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Article ; Online: The utilization of cytologic and small biopsy samples for ancillary molecular testing.

Roh, Michael H

Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

2019 Volume 32, Issue Suppl 1, Page(s) 77–85

Abstract: There has recently been an increased emphasis on the utilization of cytologic samples and small biopsies for not only diagnostic purposes but also for ancillary testing. In some instances, the ancillary tests contribute to the diagnosis and in other ... ...

Abstract	There has recently been an increased emphasis on the utilization of cytologic samples and small biopsies for not only diagnostic purposes but also for ancillary testing. In some instances, the ancillary tests contribute to the diagnosis and in other scenarios, they provide prognostic and theranostic information for the management of patients with advanced stage cancer. These ancillary tests include immunohistochemical biomarker analysis, molecular mutation analysis, and cytogenetic tests. Despite the finite nature of the cellular material procured in cytologic and small tissue biopsies, pathologists are tasked with ordering an increasing number of tests using these limited samples. This requires the pathologists to utilize and triage these samples in an optimal fashion so that as much information can be gleaned from a given specimen. This review will focus on the pre-analytic requirements for ancillary molecular and cytogenetic tests in the context of a discussion of the various preparation methods for cytologic and small biopsy specimens. The goal will be to provide the reader with the necessary concepts that can be utilized to develop optimal specimen selection and triage strategies to maximize the chances of effectively utilizing these samples for comprehensive diagnostic and relevant ancillary testing purposes.
MeSH term(s)	Biopsy ; Cytodiagnosis/methods ; Humans ; Molecular Diagnostic Techniques ; Pathology, Clinical ; Pathology, Molecular
Language	English
Publishing date	2019-01-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645073-8
ISSN	1530-0285 ; 0893-3952
ISSN (online)	1530-0285
ISSN	0893-3952
DOI	10.1038/s41379-018-0138-z
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Article: The Utilization of Cytologic Fine-Needle Aspirates of Lung Cancer for Molecular Diagnostic Testing.

Roh, Michael H

Journal of pathology and translational medicine

2015 Volume 49, Issue 4, Page(s) 300–309

Abstract: In this era of precision medicine, our understanding and knowledge of the molecular landscape associated with lung cancer pathogenesis continues to evolve. This information is being increasingly exploited to treat advanced stage lung cancer patients with ...

Abstract	In this era of precision medicine, our understanding and knowledge of the molecular landscape associated with lung cancer pathogenesis continues to evolve. This information is being increasingly exploited to treat advanced stage lung cancer patients with tailored, targeted therapy. During the management of these patients, minimally invasive procedures to obtain samples for tissue diagnoses are desirable. Cytologic fine-needle aspirates are often utilized for this purpose and are important not only for rendering diagnoses to subtype patients' lung cancers, but also for ascertaining molecular diagnostic information for treatment purposes. Thus, cytologic fine-needle aspirates must be utilized and triaged judiciously to achieve both objectives. In this review, strategies in utilizing fine-needle aspirates will be discussed in the context of our current understanding of the clinically actionable molecular aberrations underlying non-small cell lung cancer and the molecular assays applied to these samples in order to obtain treatment-relevant molecular diagnostic information.
Language	English
Publishing date	2015-07-15
Publishing country	Korea (South)
Document type	Journal Article ; Review
ZDB-ID	3022395-7
ISSN	2383-7845 ; 2383-7837
ISSN (online)	2383-7845
ISSN	2383-7837
DOI	10.4132/jptm.2015.06.16
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Article ; Online: Triage of cytologic direct smears for ancillary studies: a case-based illustration and review.

Roh, Michael H

Archives of pathology & laboratory medicine

2013 Volume 137, Issue 9, Page(s) 1185–1190

Abstract: In patients with advanced-stage cancer, small biopsies including fine-needle aspirates may be the only opportunity to obtain diagnostic tissue. In the current era of precision medicine, there is an increasing emphasis on the performance of ancillary ... ...

Abstract	In patients with advanced-stage cancer, small biopsies including fine-needle aspirates may be the only opportunity to obtain diagnostic tissue. In the current era of precision medicine, there is an increasing emphasis on the performance of ancillary molecular tests that can provide insights into prognosis and targeted chemotherapeutic options for patient management. Cytopathologists must meet this challenge by accurately diagnosing these fine-needle aspirates and ensuring that adequate material has been obtained for anticipated molecular studies. Herein, we describe a case of a fine-needle aspiration illustrating these principles, especially focusing on the utilization of direct smears for ancillary studies.
MeSH term(s)	Aged ; Ancillary Services, Hospital ; Biopsy, Fine-Needle/methods ; Cytological Techniques/methods ; Ear Auricle/pathology ; Humans ; Lymphatic Metastasis ; Male ; Melanoma/pathology ; Neoplasm Recurrence, Local/pathology ; Skin Neoplasms/pathology ; Triage/methods
Language	English
Publishing date	2013-09
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	194119-7
ISSN	1543-2165 ; 0363-0153 ; 0096-8528 ; 0003-9985
ISSN (online)	1543-2165
ISSN	0363-0153 ; 0096-8528 ; 0003-9985
DOI	10.5858/arpa.2013-0235-CR
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Article ; Online: Prenatal exposure to valproic acid reduces synaptic δ-catenin levels and disrupts ultrasonic vocalization in neonates.

Roh, Seung Hyun / Mendez-Vazquez, Hadassah / Sathler, Matheus F / Doolittle, Michael J / Zaytseva, Anastasiya / Brown, Hannah / Sainsbury, Morgan / Kim, Seonil

Neuropharmacology

2024 Volume 253, Page(s) 109963

Abstract: Valproic acid (VPA) is an effective and commonly prescribed drug for epilepsy and bipolar disorder. However, children born from mothers treated with VPA during pregnancy exhibit an increased incidence of autism spectrum disorder (ASD). Although VPA may ... ...

Abstract	Valproic acid (VPA) is an effective and commonly prescribed drug for epilepsy and bipolar disorder. However, children born from mothers treated with VPA during pregnancy exhibit an increased incidence of autism spectrum disorder (ASD). Although VPA may impair brain development at the cellular level, the mechanism of VPA-induced ASD has not been completely addressed. A previous study has found that VPA treatment strongly reduces δ-catenin mRNA levels in cultured human neurons. δ-catenin is important for the control of glutamatergic synapses and is strongly associated with ASD. VPA inhibits dendritic morphogenesis in developing neurons, an effect that is also found in neurons lacking δ-catenin expression. We thus hypothesize that prenatal exposure to VPA significantly reduces δ-catenin levels in the brain, which impairs glutamatergic synapses to cause ASD. Here, we found that prenatal exposure to VPA markedly reduced δ-catenin levels in the brain of mouse pups. VPA treatment also impaired dendritic branching in developing mouse cortical neurons, which was partially reversed by elevating δ-catenin expression. Prenatal VPA exposure significantly reduced synaptic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor levels and postsynaptic density 95 (PSD95) in the brain of mouse pups, indicating dysfunctions in glutamatergic synaptic transmission. VPA exposure also significantly altered ultrasonic vocalization (USV) in newly born pups when they were isolated from their nest. Moreover, VPA-exposed pups show impaired hypothalamic response to isolation, which is required to produce animals' USVs following isolation from the nest. Therefore, these results suggest that VPA-induced ASD pathology can be mediated by the loss of δ-catenin functions.
Language	English
Publishing date	2024-04-23
Publishing country	England
Document type	Journal Article
ZDB-ID	218272-5
ISSN	1873-7064 ; 0028-3908
ISSN (online)	1873-7064
ISSN	0028-3908
DOI	10.1016/j.neuropharm.2024.109963
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Article ; Online: Economic optimization of Wolbachia-infected Aedes aegypti release to prevent dengue.

Hollingsworth, Brandon D / Cho, Chanheung / Vella, Michael / Roh, Hyeongyul / Sass, Julian / Lloyd, Alun L / Brown, Zachary S

Pest management science

2024

Abstract: Background: Dengue virus, primarily transmitted by the Aedes aegypti mosquito, is a major public health concern affecting ≈3.83 billion people worldwide. Recent releases of Wolbachia-transinfected Ae. aegypti in several cities worldwide have shown that ... ...

Abstract	Background: Dengue virus, primarily transmitted by the Aedes aegypti mosquito, is a major public health concern affecting ≈3.83 billion people worldwide. Recent releases of Wolbachia-transinfected Ae. aegypti in several cities worldwide have shown that it can reduce dengue transmission. However, these releases are costly, and, to date, no framework has been proposed for determining economically optimal release strategies that account for both costs associated with disease risk and releases. Results: We present a flexible stochastic dynamic programming framework for determining optimal release schedules for Wolbachia-transinfected mosquitoes that balances the cost of dengue infection with the costs of rearing and releasing transinfected mosquitoes. Using an ordinary differential equation model of Wolbachia and dengue in a hypothetical city loosely describing areas at risk of new dengue epidemics, we determined that an all-or-nothing release strategy that quickly brings Wolbachia to fixation is often the optimal solution. Based on this, we examined the optimal facility size, finding that it was inelastic with respect to the mosquito population size, with a 100% increase in population size resulting in a 50-67% increase in optimal facility size. Furthermore, we found that these results are robust to mosquito life-history parameters and are mostly determined by the mosquito population size and the fitness costs associated with Wolbachia. Conclusions: These results reinforce that Wolbachia-transinfected mosquitoes can reduce the cost of dengue epidemics. Furthermore, they emphasize the importance of determining the size of the target population and fitness costs associated with Wolbachia before releases occur. © 2024 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
Language	English
Publishing date	2024-03-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2001705-4
ISSN	1526-4998 ; 1526-498X
ISSN (online)	1526-4998
ISSN	1526-498X
DOI	10.1002/ps.8086
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Article ; Online: I Might Have Some Bad News: Disclosing Preliminary Pathology Results.

Roh, Michael H / Shuman, Andrew G

AMA journal of ethics

2016 Volume 18, Issue 8, Page(s) 779–785

Abstract: Cytopathology is a subspecialty of pathology in which pathologists frequently interact directly with patients. Often this interaction is in the context of fine needle aspiration (FNA) procedures performed at the bedside by the cytopathologist or by ... ...

Abstract	Cytopathology is a subspecialty of pathology in which pathologists frequently interact directly with patients. Often this interaction is in the context of fine needle aspiration (FNA) procedures performed at the bedside by the cytopathologist or by another clinician with the cytopathologist present. Patient requests for preliminary results in such settings raise fundamental questions about professional scope of practice and communication of uncertainty that apply not merely to pathologists but to all clinicians. In certain settings, cytopathologists may share preliminary diagnostic impressions directly with patients. Essential to these conversations is the need to articulate potential uncertainty about both the diagnosis and next steps. In addition, the involvement and notification of the referring physician is obligatory, both for care coordination and to ensure that patients receive a consistent message.
MeSH term(s)	Communication ; Disclosure/ethics ; Ethics, Medical ; Humans ; Male ; Pathology, Clinical/ethics ; Physician-Patient Relations ; Uncertainty
Language	English
Publishing date	2016-08-01
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2376-6980
ISSN (online)	2376-6980
DOI	10.1001/journalofethics.2016.18.8.ecas3-1608
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Article ; Online: The Utilization of Cytologic Fine-Needle Aspirates of Lung Cancer for Molecular Diagnostic Testing

Michael H. Roh

Journal of Pathology and Translational Medicine, Vol 49, Iss 4, Pp 300-

2015 Volume 309

Abstract	In this era of precision medicine, our understanding and knowledge of the molecular landscape associated with lung cancer pathogenesis continues to evolve. This information is being increasingly exploited to treat advanced stage lung cancer patients with tailored, targeted therapy. During the management of these patients, minimally invasive procedures to obtain samples for tissue diagnoses are desirable. Cytologic fine-needle aspirates are often utilized for this purpose and are important not only for rendering diagnoses to subtype patients’ lung cancers, but also for ascertaining molecular diagnostic information for treatment purposes. Thus, cytologic fine-needle aspirates must be utilized and triaged judiciously to achieve both objectives. In this review, strategies in utilizing fine-needle aspirates will be discussed in the context of our current understanding of the clinically actionable molecular aberrations underlying non-small cell lung cancer and the molecular assays applied to these samples in order to obtain treatment-relevant molecular diagnostic information.
Keywords	Lung neoplasms ; Cytology ; Biopsy ; fine-needle ; Molecular testing ; Precision medicine ; Pathology ; RB1-214
Subject code	610
Language	English
Publishing date	2015-07-01T00:00:00Z
Publisher	Korean Society of Pathologists & the Korean Society for Cytopathology
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Metastases to the Pancreas Encountered on Endoscopic Ultrasound-Guided, Fine-Needle Aspiration.

Pang, Judy C / Roh, Michael H

Archives of pathology & laboratory medicine

2015 Volume 139, Issue 10, Page(s) 1248–1252

Abstract: Metastatic lesions in the pancreas are very uncommon and may be difficult to differentiate from the more commonly encountered primary neoplasms derived from the exocrine and endocrine pancreas because of the significant overlap in clinical presentation, ... ...

Abstract	Metastatic lesions in the pancreas are very uncommon and may be difficult to differentiate from the more commonly encountered primary neoplasms derived from the exocrine and endocrine pancreas because of the significant overlap in clinical presentation, imaging, and cytologic features. Metastasis to the pancreas may occur years after treatment of the primary neoplasm and is often not considered on initial evaluation because of the rarity of such events. The possibility of a metastasis to the pancreas should be entertained in patients with any prior history of malignancy because a proper diagnosis is essential in identifying surgical candidates, or avoiding potentially unnecessary surgery and facilitating triage to more appropriate nonoperative therapy. Herein, we describe intrapancreatic metastases secondary to renal cell carcinoma, melanoma, and lung carcinoma, as documented by cytologic examination of endoscopic ultrasound-guided fine-needle aspiration of the pancreatic masses.
MeSH term(s)	Carcinoma, Renal Cell/pathology ; Diagnosis, Differential ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods ; Humans ; Kidney Neoplasms/pathology ; Lung Neoplasms/pathology ; Melanoma/pathology ; Pancreas/pathology ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/secondary ; Sensitivity and Specificity
Language	English
Publishing date	2015-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	194119-7
ISSN	1543-2165 ; 0363-0153 ; 0096-8528 ; 0003-9985
ISSN (online)	1543-2165
ISSN	0363-0153 ; 0096-8528 ; 0003-9985
DOI	10.5858/arpa.2015-0200-RA
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Article: Prenatal exposure to valproic acid reduces synaptic δ-catenin levels and disrupts ultrasonic vocalization in neonates.

Roh, Seung Hyun / Mendez-Vazquez, Hadassah / Sathler, Matheus F / Doolittle, Michael J / Zaytseva, Anastasiya / Brown, Hannah / Sainsbury, Morgan / Kim, Seonil

bioRxiv : the preprint server for biology

2023

Abstract	Valproic acid (VPA) is an effective and commonly prescribed drug for epilepsy and bipolar disorder. However, children born from mothers treated with VPA during pregnancy exhibit an increased incidence of autism spectrum disorder (ASD). Although VPA may impair brain development at the cellular level, the mechanism of VPA-induced ASD has not been completely addressed. A previous study has found that VPA treatment strongly reduces δ-catenin mRNA levels in cultured human neurons. δ-catenin is important for the control of glutamatergic synapses and is strongly associated with ASD. VPA inhibits dendritic morphogenesis in developing neurons, an effect that is also found in neurons lacking δ-catenin expression. We thus hypothesize that prenatal exposure to VPA significantly reduces δ-catenin levels in the brain, which impairs glutamatergic synapses to cause ASD. Here, we found that prenatal exposure to VPA markedly reduced δ-catenin levels in the brain of mouse pups. VPA treatment also impaired dendritic branching in developing mouse cortical neurons, which was reversed by elevating δ-catenin expression. Prenatal VPA exposure significantly reduced synaptic AMPA receptor levels and postsynaptic density 95 (PSD95) in the brain of mouse pups, indicating dysfunctions in glutamatergic synaptic transmission. VPA exposure also significantly altered ultrasonic vocalization (USV) in newly born pups when they were isolated from their nest. Moreover, VPA-exposed pups show impaired hypothalamic response to isolation, which is required to produce animals' USVs following isolation from the nest. Therefore, these results suggest that VPA-induced ASD pathology can be mediated by the loss of δ-catenin functions. Highlights: Prenatal exposure of valproic acid (VPA) in mice significantly reduces synaptic δ-catenin protein and AMPA receptor levels in the pups' brains.VPA treatment significantly impairs dendritic branching in cultured cortical neurons, which is reversed by increased δ-catenin expression.VPA exposed pups exhibit impaired communication such as ultrasonic vocalization.Neuronal activation linked to ultrasonic vocalization is absent in VPA-exposed pups.The loss of δ-catenin functions underlies VPA-induced autism spectrum disorder (ASD) in early childhood.
Language	English
Publishing date	2023-12-15
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.12.14.571709
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Article ; Online: Reply to Ancillary techniques on direct-smear aspirate slides: a significant evolution for cytopathology techniques.

Knoepp, Stewart M / Roh, Michael H

Cancer cytopathology

2013 Volume 121, Issue 5, Page(s) 276

MeSH term(s)	Carcinoma, Non-Small-Cell Lung/diagnosis ; Cytodiagnosis/methods ; Histocytological Preparation Techniques ; Humans ; Lung Neoplasms/diagnosis ; Melanoma/diagnosis ; Pancreatic Neoplasms/diagnosis
Language	English
Publishing date	2013-05
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	2594979-2
ISSN	1934-6638 ; 1934-662X
ISSN (online)	1934-6638
ISSN	1934-662X
DOI	10.1002/cncy.21295
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