1.Robotic Prostatectomy: What We Have Learned and Where We Are Going.
Yonsei Medical Journal 2009;50(2):177-181
Radical prostatectomy became a mainstay of treatment for prostate cancer in the United States after the pioneering work of Walsh in defining the nerve sparing technique. Efforts to reproduce this operation in a minimally invasive fashion resulted in slow progress that recently have flourished with the application of the daVinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) by Menon and colleagues. This article summarizes the origins of robotic prostatectomy, some of the current data regarding this operation and potential future directions.
Humans
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Male
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Prostatectomy/*methods
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Prostatic Neoplasms/*surgery
;
*Robotics
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Surgical Procedures, Minimally Invasive/*methods
2.Prospective Characterization of Cognitive Function in Typical and ‘Brainstem Predominant'Progressive Supranuclear Palsy Phenotypes
Young Eun C LEE ; David R WILLIAMS ; Jacqueline F I ANDERSON
Journal of Movement Disorders 2018;11(2):72-77
OBJECTIVE: Clinicopathological studies over the last decade have broadened the clinical spectrum of progressive supranuclear palsy (PSP) to include several distinct clinical syndromes. We examined the cognitive profiles of patients with PSP-Richardson's syndrome (PSP-RS) and two atypical ‘brainstem predominant' PSP phenotypes (PSP-parkinsonism, PSP-P; and PSP-pure akinesia with gait freezing, PSP-PAGF) using a comprehensive neuropsychological battery. METHODS: Fourteen patients diagnosed as PSP-RS, three patients with PSP-P and four patients with PSP-PAGF were assessed using a comprehensive battery of neuropsychological tests.
Cognition
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Executive Function
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Freezing
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Gait
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Humans
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Neuropsychological Tests
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Neuropsychology
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Paralysis
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Phenotype
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Prospective Studies
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Supranuclear Palsy, Progressive
3.Prevalence of incidental distal biceps signal changes on magnetic resonance imaging
Eugene KIM ; Joost T.P. KORTLEVER ; Amanda I. GONZALEZ ; David RING ; Lee M. REICHEL
Clinics in Shoulder and Elbow 2023;26(3):260-266
Background:
Knowledge of the base rate of signal changes consistent with distal biceps tendinopathy on magnetic resonance imaging (MRI) has the potential to influence strategies for diagnosis and treatment of people that present with elbow pain. The aim of this study is to measure the prevalence of distal biceps tendon signal changes on MRIs of the elbow by indication for imaging.
Methods:
MRI data for 1,306 elbows were retrospectively reviewed for mention of signal change in distal biceps tendon. The reports were sorted by indication.
Results:
Signal changes consistent with distal biceps tendinopathy were noted in 197 of 1,306 (15%) patients, including 34% of patients with biceps pain, 14% of patients with unspecified pain, and 8% of patients with a specific non-biceps indication. Distal biceps tendon changes noted on radiology reports were associated with older age, male sex, and radiologists with musculoskeletal fellowship training.
Conclusions
The finding that distal biceps MRI signal changes consistent with tendinopathy are common even in asymptomatic elbows reduces the probability that symptoms correlate with pathology on imaging. The accumulation of signal changes with age, also independent of symptoms, suggests that tendon pathology persists after symptoms resolve, that some degree of distal biceps tendinopathy is common in a human lifetime, and that tendinopathy may often be accommodated without seeking care.Level of evidence: IV.
4.Hydration status affects osteopontin expression in the rat kidney.
Su Youn LEE ; Sae Jin LEE ; Hong Lin PIAO ; Suk Young YANG ; I David WEINER ; Jin KIM ; Ki Hwan HAN
Journal of Veterinary Science 2016;17(3):269-277
Osteopontin (OPN) is a secretory protein that plays an important role in urinary stone formation. Hydration status is associated with the development of urolithiasis. This study was conducted to examine the effects of dehydration and hydration on OPN expression in the rat kidney. Animals were divided into three groups, control, dehydrated, and hydrated. Kidney tissues were processed for light and electron microscope immunocytochemistry, in situ hybridization, and immunoblot analysis. Dehydration induced a significant increase in OPN protein expression, whereas increased fluid intake induced a decrease in protein expression. Under control conditions, OPN protein and mRNA expression were only detected in the descending thin limb (DTL). Dehydration induced increased expression in the DTL and the development of detectable expression in the thick ascending limb (TAL). In contrast, OPN expression levels declined to less than the controls in the DTL after hydration, while no expression of either protein or mRNA was detectable in the TAL. Immunoelectron microscopy demonstrated that hydration status altered tubular ultrastructure and intracellular OPN expression in the Golgi apparatus and secretory cytoplasmic vesicles. These data confirm that changes in oral fluid intake can regulate renal tubular epithelial cell OPN expression.
Animals
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Control Groups
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Cytoplasmic Vesicles
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Dehydration
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Epithelial Cells
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Extremities
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Golgi Apparatus
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Immunohistochemistry
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In Situ Hybridization
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Kidney*
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Microscopy, Immunoelectron
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Osteopontin*
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Rats*
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RNA, Messenger
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Urinary Calculi
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Urolithiasis
5.Pandemic (H1N1) 2009: clinical and laboratory findings of the first fifty cases in Singapore.
Monica CHAN ; Mark I CHEN ; Angela CHOW ; Caroline P S LEE ; Adriana S H TAN ; David Chien LYE ; Yee Sin LEO
Annals of the Academy of Medicine, Singapore 2010;39(4):267-266
INTRODUCTIONSince the fi rst imported case on 26 May 2009, pandemic (H1N1) 2009 has spread from travellers and has resulted in sustained community transmission. Singapore began with a strict containment policy where all suspected and confirmed cases of pandemic (H1N1) 2009 were admitted for testing. We describe here the clinical and laboratory characteristics of the fi rst 50 adult cases with confirmed pandemic (H1N1) 2009.
MATERIALS AND METHODSA review was conducted of medical notes of adult patients with confirmed pandemic (H1N1) 2009 by polymerase chain reaction assay from combined nasal and throat swabs admitted to the Communicable Disease Centre, Tan Tock Seng Hospital.
RESULTSFrom 26 May to 18 June 2009, 50 patients with a median age of 27 years old were admitted at a median of 3 days from illness onset. Half were male and all were travellers arriving in Singapore. Non-Singaporean citizens (38%) and other ethnic groups (40%) were over-represented. History of fever was reported in 90% and respiratory symptoms in 92%. Gastrointestinal symptoms were uncommon, present in 4% only. Temperatures on presentation of >or=38.0 degrees C, >or=37.8 degrees C and >or=37.5 degrees C were present in 48%, 56% and 76%, respectively. Only 46% of patients met the United States Centers for Disease Control and Prevention (US CDC) case definition of influenza-like illness (ILI). Clinical and laboratory findings were unremarkable for the majority. All cases were treated with oseltamivir and had uncomplicated recovery.
CONCLUSIONPandemic (H1N1) 2009 had mild clinical and laboratory findings in immunocompetent patients. Use of the US CDC ILI criteria alone would have detected less than half of confirmed cases.
Adult ; Communicable Diseases, Emerging ; epidemiology ; Disease Outbreaks ; Female ; Humans ; Influenza A Virus, H1N1 Subtype ; isolation & purification ; Influenza, Human ; diagnosis ; epidemiology ; Male ; Medical Audit ; Middle Aged ; Polymerase Chain Reaction ; Singapore ; epidemiology ; Young Adult
6.Utility of Seated Lateral Radiographs in the Diagnosis and Classification of Lumbar Degenerative Spondylolisthesis
Tariq Z. ISSA ; Yunsoo LEE ; Emily BERTHIAUME ; Mark J. LAMBRECHTS ; Caroline ZAWORSKI ; Qudratallah S. QADIRI ; Henley SPRACKLEN ; Richard PADOVANO ; Jackson WEBER ; John J. MANGAN ; Jose A. CANSECO ; Barrett I. WOODS ; I. David KAYE ; Alan S. HILIBRAND ; Christopher K. KEPLER ; Alexander R. VACCARO ; Gregory D. SCHROEDER ; Joseph K. LEE
Asian Spine Journal 2023;17(4):721-728
Methods:
We assessed baseline neutral upright, standing flexion, seated lateral radiographs, and magnetic resonance imaging (MRI) for patients identified with spondylolisthesis from January 2021 to May 2022 by a single spine surgeon. DS was classified by Meyerding and Clinical and Radiographic Degenerative Spondylolisthesis classifications. A difference of >10° or >8% between views, respectively, was used to characterize angular and translational instability. Analysis of variance and paired chi-square tests were utilized to compare modalities.
Results:
A total of 136 patients were included. Seated lateral and standing flexion radiographs showed the greatest slip percentage (16.0% and 16.7%), while MRI revealed the lowest (12.2%, p <0.001). Standing flexion and lateral radiographs when seated produced more kyphosis (4.66° and 4.97°, respectively) than neutral upright and MRI (7.19° and 7.20°, p <0.001). Seated lateral performed similarly to standing flexion in detecting all measurement parameters and categorizing DS (all p >0.05). Translational instability was shown to be more prevalent when associated with seated lateral or standing flexion than when combined with neutral upright (31.5% vs. 20.2%, p =0.041; and 28.1% vs. 14.6%, p =0.014, respectively). There were no differences between seated lateral or standing flexion in the detection of instability (all p >0.20).
Conclusions
Seated lateral radiographs are appropriate alternatives for standing flexion radiographs. Films taken when standing up straight do not offer any more information for DS detection. Rather than standing flexion-extension radiographs, instability can be detected using an MRI, which is often performed preoperatively, paired with a single seated lateral radiograph.
7.Multidisciplinary perspectives on newly revised 2018 FIGO staging of cancer of the cervix uteri
Jonathan S BEREK ; Koji MATSUO ; Brendan H GRUBBS ; David K GAFFNEY ; Susanna I LEE ; Aoife KILCOYNE ; Gi Jeong CHEON ; Chong Woo YOO ; Lu LI ; Yifeng SHAO ; Tianhui CHEN ; Miseon KIM ; Mikio MIKAMI
Journal of Gynecologic Oncology 2019;30(2):e40-
No abstract available.
Uterine Cervical Neoplasms
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Uterus
8.How Does the Severity of Neuroforaminal Compression in Cervical Radiculopathy Affect Outcomes of Anterior Cervical Discectomy and Fusion
Mark J. LAMBRECHTS ; Tariq Z. ISSA ; Yunsoo LEE ; Khoa S. TRAN ; Jeremy HEARD ; Caroline PURTILL ; Tristan B. FRIED ; Samuel OH ; Erin KIM ; John J. MANGAN ; Jose A. CANSECO ; I. David KAYE ; Jeffrey A. RIHN ; Alan S. HILIBRAND ; Alexander R. VACCARO ; Christopher K. KEPLER ; Gregory D. SCHROEDER
Asian Spine Journal 2023;17(6):1051-1058
Methods:
Patients undergoing primary, elective 1–3 level ACDF for radiculopathy at a single academic center between 2015 and 2021 were identified retrospectively. Cervical FS was evaluated using axial T2-weighted MRI images via a validated grading scale. The maximum degree of stenosis was used for multilevel disease. Motor symptoms were classified using encounters at their final preoperative and first postoperative visits, with examinations ≤3/5 indicating weakness. PROMs were obtained preoperatively and at 1-year follow-up. Bivariate analysis was used to compare outcomes based on stenosis severity, followed by multivariable analysis.
Results:
This study included 354 patients, 157 with moderate stenosis and 197 with severe stenosis. Overall, 58 patients (16.4%) presented with upper extremity weakness ≤3/5. A similar number of patients in both groups presented with baseline motor weakness (13.5% vs. 16.55, p =0.431). Postoperatively, 97.1% and 87.0% of patients with severe and moderate FS, respectively, experienced full motor recovery (p =0.134). At 1-year, patients with severe neuroforaminal stenosis presented with significantly worse 12-item Short Form Survey Physical Component Score (PCS-12) (33.3 vs. 37.3, p =0.049) but demonstrated a greater magnitude of improvement (Δ PCS-12: 5.43 vs. 0.87, p =0.048). Worse stenosis was independently associated with greater ΔPCS-12 at 1-year (β =5.59, p =0.022).
Conclusions
Patients with severe FS presented with worse preoperative physical health. While ACDF improved outcomes and conferred similar motor recovery in all patients, those with severe FS reported much better improvement in physical function.
9.Comprehensive functional annotation of susceptibility variants identifies genetic heterogeneity between lung adenocarcinoma and squamous cell carcinoma.
Na QIN ; Yuancheng LI ; Cheng WANG ; Meng ZHU ; Juncheng DAI ; Tongtong HONG ; Demetrius ALBANES ; Stephen LAM ; Adonina TARDON ; Chu CHEN ; Gary GOODMAN ; Stig E BOJESEN ; Maria Teresa LANDI ; Mattias JOHANSSON ; Angela RISCH ; H-Erich WICHMANN ; Heike BICKEBOLLER ; Gadi RENNERT ; Susanne ARNOLD ; Paul BRENNAN ; John K FIELD ; Sanjay SHETE ; Loic LE MARCHAND ; Olle MELANDER ; Hans BRUNNSTROM ; Geoffrey LIU ; Rayjean J HUNG ; Angeline ANDREW ; Lambertus A KIEMENEY ; Shan ZIENOLDDINY ; Kjell GRANKVIST ; Mikael JOHANSSON ; Neil CAPORASO ; Penella WOLL ; Philip LAZARUS ; Matthew B SCHABATH ; Melinda C ALDRICH ; Victoria L STEVENS ; Guangfu JIN ; David C CHRISTIANI ; Zhibin HU ; Christopher I AMOS ; Hongxia MA ; Hongbing SHEN
Frontiers of Medicine 2021;15(2):275-291
Although genome-wide association studies have identified more than eighty genetic variants associated with non-small cell lung cancer (NSCLC) risk, biological mechanisms of these variants remain largely unknown. By integrating a large-scale genotype data of 15 581 lung adenocarcinoma (AD) cases, 8350 squamous cell carcinoma (SqCC) cases, and 27 355 controls, as well as multiple transcriptome and epigenomic databases, we conducted histology-specific meta-analyses and functional annotations of both reported and novel susceptibility variants. We identified 3064 credible risk variants for NSCLC, which were overrepresented in enhancer-like and promoter-like histone modification peaks as well as DNase I hypersensitive sites. Transcription factor enrichment analysis revealed that USF1 was AD-specific while CREB1 was SqCC-specific. Functional annotation and gene-based analysis implicated 894 target genes, including 274 specifics for AD and 123 for SqCC, which were overrepresented in somatic driver genes (ER = 1.95, P = 0.005). Pathway enrichment analysis and Gene-Set Enrichment Analysis revealed that AD genes were primarily involved in immune-related pathways, while SqCC genes were homologous recombination deficiency related. Our results illustrate the molecular basis of both well-studied and new susceptibility loci of NSCLC, providing not only novel insights into the genetic heterogeneity between AD and SqCC but also a set of plausible gene targets for post-GWAS functional experiments.
Adenocarcinoma of Lung/genetics*
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Carcinoma, Non-Small-Cell Lung/genetics*
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Carcinoma, Squamous Cell/genetics*
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Genetic Heterogeneity
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Genetic Predisposition to Disease
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Genome-Wide Association Study
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Humans
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Lung Neoplasms/genetics*
;
Polymorphism, Single Nucleotide