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Contreras Yametti GP, Robbins G, Chowdhury A, Narang S, Ostrow TH, Kilberg H, Greenberg J, Kramer L, Raetz E, Tsirigos A, Evensen NA, Carroll WL. SETD2 mutations do not contribute to clonal fitness in response to chemotherapy in childhood B cell acute lymphoblastic leukemia. Leuk Lymphoma 2024; 65:78-90. [PMID: 37874744 DOI: 10.1080/10428194.2023.2273752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/14/2023] [Indexed: 10/26/2023]
Abstract
Mutations in genes encoding epigenetic regulators are commonly observed at relapse in B cell acute lymphoblastic leukemia (B-ALL). Loss-of-function mutations in SETD2, an H3K36 methyltransferase, have been observed in B-ALL and other cancers. Previous studies on mutated SETD2 in solid tumors and acute myelogenous leukemia support a role in promoting resistance to DNA damaging agents. We did not observe chemoresistance, an impaired DNA damage response, nor increased mutation frequency in response to thiopurines using CRISPR-mediated knockout in wild-type B-ALL cell lines. Likewise, restoration of SETD2 in cell lines with hemizygous mutations did not increase sensitivity. SETD2 mutations affected the chromatin landscape and transcriptional output that was unique to each cell line. Collectively our data does not support a role for SETD2 mutations in driving clonal evolution and relapse in B-ALL, which is consistent with the lack of enrichment of SETD2 mutations at relapse in most studies.
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Affiliation(s)
- Gloria P Contreras Yametti
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Gabriel Robbins
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Ashfiyah Chowdhury
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Sonali Narang
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Talia H Ostrow
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Harrison Kilberg
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Joshua Greenberg
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Lindsay Kramer
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Elizabeth Raetz
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Aristotelis Tsirigos
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - Nikki A Evensen
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
| | - William L Carroll
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
- Department of Pathology, NYU Langone Health, New York, NY, USA
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Narang S, Evensen NA, Saliba J, Pierro J, Loh ML, Brown PA, Kolekar P, Mulder H, Shao Y, Easton J, Ma X, Tsirigos A, Carroll WL. NSD2 E1099K drives relapse in pediatric acute lymphoblastic leukemia by disrupting 3D chromatin organization. Genome Biol 2023; 24:64. [PMID: 37016431 PMCID: PMC10071675 DOI: 10.1186/s13059-023-02905-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/20/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND The NSD2 p.E1099K (EK) mutation is shown to be enriched in patients with relapsed acute lymphoblastic leukemia (ALL), indicating a role in clonal evolution and drug resistance. RESULTS To uncover 3D chromatin architecture-related mechanisms underlying drug resistance, we perform Hi-C on three B-ALL cell lines heterozygous for NSD2 EK. The NSD2 mutation leads to widespread remodeling of the 3D genome, most dramatically in terms of compartment changes with a strong bias towards A compartment shifts. Systematic integration of the Hi-C data with previously published ATAC-seq, RNA-seq, and ChIP-seq data show an expansion in H3K36me2 and a shrinkage in H3K27me3 within A compartments as well as increased gene expression and chromatin accessibility. These results suggest that NSD2 EK plays a prominent role in chromatin decompaction through enrichment of H3K36me2. In contrast, we identify few changes in intra-topologically associating domain activity. While compartment changes vary across cell lines, a common core of decompacting loci are shared, driving the expression of genes/pathways previously implicated in drug resistance. We further perform RNA sequencing on a cohort of matched diagnosis/relapse ALL patients harboring the relapse-specific NSD2 EK mutation. Changes in patient gene expression upon relapse significantly correlate with core compartment changes, further implicating the role of NSD2 EK in genome decompaction. CONCLUSIONS In spite of cell-context-dependent changes mediated by EK, there appears to be a shared transcriptional program dependent on compartment shifts which could explain phenotypic differences across EK cell lines. This core program is an attractive target for therapeutic intervention.
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Affiliation(s)
- Sonali Narang
- Perlmutter Cancer Center, NYU Langone Health, Smilow 1211, 560 First Avenue, New York, NY, 10016, USA
| | - Nikki A Evensen
- Perlmutter Cancer Center, NYU Langone Health, Smilow 1211, 560 First Avenue, New York, NY, 10016, USA
| | - Jason Saliba
- Perlmutter Cancer Center, NYU Langone Health, Smilow 1211, 560 First Avenue, New York, NY, 10016, USA
| | - Joanna Pierro
- Northwell Health, Staten Island University Hospital, Staten Island, NY, USA
| | - Mignon L Loh
- Department of Pediatrics, Benioff Children's Hospital and The Helen Diller Family Comprehensive Cancer Center University of California, San Francisco, San Francisco, CA, USA
| | - Patrick A Brown
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pandurang Kolekar
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Heather Mulder
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ying Shao
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - John Easton
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Xiaotu Ma
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Aristotelis Tsirigos
- Perlmutter Cancer Center, NYU Langone Health, Smilow 1211, 560 First Avenue, New York, NY, 10016, USA.
- Department of Pathology, NYU Langone Health, New York, NY, USA.
- Perlmutter Cancer Center, NYU Langone Health, Science Building 800, 435 East 30th Street, New York, NY, 10016, USA.
| | - William L Carroll
- Perlmutter Cancer Center, NYU Langone Health, Smilow 1211, 560 First Avenue, New York, NY, 10016, USA.
- Department of Pediatrics, NYU Langone Health, New York, NY, USA.
- Division of Pediatric Hematology/Oncology, NYU Langone Health, New York, NY, USA.
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Jin Q, Gutierrez Diaz B, Pieters T, Zhou Y, Narang S, Fijalkwoski I, Borin C, Van Laere J, Payton M, Cho BK, Han C, Sun L, Serafin V, Yacu G, Von Loocke W, Basso G, Veltri G, Dreveny I, Ben-Sahra I, Goo YA, Safgren SL, Tsai YC, Bornhauser B, Suraneni PK, Gaspar-Maia A, Kandela I, Van Vlierberghe P, Crispino JD, Tsirigos A, Ntziachristos P. Oncogenic deubiquitination controls tyrosine kinase signaling and therapy response in acute lymphoblastic leukemia. Sci Adv 2022; 8:eabq8437. [PMID: 36490346 PMCID: PMC9733937 DOI: 10.1126/sciadv.abq8437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 11/03/2022] [Indexed: 06/17/2023]
Abstract
Dysregulation of kinase signaling pathways favors tumor cell survival and therapy resistance in cancer. Here, we reveal a posttranslational regulation of kinase signaling and nuclear receptor activity via deubiquitination in T cell acute lymphoblastic leukemia (T-ALL). We observed that the ubiquitin-specific protease 11 (USP11) is highly expressed and associates with poor prognosis in T-ALL. USP11 ablation inhibits leukemia progression in vivo, sparing normal hematopoiesis. USP11 forms a complex with USP7 to deubiquitinate the oncogenic lymphocyte cell-specific protein-tyrosine kinase (LCK) and enhance its activity. Impairment of LCK activity leads to increased glucocorticoid receptor (GR) expression and glucocorticoids sensitivity. Genetic knockout of USP7 improved the antileukemic efficacy of glucocorticoids in vivo. The transcriptional activation of GR target genes is orchestrated by the deubiquitinase activity and mediated via an increase in enhancer-promoter interaction intensity. Our data unveil how dysregulated deubiquitination controls leukemia survival and drug resistance, suggesting previously unidentified therapeutic combinations toward targeting leukemia.
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Affiliation(s)
- Qi Jin
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
- Simpson Querrey Center for Epigenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Blanca Gutierrez Diaz
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
- Simpson Querrey Center for Epigenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Tim Pieters
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University and University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Yalu Zhou
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
- Simpson Querrey Center for Epigenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sonali Narang
- Department of Pathology, New York University School of Medicine, New York, NY, USA
- Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
- Applied Bioinformatics Laboratories, Office of Science and Research, New York University School of Medicine, New York, NY, USA
| | - Igor Fijalkwoski
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University and University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Cristina Borin
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University and University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - Jolien Van Laere
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University and University Hospital, Ghent, Belgium
| | - Monique Payton
- Division of Experimental Hematology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Byoung-Kyu Cho
- Proteomics Center of Excellence, Northwestern University, Evanston, IL, USA
| | - Cuijuan Han
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
- Simpson Querrey Center for Epigenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Limin Sun
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
- Simpson Querrey Center for Epigenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Valentina Serafin
- Oncohematology Laboratory, Department of Women’s and Children’s Health, University of Padova, Padova, Italy
- Department of Surgery Oncology and Gastroenterology, Oncology and Immunology Section, University of Padova, Padova, Italy
| | - George Yacu
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
| | - Wouter Von Loocke
- Department of Pathology, New York University School of Medicine, New York, NY, USA
| | - Giuseppe Basso
- Oncohematology Laboratory, Department of Women’s and Children’s Health, University of Padova, Padova, Italy
- Department of Surgery Oncology and Gastroenterology, Oncology and Immunology Section, University of Padova, Padova, Italy
| | - Giulia Veltri
- Oncohematology Laboratory, Department of Women’s and Children’s Health, University of Padova, Padova, Italy
| | - Ingrid Dreveny
- School of Pharmacy, University of Nottingham, Nottingham NG7 2RD, UK
| | - Issam Ben-Sahra
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
- Simpson Querrey Center for Epigenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Young Ah Goo
- Department of Biochemistry and Molecular Genetics, Northwestern University, Chicago, IL, USA
- Simpson Querrey Center for Epigenetics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Proteomics Center of Excellence, Northwestern University, Evanston, IL, USA
| | - Stephanie L. Safgren
- Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Yi-Chien Tsai
- University Children’s Hospital, Division of Pediatric Oncology, University of Zurich, Zurich, Switzerland
| | - Beat Bornhauser
- University Children’s Hospital, Division of Pediatric Oncology, University of Zurich, Zurich, Switzerland
| | | | - Alexandre Gaspar-Maia
- Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Irawati Kandela
- Center for Developmental Therapeutics, Northwestern University, Evanston, IL, USA
| | - Pieter Van Vlierberghe
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University and University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
| | - John D. Crispino
- Division of Experimental Hematology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Aristotelis Tsirigos
- Department of Pathology, New York University School of Medicine, New York, NY, USA
- Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine, New York, NY, USA
- Applied Bioinformatics Laboratories, Office of Science and Research, New York University School of Medicine, New York, NY, USA
| | - Panagiotis Ntziachristos
- Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
- Center for Medical Genetics, Ghent University and University Hospital, Ghent, Belgium
- Cancer Research Institute Ghent (CRIG), Ghent, Belgium
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4
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Carcamo S, Nguyen CB, Grossi E, Filipescu D, Alpsoy A, Dhiman A, Sun D, Narang S, Imig J, Martin TC, Parsons R, Aifantis I, Tsirigos A, Aguirre-Ghiso JA, Dykhuizen EC, Hasson D, Bernstein E. Altered BAF occupancy and transcription factor dynamics in PBAF-deficient melanoma. Cell Rep 2022; 39:110637. [PMID: 35385731 PMCID: PMC9013128 DOI: 10.1016/j.celrep.2022.110637] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/04/2022] [Accepted: 03/16/2022] [Indexed: 12/25/2022] Open
Abstract
ARID2 is the most recurrently mutated SWI/SNF complex member in melanoma; however, its tumor-suppressive mechanisms in the context of the chromatin landscape remain to be elucidated. Here, we model ARID2 deficiency in melanoma cells, which results in defective PBAF complex assembly with a concomitant genomic redistribution of the BAF complex. Upon ARID2 depletion, a subset of PBAF and shared BAF-PBAF-occupied regions displays diminished chromatin accessibility and associated gene expression, while BAF-occupied enhancers gain chromatin accessibility and expression of genes linked to the process of invasion. As a function of altered accessibility, the genomic occupancy of melanoma-relevant transcription factors is affected and significantly correlates with the observed transcriptional changes. We further demonstrate that ARID2-deficient cells acquire the ability to colonize distal organs in multiple animal models. Taken together, our results reveal a role for ARID2 in mediating BAF and PBAF subcomplex chromatin dynamics with consequences for melanoma metastasis.
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Affiliation(s)
- Saul Carcamo
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Tisch Cancer Institute Bioinformatics for Next Generation Sequencing (BiNGS) Shared Resource Facility, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Christie B Nguyen
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Elena Grossi
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Dan Filipescu
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Aktan Alpsoy
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907, USA
| | - Alisha Dhiman
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907, USA
| | - Dan Sun
- Division of Hematology and Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Sonali Narang
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, New York, NY 10016, USA
| | - Jochen Imig
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, New York, NY 10016, USA
| | - Tiphaine C Martin
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Ramon Parsons
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Iannis Aifantis
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, New York, NY 10016, USA
| | - Aristotelis Tsirigos
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, New York, NY 10016, USA; Applied Bioinformatics Laboratories, NYU School of Medicine, New York, NY 10016, USA
| | - Julio A Aguirre-Ghiso
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Division of Hematology and Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Emily C Dykhuizen
- Department of Medicinal Chemistry and Molecular Pharmacology, Purdue University, West Lafayette, IN 47907, USA
| | - Dan Hasson
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Tisch Cancer Institute Bioinformatics for Next Generation Sequencing (BiNGS) Shared Resource Facility, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Emily Bernstein
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
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5
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Das S, Gupta C, Jain C, Rai G, Alqumber MAA, Singh PK, Sharma R, Tyagi A, Salhotra R, Narang S, Singh NP, Dar SA. Utility of serum Galactomannan in diagnosing COVID-19 patients with suspected IPA: an observational study in resource limited settings. Eur Rev Med Pharmacol Sci 2022; 26:710-714. [PMID: 35113446 DOI: 10.26355/eurrev_202201_27897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To study the utility of Galactomannan (GM) antigen as a screening marker for diagnosing invasive pulmonary aspergillosis (IPA) in coronavirus disease 2019 (COVID-19) patients. PATIENTS AND METHODS The serum samples from patients with severe COVID-19 diseases admitted to the Critical Care Unit were collected on the 5th day of admission for GM screening. The samples were analysed by enzyme linked immune sorbent assay (ELISA) and GM index of more than 1 was considered as positive. All GM positive patients were serially followed until discharge or death. RESULTS The GM was raised in serum of 12 out of 38 patients, indicating an incidence of possible COVID-19 associated IPA (CAPA) in 31.57% of patients. The median age of these CAPA patients was 56.5 years, males were significantly more affected than females. The inflammatory marker serum ferritin was raised in all 12 patients (median value of 713.74 ng/ml), while IL-6 was raised in 9 patients (median value of 54.13 ng/ml). None of these patients received antifungals. Their median length of hospital stay was 20 days (IQR: 12, 34 days). All these patients succumbed to the illness. CONCLUSIONS The serum GM appears to be sensitive diagnostic tool to identify early IPA in COVID-19 patients and pre-emptive antifungal therapy could play a role in salvaging these patients.
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Affiliation(s)
- S Das
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
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Pringle H, Donigiewicz U, Bennett M, Fowler GF, Walker E, Ball S, Narang S, Bethune RM. P61 Impact of the COVID-19 pandemic on the presentation and management of acute appendicitis: a single-centre analysis. BJS Open 2021. [PMCID: PMC8030173 DOI: 10.1093/bjsopen/zrab032.060] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction The COVID-19 pandemic has influenced the delivery of healthcare. In accordance with the UK Joint Royal Colleges’ advice the management of acute appendicitis (AA) changed with greater consideration for non-operative management (NOM) or open appendicectomy where operative management (OM) s sought. Our aim is to share our experience of the presentation, management and outcomes for patients presenting to our Trust with AA to guide care for future viral pandemics. Methods This single-centre retrospective cohort study included patients diagnosed with AA in March to July 2019 compared with March to July 2020. Medical records were used to evaluate demographics, inflammatory markers, imaging, severity, management, histology, length of stay (LOS), complications and 90-day outcomes. Results There were 149 and 125 patients in the 2019 and 2020 cohort, respectively. 14 patients (9.4%) had NOM in 2019 versus 31 patients (24.8%) in 2020 (p = 0.001). In the 2019 OM group 125 patients (92.6%) had laparoscopic appendicectomy versus 69 (73.4%) in 2020. 59 patients (39.6%) had a CT in 2019 versus 70 (56%) in 2020. The median LOS was 4 days (interquartile range (IQR) 3 to 6 days) in 2019 and 3 days (IQR 2 to 5 days) in 2020 (p = 0.03). Two patients in each year who received NOM had treatment failure (14.3% in 2019 and 6.5% in 2020). Three patients in 2019 who had OM had treatment failure (2.2%). Of 95 patients tested for COVID-19 all but one was negative. Conclusion During the COVID-19 pandemic there was no observed increase in severity of AA, patients had a shorter LOS and were more likely to have imaging. NOM proportionally increased with no observed change in outcomes.
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Affiliation(s)
| | | | | | | | | | - S Ball
- Royal Devon & Exeter Hospital
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7
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Wang E, Zhou H, Nadorp B, Cayanan G, Chen X, Yeaton AH, Nomikou S, Witkowski MT, Narang S, Kloetgen A, Thandapani P, Ravn-Boess N, Tsirigos A, Aifantis I. Surface antigen-guided CRISPR screens identify regulators of myeloid leukemia differentiation. Cell Stem Cell 2021; 28:718-731.e6. [PMID: 33450187 PMCID: PMC8145876 DOI: 10.1016/j.stem.2020.12.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 10/19/2020] [Accepted: 12/09/2020] [Indexed: 12/16/2022]
Abstract
Lack of cellular differentiation is a hallmark of many human cancers, including acute myeloid leukemia (AML). Strategies to overcome such a differentiation blockade are an approach for treating AML. To identify targets for differentiation-based therapies, we applied an integrated cell surface-based CRISPR platform to assess genes involved in maintaining the undifferentiated state of leukemia cells. Here we identify the RNA-binding protein ZFP36L2 as a critical regulator of AML maintenance and differentiation. Mechanistically, ZFP36L2 interacts with the 3' untranslated region of key myeloid maturation genes, including the ZFP36 paralogs, to promote their mRNA degradation and suppress terminal myeloid cell differentiation. Genetic inhibition of ZFP36L2 restores the mRNA stability of these targeted transcripts and ultimately triggers myeloid differentiation in leukemia cells. Epigenome profiling of several individuals with primary AML revealed enhancer modules near ZFP36L2 that associated with distinct AML cell states, establishing a coordinated epigenetic and post-transcriptional mechanism that shapes leukemic differentiation.
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Affiliation(s)
- Eric Wang
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA.
| | - Hua Zhou
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA; Applied Bioinformatics Laboratories, NYU School of Medicine, New York, NY 10016, USA
| | - Bettina Nadorp
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Geraldine Cayanan
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Xufeng Chen
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Anna H Yeaton
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Sofia Nomikou
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Matthew T Witkowski
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Sonali Narang
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Andreas Kloetgen
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Palaniraja Thandapani
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Niklas Ravn-Boess
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Aristotelis Tsirigos
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA; Applied Bioinformatics Laboratories, NYU School of Medicine, New York, NY 10016, USA; Institute for Computational Medicine, NYU School of Medicine, New York, NY 10016, USA
| | - Iannis Aifantis
- Department of Pathology and Laura & Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA.
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8
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Praveen M, Jain N, Raizada N, Sharma S, Narang S, Madhu SV. Anaemia in patients with type 2 diabetes mellitus without nephropathy is related to iron deficiency. Diabetes Metab Syndr 2020; 14:1837-1840. [PMID: 32961516 DOI: 10.1016/j.dsx.2020.09.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Iron deficiency anaemia, although well reported in diabetic nephropathy, has not been well studied in type 2 diabetes patients in the absence of nephropathy. We studied the prevalence of anaemia and iron deficiency in type 2 diabetes patients without nephropathy. MATERIAL AND METHODS A total of 89 patients were selected for this study. 24 h urine protein less than 500 mg was used as the criteria to rule out diabetic nephropathy. Complete hemogram, iron profile and high sensitivity C reactive protein (hs CRP) levels were performed in each patient.Functional iron deficiency (FID) was defined as serum ferritin more than 100 μg/l with serum transferrin less than 20% and total iron deficiency state was defined as serum ferritin less than 100 μg/l. RESULTS Fifteen patients (16.8%)had anaemia out of which 13 had total iron deficiency and one each had functional iron deficiency and normal iron status respectively. Assessment of the iron status overall showed that 49 patients had TID (55.05%), 16 had FID (17.9%)and 24 (27.05%) had normal iron status. The hs-CRP was significantly higher in those with iron deficiency. CONCLUSIONS The present study found a high prevalence of iron deficiency anaemia in type 2 diabetic patients even in the absence of nephropathy. Most of the diabetic subjects also displayed an iron deficiency state the cause of which needs further investigation.
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Affiliation(s)
- M Praveen
- Department of Medicine, University College of Medical Sciences (University of Delhi) & GTB Hospital, Dilshad Garden, Delhi, 110095, India
| | - N Jain
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Dilshad Garden, Delhi, 110095, India
| | - N Raizada
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Dilshad Garden, Delhi, 110095, India
| | - S Sharma
- Department of Pathology, University College of Medical Sciences (University of Delhi) & GTB Hospital, Dilshad Garden, Delhi, 110095, India
| | - S Narang
- Department of Medicine, University College of Medical Sciences (University of Delhi) & GTB Hospital, Dilshad Garden, Delhi, 110095, India
| | - S V Madhu
- Department of Endocrinology, Centre for Diabetes Endocrinology & Metabolism, University College of Medical Sciences (University of Delhi) & GTB Hospital, Dilshad Garden, Delhi, 110095, India.
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9
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Saint Fleur-Lominy S, Evensen NA, Bhatla T, Sethia G, Narang S, Choi JH, Ma X, Yang JJ, Kelly S, Raetz E, Harvey RC, Willman C, Loh ML, Hunger SP, Brown PA, Getz KM, Meydan C, Mason CE, Tsirigos A, Carroll WL. Evolution of the Epigenetic Landscape in Childhood B Acute Lymphoblastic Leukemia and Its Role in Drug Resistance. Cancer Res 2020; 80:5189-5202. [PMID: 33067268 DOI: 10.1158/0008-5472.can-20-1145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/13/2020] [Accepted: 10/12/2020] [Indexed: 11/16/2022]
Abstract
Although B-cell acute lymphoblastic leukemia (B-ALL) is the most common malignancy in children and while highly curable, it remains a leading cause of cancer-related mortality. The outgrowth of tumor subclones carrying mutations in genes responsible for resistance to therapy has led to a Darwinian model of clonal selection. Previous work has indicated that alterations in the epigenome might contribute to clonal selection, yet the extent to which the chromatin state is altered under the selective pressures of therapy is unknown. To address this, we performed chromatin immunoprecipitation, gene expression analysis, and enhanced reduced representation bisulfite sequencing on a cohort of paired diagnosis and relapse samples from individual patients who all but one relapsed within 36 months of initial diagnosis. The chromatin state at diagnosis varied widely among patients, while the majority of peaks remained stable between diagnosis and relapse. Yet a significant fraction was either lost or newly gained, with some patients showing few differences and others showing massive changes of the epigenetic state. Evolution of the epigenome was associated with pathways previously linked to therapy resistance as well as novel candidate pathways through alterations in pyrimidine biosynthesis and downregulation of polycomb repressive complex 2 targets. Three novel, relapse-specific superenhancers were shared by a majority of patients including one associated with S100A8, the top upregulated gene seen at relapse in childhood B-ALL. Overall, our results support a role of the epigenome in clonal evolution and uncover new candidate pathways associated with relapse. SIGNIFICANCE: This study suggests a major role for epigenetic mechanisms in driving clonal evolution in B-ALL and identifies novel pathways associated with drug resistance.
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Affiliation(s)
- Shella Saint Fleur-Lominy
- Perlmutter Cancer Center, NYU Langone Health, New York, New York.,Department of Medicine, NYU Langone Health, New York, New York
| | - Nikki A Evensen
- Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Teena Bhatla
- Department of Pediatrics, Children's Hospital of New Jersey at NBI, RWJBarnabas Health, Newark, New Jersey
| | - Gunjan Sethia
- Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Sonali Narang
- Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Jun H Choi
- Department of Medicine, NYU Langone Health, New York, New York
| | - Xiaotu Ma
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jun J Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Stephen Kelly
- Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Elizabeth Raetz
- Perlmutter Cancer Center, NYU Langone Health, New York, New York.,Department of Pediatrics, NYU Health, New York, New York
| | - Richard C Harvey
- University of New Mexico Comprehensive Cancer Center, Department of Pathology, University of New Mexico School of Medicine and Health Sciences Center, Albuquerque, New Mexico
| | - Cheryl Willman
- University of New Mexico Comprehensive Cancer Center, Department of Pathology, University of New Mexico School of Medicine and Health Sciences Center, Albuquerque, New Mexico
| | - Mignon L Loh
- Department of Pediatrics, UCSF Benioff Children's Hospital, San Francisco, California
| | - Stephen P Hunger
- Department of Pediatrics and the Center for Childhood Cancer Research, Children's Hospital of Philadelphia and The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Patrick A Brown
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kylie M Getz
- Department of Physiology and Biophysics and Institute for Computational Biomedicine and Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York
| | - Cem Meydan
- Department of Physiology and Biophysics and Institute for Computational Biomedicine and Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York
| | - Christopher E Mason
- Department of Physiology and Biophysics and Institute for Computational Biomedicine and Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York
| | - Aristotelis Tsirigos
- Perlmutter Cancer Center, NYU Langone Health, New York, New York. .,Department of Pathology, NYU Langone Health, New York, New York
| | - William L Carroll
- Perlmutter Cancer Center, NYU Langone Health, New York, New York. .,Department of Pediatrics, NYU Health, New York, New York.,Department of Pathology, NYU Langone Health, New York, New York
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10
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Pierro J, Saliba J, Narang S, Sethia G, Fleur-Lominy SS, Chowdhury A, Moriyama T, Schmiegelow K, Yang JJ, Loh ML, Brown PA, Zhang J, Ma X, Tsirigos A, Evensen NA, Carroll WL. Abstract 5399: The NSD2 p.E1099K mutation is enriched at relapse and confers drug resistance in a cell context dependent manner in pediatric acute lymphoblastic leukemia. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-5399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Outcomes for children with relapsed acute lymphoblastic leukemia (ALL) remain poor. Mutations in epigenetic modifiers are commonly found at relapse, including the activating p.E1099K (EK) mutation within the conserved SET domain of NSD2, which has been reported in 10% of patients at relapse. NSD2 has 3 isoforms, two of which (Types II and REIIBP) contain the SET domain. Our aim was to determine the role of NSD2 in driving relapse and further elucidate the prevalence of NSD2 EK in patient samples.
Methods: Whole genome/exome sequencing was performed on diagnosis/relapse ALL pairs and data were aggregated for somatic SNVs/indels. NSD2 EK positive cases at relapse were subject to ultra-deep targeted re-sequencing to determine the presence of small subclones at diagnosis. To investigate the role of NSD2 and its isoforms in mediating relapse, short hairpin RNAs (shRNAs) were used to knockdown (KD) NSD2 in three NSD2 EK mutant cell lines with non-targeting (NT) shRNA used as controls. Cells were treated with chemotherapy commonly used in pediatric ALL and assessed for cytotoxicity by CellTiter- Glo®. To determine NSD2's impact on gene expression and the epigenetic landscape, RNAseq, ChIPseq, ATACseq, and Hi-C were performed using standard techniques.
Results: Examination of paired ALL patient samples revealed enrichment of NSD2 EK clones at relapse. B-ALL cell lines heterozygous for NSD2 EK (RS4;11, RCH-ACV, SEM) revealed that KD led to decreased proliferation in all lines and decreased clonal growth in RCH-ACV relative to NT. Furthermore, increased sensitivity to various chemotherapeutic agents was observed in the KD lines compared to NT controls, but the pattern of drug sensitivity varied among lines implying cell context specific drug responses. Simultaneous knockdown of Type II and REIIBP had a greater impact than Type II alone, indicating both SET containing EK isoforms contribute to phenotypic changes. When comparing gene expression changes in NT vs KD, minimal overlap in differential genes was noted among the three cell lines (4.4% upregulated, 1.7% downregulated) indicating significant diversity in transcriptional reprogramming. ATACseq of the NT and KD for all three lines revealed intergenic regions as the most affected by NSD2 with RCH-ACV and RS4;11 NT lines having more open chromatin compared to their KD whereas SEM NT displayed marked peak loss compared to its KD. Less than 2% of differential intergenic regions were shared among the lines. Hi-C analysis demonstrated disparity in chromosome architecture among NSD2 EK lines as well. Shifts in intergenic regions was further supported by ChIPseq, which revealed increased H3K36me2 across intergenic regions in RS4;11 NT compared to KD. Lastly, we noted a strong correlation of increased gene expression with increased H3K36me2, H3K9ac, and H3K27ac at promoters and gene bodies.
Conclusions: NSD2 EK plays a unique role in mediating clonal fitness through pleiotropic mechanisms that are dependent on the underlying cellular context.
Citation Format: Joanna Pierro, Jason Saliba, Sonali Narang, Gunjan Sethia, Shella Saint Fleur-Lominy, Ashfiyah Chowdhury, Takaya Moriyama, Kjeld Schmiegelow, Jun J. Yang, Mignon L. Loh, Patrick A. Brown, Jinghui Zhang, Xiaotu Ma, Aristotelis Tsirigos, Nikki A. Evensen, William L. Carroll. The NSD2 p.E1099K mutation is enriched at relapse and confers drug resistance in a cell context dependent manner in pediatric acute lymphoblastic leukemia [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 5399.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Jun J. Yang
- 2St. Jude Children's Research Hospital, Memphis, TN
| | - Mignon L. Loh
- 4Benioff Children's Hospital and The Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
| | - Patrick A. Brown
- 5The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | | | - Xiaotu Ma
- 2St. Jude Children's Research Hospital, Memphis, TN
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11
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Saliba J, Evensen NA, Meyer JA, Newman D, Nersting J, Narang S, Ma X, Schmiegelow K, Carroll WL. Feasibility of monitoring peripheral blood to detect emerging clones in children with acute lymphoblastic leukemia †. Pediatr Blood Cancer 2020; 67:e28306. [PMID: 32391957 DOI: 10.1002/pbc.28306] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/26/2020] [Accepted: 03/15/2020] [Indexed: 11/09/2022]
Abstract
Relapse-enriched somatic variants drive drug resistance in childhood acute lymphoblastic leukemia. We used digital droplet-based polymerase chain reaction to establish whether relapse-enriched mutations in emerging subclones could be detected in peripheral blood samples before frank relapse. Although limitations in sensitivity for some probes hindered detection of certain variants, we successfully detected variants in NT5C2 and PRPS1 at a fractional abundance of 0.005% to 0.3%, 41 to 116 days before relapse. As mutations in both these genes confer resistance to thiopurines, early detection protocols using peripheral blood could be implemented to preemptively alter maintenance therapy to extinguish resistant clones before overt relapse.
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Affiliation(s)
- Jason Saliba
- Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York.,Department of Pathology, Perlmutter Cancer Center, NYU Langone Health, New York
| | - Nikki A Evensen
- Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York.,Department of Pathology, Perlmutter Cancer Center, NYU Langone Health, New York
| | - Julia A Meyer
- Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Daniel Newman
- Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York.,Department of Pathology, Perlmutter Cancer Center, NYU Langone Health, New York
| | - Jacob Nersting
- Department of Pediatrics and Adolescent Medicine, The University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Sonali Narang
- Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York.,Department of Pathology, Perlmutter Cancer Center, NYU Langone Health, New York
| | - Xiaotu Ma
- St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The University Hospital Rigshospitalet, Copenhagen, Denmark.,Faculty of Medicine, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - William L Carroll
- Department of Pediatrics, Perlmutter Cancer Center, NYU Langone Health, New York.,Department of Pathology, Perlmutter Cancer Center, NYU Langone Health, New York.,Division of Pediatric Hematology/Oncology, NYU Langone Health, New York
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12
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Pierro J, Saliba J, Narang S, Sethia G, Saint Fleur-Lominy S, Chowdhury A, Qualls A, Fay H, Kilberg HL, Moriyama T, Fuller TJ, Teachey DT, Schmiegelow K, Yang JJ, Loh ML, Brown PA, Zhang J, Ma X, Tsirigos A, Evensen NA, Carroll WL. The NSD2 p.E1099K Mutation Is Enriched at Relapse and Confers Drug Resistance in a Cell Context-Dependent Manner in Pediatric Acute Lymphoblastic Leukemia. Mol Cancer Res 2020; 18:1153-1165. [PMID: 32332049 DOI: 10.1158/1541-7786.mcr-20-0092] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/10/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022]
Abstract
The NSD2 p.E1099K (EK) mutation is observed in 10% of acute lymphoblastic leukemia (ALL) samples with enrichment at relapse indicating a role in clonal evolution and drug resistance. To discover mechanisms that mediate clonal expansion, we engineered B-precursor ALL (B-ALL) cell lines (Reh, 697) to overexpress wildtype (WT) and EK NSD2, but observed no differences in proliferation, clonal growth, or chemosensitivity. To address whether NSD2 EK acts collaboratively with other pathways, we used short hairpin RNAs to knockdown expression of NSD2 in B-ALL cell lines heterozygous for NSD2 EK (RS4;11, RCH-ACV, SEM). Knockdown resulted in decreased proliferation in all lines, decreased clonal growth in RCH-ACV, and increased sensitivity to cytotoxic chemotherapeutic agents, although the pattern of drug sensitivity varied among cell lines implying that the oncogenic properties of NSD2 mutations are likely cell context specific and rely on cooperative pathways. Knockdown of both Type II and REIIBP EK isoforms had a greater impact than knockdown of Type II alone, suggesting that both SET containing EK isoforms contribute to phenotypic changes driving relapse. Furthermore, in vivo models using both cell lines and patient samples revealed dramatically enhanced proliferation of NSD2 EK compared with WT and reduced sensitivity to 6-mercaptopurine in the relapse sample relative to diagnosis. Finally, EK-mediated changes in chromatin state and transcriptional output differed dramatically among cell lines further supporting a cell context-specific role of NSD2 EK. These results demonstrate a unique role of NSD2 EK in mediating clonal fitness through pleiotropic mechanisms dependent on the genetic and epigenetic landscape. IMPLICATIONS: NSD2 EK mutation leads to drug resistance and a clonal advantage in childhood B-ALL.
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Affiliation(s)
- Joanna Pierro
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York.,Division of Pediatric Hematology/Oncology, Hassenfeld Children's Hospital at NYU Langone Health, New York, New York
| | - Jason Saliba
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Sonali Narang
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Gunjan Sethia
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Shella Saint Fleur-Lominy
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York.,Division of Medical Hematology/Oncology, NYU Langone Health, New York, New York
| | - Ashfiyah Chowdhury
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Anita Qualls
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Hannah Fay
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Harrison L Kilberg
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Takaya Moriyama
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Tori J Fuller
- Department of Pediatrics and the Center for Childhood Cancer Research, Children's Hospital of Philadelphia and The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania
| | - David T Teachey
- Department of Pediatrics and the Center for Childhood Cancer Research, Children's Hospital of Philadelphia and The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kjeld Schmiegelow
- Department of Pediatrics and Adolescent Medicine, The University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Jun J Yang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Mignon L Loh
- Department of Pediatrics, Benioff Children's Hospital and The Helen Diller Family Comprehensive Cancer Center University of California, San Francisco, San Francisco, California
| | - Patrick A Brown
- The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jinghui Zhang
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Xiaotu Ma
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Aristotelis Tsirigos
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - Nikki A Evensen
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York
| | - William L Carroll
- Departments of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, New York. .,Division of Pediatric Hematology/Oncology, Hassenfeld Children's Hospital at NYU Langone Health, New York, New York
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13
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Humphries AC, Narang S, Mlodzik M. Mutations associated with human neural tube defects display disrupted planar cell polarity in Drosophila. eLife 2020; 9:e53532. [PMID: 32234212 PMCID: PMC7180057 DOI: 10.7554/elife.53532] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
Planar cell polarity (PCP) and neural tube defects (NTDs) are linked, with a subset of NTD patients found to harbor mutations in PCP genes, but there is limited data on whether these mutations disrupt PCP signaling in vivo. The core PCP gene Van Gogh (Vang), Vangl1/2 in mammals, is the most specific for PCP. We thus addressed potential causality of NTD-associated Vangl1/2 mutations, from either mouse or human patients, in Drosophila allowing intricate analysis of the PCP pathway. Introducing the respective mammalian mutations into Drosophila Vang revealed defective phenotypic and functional behaviors, with changes to Vang localization, post-translational modification, and mechanistic function, such as its ability to interact with PCP effectors. Our findings provide mechanistic insight into how different mammalian mutations contribute to developmental disorders and strengthen the link between PCP and NTD. Importantly, analyses of the human mutations revealed that each is a causative factor for the associated NTD.
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Affiliation(s)
- Ashley C Humphries
- Department of Cell, Developmental and Regenerative BiologyNew YorkUnited States
- Icahn School of Medicine at Mount SinaiNew YorkUnited States
- Graduate School of Biomedical SciencesNew YorkUnited States
| | - Sonali Narang
- Department of Cell, Developmental and Regenerative BiologyNew YorkUnited States
- Icahn School of Medicine at Mount SinaiNew YorkUnited States
- Graduate School of Biomedical SciencesNew YorkUnited States
| | - Marek Mlodzik
- Department of Cell, Developmental and Regenerative BiologyNew YorkUnited States
- Icahn School of Medicine at Mount SinaiNew YorkUnited States
- Graduate School of Biomedical SciencesNew YorkUnited States
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14
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Sakellaropoulos T, Vougas K, Narang S, Koinis F, Kotsinas A, Polyzos A, Moss TJ, Piha-Paul S, Zhou H, Kardala E, Damianidou E, Alexopoulos LG, Aifantis I, Townsend PA, Panayiotidis MI, Sfikakis P, Bartek J, Fitzgerald RC, Thanos D, Mills Shaw KR, Petty R, Tsirigos A, Gorgoulis VG. A Deep Learning Framework for Predicting Response to Therapy in Cancer. Cell Rep 2019; 29:3367-3373.e4. [PMID: 31825821 DOI: 10.1016/j.celrep.2019.11.017] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/16/2019] [Accepted: 11/05/2019] [Indexed: 02/07/2023] Open
Abstract
A major challenge in cancer treatment is predicting clinical response to anti-cancer drugs on a personalized basis. Using a pharmacogenomics database of 1,001 cancer cell lines, we trained deep neural networks for prediction of drug response and assessed their performance on multiple clinical cohorts. We demonstrate that deep neural networks outperform the current state in machine learning frameworks. We provide a proof of concept for the use of deep neural network-based frameworks to aid precision oncology strategies.
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Affiliation(s)
- Theodore Sakellaropoulos
- Department of Pathology, NYU School of Medicine, New York, NY 10016, USA; Laura and Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Konstantinos Vougas
- Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou Str., Athens 11527, Greece; Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece.
| | - Sonali Narang
- Department of Pathology, NYU School of Medicine, New York, NY 10016, USA; Laura and Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Filippos Koinis
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece
| | - Athanassios Kotsinas
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece
| | - Alexander Polyzos
- Sanford I. Weill Department of Medicine, Sandra and Edward Meyer Cancer Center, Weill Cornell Medicine, New York, NY 10021, USA
| | - Tyler J Moss
- Sheikh Khalifa Bin Zayed al Nahyan Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Sarina Piha-Paul
- Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Hua Zhou
- Applied Bioinformatics Laboratories, NYU School of Medicine, New York, NY 10016, USA
| | - Eleni Kardala
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece
| | - Eleni Damianidou
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece
| | - Leonidas G Alexopoulos
- School of Mechanical Engineering, National Technical University of Athens, Zografou 15780, Greece
| | - Iannis Aifantis
- Department of Pathology, NYU School of Medicine, New York, NY 10016, USA; Laura and Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA
| | - Paul A Townsend
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester Cancer Research Centre, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester M20 4GJ, UK
| | - Mihalis I Panayiotidis
- Department of Applied Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK; Department of Electron Microscopy & Molecular Pathology, Cyprus Institute of Neurology & Genetics, Nicosia, 2371, Cyprus
| | - Petros Sfikakis
- 1st Department of Propaedeutic Internal Medicine, Medical School, Laikon Hospital, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece; Center for New Biotechnologies and Precision Medicine, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece
| | - Jiri Bartek
- Genome Integrity Unit, Danish Cancer Society Research Centre, Strandboulevarden 49, Copenhagen 2100, Denmark; Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Hněvotínská, Olomouc 1333/5 779 00, Czech Republic; Science for Life Laboratory, Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institute, Stockholm SE-171 77, Sweden
| | - Rebecca C Fitzgerald
- Medical Research Council Cancer Unit, Hutchison/Medical Research Council Research Centre, University of Cambridge, Cambridge CB2 0XZ, UK
| | - Dimitris Thanos
- Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou Str., Athens 11527, Greece
| | - Kenna R Mills Shaw
- Sheikh Khalifa Bin Zayed al Nahyan Institute for Personalized Cancer Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Russell Petty
- Division of Molecular and Clinical Medicine, Ninewells Hospital and School of Medicine, University of Dundee, Dundee DD1 9SY, UK
| | - Aristotelis Tsirigos
- Department of Pathology, NYU School of Medicine, New York, NY 10016, USA; Laura and Isaac Perlmutter Cancer Center, NYU School of Medicine, New York, NY 10016, USA; Applied Bioinformatics Laboratories, NYU School of Medicine, New York, NY 10016, USA.
| | - Vassilis G Gorgoulis
- Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou Str., Athens 11527, Greece; Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, Manchester Cancer Research Centre, NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester M20 4GJ, UK; 1st Department of Propaedeutic Internal Medicine, Medical School, Laikon Hospital, National and Kapodistrian University of Athens, 75 Mikras Asias Str., Athens 11527, Greece.
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15
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Chen X, Glytsou C, Zhou H, Narang S, Reyna DE, Lopez A, Sakellaropoulos T, Gong Y, Kloetgen A, Yap YS, Wang E, Gavathiotis E, Tsirigos A, Tibes R, Aifantis I. Targeting Mitochondrial Structure Sensitizes Acute Myeloid Leukemia to Venetoclax Treatment. Cancer Discov 2019; 9:890-909. [PMID: 31048321 DOI: 10.1158/2159-8290.cd-19-0117] [Citation(s) in RCA: 158] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/15/2019] [Accepted: 04/30/2019] [Indexed: 02/06/2023]
Abstract
The BCL2 family plays important roles in acute myeloid leukemia (AML). Venetoclax, a selective BCL2 inhibitor, has received FDA approval for the treatment of AML. However, drug resistance ensues after prolonged treatment, highlighting the need for a greater understanding of the underlying mechanisms. Using a genome-wide CRISPR/Cas9 screen in human AML, we identified genes whose inactivation sensitizes AML blasts to venetoclax. Genes involved in mitochondrial organization and function were significantly depleted throughout our screen, including the mitochondrial chaperonin CLPB. We demonstrated that CLPB is upregulated in human AML, it is further induced upon acquisition of venetoclax resistance, and its ablation sensitizes AML to venetoclax. Mechanistically, CLPB maintains the mitochondrial cristae structure via its interaction with the cristae-shaping protein OPA1, whereas its loss promotes apoptosis by inducing cristae remodeling and mitochondrial stress responses. Overall, our data suggest that targeting mitochondrial architecture may provide a promising approach to circumvent venetoclax resistance. SIGNIFICANCE: A genome-wide CRISPR/Cas9 screen reveals genes involved in mitochondrial biological processes participate in the acquisition of venetoclax resistance. Loss of the mitochondrial protein CLPB leads to structural and functional defects of mitochondria, hence sensitizing AML cells to apoptosis. Targeting CLPB synergizes with venetoclax and the venetoclax/azacitidine combination in AML in a p53-independent manner.See related commentary by Savona and Rathmell, p. 831.This article is highlighted in the In This Issue feature, p. 813.
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Affiliation(s)
- Xufeng Chen
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York
| | - Christina Glytsou
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York
| | - Hua Zhou
- Applied Bioinformatics Laboratories, NYU School of Medicine, New York, New York
| | - Sonali Narang
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York
| | - Denis E Reyna
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York.,Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.,Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York
| | - Andrea Lopez
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York.,Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.,Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York
| | - Theodore Sakellaropoulos
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York
| | - Yixiao Gong
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York.,Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andreas Kloetgen
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York
| | - Yoon Sing Yap
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York
| | - Eric Wang
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York
| | - Evripidis Gavathiotis
- Department of Biochemistry, Albert Einstein College of Medicine, Bronx, New York.,Department of Medicine, Albert Einstein College of Medicine, Bronx, New York.,Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York
| | - Aristotelis Tsirigos
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York.,Applied Bioinformatics Laboratories, NYU School of Medicine, New York, New York
| | - Raoul Tibes
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York.
| | - Iannis Aifantis
- Department of Pathology, NYU Langone Health and NYU School of Medicine, New York, New York. .,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health and NYU School of Medicine, New York, New York
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16
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Narang S, Raju SK, Kumar R. ABC analysis of anti cancer drugs in a tertiary care Employees’ State Insurance Corporation Hospital in Delhi. ACTA ACUST UNITED AC 2018. [DOI: 10.18203/2394-6040.ijcmph20181727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Material management is co-ordinated activities comprising of planning, acquiring, storing and controlling the supply of various items for optimal use. Effective inventory management can bring about a substantial decrease in expenditure. ABC analysis categorizes all items based on their annual drug expenditure into three categories A, B and C for better control by different level managers.Methods: ABC analysis for anticancer drugs was done in ESIC Hospital, Basaidarapur which is a tertiary care hospital of ESI Corporation in Delhi. Total number of drugs analysed were 98 with total annual expenditure of Rupees 5.77 crores approximately.Results: 12.2% (n=12), 16.3% (n=16) and 71.4% (n=70) items were found to be in A, B and C categories respectively.Conclusions: ABC analysis identified the drugs which need more strict control by top level management. Inventory control techniques should be an integral part of any hospital store.
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17
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Farooqi A, Narang S, Li J, Bishop A, McAleer M, Tatsui C, Rhines L, Amini B, Ghia A. Early Outcomes of a Novel Hypofractionated Dose Escalated Spine Simultaneous Integrated Boost Technique for Treatment of Metastatic Lesions Not Amenable to Spine Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.763] [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: 11/24/2022]
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18
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Lee J, Aristophanous M, Akhtari M, Milgrom S, Bouthaina D, Pinnix C, Narang S, Rao A, Court L, Smith G. SU-F-R-14: PET Based Radiomics to Predict Outcomes in Patients with Hodgkin Lymphoma. Med Phys 2016. [DOI: 10.1118/1.4955786] [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: 11/07/2022] Open
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19
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Kubota T, Mizuta T, Katagiri H, Shimaguchi M, Okumura K, Sakamoto T, Sakata T, Kunisaki S, Matsumoto R, Nishida K, Schaprynsky V, Vorovsky O, Romanchuk V, Basta M, Fischer J, Wink J, Kovach S, Tan WB, Tang SW, Clara ES, Hu J, Wijerathne S, Cheah WK, Shabbir A, Lomanto D, Siawash M, de Jager-Kieviet JWA, Tjon A Ten W, Roumen RM, Scheltinga MR, van Assen T, Boelens OB, van Eerten PV, Perquin C, DeAsis F, Salabat M, Leung D, Schindler N, Robicsek A, Denham W, Ujiki M, Bauder A, Mackay D, Maggiori L, Moszkowicz D, Zappa M, Mongin C, Panis Y, Köhler G, Hofmann A, Lechner M, Mayer F, Emmanuel K, Fortelny R, Gruber-Blum S, May C, Glaser K, Redl H, Petter-Puchner A, Narang S, Alam N, Campain N, McGrath J, Daniels IR, Smart NJ. Complex Cases in Abdominal Wall Repair and Prophilactic Mesh. Hernia 2015; 19 Suppl 1:S133-7. [PMID: 26518790 DOI: 10.1007/bf03355340] [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: 11/28/2022]
Affiliation(s)
- T Kubota
- Tokyo Bay Medical Center, Urayasu, Japan
| | - T Mizuta
- Tokyo Bay Medical Center, Urayasu, Japan
| | - H Katagiri
- Tokyo Bay Medical Center, Urayasu, Japan
| | | | - K Okumura
- Tokyo Bay Medical Center, Urayasu, Japan
| | - T Sakamoto
- Tokyo Bay Medical Center, Urayasu, Japan
| | - T Sakata
- Tokyo Bay Medical Center, Urayasu, Japan
| | - S Kunisaki
- Tokyo Bay Medical Center, Urayasu, Japan
| | | | - K Nishida
- Yokosuka Uwamachi Hospital, Yokosuka, Japan
| | - V Schaprynsky
- National Pirogov Memorial Medical University Vinnitsa, Vinnitsa, Ukraine
| | - O Vorovsky
- National Pirogov Memorial Medical University Vinnitsa, Vinnitsa, Ukraine
| | - V Romanchuk
- National Pirogov Memorial Medical University Vinnitsa, Vinnitsa, Ukraine
| | - M Basta
- University of Pennsylvania Health System, Philadelphia, USA
| | - J Fischer
- University of Pennsylvania Health System, Philadelphia, USA.,Hospital of the University of Pennsylvania, Philadelphia, USA
| | - J Wink
- University of Pennsylvania Health System, Philadelphia, USA
| | - S Kovach
- University of Pennsylvania Health System, Philadelphia, USA.,Hospital of the University of Pennsylvania, Philadelphia, USA
| | - W B Tan
- Minimally Invasive Surgical Center - Department of Surgery, National University Health System, Singapore, Singapore
| | - S W Tang
- Minimally Invasive Surgical Center - Department of Surgery, National University Health System, Singapore, Singapore
| | - E Sta Clara
- Minimally Invasive Surgical Center - Department of Surgery, National University Health System, Singapore, Singapore
| | - J Hu
- Minimally Invasive Surgical Center - Department of Surgery, National University Health System, Singapore, Singapore
| | - S Wijerathne
- Minimally Invasive Surgical Center - Department of Surgery, National University Health System, Singapore, Singapore
| | - W K Cheah
- Minimally Invasive Surgical Center - Department of Surgery, National University Health System, Singapore, Singapore
| | - A Shabbir
- Minimally Invasive Surgical Center - Department of Surgery, National University Health System, Singapore, Singapore
| | - D Lomanto
- Minimally Invasive Surgical Center - Department of Surgery, National University Health System, Singapore, Singapore
| | - M Siawash
- Department of Surgery, Máxima Medical Center, Veldhoven, Netherlands
| | | | - W Tjon A Ten
- Department of Pediatrics, Máxima Medical Center, Veldhoven, Netherlands
| | - R M Roumen
- Department of Surgery, Máxima Medical Center, Veldhoven, Netherlands.,Máxima Medical Center, Veldhoven, Netherlands.,Center of Excellence for Abdominal Wall and Groin Pain, SolviMáx, Eindhoven, Netherlands
| | - M R Scheltinga
- Department of Surgery, Máxima Medical Center, Veldhoven, Netherlands.,Máxima Medical Center, Veldhoven, Netherlands.,Center of Excellence for Abdominal Wall and Groin Pain, SolviMáx, Eindhoven, Netherlands
| | - T van Assen
- Máxima Medical Center, Veldhoven, Netherlands
| | - O B Boelens
- Maasziekenhuis Pantein, Boxmeer, Netherlands
| | - P V van Eerten
- Máxima Medical Center, Veldhoven, Netherlands.,Center of Excellence for Abdominal Wall and Groin Pain, SolviMáx, Eindhoven, Netherlands
| | - C Perquin
- Máxima Medical Center, Veldhoven, Netherlands.,Center of Excellence for Abdominal Wall and Groin Pain, SolviMáx, Eindhoven, Netherlands
| | - F DeAsis
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA
| | - M Salabat
- Department of Surgery, University Chicago Pritzker School of Medicine, Chicago, USA
| | - D Leung
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA
| | - N Schindler
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA.,Department of Surgery, University Chicago Pritzker School of Medicine, Chicago, USA
| | - A Robicsek
- Department of Clinical Analytics, NorthShore University HealthSystem, Evanston, USA.,Department of Surgery, University Chicago Pritzker School of Medicine, Chicago, USA
| | - W Denham
- Department of Surgery, NorthShore University HealthSystem, Evanston, USA.,Department of Surgery, University Chicago Pritzker School of Medicine, Chicago, USA
| | - M Ujiki
- Department of Surgery, University Chicago Pritzker School of Medicine, Chicago, USA
| | - A Bauder
- Hospital of the University of Pennsylvania, Philadelphia, USA
| | - D Mackay
- Hospital of the University of Pennsylvania, Philadelphia, USA
| | - L Maggiori
- Colorectal Surgery, Hopital Beaujon, Clichy, France
| | - D Moszkowicz
- Colorectal Surgery, Hopital Beaujon, Clichy, France
| | - M Zappa
- Radiology, Hopital Beaujon, Clichy, France
| | - C Mongin
- Colorectal Surgery, Hopital Beaujon, Clichy, France
| | - Y Panis
- Colorectal Surgery, Hopital Beaujon, Clichy, France
| | - G Köhler
- Department of General and Visceral Surgery, Sisters of Charity Hospital, Linz, Austria
| | - A Hofmann
- Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, Austria
| | - M Lechner
- Department of Surgery, Paracelsus Medical University, Salzburg, Austria
| | - F Mayer
- Department of Surgery, Paracelsus Medical University, Salzburg, Austria
| | - K Emmanuel
- Department of General and Visceral Surgery, Sisters of Charity Hospital, Linz, Austria
| | - R Fortelny
- Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, Austria
| | - S Gruber-Blum
- Cluster of Tissue engeneering, Ludwig Boltzmann Institute of Traumatology, Vienna, Austria
| | - C May
- Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, Austria
| | - K Glaser
- Department of General, Visceral and Oncological Surgery, Wilhelminenspital, Vienna, Austria
| | - H Redl
- Cluster of Tissue engeneering, Ludwig Boltzmann Institute of Traumatology, Vienna, Austria
| | - A Petter-Puchner
- Department of Surgery, Paracelsus Medical University, Salzburg, Austria
| | - S Narang
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - N Alam
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - N Campain
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - J McGrath
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - I R Daniels
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - N J Smart
- Exeter Surgical Health Services Research Unit (HeSRU), Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
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Harlaar J, Deerenberg EB, Dwarkasing RS, Kamperman AM, Jeekel J, Lange JF, Samartsev VA, Gavrilov VA, Kuchumov AG, Nyashin YI, Vildeman VE, Slovikov SV, Rubtsova EA, Parshakov AA, Morawski J, Miller A, Kallenberger G, Hannen C, Strey CW, Robin A, López-Monclús J, Melero D, Blazquez L, Moreno A, Palencia N, Cruz A, López-Quindós P, Aguilera A, Jimenez C, Becerra R, García M, Galván A, Gonzalez E, García-Ureña MA, Costa T, Abdalla R, Garcia R, Costa R, Williams Z, Kotwall C, Tenzel P, Alam N, Narang S, Pathak S, Daniels I, Smart N, Guérin G, Ordrenneau C, Bouré L, Turquier F, Abbonante F. Abdominal Wall "Closure". Hernia 2015; 19 Suppl 1:S123-6. [PMID: 26518787 DOI: 10.1007/bf03355338] [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: 11/28/2022]
Affiliation(s)
- J Harlaar
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - E B Deerenberg
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - R S Dwarkasing
- Department of Radiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - A M Kamperman
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J Jeekel
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - J F Lange
- Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - V A Samartsev
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - V A Gavrilov
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - A G Kuchumov
- Perm National Research Polytechnical University, Perm, Russia
| | - Y I Nyashin
- Perm National Research Polytechnical University, Perm, Russia
| | - V E Vildeman
- Perm National Research Polytechnical University, Perm, Russia
| | - S V Slovikov
- Perm National Research Polytechnical University, Perm, Russia
| | - E A Rubtsova
- Perm State National Research University, Perm, Russia
| | - A A Parshakov
- Perm State Medical University named after ac. E.A Wagner, Perm, Russia
| | - J Morawski
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - A Miller
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | | | - C Hannen
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - C W Strey
- Diakoniekrankenhaus Friederikenstift, Hannover, Germany
| | - A Robin
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - D Melero
- Hospital del Henares, Coslada (Madrid), Spain
| | - L Blazquez
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Moreno
- Hospital del Henares, Coslada (Madrid), Spain
| | - N Palencia
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Cruz
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - A Aguilera
- Hospital del Henares, Coslada (Madrid), Spain
| | - C Jimenez
- Hospital del Henares, Coslada (Madrid), Spain
| | - R Becerra
- Hospital del Henares, Coslada (Madrid), Spain
| | - M García
- Hospital del Henares, Coslada (Madrid), Spain
| | - A Galván
- Hospital del Henares, Coslada (Madrid), Spain
| | - E Gonzalez
- Hospital del Henares, Coslada (Madrid), Spain
| | | | - T Costa
- University of Sao Paulo, Sao Paulo, Brazil
| | - R Abdalla
- University of Sao Paulo, Sao Paulo, Brazil
| | - R Garcia
- Hospital Sirio Libanes, Sao Paulo, Brazil
| | - R Costa
- Hospital Sirio Libanes, Sao Paulo, Brazil
| | - Z Williams
- New Hanover Regional Medical Center, Wilmington, USA
| | - C Kotwall
- New Hanover Regional Medical Center, Wilmington, USA
| | - P Tenzel
- New Hanover Regional Medical Center, Wilmington, USA
| | - N Alam
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - S Narang
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - S Pathak
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - I Daniels
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | - N Smart
- HeSRU, Royal Devon and Exeter Hospital, Exeter, UK
| | | | | | | | | | - F Abbonante
- Department of Surgery-Plastic Surgery, Catanzaro City Hospital, Catanzaro, Italy
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Yang D, Narang S, Rao G, Martinez J, Rao A. NI-84 * MOLECULAR CHARACTERISTICS UNDERLYING THE RADIOLOGICALLY-DEFINED VOLUMETRIC COMPOSITION OF GLIOBLASTOMA. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou264.82] [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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22
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Narang S, Rao G, Heimberger A, Martinez J, Rao A. IB-08 * COMPUTATIONAL IMAGING FEATURES DERIVED FROM MRI IMAGES OF THE BRAIN CAN DISCRIMINATE IMMUNE SIGNATURE STATUS IN GLIOBLASTOMA MULTIFORME (GBM). Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou257.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Narang S, Sood S, Kaur B, Singh R, Mallik A, Kaur J. Atorvastatin in clinically-significant macular edema in diabetics with a normal lipid profile. Nepal J Ophthalmol 2013; 4:23-8. [PMID: 22343992 DOI: 10.3126/nepjoph.v4i1.5846] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Lipid-lowering drugs preserve vision and reduce the risk of hard exudates in clinically-significant macular edema(CSME) in diabetics with an abnormal lipid profile. But their role in reducing CSME in diabetics with a normal lipid profile is not yet known. OBJECTIVE To evaluate the role of atorvastatin in CSME in diabetics with a normal lipid profile. MATERIALS AND METHODS A prospective, randomized clinical trial was carried out. Thirty CSME patients with a normal lipid profile were randomly divided into Group A and B. Atorvastatin had been started in Group A four weeks prior to laser treatment. The main outcome measures were any improvement or deterioration in visual acuity and macular edema and hard exudates at six months follow-up. STATISTICS Both the groups were compared using unpaired t test for quantitative parameters and chi-square test for qualitative parameters. A p value of less than 0.05 was taken as significant. RESULTS Visual acuity, macular edema and hard exudates resolution was not significantly different in the two groups (P = 0.14, 0.62, 0.39 respectively). CONCLUSION Atorvastatin does not affect treatment outcome in CSME with a normal lipid profile over a short term follow-up.
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Affiliation(s)
- S Narang
- Government Medical College Hospital, Chandigarh, India.
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Abstract
BACKGROUND Pupillary abnormalities with complete or incomplete form of VKH have rarely been reported. We report a case of "probable" Vogt- Koyanagi-Haradas (VKH) disease associated with tonic pupils. CASE A young healthy male presented with 15 days' history of bilateral decrease in vision. The patient had bilateral panuveitis with exudative retinal detachment associated with tonic pupils. There were no other systemic associations. The ultrasonography and fluorescein angiography findings were consistent with VKH disease. CONCLUSION Pupillary reaction abnormalities though uncommon could be seen in association with "probable" VKH disease.
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Affiliation(s)
- S Narang
- Department of Ophthalmology, Government Medical College, Chandigarh, India.
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Abstract
INTRODUCTION Endophthalmitis is the most dreaded complication of ocular trauma and knowledge of the microbial contaminants is essential to start empirical antibiotic therapy. PURPOSE To determine incidence of contamination after open globe injuries (OGI) in our setup and to identify the spectrum of microorganisms contaminating open globe injuries. MATERIAL AND METHODS A prospective study including 50 consecutive eyes of open globe injury over a period of two years was conducted. Intra-operatively, 4 - 5 samples were taken from the inferior conjunctival sac and anterior chamber at the beginning and end of the open globe injury repair. Any abscised tissue or foreign body was also sent for culture sensitivity. A vitreous tap was taken from eyes with posterior segment trauma with signs of endophthalmitis. RESULTS Microbial cultures were positive in13 eyes (26 %). The microbial spectrum included Aspergillus species in 45.6 %, Alternaria in 15.2 %, Curvularia in 15.2 %, Staphylococcus aureus in 7.6 %, Bacillus species in 7.6 %, and Streptococcus pneumoniae in 7.6 %. Of these 13 eyes, nine eyes developed clinically evident frank endophthalmitis during follow-up. Overall, endophthalmitis developed in 20 eyes (40 %). There was a significant association between the initial contamination and development of endophthalmitis (p less than 0.05). 53 % of culture positive cases achieved ambulatory vision compared to 73 % of culture-negative cases. CONCLUSION Initial contamination was seen in 26 % of OGI cases. Aspergillus (fungus) was the commonest contaminant. There was a strong correlation between the initial contamination and development of endophthalmitis. Culture-negative cases had a trend towards better final visual outcome than culture-positive cases. Close follow up of cases showing contamination following OGI is recommended.
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Affiliation(s)
- S Bhala
- Department of Ophthalmology and Microbiology, Government Medical College Hospital, Chandigarh, India.
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Guenther BA, Brown JM, Siddiqui AP, Narang S. Ramped Target Presentation Increases the Magnitude of Location-Based Inhibition of Return. J Vis 2011. [DOI: 10.1167/11.11.125] [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: 11/24/2022] Open
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Siddiqui A, Brown J, Guenther B, Narang S. Reducing expectations: Is an extension of current boundary extension theories needed? J Vis 2011. [DOI: 10.1167/11.11.1128] [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: 11/24/2022] Open
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Guenther BA, Brown JM, Narang S, Siddiqui AP. Studying object-based attention with a steady/pulsed-pedestal paradigm. J Vis 2010. [DOI: 10.1167/10.7.175] [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: 11/24/2022] Open
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Guenther BA, Narang S, Siddiqui AP, Brown JM. Exploring the causes of object effects on location-based inhibition of return when using spatial frequency specific cues and targets. J Vis 2010. [DOI: 10.1167/9.8.226] [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: 11/24/2022] Open
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Siddiqui AP, Narang S, Guenther BA, Brown JM. The time-course of covert cuing using spatial frequency targets. J Vis 2010. [DOI: 10.1167/9.8.232] [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: 11/24/2022] Open
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Bhagwat A, Taneja S, Singal N, Narang S. Point-of-care device: a word of caution. Anaesth Intensive Care 2009; 37:138-139. [PMID: 19160554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Narang S, Dali JS, Agarwal M, Garg R. Evaluation of the efficacy of magnesium sulphate as an adjuvant to lignocaine for intravenous regional anaesthesia for upper limb surgery. Anaesth Intensive Care 2008; 36:840-4. [PMID: 19115654 DOI: 10.1177/0310057x0803600614] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Several additives have been combined with local anaesthetics for intravenous regional anaesthesia to improve block quality, analgesia and to decrease tourniquet pain. Magnesium sulphate is one potential additive. This prospective, randomised, double-blinded study was conducted in 30 ASA physical status I or II patients undergoing upper limb surgery under tourniquet. In group L, patients received intravenous regional anaesthesia with lignocaine alone (9 ml of 2% lignocaine diluted with normal saline to total volume of 36 ml). Patients in group M received intravenous regional anaesthesia with lignocaine plus magnesium sulphate (6 ml of 25% magnesium sulphate plus 9 ml of 2% lignocaine diluted with normal saline to total volume of 36 ml). Assessment was by observing the response to injection of drug; sensory and motor block and tourniquet pain. The mean time of onset of sensory block was 12.40 and 3.47 minutes in groups L and M respectively (P < 0.001). The average times of onset of motor block in groups L and M were 17 and six minutes respectively (P < 0.001). Of the patients in group M, 66.7% reported moderate to severe pain while the drug was being injected, compared to 20% in group L (P=0.011). There was a statistically significant difference in visual analogue scale for tourniquet pain at 10 and 30 minutes after tourniquet inflation (lower in group M). These findings indicate that magnesium sulphate added as an adjuvant to lignocaine hastens the onset of sensory and motor block and decreases tourniquet pain. However there is increased incidence of transient pain on injection if magnesium sulphate is added.
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Affiliation(s)
- S Narang
- Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi, India
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Bhagwat AG, Saxena K, Narang S, Jain S. 'Universal' leak test? Anaesth Intensive Care 2008; 36:912-913. [PMID: 19117091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Abstract
The purpose of this study was to determine the prevalence of intestinal parasites in HIV patients with or without diarrhoea and to see an association between diarrhoea and the coccidian parasites in our setting. Stool samples from 113 HIV patients, 34 chronic diarrhoea and 79 without any history of diarrhoea were collected and examined for enteric parasites by microscopy. One hundred and thirteen control samples from HIV negative patients complaining of prolonged diarrhoea were also collected and analysed. Prevalence of coccidian parasites in HIV and non-HIV patients; with and without diarrhoea was compared using chi-square tests. Enteric parasites were detected in 55.8% HIV patients with diarrhoea compared to 16.4% in patients without diarrhoea (P<0.001). Isospora belli was found in 41.1% (14/34) of chronic diarrhoea and 6.3% (5/79) in non-diarrhoeal cases (P<0.001). Cryptosporidium was detected in 20.6% (7/34) of chronic diarrhoea and 2.5% (2/79) in non-diarrhoeal cases (P<0.001). Cyclospora cayetanensis associated diarrhoea was detected in only one case of chronic diarrhoea (2.9%). CD4+ T-cell count was lower (180 cells/microL) in diarrhoeal HIV patients as compared to non-diarrhoeal patients. Coccidian parasites were seen at a mean CD4+ T-cell count of 186.3 cells/microL. This study concluded that Isospora belli was the predominant parasite followed by Cryptosporidium spp. and both were strongly associated with diarrhoea among HIV patients.
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Affiliation(s)
- S Gupta
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi-110 029, India
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Dwivedi S, Rajpal S, Narang S. Cardiotoxic Manifestations of Yellow Oleander (Thevetia nerifolia) Poisoning and its Treatment: A Case Report. Indian Heart J 2006; 58:450-451. [PMID: 19057059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
A 30-year-'old female came to the hospital with complaints of vomiting, drowsiness and bradycardia after ingesting five seeds of yellow oleander (Thevetia nerifolia - pila kaner) with the intent of committing suicide. Whereas the usual complication is hyperkalemia, she was suffering from hypokalemia. She responded to conventional treatment, consisting of atropine and correction of electrolytes. This report discusses the cardiotoxic and neurotoxic manifestations of yellow oleander poisoning, its early diagnosis and prompt treatment. We would like to emphasize the importance of taking an electrocardiogram in all cases of poisoning.
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Affiliation(s)
- S Dwivedi
- Department of Medicine, University College of Medical Sciences and GTB Hospital, Delhi
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Narang S, Handa U, Nanda A, Bansal R, Nahar R, Sood S. Primary intravitreal hydatid cyst: diagnosis on cytological examination. Ann Trop Med Parasitol 2006; 100:371-4. [PMID: 16762117 DOI: 10.1179/136485906x91495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- S Narang
- Department of Ophthalmology, Government Medical College Hospital, Sector 32, Chandigarh 160 030, India.
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Narang S, Sahai V, Bisaria VS. Optimization of xylanase production by Melanocarpus albomyces IIS68 in solid state fermentation using response surface methodology. J Biosci Bioeng 2005; 91:425-7. [PMID: 16233017 DOI: 10.1263/jbb.91.425] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2000] [Accepted: 01/30/2001] [Indexed: 11/17/2022]
Abstract
Xylanase production by the thermophilic fungus, Melanocarpus albomyces IIS68, during solid state fermentation of wheat straw was studied and the effects of various variables were observed. Using the response surface methodology and the multivariant statistical approach, the optimum levels of the variables affecting xylanase production were determined. The optimum levels of the variables were 600-850 microm particle size, 43 h inoculum age, 1.37% Tween 80, 86% initial moisture content, 5.1% urea, 0.74% yeast extract and a harvest time of 96 h. Under these optimized conditions, xylanase activity of 7760 U/g initial dry substrate was obtained which was in very good agreement with the value predicted by the quadratic model (7890 U/g initial dry substrate).
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Affiliation(s)
- S Narang
- Department of Biochemical Engineering and Biotechnology, Indian Institute of technology, Delhi, Hauz Khas, New Delhi-110016, India
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Sharma A, Samal A, Narang S, Gutpa A, Ram J, Gupta A. Frequency doubled Nd:YAG (532 nm) laser photocoagulation in corneal vascularisation: efficacy and time sequenced changes. Indian J Ophthalmol 2001; 49:235-40. [PMID: 12930115] [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: 03/04/2023] Open
Abstract
PURPOSE To evaluate the efficacy of frequency-doubled Nd:YAG (532 nm) laser treatment in quiescent corneal vascularisation, and to record the sequential changes in lasered vessels and complications in eyes with one and two quadrant vascularisation. METHODS Thirty eyes (30 patients)--15 eyes (15 patients) with one-quadrant and 15 eyes (15 patients) with two-quadrant corneal vascularisation were treated. Frequency-doubled Nd:YAG laser (532 nm) was used at laser setting of 120-480 mw power, 50-150 mm spot size and 0.05 sec pulse duration. The area of corneal vascularisation, status of treated corneal vessels, area of corneal opacity and visual acuity were recorded before treatment, at one week after treatment and thereafter at monthly intervals up to three months. RESULTS The mean area of corneal vascularisation decreased from 20.09% to 8.31% of the total corneal area in group I (p<0.01) and from 44.34% to 20.67% of the total corneal area in group II (p<0.01) at 3 months' follow-up. The mean reduction in the area of corneal vascularisation was 58.64% in group I and 53.38% in group II (p>0.05). Of 148 corneal vessels treated, 60 (44.6%) were totally occluded, 44 (30%) partially occluded, 37 (28%) recanalized and there was one shunt vessel at one week following laser treatment. At three months' follow-up, 80 (54.15%) vessels were totally occluded, 14 (9%) partially occluded, 52 (35.14%) recanalised and two shunt vessels appeared. Thus, at three months' follow-up, the number of totally occluded vessels increased and partially occluded vessels decreased. Superficial corneal haemorrhage was observed in 4 (14%) patients. CONCLUSION Frequency-doubled Nd:YAG (532 nm) laser photocoagulation appears a safe and effective means of reducing the area of corneal vascularisation in quiescent eyes with vascularised corneal opacities.
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Affiliation(s)
- A Sharma
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Narang S, Gupta A, Gupta V, Dogra MR, Ram J, Pandav SS, Chakrabarti A. Fungal endophthalmitis following cataract surgery: clinical presentation, microbiological spectrum, and outcome. Am J Ophthalmol 2001; 132:609-17. [PMID: 11704021 DOI: 10.1016/s0002-9394(01)01180-1] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine the clinical presentation, microbiological spectrum, and outcome in cases of fungal endophthalmitis following cataract surgery. DESIGN Observational case series. METHODS SETTING Tertiary referral hospital. PATIENTS Retrospective analysis of 27 cases of smear- and culture-proven fungal endophthalmitis. INTERVENTION Pars plana vitrectomy in 18 eyes, where the corneal condition did not preclude the same. All eyes received intravitreal amphotericin B and dexamethasone along with systemic antifungal agents. MAIN OUTCOME MEASURES Functional success: Final visual acuity of 3/60 or better with attached retina. Anatomical success: Final visual acuity of better than light perception with preserved anatomy of globe. RESULTS The majority of the eyes (22 of the 27) had early onset and diffuse presentation (that is, anterior segment as well as posterior vitreous exudates). Substantial corneal involvement was seen in 14 eyes (51.85%). Aspergillus sp. was the most common isolate. Multivariate analysis using forward stepwise logistic regression showed corneal involvement as the single most important risk factor in determining final visual outcome (P =.0429). CONCLUSIONS Early onset and diffuse presentation, which mimics bacterial endophthalmitis, stresses the importance of both bacterial and fungal cultures from intraocular fluids to reach a diagnosis apart from the clinical judgment. Corneal involvement was the most important predictor of outcome in cases of fungal endophthalmitis.
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Affiliation(s)
- S Narang
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, 160012, Chandigarh, India
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Abstract
Advances in technique and equipment have led to a significant increase in the popularity of phacoemulsification and have increased its safety and efficiency. We describe a technique, phakonit, in which the lens is emulsified through a 0.9 mm clear corneal temporal incision. A cortical wash with bimanual irrigation/aspiration is followed by enlarging the incision to 2.0 mm and inserting a Staar sub-2.0 mm foldable intraocular lens. Phakonit is a safe, precise method of phacoemulsification with minimal intraoperative or postoperative complications.
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Affiliation(s)
- A Agarwal
- Dr. Agarwal's Eye Hospital, 19 Cathedral Road, Chennai, India.
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Narang S, Rajeshwari S, Khalid S. A case of sick sinus syndrome presenting for emergency surgery. Middle East J Anaesthesiol 2001; 16:365-70. [PMID: 11789471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Affiliation(s)
- S Narang
- Department of Anaesthesia, Nizwa Hospital, Ministry of Health, Postal Code: 611 post, box 1222, Oman
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Munjal S, Gujral M, Narang S. Lingual cysticercosis--a case report. INDIAN J PATHOL MICR 2001; 44:459. [PMID: 12035365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Cysticercosis is unlikely to be the first diagnosis for a swelling over the tongue. In this report we document an unusual case of lingual cysticercosis presenting as an isolated lesion.
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Affiliation(s)
- S Munjal
- Department of Pathology, MGM Medical College, Indore, MP
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Abstract
Anesthesia for patients with mediastinal masses carries a significant risk for fatal or near-fatal cardiorespiratory events. Careful history taking and thorough preoperative investigation, including CT, identify most susceptible patients. Preoperative fiberoptic bronchoscopy performed by or involving the anesthesiologist is invaluable for determining the plan for intubation and ventilation. A coordinated approach involving anesthesiologists and surgeons is essential.
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Affiliation(s)
- S Narang
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Gupta V, Gupta A, Kaur R, Narang S, Dogra MR. Efficacy of various laser wavelengths in the treatment of clinically significant macular edema in diabetics. Ophthalmic Surg Lasers 2001; 32:397-405. [PMID: 11563784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
BACKGROUND AND OBJECTIVE To compare various laser wavelengths: argon green (514 nm), vs krypton red (647 nm), vs frequency doubled Nd:YAG (532 nm), and vs diode (810 nm), for laser photocoagulation treatment in clinically significant macular edema (CSME) in diabetics. PATIENTS AND METHODS Four different wavelengths were used to sequentially treat 271 eyes of 164 diabetic patients with CSME. Follow up was conducted for a minimum of 6 months (9.8 +/- 1.3 months). Retreatment was performed if residual edema involving the foveal avascular zone persisted at 3 months. RESULTS Reduction/elimination of CSME was observed in 93.3% of argon-treated eyes, 88.5% in krypton red group, 92.9% with frequency doubled Nd:YAG, and 84.8% with diode laser with no statistically significant difference between the groups (P > 0.05 for all groups). The number of eyes requiring retreatment was highest with the diode laser having 44.3% of eyes requiring retreatment and least with frequency doubled Nd:YAG having only 15.5% of eyes requiring retreatment (P = 0.0002). CONCLUSIONS All lasers are equally effective in reducing/eliminating CSME. However, Nd:YAG may have an advantage because of requiring fewer retreatments.
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Affiliation(s)
- V Gupta
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Gupta A, Narang S, Gupta V, Sharma A, Pandav SS, Singh P. Successful closure of spontaneous scleral fistula in retinochoroidal coloboma. Arch Ophthalmol 2001; 119:1220-1. [PMID: 11483101 DOI: 10.1001/archopht.119.8.1220] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- A Gupta
- Department of Ophthalmology, PGIMER, Chandigarh, India.
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Dogra MR, Narang S, Biswas C, Gupta A, Narang A. Threshold retinopathy of prematurity: ocular changes and sequelae following cryotherapy. Indian J Ophthalmol 2001; 49:97-101. [PMID: 15884513] [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: 05/02/2023] Open
Abstract
PURPOSE To determine ocular changes and sequelae following cryotherapy for threshold retinopathy of prematurity (ROP). METHODS This is a retrospective study of 49 eyes of 26 premature babies with threshold ROP treated with cryotherapy between 1995 and 1998. All eyes included in the study had favourable structural outcome after cryotherapy. Follow-up examination of all babies was done 12 - 62 months (average 28 months) after cryotherapy. Visual axis, fixation pattern, anterior segment examination, cycloplegic refraction and dilated fundus examination with indirect ophthalmoscopy were undertaken in all eyes during follow-up. RESULTS Posterior pole retinal residuae observed following cryotherapy were tortousity of blood vessels in 32 (65.3%), narrow temporal arcade in 22 (44.89%), temporal crescent in 17 (34.69%), disc drag in 13 (26.53%) and macular heterotopia in 7 (14.28%) eyes. Myopia was observed in 20 (40.82%) eyes and strabismus in 5 (19.23%) babies. The significant risk factor for ocular changes was ROP with more clock hours of involvement (p < 0.05). Higher period of gestation was associated with posterior pole changes (p< 0.05). CONCLUSIONS All premature babies with threshold ROP treated with cryotherapy require frequent and long-term follow up to look for retinal residuae, refractive status, and ocular motility disorders.
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Affiliation(s)
- M R Dogra
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Kaushik S, Ram J, Dogra MR, Narang S, Brar GS, Gupta A. Traumatic lens abscess with chornic endophthalmitis successfully treated with pars plana lensectomy and vitrectomy. Ophthalmic Surg Lasers 2001; 32:239-42. [PMID: 11371092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Intralenticular abscess is a rare entity and has been infrequently reported after surgery, metastatic infection, or trauma. We report a case of post traumatic lens abscess with low-grade endophthalmitis following a penetrating eye injury with a splinter of wood. The patient was successfully treated with a pars plana lensectomy and vitrectomy. Despite thorough microbiological investigations, no causative organism could be isolated.
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Affiliation(s)
- S Kaushik
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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