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  1. AU="Kang, Christopher Y"
  2. AU="Martins, Stella Maris Seixas"
  3. AU=Rybniker Jan AU=Rybniker Jan
  4. AU="Kroes, Rob"
  5. AU="Gancitano, Giuseppe"
  6. AU="Beaty, B J"
  7. AU="Kiès, Philippine"
  8. AU="Zlatko Trajanoski"
  9. AU="Hopke, Philip K"
  10. AU="Kothandaraman, Venkatraman"
  11. AU="Wiencek, Joesph R"
  12. AU="Gachon, Philippe"
  13. AU="Tsuboi, Yoshio"
  14. AU=Woolard Stacie N AU=Woolard Stacie N
  15. AU="Rowland, Jonathan"
  16. AU="Chloe C. Y. Wong"

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  1. Artikel ; Online: Is Routine Continuous EEG for Traumatic Brain Injury Beneficial?

    Aquino, Lia / Kang, Christopher Y / Harada, Megan Y / Ko, Ara / Do-Nguyen, Amy / Ley, Eric J / Margulies, Daniel R / Alban, Rodrigo F

    The American surgeon

    2017  Band 83, Heft 12, Seite(n) 1433–1437

    Abstract: Severe traumatic brain injury (TBI) is associated with increased risk for early clinical and subclinical seizures. The use of continuous electroencephalography (cEEG) monitoring after TBI allows for identification and treatment of seizures that may ... ...

    Abstract Severe traumatic brain injury (TBI) is associated with increased risk for early clinical and subclinical seizures. The use of continuous electroencephalography (cEEG) monitoring after TBI allows for identification and treatment of seizures that may otherwise occur undetected. Benefits of "routine" cEEG after TBI remain controversial. We examined the rate of subclinical seizures identified by cEEG in TBI patients admitted to a Level I trauma center. We analyzed a cohort of trauma patients with moderate to severe TBI (head Abbreviated Injury Score ≥3) who received cEEG within seven days of admission between October 2011 and May 2015. Demographics, clinical data, injury severity, and costs were recorded. Clinical characteristics were compared between those with and without seizures as identified by cEEG. A total of 106 TBI patients with moderate to severe TBI received a cEEG during the study period. Most were male (74%) with a mean age of 55 years. Subclinical seizures were identified by cEEG in only 3.8 per cent of patients. Ninety-three per cent were on antiseizure prophylaxis at the time of cEEG. Patients who had subclinical seizures were significantly older than their counterparts (80 vs 54 years, P = 0.03) with a higher mean head Abbreviated Injury Score (5.0 vs 4.0, P = 0.01). Mortality and intensive care unit stay were similar in both groups. Of all TBI patients who were monitored with cEEG, seizures were identified in only 3.8 per cent. Seizures were more likely to occur in older patients with severe head injury. Given the high cost of routine cEEG and the low incidence of subclinical seizures, we recommend cEEG monitoring only when clinically indicated.
    Mesh-Begriff(e) Abbreviated Injury Scale ; Aged ; Aged, 80 and over ; Brain Injuries, Traumatic/complications ; Electroencephalography/methods ; Female ; Glasgow Coma Scale ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Seizures/diagnosis ; Seizures/etiology ; Trauma Centers
    Sprache Englisch
    Erscheinungsdatum 2017-12-01
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Perioperative use of the imacor hemodynamic transesophageal echocardiography probe in cardiac surgery patients: initial experience.

    Sarosiek, Konrad / Kang, Christopher Y / Johnson, Caitlyn M / Pitcher, Harrison / Hirose, Hitoshi / Cavarocchi, Nicholas C

    ASAIO journal (American Society for Artificial Internal Organs : 1992)

    2014  Band 60, Heft 5, Seite(n) 553–558

    Abstract: Echocardiography is the standard to assess heart function although obtaining transesophageal echocardiography (TEE) on an emergent basis may be limited by its availability. A transoral miniaturized hemodynamic TEE (hTEE) probe (ImaCor Inc.) was developed ...

    Abstract Echocardiography is the standard to assess heart function although obtaining transesophageal echocardiography (TEE) on an emergent basis may be limited by its availability. A transoral miniaturized hemodynamic TEE (hTEE) probe (ImaCor Inc.) was developed to provide direct visualization of the heart, and we hypothesized that the probe could provide hemodynamic information useful for patient management. Data from 2011 to 2012 was retrospectively collected. Four hundred ninety patients were treated in the cardiovascular intensive care unit of which 61 underwent hTEE monitoring and were divided into three groups: patients on extracorporeal membrane oxygenation (ECMO) (n = 25), ventricular assist device (VAD) (n = 6), and others (n = 30). Patient charts were reviewed to investigate the indications for the use of hTEE, findings, and the interventions performed. The indications for probe insertion were hemodynamic instability (n = 32), ECMO weaning (n = 10), VAD alarm (n = 1), tamponade (n = 14), pulmonary embolism (n = 2), and intra-aortic balloon pump wean (n = 2). In all 61 cases, we were successfully able to diagnose and treat the etiology of instability based on the hTEE findings. Utilization of the hTEE probe successfully diagnosed and aided therapy in all patients with hemodynamic instability refractory to initial therapy and provides a valuable tool to aid clinicians in the management of postoperative hemodynamics.
    Mesh-Begriff(e) Cardiology/instrumentation ; Echocardiography, Transesophageal/methods ; Female ; Hemodynamics/physiology ; Humans ; Male ; Middle Aged ; Perioperative Care/methods ; Point-of-Care Systems ; Retrospective Studies
    Sprache Englisch
    Erscheinungsdatum 2014-09
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 759982-1
    ISSN 1538-943X ; 0162-1432 ; 1058-2916
    ISSN (online) 1538-943X
    ISSN 0162-1432 ; 1058-2916
    DOI 10.1097/MAT.0000000000000113
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel: Hypothyroidism in Pancreatic Cancer: Role of Exogenous Thyroid Hormone in Tumor Invasion-Preliminary Observations.

    Sarosiek, Konrad / Gandhi, Ankit V / Saxena, Shivam / Kang, Christopher Y / Chipitsyna, Galina I / Yeo, Charles J / Arafat, Hwyda A

    Journal of thyroid research

    2016  Band 2016, Seite(n) 2454989

    Abstract: According to the epidemiological studies, about 4.4% of American general elderly population has a pronounced hypothyroidism and relies on thyroid hormone supplements daily. The prevalence of hypothyroidism in our patients with pancreatic cancer was much ... ...

    Abstract According to the epidemiological studies, about 4.4% of American general elderly population has a pronounced hypothyroidism and relies on thyroid hormone supplements daily. The prevalence of hypothyroidism in our patients with pancreatic cancer was much higher, 14.1%. A retrospective analysis was performed on patients who underwent pancreaticoduodenectomy (Whipple procedure) or distal pancreatectomy and splenectomy (DPS) at Thomas Jefferson University Hospital, Philadelphia, from 2005 to 2012. The diagnosis of hypothyroidism was correlated with clinicopathologic parameters including tumor stage, grade, and survival. To further understand how thyroid hormone affects pancreatic cancer behavior, functional studies including wound-induced cell migration, proliferation, and invasion were performed on pancreatic cancer cell lines, MiaPaCa-2 and AsPC-1. We found that hypothyroid patients taking exogenous thyroid hormone were more than three times likely to have perineural invasion, and about twice as likely to have higher T stage, nodal spread, and overall poorer prognostic stage (P < 0.05). Pancreatic cancer cell line studies demonstrated that exogenous thyroid hormone treatment increased cell proliferation, migration, and invasion (P < 0.05). We conclude that exogenous thyroid hormone may contribute to the progression of pancreatic cancer.
    Sprache Englisch
    Erscheinungsdatum 2016-03-31
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2090-8067
    ISSN 2090-8067
    DOI 10.1155/2016/2454989
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel ; Online: Conserved Metabolic Changes in Nondiabetic and Type 2 Diabetic Bariatric Surgery Patients: Global Metabolomic Pilot Study.

    Sarosiek, Konrad / Pappan, Kirk L / Gandhi, Ankit V / Saxena, Shivam / Kang, Christopher Y / McMahon, Heather / Chipitsyna, Galina I / Tichansky, David S / Arafat, Hwyda A

    Journal of diabetes research

    2016  Band 2016, Seite(n) 3467403

    Abstract: The goal of this study was to provide insight into the mechanism by which bariatric surgical procedures led to weight loss and improvement or resolution of diabetes. Global biochemical profiling was used to evaluate changes occurring in nondiabetic and ... ...

    Abstract The goal of this study was to provide insight into the mechanism by which bariatric surgical procedures led to weight loss and improvement or resolution of diabetes. Global biochemical profiling was used to evaluate changes occurring in nondiabetic and type 2 diabetic (T2D) patients experiencing either less extreme sleeve gastrectomy or a full gastric bypass. We were able to identify changes in metabolism that were affected by standard preoperation liquid weight loss diet as well as by bariatric surgery itself. Preoperation weight-loss diet was associated with a strong lipid metabolism signature largely related to the consumption of adipose reserves for energy production. Glucose usage shift away from glycolytic pyruvate production toward pentose phosphate pathway, via glucose-6-phosphate, appeared to be shared across all patients regardless of T2D status or bariatric surgery procedure. Our results suggested that bariatric surgery might promote antioxidant defense and insulin sensitivity through both increased heme synthesis and HO activity or expression. Changes in histidine and its metabolites following surgery might be an indication of altered gut microbiome ecology or liver function. This initial study provided broad understanding of how metabolism changed globally in morbidly obese nondiabetic and T2D patients following weight-loss surgery.
    Mesh-Begriff(e) Bariatric Surgery ; Diabetes Mellitus, Type 2/metabolism ; Energy Intake ; Glutathione/metabolism ; Glycolysis ; Heme/metabolism ; Humans ; Hydroxybutyrates/metabolism ; Metabolomics ; Pilot Projects ; Weight Loss
    Chemische Substanzen Hydroxybutyrates ; Heme (42VZT0U6YR) ; Glutathione (GAN16C9B8O) ; 2-hydroxybutyric acid (O0ADR0I4H5)
    Sprache Englisch
    Erscheinungsdatum 2016-01-10
    Erscheinungsland England
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2711897-6
    ISSN 2314-6753 ; 2314-6745
    ISSN (online) 2314-6753
    ISSN 2314-6745
    DOI 10.1155/2016/3467403
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Differential expression of cytochrome P450 omega-hydroxylase isoforms and their association with clinicopathological features in pancreatic ductal adenocarcinoma.

    Gandhi, Ankit V / Saxena, Shivam / Relles, Daniel / Sarosiek, Konrad / Kang, Christopher Y / Chipitsyna, Galina / Sendecki, Jocelyn Andrel / Yeo, Charles J / Arafat, Hwyda A

    Annals of surgical oncology

    2013  Band 20 Suppl 3, Seite(n) S636–43

    Abstract: Background: The cytochrome P450 (CYP) superfamily consists of enzymes that catalyze the oxidation of lipids, steroids, and drugs. In particular, the CYP4 family plays an essential role in lipid metabolism by the ω-hydroxylation of terminal ends of fatty ...

    Abstract Background: The cytochrome P450 (CYP) superfamily consists of enzymes that catalyze the oxidation of lipids, steroids, and drugs. In particular, the CYP4 family plays an essential role in lipid metabolism by the ω-hydroxylation of terminal ends of fatty acids. Disturbance of this system has been associated with increased angiogenesis, proliferation, and metastasis of several cancers. This study aimed to detect the expression of CYP4 isoforms (CYP4A11, CYP4F2, CYP4F3) in pancreatic ductal adenocarcinoma (PDA) and their association with clinicopathological features.
    Methods: Pancreatic specimens were collected from 73 patients who underwent surgical resection at the Thomas Jefferson University Hospital. Quantitative polymerase chain reaction was used to examine the cytochrome P450 isoforms in PDA (n = 62), adjacent-normal (n = 30), and benign tissues (n = 11). Logistic regression models were used to analyze gene expression among tissue types. Spearman rank correlations were calculated for isoform expression and for age. Differences in expression by gender were assessed via t test. Other clinicopathological variables (diabetes, smoking, obesity, T stage, perineural invasion, nodal status) were analyzed by Wilcoxon rank sum.
    Results: CYP4 expression for isoforms was significantly higher in PDA tissues versus matched-adjacent tissues (p < 0.01). PDA tumors expressed significantly higher levels of CYP4F2 and CYP4F3 when compared to benign lesions (p < 0.01). Significant associations were found between low levels of CYP4F2 and CYP4F3 and increased age of PDA patients. Interestingly, all isoforms were expressed at higher levels in male patients.
    Conclusions: Transcriptional upregulation of cytochrome P450 ω-hydroxylase suggests that these enzymes have the potential to be used as distinguishing markers in pancreatic pathology.
    Mesh-Begriff(e) Aged ; Carcinoma, Pancreatic Ductal/genetics ; Carcinoma, Pancreatic Ductal/mortality ; Carcinoma, Pancreatic Ductal/pathology ; Cytochrome P-450 Enzyme System/genetics ; Female ; Follow-Up Studies ; Humans ; Isoenzymes ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Pancreas/metabolism ; Pancreatic Neoplasms/genetics ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/pathology ; Prognosis ; RNA, Messenger/genetics ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; Survival Rate
    Chemische Substanzen Isoenzymes ; RNA, Messenger ; Cytochrome P-450 Enzyme System (9035-51-2) ; cytochrome P-450 omega-hydroxylase (EC 1.14.99.-)
    Sprache Englisch
    Erscheinungsdatum 2013-12
    Erscheinungsland United States
    Dokumenttyp Comparative Study ; Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-013-3128-x
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: Clinical significance of serum COL6A3 in pancreatic ductal adenocarcinoma.

    Kang, Christopher Y / Wang, Jonathan / Axell-House, Dierdre / Soni, Pranay / Chu, Mon-Li / Chipitsyna, Galina / Sarosiek, Konrad / Sendecki, Jocelyn / Hyslop, Terry / Al-Zoubi, Mazhar / Yeo, Charles J / Arafat, Hwyda A

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

    2013  Band 18, Heft 1, Seite(n) 7–15

    Abstract: Type VI collagen (COL6) forms a microfibrillar network often associated with type I collagen and constitutes a major component of the desmoplastic reaction in pancreatic ductal adenocarcinoma (PDA). We have demonstrated recently that the α3 chain of COL6, ...

    Abstract Type VI collagen (COL6) forms a microfibrillar network often associated with type I collagen and constitutes a major component of the desmoplastic reaction in pancreatic ductal adenocarcinoma (PDA). We have demonstrated recently that the α3 chain of COL6, COL6A3, is highly expressed in PDA tissue and undergoes tumor-specific alternative splicing. In this study, we investigated the diagnostic value and clinical significance of circulating COL6A3 protein and mRNA in PDA. COL6A3 levels in sera from patients with PDA (n = 44), benign lesions (n = 46) and age-matched healthy volunteers (n = 30) were analyzed by enzyme-linked immunosorbent assays (ELISA). Predictive abilities of COL6A3 were examined using receiver operating characteristic (ROC) curves from logistic regression models for PDA versus normal or benign serum levels. Expression levels were correlated with clinicopathological parameters. Real-time PCR was used to analyze the presence of COL6A3 mRNA containing alternative spliced exons E3, E4, and E6. Circulating COL6A3 protein levels were significantly elevated in PDA patients when compared to healthy sera (p = 0.0001) and benign lesions (p = 0.0035). The overall area under the ROC was 0.975. Log(COL6A3) alone provided good discrimination between PDA and benign lesions (area under the curve (AUC) = 0.817), but combined with CA19-9 provided excellent discrimination (AUC = 0.904). Interestingly, high COL6A3 serum levels were significantly associated with perineural invasion and cigarette smoking. Combined E3, E4, and E6 serum RNA values provided good sensitivity but low specificity. Our data demonstrate for the first time the potential clinical significance of circulating COL6A3 in the diagnosis of pancreatic malignancy.
    Mesh-Begriff(e) Adenocarcinoma/diagnosis ; Adenocarcinoma/pathology ; Aged ; Area Under Curve ; Biomarkers, Tumor/blood ; CA-19-9 Antigen/blood ; Case-Control Studies ; Collagen Type VI/blood ; Collagen Type VI/genetics ; Enteric Nervous System/pathology ; Exons ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Invasiveness ; Pancreas/innervation ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/pathology ; Proportional Hazards Models ; RNA, Messenger/blood ; ROC Curve
    Chemische Substanzen Biomarkers, Tumor ; CA-19-9 Antigen ; Collagen Type VI ; RNA, Messenger
    Sprache Englisch
    Erscheinungsdatum 2013-09-04
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1007/s11605-013-2326-y
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: Overexpressing TNF-alpha in pancreatic ductal adenocarcinoma cells and fibroblasts modifies cell survival and reduces fatty acid synthesis via downregulation of sterol regulatory element binding protein-1 and activation of acetyl CoA carboxylase.

    Al-Zoubi, Mazhar / Chipitsyna, Galina / Saxena, Shivam / Sarosiek, Konrad / Gandhi, Ankit / Kang, Christopher Y / Relles, Daniel / Andrelsendecki, Jocelyn / Hyslop, Terry / Yeo, Charles J / Arafat, Hwyda A

    Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

    2013  Band 18, Heft 2, Seite(n) 257–68; discussion 268

    Abstract: The effect of tumor necrosis factor-alpha (TNF-α) gene delivery has been suggested as a potentially useful therapeutic approach to improve the chemotherapeutic treatment of patients with pancreatic ductal adenocarcinoma (PDA), but the exact mechanism of ... ...

    Abstract The effect of tumor necrosis factor-alpha (TNF-α) gene delivery has been suggested as a potentially useful therapeutic approach to improve the chemotherapeutic treatment of patients with pancreatic ductal adenocarcinoma (PDA), but the exact mechanism of its action is not clearly understood. In this study, we analyzed the expression profile of TNF-α in PDA tissue and explored its potential role in fatty acid synthase (FAS) regulation in PDA cells and in fibroblasts. Quantitative real-time polymerase chain reaction was used to examine the expression of TNF-α in PDA, matching adjacent tissues, and benign lesions. Logistic regression models with robust variance were used to analyze the gene expression levels, and Kaplan-Meier survival curves were generated. In vitro, we overexpressed the TNF-α gene in PDA cells and fibroblasts and analyzed its effect on cell survival, migration, and on members of the FAS signaling pathway. We also evaluated TNF-α effects on a panel of inflammation-, angiogenesis-, and metastasis-related markers. In the tumor tissue of PDA patients, compared with their matched adjacent tissue, expression levels of TNF-α were not statistically different and did not correlate with survival or any other examined clinicopathological features. Overexpression of TNF-α significantly (p < 0.05) reduced PDA and fibroblast cell migration. In PDA cells that highly overexpress TNF-α, this was associated with a significant reduction of FAS mRNA and protein expression levels and significant (p < 0.05) reduction of SREBP-1 and ACC mRNA. Reduction of FAS by TNF-α was inhibited when either SREBP-1 or ACC was knocked down by siRNA. PDA cells and fibroblasts that overexpress TNF-α displayed differential regulation of several inflammation-related markers and reduced levels of metastasis-related genes. Our data demonstrate a previously unknown multi-targeted involvement of TNF-α in PDA lipogenesis and inflammation and metastasis and suggest that intratumoral introduction of TNF-α may have the potential as a novel therapeutic approach in human PDA.
    Mesh-Begriff(e) AMP-Activated Protein Kinase Kinases ; AMP-Activated Protein Kinases/metabolism ; Acetyl-CoA Carboxylase/genetics ; Acetyl-CoA Carboxylase/metabolism ; Adenocarcinoma/genetics ; Adenocarcinoma/metabolism ; Adenocarcinoma/pathology ; Aged ; Cell Movement ; Cell Survival ; Cystadenoma/genetics ; Cystadenoma/metabolism ; Cystadenoma/pathology ; Down-Regulation ; Fatty Acids/biosynthesis ; Fatty Acids/genetics ; Female ; Fibroblasts ; Gene Expression ; Gene Expression Regulation, Neoplastic ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Pancreas/metabolism ; Pancreatic Neoplasms/genetics ; Pancreatic Neoplasms/metabolism ; Pancreatic Neoplasms/pathology ; Phosphorylation ; Protein Serine-Threonine Kinases/metabolism ; RNA, Messenger/metabolism ; ROC Curve ; Signal Transduction ; Sterol Regulatory Element Binding Protein 1/genetics ; Sterol Regulatory Element Binding Protein 1/metabolism ; Survival Rate ; Tumor Cells, Cultured ; Tumor Necrosis Factor-alpha/genetics ; Tumor Necrosis Factor-alpha/metabolism
    Chemische Substanzen Fatty Acids ; RNA, Messenger ; Sterol Regulatory Element Binding Protein 1 ; Tumor Necrosis Factor-alpha ; Protein Serine-Threonine Kinases (EC 2.7.11.1) ; STK11 protein, human (EC 2.7.11.1) ; AMP-Activated Protein Kinase Kinases (EC 2.7.11.3) ; AMP-Activated Protein Kinases (EC 2.7.11.31) ; Acetyl-CoA Carboxylase (EC 6.4.1.2)
    Sprache Englisch
    Erscheinungsdatum 2013-10-04
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2012365-6
    ISSN 1873-4626 ; 1934-3213 ; 1091-255X
    ISSN (online) 1873-4626 ; 1934-3213
    ISSN 1091-255X
    DOI 10.1007/s11605-013-2370-7
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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