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Article ; Online: Emerging new technology: are surgeons leading or being led?

Papa, Moshe Z / Zbar, Andrew P / Zippel, Douglas B

2013 Volume 107, Issue 7, Page(s) 683–684

MeSH term(s)	Biomedical Technology/economics ; Biomedical Technology/trends ; Coercion ; Conflict of Interest ; Endoscopy/adverse effects ; Evaluation Studies as Topic ; Health Care Sector/economics ; Health Care Sector/standards ; Health Care Sector/trends ; Humans ; Operating Rooms/trends ; Patient Safety ; Patient Selection ; Physician-Patient Relations ; Physicians/economics ; Remuneration ; Societies, Medical ; Specialties, Surgical ; Surgical Equipment/trends ; Surgical Instruments/trends ; Treatment Outcome
Language	English
Publishing date	2013-06
Publishing country	United States
Document type	Editorial
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.23314
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Zs.A 706: Show issues

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Article: The BRCA breast cancer patient: treat the tumor or the problem?

Zippel, Douglas / Papa, Moshe Z

Journal of surgical oncology

2008 Volume 97, Issue 7, Page(s) 561–562

MeSH term(s)	Adult ; Breast Neoplasms/genetics ; Female ; Genes, BRCA1 ; Genetic Predisposition to Disease ; Genetic Testing ; Humans ; Middle Aged ; Mutation
Language	English
Publishing date	2008-06-01
Publishing country	United States
Document type	Case Reports ; Editorial
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.21000
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Zs.A 706: Show issues

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Article: BRCA1 at the crossroad of multiple cellular pathways: approaches for therapeutic interventions.

Yarden, Ronit I / Papa, Moshe Z

Molecular cancer therapeutics

2006 Volume 5, Issue 6, Page(s) 1396–1404

Abstract: Approximately 10% of the cases of breast cancer and invasive ovarian cancer are hereditary, occurring predominantly in women with germ-line mutations in the BRCA1 or BRCA2 genes. Low expression of these genes in sporadic tumors extends their significance ...

Abstract	Approximately 10% of the cases of breast cancer and invasive ovarian cancer are hereditary, occurring predominantly in women with germ-line mutations in the BRCA1 or BRCA2 genes. Low expression of these genes in sporadic tumors extends their significance to sporadic breast and ovarian cancers as well. For over a decade since its identification, extensive research has been directed toward understanding the function of the breast and ovarian tumor suppressor gene BRCA1. The long-term goal has been to identify the biochemical pathways reliant on BRCA1 that can be exploited for developing targeted therapies and benefit mutation carriers. To date, no one specific role has been identified, but rather it is clear that BRCA1 has significant roles in multiple fundamental cellular processes, including control of gene expression, chromatin remodeling, DNA repair, cell cycle checkpoint control, and ubiquitination, and overall is important for maintenance of genomic stability. Major findings and potential BRCA1-dependent therapies will be discussed.
MeSH term(s)	Animals ; BRCA1 Protein/physiology ; Breast Neoplasms/genetics ; Female ; Gene Expression Regulation, Neoplastic/physiology ; Humans ; Mutation ; Signal Transduction
Chemical Substances	BRCA1 Protein
Language	English
Publishing date	2006-07-04
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2063563-1
ISSN	1538-8514 ; 1535-7163
ISSN (online)	1538-8514
ISSN	1535-7163
DOI	10.1158/1535-7163.MCT-05-0471
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Zs.A 5750: Show issues

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Article: The use of MR imaging guided focused ultrasound in breast cancer patients; a preliminary phase one study and review.

Zippel, Douglas B / Papa, Moshe Z

Breast cancer (Tokyo, Japan)

2005 Volume 12, Issue 1, Page(s) 32–38

Abstract: The use of high energy focused ultrasound (FUS) waves to destroy tumor tissue in breast cancer is explored. High energy FUS destroys cells by raising the temperature of the treated volume high enough to denature cell proteins and bring about cellular ... ...

Abstract	The use of high energy focused ultrasound (FUS) waves to destroy tumor tissue in breast cancer is explored. High energy FUS destroys cells by raising the temperature of the treated volume high enough to denature cell proteins and bring about cellular death. The absorbed energy results in extremely high tissue gradients between target cells and surrounding tissue, so the effect of the focused energy is concentrated only at the target, leaving the healthy tissue unscathed. This phase one trial has examined the possibility of ablating breast carcinoma using MRI Guided FUS (MRIgFUS) in place of lumpectomy. Ten female patients underwent the procedure at the Chaim Sheba Medical Center between September 2002 and August 2004, using the ExAblate 2000 (InSightec, Haifa Israel Ltd.). Seven to 10 days after the procedure, all patients underwent standard lumpectomy and axillary sampling to complete standard treatment and to allow pathological evaluation of the procedure. Two patients had a complete pathological response. The remaining 8 patients had varying amounts of residual tumor; 2 had microscopic foci of residual carcinoma, 3 had 10% residual tumor, and 3 had 10-30% of residual tumor. Although still in its infancy, the future role of this type of ablation in breast cancer and other tumors is discussed.
MeSH term(s)	Aged ; Breast Neoplasms/pathology ; Breast Neoplasms/therapy ; Carcinoma, Ductal, Breast/pathology ; Carcinoma, Ductal, Breast/therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Mastectomy, Segmental ; Middle Aged ; Ultrasonic Therapy/methods
Language	English
Publishing date	2005-01-11
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2052429-8
ISSN	1340-6868
ISSN	1340-6868
DOI	10.2325/jbcs.12.32
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Zs.A 5536: Show issues

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Article ; Online: BRCA1-dependent Chk1 phosphorylation triggers partial chromatin disassociation of phosphorylated Chk1 and facilitates S-phase cell cycle arrest.

Yarden, Ronit I / Metsuyanim, Sally / Pickholtz, Itay / Shabbeer, Shabana / Tellio, Hadass / Papa, Moshe Z

The international journal of biochemistry & cell biology

2012 Volume 44, Issue 11, Page(s) 1761–1769

Abstract: Chk1 phosphorylation by the PI3-like kinases ATR and ATM is critical for its activation and its role in prevention of premature mitotic entry in response to DNA damage or stalled replication. The breast and ovarian tumor suppressor, BRCA1, is among ... ...

Abstract	Chk1 phosphorylation by the PI3-like kinases ATR and ATM is critical for its activation and its role in prevention of premature mitotic entry in response to DNA damage or stalled replication. The breast and ovarian tumor suppressor, BRCA1, is among several checkpoint mediators that are required for Chk1 activation by ATM and ATR. Previously we showed that BRCA1 is necessary for Chk1 phosphorylation and activation following ionizing radiation. BRCA1 has been implicated in S-phase checkpoint control yet its mechanism of action is not well characterized. Here we report that BRCA1 is critical for Chk1 phosphorylation in response to inhibition of replication by either cisplatin or hydroxyurea. While Chk1 phosphorylation of S317 is fully dependent on BRCA1, additional proteins may mediate S345 phosphorylation at later time points. In addition, we show that a subset of phosphorylated Chk1 is released from the chromatin in a BRCA1-dependent manner which may lead to the phosphorylation of Chk1 substrate, Cdc25C, on S216 and to S-phase checkpoint activation. Inhibition of Chk1 kinase by UCN-01 or expression of Chk1 phosphorylation mutants in which the serine residues were substituted with alanine residues abrogates BRCA1-dependent cell cycle arrest in response replication inhibition. These data reveal that BRCA1 facilitates Chk1 phosphorylation and its partial chromatin dissociation following replication inhibition that is likely to be required for S-phase checkpoint signaling.
MeSH term(s)	BRCA1 Protein/metabolism ; Cell Cycle Checkpoints/drug effects ; Cell Cycle Checkpoints/radiation effects ; Cell Line, Tumor ; Checkpoint Kinase 1 ; Chromatin/drug effects ; Chromatin/metabolism ; DNA Damage ; DNA Replication/drug effects ; DNA Replication/radiation effects ; Enzyme Activation/drug effects ; Enzyme Activation/radiation effects ; Humans ; Hydroxyurea/pharmacology ; Mutant Proteins/metabolism ; Phosphorylation/drug effects ; Phosphorylation/radiation effects ; Phosphoserine/metabolism ; Protein Kinases/metabolism ; Radiation, Ionizing ; S Phase/drug effects ; S Phase/radiation effects ; Signal Transduction/drug effects ; Signal Transduction/radiation effects ; Stress, Physiological/drug effects ; Stress, Physiological/radiation effects
Chemical Substances	BRCA1 Protein ; Chromatin ; Mutant Proteins ; Phosphoserine (17885-08-4) ; Protein Kinases (EC 2.7.-) ; CHEK1 protein, human (EC 2.7.11.1) ; Checkpoint Kinase 1 (EC 2.7.11.1) ; Hydroxyurea (X6Q56QN5QC)
Language	English
Publishing date	2012-06-26
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1228429-4
ISSN	1878-5875 ; 1357-2725
ISSN (online)	1878-5875
ISSN	1357-2725
DOI	10.1016/j.biocel.2012.06.026
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Zs.A 431: Show issues

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Article ; Online: Appendiceal carcinoid at a large tertiary center: pathologic findings and long-term follow-up evaluation.

Shapiro, Ron / Eldar, Shai / Sadot, Eran / Papa, Moshe Z / Zippel, Douglas B

American journal of surgery

2011 Volume 201, Issue 6, Page(s) 805–808

Abstract: Background: Appendiceal carcinoid tumor is the most common type of primary appendiceal malignant lesion. Nonetheless; it is an exceedingly rare diagnosis; found in only about .3% to .9% of appendectomy specimens. We report the clinical and pathologic ... ...

Abstract	Background: Appendiceal carcinoid tumor is the most common type of primary appendiceal malignant lesion. Nonetheless; it is an exceedingly rare diagnosis; found in only about .3% to .9% of appendectomy specimens. We report the clinical and pathologic characteristics of carcinoids found with long-term follow-up evaluation. Methods: Data of patients who were histologically reported to have carcinoid tumor of the appendix; in a single center; during a 16-year period were collected retrospectively. In addition; patients were contacted for current follow-up information. Results: A total of 44 patients were diagnosed with appendiceal carcinoid during the study period. The median follow-up period for the cohort was 7 years. No evidence of any recurrent disease or other noncarcinoid neoplasm was found. Conclusions: Our data confirm the good prognosis as seen in earlier reports. The long-term significance of having a carcinoid; and whether this poses a risk for future neoplasms; need even longer-term studies.
MeSH term(s)	Adolescent ; Adult ; Aged ; Appendectomy ; Appendiceal Neoplasms/diagnosis ; Appendiceal Neoplasms/epidemiology ; Appendiceal Neoplasms/surgery ; Carcinoid Tumor/diagnosis ; Carcinoid Tumor/epidemiology ; Carcinoid Tumor/surgery ; Child ; Diagnosis, Differential ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Incidence ; Israel/epidemiology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Time Factors ; Young Adult
Language	English
Publishing date	2011-06
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2010.04.016
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Uk I Zs.42: Show issues

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Article ; Online: The significance of occult carcinoids in the era of laparoscopic appendectomies.

Shapiro, Ron / Eldar, Shai / Sadot, Eran / Venturero, Moris / Papa, Moshe Z / Zippel, Douglas B

Surgical endoscopy

2010 Volume 24, Issue 9, Page(s) 2197–2199

Abstract: Background: We present data acquired in our institution about the incidence of incidental appendiceal carcinoids over a period of 16 years. The possibility of occult carcinoids raises the question of appendectomy of a noninflamed appendix during ... ...

Abstract	Background: We present data acquired in our institution about the incidence of incidental appendiceal carcinoids over a period of 16 years. The possibility of occult carcinoids raises the question of appendectomy of a noninflamed appendix during diagnostic laparoscopy for suspected appendicitis. Methods: We performed a retrospective chart analysis of the surgical registry of a university-affiliated tertiary care center of a major population area for the past 16 years. Data were collected on all patients (n = 7592) who underwent appendectomy for the presumed diagnosis of acute appendicitis. Outcome measures were the incidence of incidental carcinoids of the appendix found during appendectomies and whether the introduction of laparoscopic appendectomy should alter the surgical management of a normal-appearing appendix. Results: A total of 20 carcinoid appendices were resected by open surgery and 17 by laparoscopy. The diagnosis of a carcinoid tumor was not suspected in any patient before the operation, nor was a tumor identified at the time of the operation. In 6 (16%) patients the appendix appeared normal at the time of the operation. Conclusions: It has long been the standard of care to remove any appendix found in laparotomy for suspected appendicitis, but it is not clear what should be done during laparoscopy for suspected appendicitis when the appendix appears normal. Our data confirm the presence of occult carcinoids in normal-appearing appendices. Further studies are needed to determine the clinical significance of this finding.
MeSH term(s)	Adolescent ; Adult ; Appendectomy/methods ; Appendiceal Neoplasms/epidemiology ; Appendiceal Neoplasms/pathology ; Appendiceal Neoplasms/surgery ; Carcinoid Tumor/epidemiology ; Carcinoid Tumor/pathology ; Carcinoid Tumor/surgery ; Child ; Female ; Humans ; Incidence ; Incidental Findings ; Laparoscopy/methods ; Male ; Middle Aged ; Registries ; Retrospective Studies
Language	English
Publishing date	2010-02-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-010-0926-0
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Zs.A 2214: Show issues

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Article ; Online: Single-nucleotide polymorphisms in the p53 pathway genes modify cancer risk in BRCA1 and BRCA2 carriers of Jewish-Ashkenazi descent.

Yarden, Ronit I / Friedman, Eitan / Metsuyanim, Sally / Olender, Tzvia / Ben-Asher, Edna / Papa, Moshe Z

Molecular carcinogenesis

2010 Volume 49, Issue 6, Page(s) 545–555

Abstract: Germline mutations in the BRCA1 and BRCA2 genes are associated with a significantly increased lifetime risk for developing breast and/or ovarian cancer. However, incomplete penetrance and substantial variability in age of disease onset among carriers of ... ...

Abstract	Germline mutations in the BRCA1 and BRCA2 genes are associated with a significantly increased lifetime risk for developing breast and/or ovarian cancer. However, incomplete penetrance and substantial variability in age of disease onset among carriers of the same mutation suggests the involvement of additional modifier genes and/or environmental factors. Somatic inactivating mutations in the p53 gene and genes of the p53 pathway often accompany BRCA1/2-associated tumors. Therefore, we assessed whether these genes are modifiers of penetrance. We genotyped Jewish-Ashkenazi women for functional single-nucleotide polymorphisms (SNPs) in the AKT1 (C>T rs3730358) and the PERP (C>T rs2484067) genes that affect p53-mediated apoptosis, as well as two tag-SNPs in the CHEK2 (C>T rs743184) and the ZBRK1/ZNF350 (G>A rs2278414) genes that encode for proteins involved in growth arrest following DNA damage. The study population included 138 healthy women, 148 breast/ovarian cancer BRCA1/2 mutation carriers, 121 asymptomatic BRCA1/2 mutation carriers, and 210 sporadic noncarrier breast cancer patients. Utilizing lambda(2) and Kaplan-Meier analysis revealed a hazard ratio (HR) of 3.23 (95% CI: 1.44-54, P = 0.0184) for the TT genotype of AKT (rs3730358), HR = 2.105 (95% CI: 1.049-7.434, P = 0.039) for CHEK2 CC genotype (rs743184), and HR = 2.4743 (95% CI: 1.205-11.53, P = 0.022) for the AG genotype of ZBRK1/ZNF350 (rs2278414). No significant association between PERP variants and cancer was identified HR = 0.662 (95% CI: 0.289-1.324, P = 0.261). Our results suggest that genes that act upstream of p53, or participate in the DNA damage response, may modify the risk of cancer in women with mutant BRCA1/2 alleles.
MeSH term(s)	Adult ; Breast Neoplasms/ethnology ; Breast Neoplasms/genetics ; Female ; Genes, BRCA1 ; Genes, BRCA2 ; Genes, p53 ; Genetic Predisposition to Disease ; Humans ; Jews/genetics ; Middle Aged ; Mutation ; Ovarian Neoplasms/ethnology ; Ovarian Neoplasms/genetics ; Polymorphism, Single Nucleotide
Language	English
Publishing date	2010-06
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1004029-8
ISSN	1098-2744 ; 0899-1987
ISSN (online)	1098-2744
ISSN	0899-1987
DOI	10.1002/mc.20618
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Zs.A 2664: Show issues

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Article ; Online: The posterior intrahepatic approach to the left portal pedicle using the ligamentum venosum: anatomical basis.

Sareli, Merab / Chanukvadze, Ilia / Valeanu, Adrian / Zippel, Douglas B / Shapiro, Ron / Papa, Moshe Z

Surgical and radiologic anatomy : SRA

2009 Volume 31, Issue 10, Page(s) 809–813

Abstract: Purpose: Prevention of blood loss in liver resections is essential for reducing postoperative morbidity. The main method to control bleeding during surgery of the left hemiliver is occlusion of the left portal pedicle. This may be accomplished by hilar, ...

Abstract	Purpose: Prevention of blood loss in liver resections is essential for reducing postoperative morbidity. The main method to control bleeding during surgery of the left hemiliver is occlusion of the left portal pedicle. This may be accomplished by hilar, fissural or posterior intrahepatic techniques. However, these techniques may injure transposed vessels or bile ducts from the right portal pedicle to the left. The purpose of this study was to describe the anatomical aspects of the posterior intrahepatic ligamentum venosum approach to the left portal pedicle. Methods: Anatomical study was carried out on 215 isolated adult livers. In 57 specimens, sections of the extra- and intrahepatic portions of the left portal pedicle were prepared under stereoscopic microscopy. Results: The ligamentum venosum is the anatomical landmark between the medial and lateral portions of the left portal vein. The convergence of the ligamentum venosum along the left portal pedicle is where the left portal sheath reaches its maximal thickness and these connections are tight. In 8-12%, the medial portion of the left portal pedicle includes a transposed right paramedian vein or right-sided bile ducts. Conclusions: According to our anatomical study, we believe that it is possible to use the ligamentum venosum as an anatomical guide to achieve a controlled approach of the left portal pedicle during left-sided hepatectomies. Moreover, ligation of the left portal pedicle at its convergence with the ligamentum venosum may prevent erroneous injury of transposed right paramedian vessels or bile ducts.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Loss, Surgical/prevention & control ; Cadaver ; Female ; Hepatectomy/methods ; Humans ; Ligaments/anatomy & histology ; Liver/blood supply ; Male ; Middle Aged
Language	English
Publishing date	2009-07-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	632839-8
ISSN	1279-8517 ; 0930-312X ; 0930-1038
ISSN (online)	1279-8517
ISSN	0930-312X ; 0930-1038
DOI	10.1007/s00276-009-0530-y
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Article: Germline CHEK2 mutations in Jewish Ashkenazi women at high risk for breast cancer.

Laitman, Yael / Kaufman, Bella / Lahad, Ephrat Levy / Papa, Moshe Z / Friedman, Eitan

The Israel Medical Association journal : IMAJ

2007 Volume 9, Issue 11, Page(s) 791–796

Abstract: Background: Germline mutations in BRCA1 and BRCA2 genes account for only 20-40% of familial breast cancer cases. The CHEK2 gene encodes a checkpoint kinase, involved in response to DNA damage, and hence is a candidate gene for breast cancer ... ...

Abstract	Background: Germline mutations in BRCA1 and BRCA2 genes account for only 20-40% of familial breast cancer cases. The CHEK2 gene encodes a checkpoint kinase, involved in response to DNA damage, and hence is a candidate gene for breast cancer susceptibility. Indeed, the CHEK21100delC truncating mutation was reported in a subset of mostly North European breast cancer families. The rate of the CHEK21100delC variant in the Ashkenazi Jewish population was reported to be 0.3%. Objectives: To evaluate whether CHEK2 germline mutations contribute to a breast cancer predisposition in Ashkenazi Jewish high risk families. Methods: High risk Ashkenazi Jewish women, none of whom was a carrier of the predominant Jewish mutations in BRCA1/BRCA2, were genotyped for germline mutations in the CHEK2 gene by exon-specific polymerase chain reaction followed by denaturing gradient gel electrophoresis and sequencing of abnormally migrating fragments. Results:** Overall, 172 high risk women were genotyped: 75 (43.6%) with breast cancer (average age at diagnosis 49.6 +/- 9.6 years, mean +/- SD) and 97 asymptomatic individuals (age at counseling 48.3 +/- 8.2 years). No truncating mutations were noted and four previously described missense mutations were detected (R3W 1.2%, 1157T 1.2%, R180C 0.6% and S428F 5%), one silent polymorphism (E84E 20.5%) and one novel missense mutation (Y424H 1.2%). Segregation analysis of the 1157T and S428F mutations (shown to affect protein function) with the cancer phenotype showed concordance for the CHK21157T mutation, as did two of three families with the CHK2S428F mutation. Conclusions: CHEK2 missense mutations may contribute to breast cancer susceptibility in Ashkenazi Jews.
MeSH term(s)	Adult ; Aged ; Breast Neoplasms/epidemiology ; Breast Neoplasms/genetics ; Checkpoint Kinase 2 ; Electrophoresis, Gel, Pulsed-Field ; Female ; Genetic Predisposition to Disease/ethnology ; Genetic Predisposition to Disease/genetics ; Germ-Line Mutation/genetics ; Humans ; Israel ; Jews/genetics ; Middle Aged ; Mutation, Missense/genetics ; Nucleic Acid Denaturation ; Ovarian Neoplasms/epidemiology ; Pedigree ; Protein-Serine-Threonine Kinases/genetics ; Sequence Analysis, DNA
Chemical Substances	Checkpoint Kinase 2 (EC 2.7.1.11) ; CHEK2 protein, human (EC 2.7.11.1) ; Protein-Serine-Threonine Kinases (EC 2.7.11.1)
Language	English
Publishing date	2007-11
Publishing country	Israel
Document type	Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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