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Ting S, Nguyen J, Palmer A, Rosemary Nixon AM. Contact sensitisation in oral lichen planus: An Australian perspective. Contact Dermatitis 2023; 89:335-344. [PMID: 37311568 DOI: 10.1111/cod.14366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND The role of contact sensitisation in the pathogenesis of oral lichen planus (OLP) has not been clearly defined. OBJECTIVE We aimed to evaluate relevant contact sensitisers in OLP. METHODS A retrospective study was conducted on OLP patients who underwent patch testing from 1 January 2006 to 31 December 2020 at an Australian tertiary dermatology institution, compared to cheilitis patients patch tested over the same time period. RESULTS Ninety-six OLP patients and 152 cheilitis patients were patch tested during the 15-year period. Seventy-one (73.9%) OLP patients and 100 (65.8%) cheilitis patients recorded one or more relevant reactions. Forty-three (44.8%), 22 (22.9%), 21 (21.9%) and 17 (17.7%) OLP patients had relevant reactions to mercury-related chemicals, amalgam, spearmint and carvone, respectively, compared to 6 (3.9%), 3 (2.0%), 4 (2.6%) and 0 (0%) cheilitis patients, respectively (p-value <0.001 each). Four (4.2%) OLP patients had relevant positive reactions to sodium metabisulfite, compared to none in the cheilitis group (p-value 0.021). CONCLUSION While dental amalgam is used less frequently these days, we report that mercury (found in amalgam) and additionally spearmint and carvone are relevant sensitisers in OLP in Australia. Sodium metabisulfite may also be a relevant sensitiser in OLP, which has not previously been reported.
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Affiliation(s)
- Sarajane Ting
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Jennifer Nguyen
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Amanda Palmer
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - A M Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
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2
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Zurloh M, Goetz M, Herold T, Treckmann J, Markus P, Schumacher B, Albers D, Rink A, Rosery V, Zaun G, Kostbade K, Pogorzelski M, Ting S, Schmidt H, Stiens R, Wiesweg M, Schuler M, Kasper S, Virchow I. Impact of encorafenib on survival of patients with BRAF V600E-mutant metastatic colorectal cancer in a real-world setting. J Cancer Res Clin Oncol 2023; 149:12903-12912. [PMID: 37466791 PMCID: PMC10587317 DOI: 10.1007/s00432-023-05141-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE Patients with BRAFV600E-mutant metastatic colorectal cancer (mCRC) have a dismal prognosis. The best strategies in these patients remain elusive. Against this background, we report the clinical course of patients with BRAFV600E-mutant mCRC to retrieve the best treatment strategy. PATIENTS AND METHODS Clinico-pathological data were extracted from the electronic health records. Kaplan-Meier method was used to estimate overall (OS) and progression-free survival (PFS). Objective response rate (ORR) was assessed according to RECIST 1.1. RESULTS In total, 51 patients were enrolled. FOLFOXIRI was administered to 12 patients; 29 patients received FOLFOX or FOLFIRI as first-line treatment. Median OS was 17.6 months. Median PFS with FOLFOXIRI (13.0 months) was significantly prolonged (HR 0.325) as compared to FOLFOX/FOLFIRI (4.3 months). However, this failed to translate into an OS benefit (p = 0.433). Interestingly, addition of a monoclonal antibody to chemotherapy associated with superior OS (HR 0.523). A total of 64.7% patients received further-line therapy, which included a BRAF inhibitor in 17 patients. Targeted therapy associated with very favourable OS (25.1 months). CONCLUSION Patients with BRAFV600E-mutated mCRC benefit from the addition of an antibody to first-line chemotherapy. Further-line treatment including a BRAF inhibitor has a dramatic impact on survival.
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Affiliation(s)
- M Zurloh
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Goetz
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
| | - T Herold
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - J Treckmann
- West German Cancer Center, Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - P Markus
- Department of General Surgery and Traumatology, Elisabeth Hospital, Essen, Germany
| | - B Schumacher
- Department of Gastroenterology, Elisabeth Hospital, Essen, Germany
| | - D Albers
- Department of Gastroenterology, Elisabeth Hospital, Essen, Germany
| | - A Rink
- West German Cancer Center, Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - V Rosery
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - G Zaun
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - K Kostbade
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Pogorzelski
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - S Ting
- West German Cancer Center, Institute of Pathology Essen, University Hospital Essen, Essen, Germany
- Institute of Pathology Nordhessen, Kassel, Germany
| | - H Schmidt
- Department of Gastroenterology, Hepatology and Transplant Medicine, University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - R Stiens
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - M Schuler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
| | - Stefan Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany.
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
- Medical Faculty, University Duisburg-Essen, Essen, Germany.
| | - I Virchow
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Hufelandstr. 55, 45147, Essen, Germany
- Medical Faculty, University Duisburg-Essen, Essen, Germany
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3
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Kelly R, Gan C, Ting S, Manuelpallai N, Wee E. The simultaneous occurrence of livedoid vasculopathy and lymphocytic thrombophilic arteritis in six cases. Australas J Dermatol 2023; 64:413-416. [PMID: 37185816 DOI: 10.1111/ajd.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/07/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023]
Abstract
Lymphocytic thrombophilic arteritis and livedoid vasculopathy may both present with livedo racemosa and ulceration. We present 6 cases with features of both conditions, raising the possibility that they are either closely linked or are part of a spectrum of the same condition.
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Affiliation(s)
- Robert Kelly
- Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Christian Gan
- Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Sarajane Ting
- Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia
| | | | - Edmund Wee
- Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia
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4
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Reissig TM, Tzianopoulos I, Liffers ST, Rosery VK, Guyot M, Ting S, Wiesweg M, Kasper S, Meister P, Herold T, Schmidt HH, Schumacher B, Albers D, Markus P, Treckmann J, Schuler M, Schildhaus HU, Siveke JT. Smaller panel, similar results: genomic profiling and molecularly informed therapy in pancreatic cancer. ESMO Open 2023; 8:101539. [PMID: 37148593 DOI: 10.1016/j.esmoop.2023.101539] [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: 02/04/2023] [Revised: 03/12/2023] [Accepted: 03/24/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Pancreatic cancer has a dismal prognosis. One reason is resistance to cytotoxic drugs. Molecularly matched therapies might overcome this resistance but the best approach to identify those patients who may benefit is unknown. Therefore, we sought to evaluate a molecularly guided treatment approach. MATERIALS AND METHODS We retrospectively analyzed the clinical outcome and mutational status of patients with pancreatic cancer who received molecular profiling at the West German Cancer Center Essen from 2016 to 2021. We carried out a 47-gene DNA next-generation sequencing (NGS) panel. Furthermore, we assessed microsatellite instability-high/deficient mismatch repair (MSI-H/dMMR) status and, sequentially and only in case of KRAS wild-type, gene fusions via RNA-based NGS. Patient data and treatment were retrieved from the electronic medical records. RESULTS Of 190 included patients, 171 had pancreatic ductal adenocarcinoma (90%). One hundred and three patients had stage IV pancreatic cancer at diagnosis (54%). MMR analysis in 94 patients (94/190, 49.5%) identified 3 patients with dMMR (3/94, 3.2%). Notably, we identified 32 patients with KRAS wild-type status (16.8%). To identify driver alterations in these patients, we conducted an RNA-based fusion assay on 13 assessable samples and identified 5 potentially actionable fusions (5/13, 38.5%). Overall, we identified 34 patients with potentially actionable alterations (34/190, 17.9%). Of these 34 patients, 10 patients (10/34, 29.4%) finally received at least one molecularly targeted treatment and 4 patients had an exceptional response (>9 months on treatment). CONCLUSIONS Here, we show that a small-sized gene panel can suffice to identify relevant therapeutic options for pancreatic cancer patients. Informally comparing with previous large-scale studies, this approach yields a similar detection rate of actionable targets. We propose molecular sequencing of pancreatic cancer as standard of care to identify KRAS wild-type and rare molecular subsets for targeted treatment strategies.
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Affiliation(s)
- T M Reissig
- Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, Essen, Germany; Division of Solid Tumor Translational Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Heidelberg, Germany; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - I Tzianopoulos
- Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, Essen, Germany; Division of Solid Tumor Translational Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Heidelberg, Germany; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - S-T Liffers
- Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, Essen, Germany; Division of Solid Tumor Translational Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Heidelberg, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - V K Rosery
- Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, Essen, Germany; Division of Solid Tumor Translational Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Heidelberg, Germany; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - M Guyot
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; Department of Gastroenterology, Oncology und Hematology, Diabetology and Rheumatology, Marien-Hospital Wesel, Wesel, Germany
| | - S Ting
- Institute of Pathology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - S Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - P Meister
- Department of General, Visceral and Transplantation Surgery, Hepatology, and Transplant Medicine, University Hospital Essen, Essen, Germany
| | - T Herold
- Institute of Pathology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - H H Schmidt
- Department of Gastroenterology, Hepatology, and Transplant Medicine, University Hospital Essen, Essen, Germany
| | - B Schumacher
- Department of Gastroenterology, Visceral and Trauma Surgery, Elisabeth Hospital Essen, Essen, Germany
| | - D Albers
- Department of Gastroenterology, Visceral and Trauma Surgery, Elisabeth Hospital Essen, Essen, Germany
| | - P Markus
- Department of General, Visceral and Trauma Surgery, Elisabeth Hospital Essen, Essen, Germany
| | - J Treckmann
- Department of General, Visceral and Transplantation Surgery, Hepatology, and Transplant Medicine, University Hospital Essen, Essen, Germany
| | - M Schuler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - H-U Schildhaus
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany; Institute of Pathology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - J T Siveke
- Bridge Institute of Experimental Tumor Therapy, West German Cancer Center, University Hospital Essen, Essen, Germany; Division of Solid Tumor Translational Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Heidelberg, Germany; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany; German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
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5
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Váradi M, Horváth O, Fazekas T, Csizmarik A, Módos O, Széles Á, Kenessey I, Reis H, Oláh C, Hadaschik B, Krafft U, Ting S, Furka A, Nyirády P, Szarvas T. Molecular analysis of urothelial carcinoma to predict the efficacy of immune checkpoint inhibitor therapy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01202-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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6
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Chang J, Fowler K, Ting S, Tamayo P, Burgoyne A. 721P Molecular alterations as predictors of response to immunotherapy in hepatocellular carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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7
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Deike-Hofmann K, von Lampe P, Eerikaeinen M, Ting S, Schlüter S, Schlemmer PH, Bechrakis N, Forsting M, Radbruch A. Enhancement der Vorderen Augenkammer ist ein Prediktor für die Optikusinfiltration bei Retinoblastomen. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/s-0042-1749875] [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: 11/07/2022]
Affiliation(s)
| | | | | | - S Ting
- Pathologie, Uniklinik Essen, Essen
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8
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Ho KY, Lam KKW, Wu CST, Leung DYP, Yeung WF, Hung TM, Ting S, Tong MN, Tang LN, Mak YW. Utilization of the Youth Quitline as an opportunity for an undergraduate nursing students to deliver smoking cessation counseling as their clinical placement: An implementation of a service-learning model. Nurse Educ Today 2022; 112:105330. [PMID: 35303543 DOI: 10.1016/j.nedt.2022.105330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Smoking is an important modifiable risk factor of morbidities and mortality. Although healthcare professionals play an important role in smoking cessation, their adoption of such practices is relatively low because of inadequate training. To address this issue, we incorporated a service-learning model to operate the Youth Quitline. Undergraduate nursing students were trained and received supervision while delivering smoking cessation counseling through the Youth Quitline as their clinical placement. OBJECTIVES We evaluated the effectiveness of the placement by assessing students' knowledge, attitudes and practices regarding smoking cessation and tobacco control. DESIGN One-group pretest-posttest design. SETTING Youth Quitline. PARTICIPANTS A total of 61 third-year students in a mental health nursing program. METHODS Students were required to complete 80 h at the Youth Quitline. The 80 h were divided into 20 sessions; students used four sessions to approach and recruit youth smokers in the community, then provided them with telephone counseling for the rest of the time. Prior to the placement, students attended a 2-day workshop. The outcomes were changes in students' knowledge, attitudes and practices regarding smoking cessation and tobacco control 3 months after the placement compared with baseline. RESULTS From January-June 2021, students conducted 105 outreach activities to identify 3142 smokers in the community, and provided telephone counseling for 336 smokers via Youth Quitline. Compared with baseline, significant improvements were observed in students' knowledge, attitudes and practices regarding smoking cessation and tobacco control at 3-month follow-up. CONCLUSIONS The clinical placement improved students' knowledge, attitudes and practices regarding smoking cessation and tobacco control, enhancing their competency in providing support to assist smokers to quit in their future practice. Incorporating the service-learning model in existing community-based services can provide additional venues for nursing students to practice. This is particularly important because many venues have restricted access during the COVID-19 pandemic.
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Affiliation(s)
- K Y Ho
- School of Nursing, Hong Kong Polytechnic University, Hong Kong.
| | | | - C S T Wu
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - D Y P Leung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - W F Yeung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - T M Hung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - S Ting
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - M N Tong
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - L N Tang
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
| | - Y W Mak
- School of Nursing, Hong Kong Polytechnic University, Hong Kong
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9
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Shailendranath L, Ting S. 17 Venous thromboembolism – Prevention is better than cure. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.123] [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: 11/04/2022]
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10
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Ting S, Shailendranath L, Hickey K. 20 Cold coagulation treatment of cervical intraepithelial neoplasia (CIN): Human papillomavirus (HPV) Evidence of cure. Eur J Obstet Gynecol Reprod Biol 2022. [DOI: 10.1016/j.ejogrb.2021.11.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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11
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Choi B, Lasica M, Huynh N, Sirdesai S, Nagarethinam M, Ting S, Cooke J, Hare J, Gibbs S. The Increasing Recognition of Transthyretin Cardiac Amyloidosis (ATTR-CA): Patient Characteristics and Survival in the Australian Context. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.133] [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: 10/16/2022]
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12
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Ting S, Webster M. Grenz ray therapy in disseminated superficial actinic porokeratosis: A case series of 17 patients. Australas J Dermatol 2021; 63:91-94. [PMID: 34905626 DOI: 10.1111/ajd.13769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/30/2021] [Indexed: 11/29/2022]
Abstract
The treatments available for disseminated superficial actinic porokeratosis (DSAP) have been limited and have variable efficacy. We report the largest case series to date of the use of Grenz ray therapy in 17 patients with DSAP. There was at least 50% improvement in DSAP lesions in all cases. Erythema, itching and burning were common side effects of Grenz ray therapy. We believe that Grenz ray therapy may be an effective treatment option for patients with DSAP.
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Affiliation(s)
- Sarajane Ting
- Radiotherapy Clinic, Skin Health Institute, Carlton, Victoria, Australia
| | - Michael Webster
- Radiotherapy Clinic, Skin Health Institute, Carlton, Victoria, Australia
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13
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Ting S, Nixon R. Assessment and management of itchy skin in pregnancy. Aust J Gen Pract 2021; 50:898-903. [PMID: 34845477 DOI: 10.31128/ajgp-03-21-5900] [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: 11/19/2022]
Abstract
BACKGROUND Women with rashes or itchy skin during pregnancy will often present initially to the general practitioner. Knowledge of the specific dermatoses of pregnancy will assist in diagnosis, management and, importantly, facilitation of timely escalation of care of conditions that can potentially affect the fetus. OBJECTIVE The aim of this article is to provide a diagnostic framework for approaching a pruritic rash during pregnancy as well as a helpful summary of management of pregnancy-specific dermatoses. It will assist clinicians in the identification of specific dermatoses that pose fetal risks. DISCUSSION In addition to considering non-pregnancy specific conditions when approaching pruritus or a pruritic rash in pregnancy, it is important that clinicians also consider pregnancy-specific dermatoses, which have been reclassified into four categories: polymorphic eruption of pregnancy, pemphigoid gestationis, intrahepatic cholestasis of pregnancy (ICP) and atopic eruption of pregnancy. Unlike the other dermatoses, ICP begins with pruritus, and skin changes are secondary. ICP and pemphigoid gestationis are associated with fetal risks such as prematurity and stillbirth.
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Affiliation(s)
- Sarajane Ting
- MBBS (Hons), BMedSc, FRACGP, DCH, PDipDerm, General Practitioner, Tas
| | - Rosemary Nixon
- AM, BSc (Hons), MBBS, MPH, FACD, FAFOEM, Consultant Dermatologist and Occupational Physician; Adjunct Clinical Associate Professor, Monash University, Vic; Honorary Associate Professor, The University of Melbourne, Vic; Director, Occupational Dermatology Research and Education Centre, Vic
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14
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Pogorzelski M, Lauri F, Hilser T, Hense J, Ting S, Kansy B, Gauler T, Stuschke M, Schmid K, Lang S, Zaun G, Grünwald V, Schuler M, Kasper S. 922P Efficacy of immunotherapy (IO) and subsequent systemic treatment after failure of IO in patients with recurrent or metastatic head and neck cancer in a real-world setting. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Ting S, Tam M, Kelly RI. Scarring in pyoderma gangrenosum. Australas J Dermatol 2021; 62:523-525. [PMID: 34423853 DOI: 10.1111/ajd.13701] [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: 11/29/2022]
Affiliation(s)
- Sarajane Ting
- Department of Dermatology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Mei Tam
- Department of Dermatology, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Robert I Kelly
- Department of Dermatology, St Vincent's Hospital, Melbourne, VIC, Australia
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16
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Liu X, Wen W, Tao W, Li T, Na L, Ting S, Ting W, Hanying Z, Na Z, Juanzi S. O-174 Individualized versus standard FSH dosing in predicted poor responders: an RCT. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.055] [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: 11/13/2022] Open
Abstract
Abstract
Study question
Is there a difference in fertility outcomes between individualized or standard FSH dosing in women scheduled for IVF with an expected poor response?
Summary answer
In predicted poor responders (AFC<10) undergoing IVF/ICSI, individualized FSH dosing does not improve ongoing pregnancy rates as compared to a standard FSH dose.
What is known already
Poor responders usually lead to many detrimental effects on IVF outcomes due to low oocyte number and quality which in turn result in low pregnancy outcomes and an increased chance of cycle cancellation. Clinicians often individualize the FSH dose using ovarian reserve tests (ORT), including antral follicle count (AFC), basal FSH (bFSH), and anti-Mullerian hormone (AMH). However, it is unclear whether individualized FSH dosing improves clinical outcomes.
Study design, size, duration
Between March 2019 and April 2020, we performed a single-center, parallel, open-label RCT in women with an AFC<10. A total of 661 women were randomized either to start FSH dosing at 300IU/225IU or 150IU. The primary outcome was live birth attributable to the first ART cycle within 18 months of randomization. In this abstract, we report ongoing pregnancy rates. Live birth date will be available at the meeting.
Participants/materials, setting, methods
Women referred for their first IVF/ICSI cycle, <43 years of age, AFC<10 were approached. A total of 328 women were allocated to the individualized group and 333 women were allocated to the standard group. In the individualized group, women with AFC 1-6 were assigned to 300IU/day (n = 122), while women with AFC 7-9 were assigned to 225IU/day (n = 206). In the standard group, women were assigned 150IU/day. Outcomes were evaluated from an intention-to-treat perspective.
Main results and the role of chance
For ongoing pregnancy rate attributable to the first ART cycle for individualized versus standard dosing was comparable [52.44% vs 46.25%, relative risk (RR): 1.29 (95%CI, 0.94-1.74), P = 0.11]. Biochemical pregnancy rate [62.50% vs 62.16%, RR: 1.01 (95%CI, 0.74-1.39), P = 0.929], clinical pregnancy rate [59.45% vs 58.86%, RR: 1.02 (95%CI, 0.75-1.40), P = 0.877] and multiple pregnancy rate [5.18% vs 5.12%, RR: 1.01 (95%CI, 0.51-2.02), P = 0.971] also did not differ between individualized and standard dosing. There are 24 women who are ongoing pregnancy but do not reach live birth in the completed embryo transfer cycle. The individualized group reported less poor response (31.1% vs 48.7%: P < 0.001), more obtained oocytes (6.80 ± 3.85 vs 5.28 ± 3.22; P < 0.001), less embryos (3.76 ± 2.70 vs 3.16 ± 2.42; P = 0.004), and less good quality embryos (2.61 ± 2.29 vs 2.21 ± 2.05; P = 0.018). When outcomes were compared over the first embryo transfer, ongoing pregnancy rates were 39.0% (128/328) versus 37.2% (124/333), respectively [RR:1.08 (95%CI, 0.79-1.48), P = 0.636], without differences in the other outcomes. There are 7 women who are ongoing pregnancy but do not reach live birth in the first embryo transfer cycle.
Limitations, reasons for caution
Due to the open-label character, potential selective canceling and small dose adjustments of standard dosing were allowed. This abstract reports on ongoing pregnancy. At the meeting, we will present live birth rates.
Wider implications of the findings
In women with predicted poor response, an increased dose does not increase ongoing pregnancy rates. A standard dose of 150IU/day is recommended in these women.
Trial registration number
ChiCTR1900021944
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Affiliation(s)
- X Liu
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - W Wen
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - W Tao
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - T Li
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - L Na
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - S Ting
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - W Ting
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - Z Hanying
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - Z Na
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
| | - S Juanzi
- Northwest women’s and children’s hospital, assisted reproduction center, Xi’an, China
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17
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Ting S, Kelly RI. Challenges in the diagnosis of pyoderma gangrenosum. Australas J Dermatol 2021; 62:e476-e477. [PMID: 34115376 DOI: 10.1111/ajd.13647] [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] [Received: 03/10/2021] [Accepted: 05/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Sarajane Ting
- Department of Dermatology, St Vincent's Hospital, Melbourne, Vic, Australia
| | - Robert I Kelly
- Department of Dermatology, St Vincent's Hospital, Melbourne, Vic, Australia
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18
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Nguyen J, Ting S, Paul E, Smith AL, Watts CG, Kelly J, Cust AE, Mar V. Diagnostic tools used for melanoma: A survey of Australian general practitioners and dermatologists. Australas J Dermatol 2021; 62:300-309. [PMID: 33860932 DOI: 10.1111/ajd.13595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND/OBJECTIVE Diagnostic tools such as dermoscopy, sequential digital dermoscopy imaging (SDDI), total body photography (TBP) and automated diagnostic tools are available to assist in early melanoma diagnosis. The use, accessibility and barriers of dermoscopy have been well studied; however, there are few similar studies regarding SDDI, TBP and automated diagnostic tools. We aim to understand the use of these diagnostic aids amongst Australian general practitioners (GPs) and dermatologists. METHODS Between June 2019 and January 2020, GPs and dermatologists across Australia were invited to participate in an online survey. Surveys were distributed through GP and dermatology organisations. RESULTS A total of 227 survey responses were received, 175 from GPs and 52 from dermatologists. Amongst GPs, 44.6% worked in a skin cancer clinic. Dermoscopy was used at least occasionally by 98.9% of all GPs. SDDI was used by 93.6% of skin cancer GPs, 80.8% of dermatologists and 45.3% of generalist GPs. TBP was used or recommended by 77.1% of generalist GPs, 82.3% of skin cancer GPs and 86.5% of dermatologists. The most common barriers to the use of TBP were cost, limited accessibility, poor patient compliance, and time required for both patients and doctors. Very few clinicians reported using automated diagnostic tools. There was an interest in future diagnostic aids for melanoma in 88% of GPs and dermatologists. CONCLUSION Dermoscopy, SDDI and TBP were commonly used by responding Australian skin cancer GPs and dermatologists in this survey. Automated diagnostic tools were not reported to be used routinely. Several barriers were identified for use of TBP.
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Affiliation(s)
- Jennifer Nguyen
- Victorian Melanoma Service, Alfred Health, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sarajane Ting
- Victorian Melanoma Service, Alfred Health, Melbourne, Victoria, Australia.,The Royal Australian College of General Practitioners, East Melbourne, Victoria, Australia
| | - Eldho Paul
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Andrea L Smith
- Macquarie University, Sydney, New South Wales, Australia
| | - Caroline G Watts
- The Sydney School of Public Health and Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.,Kirby Institute, UNSW, Sydney, New South Wales, Australia
| | - John Kelly
- The Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Anne E Cust
- The Sydney School of Public Health and Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Victoria Mar
- Victorian Melanoma Service, Alfred Health, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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19
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Abstract
BACKGROUND Patients with viral exanthems commonly present to the general practitioner. Although it can be challenging to make a specific diagnosis on the basis of the clinical presentation, most viral exanthems can be distinguished initially on the basis of age, distribution and morphology of the rash without requiring investigations. OBJECTIVE The aim of this article is to provide an initial guide to the clinical diagnosis of viral exanthems based on age, distribution and morphology of the rash. DISCUSSION Although most viral exanthems can present at any age, it may be helpful to initially consider certain exanthems depending on the age of the patient. Following consideration of differential diagnoses according to age groups, it is proposed that most exanthems can be distinguished by the distribution and morphology of the rash. Other diagnostic considerations include associated symptoms and diagnostic tests if applicable.
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Affiliation(s)
- Sarajane Ting
- MBBS (Hons), BMedSc, FRACGP, DCH, PDipDerm, General Practitioner, Tas
| | - Rosemary Nixon
- AM, BSc (Hons), MBBS, MPH, FACD, FAFOEM, Consultant Dermatologist and Occupational Physician; Adjunct Clinical Associate Professor, Monash University, Vic; Honorary Associate Professor, The University of Melbourne, Vic; Director, Occupational Dermatology Research and Education Centre, Vic
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20
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Ting S, Kelly RI. Three cases of Sneddon syndrome: A comparison with lymphocytic thrombophilic arteritis. Australas J Dermatol 2020; 62:e272-e275. [PMID: 33314022 DOI: 10.1111/ajd.13523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/29/2020] [Accepted: 10/28/2020] [Indexed: 12/01/2022]
Abstract
Lymphocytic thrombophilic arteritis and Sneddon syndrome can have very similar clinical presentations with chronic persistent widespread blanchable livedo racemosa. Lymphocytic thrombophilic arteritis has only recently been described and generally is associated with a benign prognosis. Sneddon syndrome is associated with the development of multiple cerebrovascular accidents and progressive neurological impairment. We present three cases of Sneddon syndrome and compare them with lymphocytic thrombophilic arteritis to identify patients at risk of neurological events.
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Affiliation(s)
- Sarajane Ting
- Department of Dermatology, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Robert I Kelly
- Department of Dermatology, St Vincent's Hospital, Fitzroy, Victoria, Australia
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21
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Choi B, Lasica M, Hare J, Chong S, Strachan L, Hocking J, Ting S, Gibbs S. 105 Diflunisal is Effective and Affordable Treatment in Transthyretin Cardiac Amyloidosis (ATTR-CM) - but Only Half of Patients can Tolerate It. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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22
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Choi B, Lasica M, Hare J, Chong S, Strachan L, Hocking J, Ting S, Gibbs S. 178 “The Giant Awakes” – Rapid Increases in the Diagnosis of Transthyretin (TTR) Amyloidosis After the ATTR-ACT Trial of Tafamidis. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Koay W, Tay S, Ting S, Hameed S. C-39 Utility of Addenbrooke's Cognitive Exam III (Singapore-Chinese Version) for Cognitive Screening and Correlation with Standardized Neuropsychological Tests. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
Dementia is a public health priority worldwide. Early screening of cognitive impairment and locating of specific impaired areas are essential for timely intervention and prolonging independence. The commonly-used Mini Mental State Examination (MMSE) is inadequate. Alternatively, the Addenbrooke's Cognitive Exam III (ACE-III) that assesses five domains (attention, memory, verbal fluency, language and visuospatial abilities) is recommended.
Thus, we aim to examine the utility of Singapore-Chinese version (ACE-III-SG-C) for case finding of cognitive impairment, and its correlation with the respective standardized neuropsychological tests.
Methods
22 participants were referred by neurologists for comprehensive neuropsychological assessment at public healthcare institution. Participants were categorized into three groups (No Cognitive Impairment, NCI: 6; Mild Cognitive Impairment, MCI: 9; Dementia: 7). The ACE-III-SG-C and MMSE were administered. ACE-III-SG-C total and individual domain scores were computed.
Results
No significant difference in age and education across three groups. The MMSE scores (F(2,19) = 5.005, p = .018) and ACE-III-SG-C total scores (F(2,19) = 21.296, p < 0.001) were significantly different across three groups. Post hoc comparisons indicated that dementia (p < .001) and MCI (p = 0.046) groups had significantly lower ACE-III-SG-C total scores than NCI group. However, the MMSE scores of the MCI and NCI groups were comparable (p = 0.850). The Modified Boston Naming Test were significantly correlated with ACE-III-SG-C language domain scores (r = .605, p = .003), but not MMSE (r = .400, p = .065).
Conclusions
ACE-III-SG-C demonstrated its usefulness for early screening of MCI and dementia. Its correlation with language test suggested potential detection for disorders with language impairment. Further research is needed to unravel its utility of describing other specific impaired areas.
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24
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Lasica M, Ting S, Cooke J, Wong C, Slocombe A, Zimmet H, Hosking P, Hare J, Gibbs S. Cardiac Transthyretin Amyloidosis: Are we Under-Diagnosing and Under-Treating? Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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25
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Abstract
Inflammation of the parathyroid glands is rare when compared to other endocrine organs. This leads to the use of descriptive terms as well as the lack of a generally accepted classification for inflammatory disorders of the parathyroid glands. This review article proposes that parathyroid inflammation be subdivided morphologically into (a) non-specific lymphocytic infiltration, which is more an expression of damage to small vessels, due to e. g. severe systemic inflammation or myocardial infarction, (b) autoimmunogenic lymphocytic parathyroiditis, (c) nonimmunogenic inflammation caused by granulomatous diseases or infections and (d) invasive sclerosing (peri) parathyroiditis. As only parathyroid glands removed due to hyperparathyroidism and normal parathyroid glands incidentally removed during thyroid surgery are seen almost exclusively in routine histopathology, virtually no information about the morphological correlate of hypoparathyroidism is available.
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Affiliation(s)
- S Ting
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| | - S Synoracki
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| | - S-Y Sheu
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| | - K W Schmid
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
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26
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Kasper S, Meiler J, Knipp H, Höhler T, Reimer P, Steinmetz H, Berger W, Linden G, Ting S, Markus P, Paul A, Dechêne A, Schumacher B, Kostbade K, Worm K, Schmid K, Herold T, Schuler M, Trarbach T. Cetuximab biweekly (q2w) plus mFOLFOX6 as 1st line therapy in patients (pts) with KRAS wild-type (wt) (exon 2) metastatic colorectal cancer (mCRC) – Primary endpoint and subgroup analysis of the CEBIFOX trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.56] [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: 11/12/2022] Open
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27
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Abstract
The cytological evaluation of fine needle biopsies (FNB) of the thyroid gland crucially depends on a close cooperation between clinicians and cytopathologists. Scintigraphy, sonography as well as clinical data and patient history are necessary for a correct interpretation of the indications for FNB; moreover, these data are of outstanding importance for cytopathologists for the correct interpretation of the cytomorphological findings. This overview describes the present standards in the acquisition, technical workup and cytopathological interpretation of thyroid gland tissue obtained by FNB, particularly focusing on the rapidly growing relevance of additional molecular pathological investigations to increase the diagnostic accuracy of thyroid FNB.
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28
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Ting S, Chen A, Reuveny S, Oh S. Integrated One Unit Microcarrier Based Process for Human Pluripotent Stem Cell Expansion, and Cardiomyocyte Differentiation and Purification. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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29
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Ting S, Synoracki S, Schmid KW. [Thyroid C cells and their pathology: Part 1: normal C cells, - C cell hyperplasia, - precursor of familial medullary thyroid carcinoma]. Pathologe 2016; 36:246-53. [PMID: 25898937 DOI: 10.1007/s00292-015-0019-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The C cells (parafollicular) of the human thyroid gland are predominantly located within the thyroid follicles, are of neuroendocrine origin and produce and secrete the peptide hormone calcitonin. Calcitonin is clinically utilized as a screening marker to detect occult medullary thyroid carcinoma (MTC) as well as in the follow-up of patients with MTC. An increase in the number of C cells is designated as C cell hyperplasia (CCH). Neoplastic CCH is caused by an autosomal dominant inherited mutation of the RET protooncogene, which develops into invasive familial MTC in the setting of multiple endocrine neoplasia (MEN) type 2 depending on the location of the mutation in the RET gene with a high variation in latency. According to the current state of knowledge CCH without a germline mutation in the RET protooncogene, designated as non-MEN2-associated CCH, seems to be unrelated to the development of sporadic MTC.
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Affiliation(s)
- S Ting
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
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30
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Weinberg L, Rachbuch C, Ting S, Howard W, Yeomans M, Gordon I, McNicol L, James K, Story D, Christophi C. A randomised controlled trial of peri-operative lidocaine infusions for open radical prostatectomy. Anaesthesia 2016; 71:405-10. [PMID: 26749026 PMCID: PMC4849200 DOI: 10.1111/anae.13368] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 12/02/2022]
Abstract
We allocated 76 men scheduled for radical retropubic prostatectomy to peri‐operative lidocaine 2% or saline 0.9%: a pre‐operative 0.075 ml.kg−1 intravenous bolus; an intra‐operative intravenous infusion at 0.075 ml.kg−1.h−1; and 24 hours' postoperative subcutaneous infusion at 0.075 ml.kg−1.h−1. Lidocaine reduced the postoperative hospital stay by a mean (95% CI) of 1.3 (0.3–2.4) days, p = 0.017, from a mean (SD) of 4.6 (3.2) days with saline. Lidocaine reduced pain at rest during the first 24 postoperative hours by a mean (95% CI) of 1.8 (0.7–2.9) mm.h−1, p = 0.001. Lidocaine reduced 24‐h morphine consumption by a mean (95% CI) of 13.9 (2.2–25.7) mg, p = 0.021, from a mean (SD) of 52.3 (26.9) mg with saline. There were no differences in other outcomes.
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Affiliation(s)
- L Weinberg
- Anaesthesia, Peri-operative and Pain Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - C Rachbuch
- Department of Anaesthesia, Eastern Health, Box Hill, Victoria, Australia
| | - S Ting
- Department of Anaesthesia, Monash Health, Clayton, Victoria, Australia
| | - W Howard
- Acute Pain Service, Austin Hospital, Heidelberg, Victoria, Australia.,Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia
| | - M Yeomans
- Acute Pain Service, Austin Hospital, Heidelberg, Victoria, Australia
| | - I Gordon
- School of Mathematics and Statistics, University of Melbourne, Melbourne, Victoria, Australia
| | - L McNicol
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.,Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia
| | - K James
- Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia
| | - D Story
- Anaesthesia, Peri-operative and Pain Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - C Christophi
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
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31
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Affiliation(s)
- S Ting
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| | - S T Schmid
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| | - S Synoracki
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| | - K W Schmid
- Institut für Pathologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Deutschland.
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32
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Abstract
Medullary thyroid carcinoma (MTC) is a very rare malignancy, which arises from parafollicular C cells and accounts for 3-5% of all thyroid cancers. MTC represents a neuroendocrine tumor with a biology that differs considerably from differentiated thyroid cancer. Presence of a RET proto-oncogene germline mutation indicates hereditary C cell disease in the context of multiple endocrine neoplasia type 2 and hence a special treatment algorithm is required. Cure of MTC is only possible through surgery. Calcitonin screening is advocated for early MTC diagnosis and preoperative MTC management stratification. In case of surgically incurable persistent MTC, estimation of calcitonin and CEA doubling time is crucial to assess tumor biology and is complemented by multimodal imaging to assess tumor burden. Treatment decisions in incurable MTC must be carefully balanced with treatment-related morbidity, since MTC may take an indolent course over years.
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Affiliation(s)
- V Tiedje
- Klinik für Endokrinologie und Stoffwechselerkrankungen, Medizinisches Zentrum, Universitätsklinikum Essen (AöR), Hufelandstr. 55, 45147, Essen, Deutschland,
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33
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Aubin HJ, Ting S, Meulien D, Torup L, François C, Luquiens A. P-81SECONDARY BENEFITS OF ALCOHOL REDUCTION WITH NALMEFENE. Alcohol Alcohol 2015. [DOI: 10.1093/alcalc/agv080.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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34
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Synoracki S, Ting S, Siebolts U, Dralle H, Koperek O, Schmid KW. Intraoperativer Gefrierschnitt der Schilddrüse. Pathologe 2015; 36:362-71. [DOI: 10.1007/s00292-015-0038-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Pogorzelski M, Ting S, Gauler T, Breitenbücher F, Vossebein I, Hoffarth S, Markowetz J, Lang S, Bergmann C, Brandau S, Abu-Jawad J, Schmid K, Schuler M, Kasper S. 39 Molecular dissection of the impact of frequent genetic alterations on the response of head and neck cancers to anti-epidermal growth factor receptor-directed therapies. Oral Oncol 2015. [DOI: 10.1016/j.oraloncology.2015.02.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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36
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Tiedje V, Ting S, Herold T, Walter R, Mairinger F, Worm K, Zwanziger D, Schmid KW, Führer D. Prognostic markers and response to vandetanib therapy in sporadic medullary thyroid cancer patients. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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37
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Tiedje V, Kroiß M, Lorenz K, Ting S, Stuschke M, Bauer S, Weber F, Brabant G, Fassnacht M, Schmid KW, Dralle H, Führer D. Protocol for the multimodal treatment of undifferentiated (anaplastic) thyroid carcinoma. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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38
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Zwanziger D, Rehn S, Ting S, Badziong J, Schmid KW, Moeller L, Führer D. The impact of claudin-1 in follicular thyroid carcinoma aggressiveness. Exp Clin Endocrinol Diabetes 2015. [DOI: 10.1055/s-0035-1547645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Walter RFH, Mairinger FD, Ting S, Vollbrecht C, Mairinger T, Theegarten D, Christoph DC, Schmid KW, Wohlschlaeger J. MDM2 is an important prognostic and predictive factor for platin-pemetrexed therapy in malignant pleural mesotheliomas and deregulation of P14/ARF (encoded by CDKN2A) seems to contribute to an MDM2-driven inactivation of P53. Br J Cancer 2015; 112:883-90. [PMID: 25668009 PMCID: PMC4453955 DOI: 10.1038/bjc.2015.27] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 08/01/2014] [Revised: 01/01/2015] [Accepted: 01/12/2015] [Indexed: 12/28/2022] Open
Abstract
Background: Malignant pleural mesothelioma (MPM) is a highly aggressive tumour that is
first-line treated with a combination of cisplatin and pemetrexed. Until
now, predictive and prognostic biomarkers are lacking, making it a
non-tailored therapy regimen with unknown outcome. P53 is frequently
inactivated in MPM, but mutations are extremely rare. MDM2 and P14/ARF
are upstream regulators of P53 that may contribute to P53 inactivation. Methods: A total of 72 MPM patients were investigated. MDM2 immunoexpression was
assessed in 65 patients. MDM2 and P14/ARF mRNA
expression was analysed in 48 patients of the overall collective. The
expression results were correlated to overall survival (OS) and
progression-free survival (PFS). Results: OS and PFS correlated highly significantly with MDM2 mRNA and protein
expression, showing a dismal prognosis for patients with elevated MDM2
expression (for OS: Score (logrank) test: P⩽0.002, and for PFS:
Score (logrank) test; P<0.007). MDM2 was identified as robust
prognostic and predictive biomarker for MPM on the mRNA and protein level.
P14/ARF mRNA expression reached no statistical
significance, but Kaplan–Meier curves distinguished patients with low
P14/ARF expression and hence shorter survival from patients
with higher expression and prolonged survival. Conclusions: MDM2 is a prognostic and predictive marker for a platin–pemetrexed
therapy of patients with MPMs. Downregulation of P14/ARF expression
seems to contribute to MDM2-overexpression-mediated P53 inactivation in MPM
patients.
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Affiliation(s)
- R F H Walter
- 1] Ruhrlandklinik, West German Lung Center, University Hospital Essen, University of Duisburg-Essen, Tüschener Weg 40, Essen D-45239, Germany [2] Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - F D Mairinger
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - S Ting
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - C Vollbrecht
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - T Mairinger
- Department of Pathology, Helios Klinikum Emil von Behring, Berlin, Germany
| | - D Theegarten
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - D C Christoph
- 1] Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany [2] Department of Medicine, Division of Medical Oncology, University of Colorado Denver, Aurora, CO, USA
| | - K W Schmid
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - J Wohlschlaeger
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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40
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Reis H, Herold T, Ting S, Worm K, Huber U, Christoph DC, Eberhardt WE, Kostbade K, Kasper S, Stamatis G, Welter S, Darwiche K, Karpf-Wissel R, Theegarten D, Schmid KW, Schuler M, Wiesweg M. HER2 expression and markers of phosphoinositide-3-kinase pathway activation define a favorable subgroup of metastatic pulmonary adenocarcinomas. Lung Cancer 2015; 88:34-41. [PMID: 25708529 DOI: 10.1016/j.lungcan.2015.02.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 01/04/2015] [Accepted: 02/01/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Pulmonary adenocarcinomas (ADC) can be sub-grouped based on dominant oncogenic drivers. EGFR mutations define an entity of metastatic ADC with favorable prognosis and high susceptibility to EGFR tyrosine kinase inhibition. In contrast, the clinical impact of additional ERBB family members in ADC is less defined. To this end we prospectively studied HER2 expression, gene amplification, and mutation in relation to outcome of patients with advanced or metastatic ADC. MATERIALS AND METHODS Diagnostic tumor biopsies from 193 sequential patients with stage III/IV ADC were prospectively studied for HER2 expression by immunohistochemistry (IHC). Cases with IHC scores 2+ or 3+ were analyzed by HER2 chromogenic in situ hybridization (CISH), and sequencing of HER2 exons 20 and 23. Additional prospectively determined biomarkers included PTEN, cMET, pAKT, and pERK expression, KRAS, EGFR, BRAF and PIK3CA mutations, and ALK fluorescence ISH (FISH). RESULTS AND CONCLUSION HER2-IHC was feasible in 176 (91.2%) cases. Of 53 (30%) cases with IHC scores 2+/3+, 45 (85%) could be studied by CISH and 34 (64%) by sequencing. The lower number of HER2-mutational analyses resulted from exhaustion of tumor tissue and DNA following mutational analysis of KRAS, EGFR, BRAF and PIK3CA. HER2 amplification was detected in 4 cases (2.3%), while no mutation was found. HER2 expression correlated with expression of pAKT and cMET. Expression of HER2 and pAKT was associated with favorable overall survival in stage IV disease. HER2-expressing ADC more frequently harbored KRAS mutations, while HER2 expression was absent in all 4 cases with BRAF mutation. HER2-IHC was not predictive of HER2 gene amplification or mutation, which both were rare events in prospectively studied patients with advanced or metastatic ADC. Expression of HER2 and pAKT define a population of patients with stage IV ADC with a distinct disease course, who could benefit from specifically tailored pharmacotherapies.
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Affiliation(s)
- H Reis
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - T Herold
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; German Cancer Research Center, 69120 Heidelberg, Germany; German Cancer Consortium (DKTK), 69120 Heidelberg, Germany
| | - S Ting
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - K Worm
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - U Huber
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - D C Christoph
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - W E Eberhardt
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; Division of Thoracic Oncology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, 45239 Essen, Germany
| | - K Kostbade
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - S Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - G Stamatis
- Division of Thoracic Surgery, Ruhrlandklinik, West German Lung Center, University Hospital Essen, 45239 Essen, Germany
| | - S Welter
- Division of Thoracic Surgery, Ruhrlandklinik, West German Lung Center, University Hospital Essen, 45239 Essen, Germany
| | - K Darwiche
- Division of Interventional Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, 45239 Essen, Germany
| | - R Karpf-Wissel
- Division of Interventional Pneumology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, 45239 Essen, Germany
| | - D Theegarten
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - K W Schmid
- Institute of Pathology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
| | - M Schuler
- German Cancer Consortium (DKTK), 69120 Heidelberg, Germany; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany; Division of Thoracic Oncology, Ruhrlandklinik, West German Lung Center, University Hospital Essen, 45239 Essen, Germany.
| | - M Wiesweg
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, 45122 Essen, Germany
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Li KC, Ting S, Prior DJ, Waddell JN, Swain MV. Microstructural analysis of Co-Cr dental alloy at the metal-porcelain interface: a pilot study. N Z Dent J 2014; 110:138-142. [PMID: 25597194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The purpose of the study was to observe whether conventional porcelain firings had an effect on the underlying microstructure of cobalt-chromium alloys used in porcelain-fused-to-metal systems. METHODS One as cast (non-veneered) and two porcelain veneered Co-Cr specimens layered with and without tungsten(W)-metal conditioner were manufactured and analysed. Electron backscatter diffraction was used to determine the crystal structures and grain size across the porcelain-fused-to-metal interface. RESULTS No difference was found in the microstructure of the alloy in both with and without W-metal conditioner. For the porcelain fired specimens, disparately sized granular structures were observed adjacent to the metal-porcelain interfaces compared to the bulk of the metal. Ellipsoid shaped grains at the alloy surface ranged between 1-11 μm in diameter and averaged 2.70 μm (SD: 2.17 μm) for the specimen layered with W-metal conditioner and 2.86 μm (SD: 1.85 μm) for the specimen layered without W-metal conditioner. Grains located in the bulk were > 200 μm with dendritic-like features. The depth of the fine grain structure adjacent to the surface had an average depth of 15 μm. The crystal structure of the surface layer was found to be predominantly hexagonal close-packed whereas the underlying bulk was a mixture of both face-centered cubic and hexagonal close-packed phases. For the as cast specimen, similar large grains of over 200 μm was observed but exhibited no dendritic like features. In addition, no fine grains were observed at the surface region of the as cast alloy. CONCLUSION Conventional porcelain firings altered the interfacial and bulk microstructure of the alloy while the presence of the W-metal conditioner had no influence on the underlying alloy microstructure.
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Darwiche K, Özkan F, Ting S, Johnen G, Brüning T, Soltermann A, Huber LC, Christoph DC, Freitag L, Franzen D. [Role of pretherapeutic biomarkers in lung cancer with special regards to bronchoscopic procedures]. Pneumologie 2014; 68:719-26. [PMID: 25003906 DOI: 10.1055/s-0034-1377299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Molecular biomarkers are becoming increasingly significant in the workup of lung carcinoma patients. They assist in diagnosis, selecting the most adequate therapy and determining prognosis. Obtaining blood based biomarkers or volatile markers in exhaled breath may provide a less invasive method in the future. For the time being, bronchoscopy is still the method of choice to obtain specimen and assess tissue based biomarkers. The techniques how specimen are collected and processed for analysis are of paramount importance.
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Affiliation(s)
- K Darwiche
- Abteilung für interventionelle Pneumologie, Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen
| | - F Özkan
- Abteilung für interventionelle Pneumologie, Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen
| | - S Ting
- Institut für Pathologie, Universitätsklinikum Essen
| | - G Johnen
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung (IPA), Institut der Ruhr-Universität Bochum
| | - T Brüning
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung (IPA), Institut der Ruhr-Universität Bochum
| | - A Soltermann
- Institut für klinische Pathologie, UniversitätsSpital Zürich, Schweiz
| | - L C Huber
- Klinik für Pneumologie, UniversitätsSpital Zürich, Schweiz
| | - D C Christoph
- Innere Klinik (Tumorforschung), Westdeutsches Tumorzentrum Essen, Universitätsklinikum Essen
| | - L Freitag
- Abteilung für interventionelle Pneumologie, Ruhrlandklinik, Westdeutsches Lungenzentrum am Universitätsklinikum Essen
| | - D Franzen
- Klinik für Pneumologie, UniversitätsSpital Zürich, Schweiz
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Mairinger F, Walter R, Werner R, Vollbrecht C, Ting S, Theegarten D, Christoph D, Schmid K, Wohlschlaeger J. 548: mRNA biomarker screening in pulmonary tumors showing neuroendocrine differentiation via NanoString nCounter. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50489-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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44
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Zwanziger D, Rehn S, Badziong J, Jaeger A, Ting S, Schmid KW, Führer D. The impact of claudin-1 on thyroid cancer invasion. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tiedje V, Ting S, Schmid KW, Moeller LC, Führer D. Aggressive treatment of a 51 year old patient with anaplastic thyroid cancer with over one year survival. Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Pogorzelski M, Ting S, Gauler TC, Breitenbuecher F, Vossebein I, Hoffarth S, Markowetz J, Lang S, Bergmann C, Brandau S, Jawad JA, Schmid KW, Schuler M, Kasper S. Impact of human papilloma virus infection on the response of head and neck cancers to anti-epidermal growth factor receptor antibody therapy. Cell Death Dis 2014; 5:e1091. [PMID: 24577089 PMCID: PMC3944273 DOI: 10.1038/cddis.2014.62] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [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: 12/17/2013] [Revised: 01/25/2014] [Accepted: 01/27/2014] [Indexed: 12/20/2022]
Abstract
Infection with human papillomaviruses (HPVs) characterizes a distinct subset of head and neck squamous cell cancers (HNSCCs). HPV-positive HNSCC preferentially affect the oropharynx and tonsils. Localized HPV-positive HNSCCs have a favorable prognosis and treatment outcome. However, the impact of HPV in advanced or metastatic HNSCC remains to be defined. In particular, it is unclear whether HPV modulates the response to cetuximab, an antibody targeting the epidermal growth factor receptor (EGFR), which is a mainstay of treatment of advanced HNSCC. To this end, we have examined the sensitivity of HPV-positive and -negative HNSCC models to cetuximab and cytotoxic drugs in vitro and in vivo. In addition, we have stably expressed the HPV oncogenes E6 and E7 in cetuximab-sensitive cancer cell lines to specifically investigate their role in the antibody response. The endogenous HPV status or the expression of HPV oncogenes had no significant impact on cetuximab-mediated suppression of EGFR signaling and proliferation in vitro. Cetuximab effectively inhibited the growth of E6- and E7-expressing tumors grafted in NOD/SCID mice. In support, formalin-fixed, paraffin-embedded tumor samples from cetuximab-treated patients with recurrent or metastatic HNSCC were probed for p16INK4a expression, an established biomarker of HPV infection. Response rates (45.5% versus 45.5%) and median progression-free survival (97 versus 92 days) following cetuximab-based therapy were similar in patients with p16INK4A-positive and p16INK4A-negative tumors. In conclusion, HPV oncogenes do not modulate the anti-EGFR antibody response in HSNCC. Cetuximab treatment should be administered independently of HPV status.
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Affiliation(s)
- M Pogorzelski
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - S Ting
- Institute of Pathology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - T C Gauler
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - F Breitenbuecher
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - I Vossebein
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - S Hoffarth
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - J Markowetz
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - S Lang
- Department of Otorhinolaryngology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - C Bergmann
- Department of Otorhinolaryngology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - S Brandau
- Department of Otorhinolaryngology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - J A Jawad
- Department of Radiotherapy, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - K W Schmid
- Institute of Pathology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - M Schuler
- 1] Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany [2] German Cancer Consortium (DKTK), Heidelberg, Germany
| | - S Kasper
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
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Hameed S, Ting S, Yan F, Ng H, Yeo D. Complementary and alternative medicine use among patients with cognitive impairment in Singapore. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gage H, Grainger L, Ting S, Williams P, Chorley C, Carey G, Borg N, Bryan K, Castleton B, Trend P, Kaye J, Khan S, Wade D. Care assistant support following specialist rehabilitation for people with Parkinson's and carers in the community: Findings from the SPIRIT RCT. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Liu JYW, Lai C, Dai D, Ting S, Choi K. Attitudes in the management of patients with dementia: comparison in doctors with and without special training. East Asian Arch Psychiatry 2013; 23:13-20. [PMID: 23535628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To explore by postal survey the different attitudes towards management of patients with dementia in physicians with and without dementia training. METHODS A questionnaire was sent to 7669 members of the Hong Kong Medical Association, which represents 61% of all locally registered medical practitioners. RESULTS In all, 448 questionnaires were returned (response rate: 6%). Among these, there were 34 questionnaires with missing data or the respondents indicated that they were either retired or not in practice. Therefore, only 414 questionnaires were used in analysis. Among these, 82 (20%) had received dementia training, 310 (75%) had not, and 22 (5%) did not indicate their choice. Twelve statements were used to explore various attitudes about dementia care. Exploratory factor analysis showed that there were 2 strong factors: confidence and negative views. The mean scores of these 2 factors were significantly different in physicians with and without dementia training. With respect to management of patients with dementia, dementia-trained physicians had significantly greater confidence (mean [standard deviation (SD)] = 5.21 [1.34]) than those who were non-trained (mean [SD] = 3.57 [1.40]; p < 0.001). Conversely, non-trained physicians had significantly stronger negative views (mean [SD] = 3.89 [1.24]) on dementia care than those who were trained (mean [SD] = 3.12 [1.36]; p < 0.001). DISCUSSION These findings suggest that providing a certain level of dementia care training for physicians is an effective way to improve confidence in managing patients with dementia, and thereby decrease possible negative attitudes towards such care.
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Affiliation(s)
- J Y W Liu
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China.
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50
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Funke F, Bonella F, Ting S, Wohlschläger J, Costabel U, Theegarten D. Todesursachen bei interstitiellen Lungenerkrankungen: Ergebnisse von 22 Obduktionen. Pneumologie 2013. [DOI: 10.1055/s-0033-1334693] [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]
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