung perfusion. Nat Commun 2019; 10:481. [PMID: 30696822 PMCID: PMC6351537 DOI: 10.1038/s41467-018-08261-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 12/21/2018] [Indexed: 12/24/2022] Open
Abstract
Availability of organs is a limiting factor for lung transplantation, leading to substantial mortality rates on the wait list. Use of organs from donors with transmissible viral infections, such as hepatitis C virus (HCV), would increase organ donation, but these organs are generally not offered for transplantation due to a high risk of transmission. Here, we develop a method for treatment of HCV-infected human donor lungs that prevents HCV transmission. Physical viral clearance in combination with germicidal light-based therapies during normothermic ex-vivo Lung Perfusion (EVLP), a method for assessment and treatment of injured donor lungs, inactivates HCV virus in a short period of time. Such treatment is shown to be safe using a large animal EVLP-to-lung transplantation model. This strategy of treating viral infection in a donor organ during preservation could significantly increase the availability of organs for transplantation and encourages further clinical development. Organs from donors with transmissible viral infections, such as hepatitis C virus (HCV), are not offered for transplantation due to a high risk of transmission. Here, Galasso et al. develop a method for treatment of HCV-infected human donor lungs that is safe and prevents HCV transmission in the pig model.
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Affiliation(s)
- Marcos Galasso
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Jordan J Feld
- Toronto Centre for Liver Disease, University Health Network, Toronto General Hospital, Toronto, M5G 2C4, ON, Canada.
| | - Yui Watanabe
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Mauricio Pipkin
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Cara Summers
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Aadil Ali
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Robert Qaqish
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Manyin Chen
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Rafaela V P Ribeiro
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Khaled Ramadan
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Layla Pires
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Vanderlei S Bagnato
- São Carlos Institute of Physics, University of São Paulo Brazil, São Paulo, 13566-590, Brazil
| | - Cristina Kurachi
- São Carlos Institute of Physics, University of São Paulo Brazil, São Paulo, 13566-590, Brazil
| | - Vera Cherepanov
- Toronto Centre for Liver Disease, University Health Network, Toronto General Hospital, Toronto, M5G 2C4, ON, Canada
| | - Gray Moonen
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Anajara Gazzalle
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Thomas K Waddell
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Mingyao Liu
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Shaf Keshavjee
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Brian C Wilson
- Princess Margaret Cancer Centre/Department of Medical Biophysics, University of Toronto, Toronto, M5G 2C4, Canada
| | - Atul Humar
- Multi-Organ Transplant Program, University Health Network, Toronto, M5G 2C4, ON, Canada
| | - Marcelo Cypel
- Latner Thoracic Surgery Research Laboratories, Toronto General Research Institute, University Health Network, Toronto, M5G 2C4, ON, Canada. .,Multi-Organ Transplant Program, University Health Network, Toronto, M5G 2C4, ON, Canada.
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Affiliation(s)
- Khaled Ramadan
- Latner Thoracic Surgery Laboratories, Toronto General Hospital Research Institute, Department of Surgery and Department of Critical Care, University of Toronto, Toronto, ON, Canada
| | - Lorenzo Del Sorbo
- Latner Thoracic Surgery Laboratories, Toronto General Hospital Research Institute, Department of Surgery and Department of Critical Care, University of Toronto, Toronto, ON, Canada
| | - Marcelo Cypel
- Latner Thoracic Surgery Laboratories, Toronto General Hospital Research Institute, Department of Surgery and Department of Critical Care, University of Toronto, Toronto, ON, Canada
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Tlili I, Khan WA, Ramadan K. MHD Flow of Nanofluid Flow Across Horizontal Circular Cylinder: Steady Forced Convection. j nanofluids 2019. [DOI: 10.1166/jon.2019.1574] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tlili I, Khan WA, Ramadan K. Entropy Generation Due to MHD Stagnation Point Flow of a Nanofluid on a Stretching Surface in the Presence of Radiation. j nanofluids 2018. [DOI: 10.1166/jon.2018.1513] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Abd Allah H, Abd El-wahab B, Ramadan K, Ali S. GINGER ETHANOLIC EXTRACT, GINGER OIL OR RICE BRAN OIL INDUCED HEPATOPROTECTIVE EFFECT AGAINST FATTY LIVER IN RATS. Arab Universities Journal of Agricultural Sciences 2018; 26:1135-1150. [DOI: 10.21608/ajs.2018.28366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Ramadan K, Dessouky MI, Elagooz S, Elkordy M, Abd El-Samie FE. Equalization and Carrier Frequency Offset Compensation for Underwater Acoustic OFDM Systems. Ann Data Sci 2018; 5:259-272. [DOI: 10.1007/s40745-017-0127-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Zhu KY, Song KW, Connors JM, Leitch H, Barnett MJ, Ramadan K, Slack GW, Abou Mourad Y, Forrest DL, Hogge DE, Nantel SH, Narayanan S, Nevill TJ, Power MM, Sanford DS, Sutherland HJ, Tucker T, Toze CL, Sehn LH, Broady R, Gerrie AS. Excellent real-world outcomes of adults with Burkitt lymphoma treated with CODOX-M/IVAC plus or minus rituximab. Br J Haematol 2018; 181:782-790. [DOI: 10.1111/bjh.15262] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/01/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Katie Y. Zhu
- Faculty of Medicine; University of British Columbia; Vancouver BC Canada
| | - Kevin W. Song
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | | | - Heather Leitch
- Division of Hematology; St. Paul's Hospital; University of British Columbia; Vancouver BC Canada
| | - Michael J. Barnett
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Khaled Ramadan
- Division of Hematology; St. Paul's Hospital; University of British Columbia; Vancouver BC Canada
| | - Graham W. Slack
- Department of Pathology and Laboratory Medicine; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Yasser Abou Mourad
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Donna L. Forrest
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Donna E. Hogge
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Stephen H. Nantel
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Sujaatha Narayanan
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Thomas J. Nevill
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Maryse M. Power
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - David S. Sanford
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Heather J. Sutherland
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Tracy Tucker
- Genetics Laboratory; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Cynthia L. Toze
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Laurie H. Sehn
- Centre for Lymphoid Cancer; BC Cancer; Vancouver BC Canada
| | - Raewyn Broady
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
| | - Alina S. Gerrie
- Hematology; Leukemia/BMT Program of BC; BC Cancer; University of British Columbia; Vancouver BC Canada
- Centre for Lymphoid Cancer; BC Cancer; Vancouver BC Canada
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Goy J, Gillan TL, Bruyere H, Huang SJT, Hrynchak M, Karsan A, Ramadan K, Connors J, Toze CL, Gerrie AS. Chronic Lymphocytic Leukemia Patients With Deletion 11q Have a Short Time to Requirement of First-Line Therapy, But Long Overall Survival: Results of a Population-Based Cohort in British Columbia, Canada. Clin Lymphoma Myeloma Leuk 2017; 17:382-389. [PMID: 28559149 DOI: 10.1016/j.clml.2017.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 04/26/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronic lymphocytic leukemia (CLL) patients with 11q22.3 deletion (11q-) have an aggressive clinical course, and thus selection of first-line therapy in this group is important. This study aimed to improve our understanding of real-world practice patterns and outcomes of CLL patients with 11q- in a population-based setting. PATIENTS AND METHODS The British Columbia CLL Database was used to identify patients with 11q-. Overall survival (OS) and treatment-free survival (TFS) were assessed after adjustment for prognostic factors. RESULTS Of 1044 patients in the database, 125 had 11q- (12%). Sixty-nine patients had 11q- identified before therapy initiation and had a median OS and TFS of 14.7 (95% confidence interval [CI], 11.3-18.1) and 2.5 (95% CI, 1.5-3.6) years. Patient with copresence of 11q- and deletion 17p had a markedly worse prognosis, with median OS of 4.9 versus 14.7 years (P < .001). Most treated patients (33 of 52) received fludarabine with or without rituximab (FR). Patients treated with FR had a median OS of 12.8 years (standard error, 1.0), which was not statistically different from those treated with alkylator-containing therapy (P = .35). CONCLUSION Although median TFS of 11q- patients in this cohort was short at 2.5 years, OS remains long at 14.7 years, even when most patients received initial treatment without alkylators.
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Affiliation(s)
- Jennifer Goy
- Leukemia/Bone Marrow Transplant Program of BC, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Tanya L Gillan
- Pathology and Laboratory Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Helene Bruyere
- Pathology and Laboratory Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Steven J T Huang
- Leukemia/Bone Marrow Transplant Program of BC, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada; Pathology and Laboratory Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Monica Hrynchak
- Molecular Cytogenetic Laboratory, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Aly Karsan
- Cancer Genetics Laboratory, Pathology and Laboratory Medicine, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada
| | - Khaled Ramadan
- Division of Hematology, St Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph Connors
- Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Cynthia L Toze
- Leukemia/Bone Marrow Transplant Program of BC, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alina S Gerrie
- Leukemia/Bone Marrow Transplant Program of BC, British Columbia Cancer Agency, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
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Nichols N, Fridman M, Ramadan K, Ford Jones L, Mistry N. Investigating the social organization of family health work: an institutional ethnography. Critical Public Health 2015. [DOI: 10.1080/09581596.2015.1119804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Huang SJT, Gillan TL, Gerrie AS, Hrynchak M, Karsan A, Ramadan K, Smith AC, Toze CL, Bruyere H. Influence of clone and deletion size on outcome in chronic lymphocytic leukemia patients with an isolated deletion 13q in a population-based analysis in British Columbia, Canada. Genes Chromosomes Cancer 2015; 55:16-24. [PMID: 26391112 DOI: 10.1002/gcc.22294] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 08/05/2015] [Indexed: 01/22/2023] Open
Abstract
Deletion of the long arm of chromosome 13 (del(13q)) as the sole abnormality in chronic lymphocytic leukemia (CLL) portends a good prognosis; however, there is great outcome heterogeneity within this subgroup. The percentage of cells with a del(13q) (clone size) and the extent of the deletion are two factors that may affect outcome in CLL patients with isolated del(13q). We analyzed 248 CLL patients from the BC Provincial CLL database identified as having isolated del(13q) detected pretreatment by interphase fluorescence in situ hybridization to determine what impact clone and deletion size had on overall survival (OS) and treatment free survival (TFS). Patients with 60% or more of nuclei with a del(13q) had shorter TFS and shorter OS. A large deletion, encompassing the RB1 gene locus, was detected in half of the 90 cases with available specimens for testing, and there was no significant difference in OS and TFS between RB1-deleted and RB1-not-deleted cases. Further study in a larger sample size is required to determine the clinical interest of RB1 locus testing; however, clone size of del(13q) does predict TFS and OS and may better refine prognosis in this clinically heterogeneous population.
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Affiliation(s)
- Steven J T Huang
- Leukemia/BMT Program of BC, Vancouver General Hospital and British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada.,Pathology and Laboratory Medicine, Vancouver General Hospital University of British Columbia, Vancouver, BC, Canada
| | - Tanya L Gillan
- Pathology and Laboratory Medicine, Vancouver General Hospital University of British Columbia, Vancouver, BC, Canada
| | - Alina S Gerrie
- Leukemia/BMT Program of BC, Vancouver General Hospital and British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada
| | - Monica Hrynchak
- Department of Laboratory Medicine Molecular Cytogenetic Laboratory, Royal Columbian Hospital, University of British Columbia, New Westminster, BC, Canada
| | - Aly Karsan
- Pathology and Laboratory Medicine, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Khaled Ramadan
- Division of Hematology, St. Paul's Hospital University of British Columbia, Vancouver, BC, Canada
| | - Adam C Smith
- Instituto De Pesquisa Pelé Pequeno Príncipe, Curitiba, Brazil and the Dept. Of Pathology, University of British Columbia, Vancouver, Canada
| | - Cynthia L Toze
- Leukemia/BMT Program of BC, Vancouver General Hospital and British Columbia Cancer Agency, University of British Columbia, Vancouver, BC, Canada
| | - Helene Bruyere
- Pathology and Laboratory Medicine, Vancouver General Hospital University of British Columbia, Vancouver, BC, Canada
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Khan J, Ramadan K, Korczeniewska O, Anwer MM, Benoliel R, Eliav E. Interleukin-10 levels in rat models of nerve damage and neuropathic pain. Neurosci Lett 2015; 592:99-106. [DOI: 10.1016/j.neulet.2015.03.001] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 02/25/2015] [Accepted: 03/01/2015] [Indexed: 12/30/2022]
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Ramadan K, Fridman M, Ford-Jones L, Mistry N, Nichols N. 118: Assessing the Child Health Information Needs of Parents and Families. Paediatr Child Health 2014. [DOI: 10.1093/pch/19.6.e35-116] [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: 11/12/2022] Open
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Ramadan K, S. Hassan E, Zhu X, Abd-Elnaby M, M. El-Rabaie ELS, E.Abd El-Samie F. Continuous Phase Modulation for Digital Video Broadcasting. IJCA 2013; 81:45-52. [DOI: 10.5120/13980-1979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Beattie KA, MacIntyre NJ, Ramadan K, Inglis D, Maly MR. Longitudinal changes in intermuscular fat volume and quadriceps muscle volume in the thighs of women with knee osteoarthritis. Arthritis Care Res (Hoboken) 2012; 64:22-9. [PMID: 21905259 DOI: 10.1002/acr.20628] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To quantify rates of change in quadriceps muscle (QM) and intermuscular fat (IMF) volumes over 2 years in women in the Osteoarthritis Initiative (OAI) study and examine group differences between those with radiographic osteoarthritis (ROA) and those without ROA. METHODS The OAI database was queried for women ≥50 years of age in the incident and progression cohorts with and without ROA at baseline. Midthigh magnetic resonance imaging scans (15 contiguous slices, 5 mm slice thickness) of eligible women were randomly selected and anonymized. Image pairs were registered. QM and IMF were segmented in the 12 most proximal matching slices with the segmenter blinded to image time point. Age-adjusted differences in QM and IMF volume changes between groups were tested using analysis of covariance. RESULTS Forty-one women without ROA (mean ± SD age 60.7 ± 7.6 years) and 45 women with ROA (mean ± SD age 64.5 ± 6.7 years) were included. Mean ± SD QM and IMF volume changes in the non-ROA group were -4.1 ± 11.1 cm(3) and 3.4 ± 7.1 cm(3), respectively, and -5.4 ± 13.5 cm(3) and 3.1 ± 7.4 cm(3) in the ROA group, respectively. Age-adjusted between-group differences in QM and IMF changes were not significant (P > 0.05). CONCLUSION Two-year changes in QM and IMF volumes appear consistent with aging and do not seem to be related to OA status. Direct comparison with a control cohort without OA risk factors could confirm this. Since group assignment was based on baseline data, there may have been women in the non-ROA group who developed ROA over followup, resulting in some overlap between groups.
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Marin D, Ramadan K, Hamilton C, Schuetz A. Tricuspid Valve Repair with Artificial Chordae in a 72-Year-Old Woman. Thorac Cardiovasc Surg 2011; 59:495-7. [DOI: 10.1055/s-0030-1250724] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Marin D, Hohe S, Ramadan K, Schütz A. Re-Redo mitral valve repair - useful or even possible - a case report. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269043] [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: 10/18/2022]
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Marin D, Ramadan K, Hohe S, Schütz A. Tricuspid valve repair with artificial chordea in a 72-year old woman. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246666] [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]
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Sim AJW, Ashaal YE, Ramadan K, Prem Chandran VP, Sebastian M, Salam IMA, Azab IA, Abu Galala KH, Ahmed M. Laparoscopic repair of perforated duodenal ulcers using collagen fleece coated with fibrin glue. ACTA ACUST UNITED AC 2009. [DOI: 10.3109/13645709509152780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hefny AF, Ahmed I, Branicki FJ, Ramadan K, Czechowski J, Abu-Zidan FM. Management of mesenteric vascular occlusion. Singapore Med J 2008; 49:316-319. [PMID: 18418524] [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: 05/26/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate our recent clinical management of mesenteric vascular occlusion (MVO) at Al-Ain Hospital, United Arab Emirates. METHODS A retrospective study was performed including all patients who were diagnosed to have MVO from December 2001 to May 2005. The records were studied with regard to clinical features, risk factors, diagnosis, treatment, and outcome. RESULTS Of the 14 patients studied, seven patients experienced mesenteric venous thrombosis (MVT), five patients mesenteric arterial occlusion (MAO), and two patients were found to have both MVT and MAO. The main risk factor for MAO was ischaemic heart disease with atrial fibrillation in four patients (80 percent). No predisposing factors were identified in three patients with MVT (primary MVT 43 percent). Contrast-enhanced computed tomography was performed in all patients and was diagnostic in 12 (86 percent) patients. Seven patients (50 percent) underwent surgery. One patient died on the ninth postoperative day (overall mortality rate 7 percent). Seven patients (50 percent) were successfully managed conservatively, five of them had only MVT, one had combined MVT and MAO, and one had only MAO. CONCLUSION Early diagnosis and prompt initiation of anticoagulation therapy, with operative intervention when indicated, are essential for a favourable outcome.
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Affiliation(s)
- A F Hefny
- Department of Surgery, Al-Ain Hospital, PO Box 1006, Al-Ain, United Arab Emirates
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Manickam S, Ramadan K, Adams B. A rare choledochal cyst of the cystic duct with an anomalous pancreaticobiliary union in an adult patient. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.cradex.2004.04.001] [Citation(s) in RCA: 2] [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: 02/06/2023]
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Affiliation(s)
- Khaled Ramadan
- Haematology SpR, Belfast City Hospital, Belfast, N. Ireland, UK
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