104 results on '"Lau, Frank H."'
Search Results
2. National health disparities in incisional hernia repair outcomes: An analysis of the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) 2012-2014
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Hoffman, Ryan D., Danos, Denise M., and Lau, Frank H.
- Published
- 2021
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3. Acellular Dermal Matrix–Associated Complications in Implant-Based Breast Reconstruction: A Multicenter, Prospective, Randomized Controlled Clinical Trial Comparing Two Human Tissues
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Broyles, Justin M., Liao, Eric C., Kim, John, Heistein, Jonathan, Sisco, Mark, Karp, Nolan, Lau, Frank H., and Chun, Yoon S.
- Published
- 2021
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4. Health Insurance Portability and Accountability Act Noncompliance in Patient Photograph Management in Plastic Surgery
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Lam, Jonathan S., Simpson, Benjamin K., and Lau, Frank H.
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- 2019
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5. Phentermine: A Systematic Review for Plastic and Reconstructive Surgeons
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Lim, Soobin, Rogers, Lori K., Tessler, Oren, Mundinger, Gerhard S., Rogers, Camille, and Lau, Frank H.
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- 2018
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6. Regenerative vs flap-based limb salvage: a multi-centered, prospective, randomized controlled trial.
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Lau, Frank H, Hoffman, Ryan D, Danos, Denise, Torabi, Radbeh, Patterson, Charles W, McKendrick, Ann D, Stalder, Mark, Dupin, Charles, and Hilaire, Hugo St.
- Abstract
Aim: The goal of this study was to compare success rates of a regenerative limb salvage approach (rLS) using dehydrated human chorion amnion membrane (dHACM) to traditional flap-based limb salvage (fLS). Materials & methods: This prospective RTC enrolled patients presenting with complex extremity wounds over a 3-year period. Primary outcomes included success of primary reconstruction, persistence of exposed structures, time to definitive closure, and time to weight bearing. Results: Patients meeting inclusion criteria were randomized to fLS (n = 14) or rLS (n = 25). The primary reconstructive method was successful for 85.7% of fLS subjects and 80% of rLS subjects (p = 1.00). Conclusion: This trial provides strong evidence that rLS is an effective option in the setting of complex extremity wounds, with success rates comparable to traditional flaps. Clinical Trial Registration: NCT03521258 (ClinicalTrials.gov) Chronic and traumatic wounds may result in loss of limb without appropriate medical treatment. Traditionally large wounds with exposed bone or other important structures require surgery to transfer healthy soft tissue (a tissue flap) from one area of the body to the defect created by the wound. Our study seeks to demonstrate an approach to similar wounds using a biologic dressing to avoid extensive surgery. We demonstrate that this biologic dressing made from human membranes has a similar success rate to flap surgery for achieving wound healing. Comparison of flap-based reconstruction to regenerative limb salvage yields similar success rates for complex extremity wounds. [ABSTRACT FROM AUTHOR]
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- 2023
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7. Abstract: Fracture Patterns Following Gunshot Wounds to the Upper Extremity
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Ibrahim, Ahmed M.S., El Hajj, Milad, Saliba, Anthony, Emelife, Patrick I., Lam, Jonathan S., Lau, Frank H., Dupin, Charles L., and Babineaux, Kelly
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- 2016
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8. The Impact of Exogenous Testosterone on Breast Cancer Risk in Transmasculine Individuals.
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Gurrala, Rakesh R., Kumar, Taruni, Yoo, Aran, Mundinger, Gerhard S., Womac, Daniel J., and Lau, Frank H.
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- 2023
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9. Pilot study of minimally adherent silver dressings for acute surgical wounds.
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Berard, Meredyth B. and Lau, Frank H.
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SURGICAL site ,SURGICAL dressings ,SILVER ,PILOT projects ,SURGICAL excision ,RANDOMIZED controlled trials - Abstract
Background and Aims: Minimally adherent silver dressings (SILVER MASD) are antimicrobial, nonirritating, provide a moist wound healing environment, and low cost. The purpose of this pilot, single‐center, non‐blinded randomized controlled trial was to quantify the outcomes of acute surgical wounds treated with MASD versus standard of care (SoC) dressings. Methods: Thirty‐two patients with acute wounds were randomized 1:1 to be treated with MASD once weekly or SoC following surgical excision of skin and/or subcutaneous tissue between September 13, 2016 and November 28, 2017. The outcome variables included clinical infection, time to wound closure, and pain scores at dressing changes. Two independent, one‐sided sample t‐tests were performed to assess statistical significance. Results: There was no difference in wound healing between SILVER MASD and SoC. Dressing changes were less painful for wounds managed with MASD silver dressings. Conclusions: The results of this study suggest that MASD are not less effective in wound healing compared to SoC while also providing the benefit of decreased pain at dressing changes. Therefore, minimally adherent silver dressings can and should be considered a viable option in the management of acute surgical wounds. [ABSTRACT FROM AUTHOR]
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- 2022
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10. Pilot phase results of a prospective, randomized controlled trial of narrowband ultraviolet B phototherapy in hospitalized COVID‐19 patients.
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Lau, Frank H., Powell, Catherine E., Adonecchi, Giacomo, Danos, Denise M., DiNardo, Andrew R., Chugden, Robert J., Wolf, Peter, and Castilla, Carmen F.
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BODY surface area , *COVID-19 , *PHOTOTHERAPY , *HOSPITAL patients - Abstract
COVID‐19 morbidity and mortality are driven by poor immune regulation. Narrowband ultraviolet B (NB‐UVB) phototherapy is standard of care in a number of immune‐dysregulated diseases. To assess the efficacy of NB‐UVB phototherapy for improving COVID‐19 outcomes in high‐risk, hospitalized, we developed the Adaptive Photo‐Protection Trial. This is a multi‐center, prospective, double‐blinded, randomized, placebo‐controlled trial. The pilot phase results are reported here. Consecutive patients admitted with a positive COVID‐19 PCR were screened for eligibility. Enrolled subjects were computer randomized 1:1 to NB‐UVB or placebo phototherapy. Subjects were treated daily with escalating doses on 27% of their body surface area for up to 8 consecutive days. Primary outcomes were safety and efficacy, defined as persistent or painful erythema and 28‐day mortality. Comparisons were made via non‐parametric exact tests. Patients in treatment (n = 15) and placebo (n = 15) arms had similar demographics. No adverse events occurred. Twenty eight‐day mortality was 13.3% in treatment vs. 33.3% in placebo arms (p = 0.39). NB‐UVB phototherapy in hospitalized COVID‐19 patients was safe. Decreased mortality was observed in treated patients but this was statistically non‐significant. Given its low‐cost, scalability, and adjunctive nature, NB‐UVB has the potential to improve COVID‐19 outcomes. Continuation of this trial is warranted. [ABSTRACT FROM AUTHOR]
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- 2022
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11. Responsiveness of the Michigan Hand Outcomes Questionnaire and Physical Measurements in Outcome Studies of Distal Radius Fracture Treatment
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Kotsis, Sandra V., Lau, Frank H., and Chung, Kevin C.
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- 2007
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12. A Role for Adipocytes and Adipose Stem Cells in the Breast Tumor Microenvironment and Regenerative Medicine.
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Brock, Courtney K., Hebert, Katherine L., Artiles, Maria, Wright, Maryl K., Cheng, Thomas, Windsor, Gabrielle O., Nguyen, Khoa, Alzoubi, Madlin S., Collins-Burow, Bridgette M., Martin, Elizabeth C., Lau, Frank H., Bunnell, Bruce A., and Burow, Matthew E.
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STEM cells ,FAT cells ,TUMOR microenvironment ,REGENERATIVE medicine ,BREAST cancer ,METABOLIC disorders - Abstract
Obesity rates are climbing, representing a confounding and contributing factor to many disease states, including cancer. With respect to breast cancer, obesity plays a prominent role in the etiology of this disease, with certain subtypes such as triple-negative breast cancer having a strong correlation between obesity and poor outcomes. Therefore, it is critical to examine the obesity-related alterations to the normal stroma and the tumor microenvironment (TME). Adipocytes and adipose stem cells (ASCs) are major components of breast tissue stroma that have essential functions in both physiological and pathological states, including energy storage and metabolic homeostasis, physical support of breast epithelial cells, and directing inflammatory and wound healing responses through secreted factors. However, these processes can become dysregulated in both metabolic disorders, such as obesity and also in the context of breast cancer. Given the well-established obesity-neoplasia axis, it is critical to understand how interactions between different cell types in the tumor microenvironment, including adipocytes and ASCs, govern carcinogenesis, tumorigenesis, and ultimately metastasis. ASCs and adipocytes have multifactorial roles in cancer progression; however, due to the plastic nature of these cells, they also have a role in regenerative medicine, making them promising tools for tissue engineering. At the physiological level, the interactions between obesity and breast cancer have been examined; here, we will delineate the mechanisms that regulate ASCs and adipocytes in these different contexts through interactions between cancer cells, immune cells, and other cell types present in the tumor microenvironment. We will define the current state of understanding of how adipocytes and ASCs contribute to tumor progression through their role in the tumor microenvironment and how this is altered in the context of obesity. We will also introduce recent developments in utilizing adipocytes and ASCs in novel approaches to breast reconstruction and regenerative medicine. [ABSTRACT FROM AUTHOR]
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- 2021
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13. Factors influencing residents’ decisions to pursue a career in hand surgery: a national survey
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Chung, Kevin C, Lau, Frank H, Kotsis, Sandra V, and Kim, H.Myra
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- 2004
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14. Silas Weir Mitchell, MD: the physician who discovered causalgia
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Lau, Frank H and Chung, Kevin C
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- 2004
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15. Treatment of a recurrent ischial ulcer with injected exosomes.
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Messa, Genevieve E, Tiongco, Rafael P, and Lau, Frank H
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EXOSOMES ,MESENCHYMAL stem cells ,PRESSURE ulcers ,ULCERS ,WOUND care - Abstract
Pressure ulcers (PUs) affect 2.5 million patients per year. Even after successful reconstruction, 50% of PUs recur. Patients with multiply recurrent PUs eventually consume all locoregional donor sites. This underscores the need for novel, less invasive approaches in PU reconstruction. Here, we report the first successful use of mesenchymal stem cell exosomes in PU reconstruction. The patient presented with a right ischial ulcer that persisted despite 9 months of wound care and appropriate antibiotic therapy. After six subcutaneous ExoFlo exosome injections over 8 weeks, the PU was completely healed. Additional studies of this promising technology should be performed. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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16. Accurately Quantifying Breast Cancer Driven Extracellular Matrix Fiber Alignment in Primary Human Breast Tissue
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Gurrala, Rakesh, Byrne, C. Ethan, Brown, Loren M., Tiongco, Rafael Felix P., Marrin, Elizabeth C., and Lau, Frank H.
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- 2021
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17. Prevalence of Accessory Branches and Other Anatomical Variations in the Radial Artery Encountered during Radial Forearm Flap Harvest: A Systematic Review and Meta-analysis.
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Hoffman, Ryan D., Danos, Denise M., Lin, Samuel J., Lau, Frank H., and Kim, Peter S.
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RADIAL artery ,ANATOMICAL variation ,META-analysis ,FOREARM ,ONLINE databases ,POSTHARVEST diseases - Abstract
Background Harvest of the radial forearm flap (RFF) for reconstructive surgery is proceeded by the Allen test to assess for adequate contralateral perfusion of the hand, yet the Allen test may fail to detect anatomical variations in the radial artery such as aberrant branching. Therefore, the goal of this study was to systematically review the literature regarding anatomical abnormalities of the radial artery that can affect flap harvest and to perform a meta-analysis to estimate the prevalence of such abnormalities. Methods A systematic review of the literature was conducted using five online databases to identify all instances of radial artery anatomical variations. Abstracts were reviewed and categorized into either (1) large cohort studies of anatomical variations identified by angiogram or (2) case reports specifically mentioning anomalous or accessory branches of the radial artery. Data from the large cohort studies were included in a random effect meta-analysis to estimate the prevalence of such variations. Results Eighteen angiogram cohort studies containing a total of 18,115 patients were included in the meta-analysis. Accessory branches were the least common anatomical variant reported, with an estimated average prevalence of 0.5%. Prevalence estimates for more common anatomical variants, including radial artery loops (0.9%), stenosis (1.3%), hypoplasia (1.9%), tortuosity (4.3%), and abnormal origin (5.6%), were also calculated. Thirteen case reports detailing anomalous branches of the radial artery were identified, seven of which involved accessory branches encountered during RFF harvest with no incidence of flap loss. Conclusion Radial artery accessory branches are exceedingly rare, but the prevalence of other anatomical variations that can affect harvest of the RFF warrants consideration. We recommend surgeons consider comprehensive screening prior to RFF harvest to avoid intraoperative discovery of anatomical variants and suggest a low threshold for repeat perfusion testing intraoperatively if radial artery accessory branches are encountered. [ABSTRACT FROM AUTHOR]
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- 2020
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18. Reconsidering the "MR Unsafe" breast tissue expander with magnetic infusion port: A case report and literature review.
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Dibbs, Rami, Culo, Bozena, Tandon, Ravi, Hilaire, Hugo St., Shellock, Frank G., and Lau, Frank H.
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LITERATURE reviews ,BREAST ,MAGNETIC resonance imaging ,TISSUES - Abstract
Breast tissue expanders (TEs) with magnetic infusion ports are labeled "MR Unsafe." Therefore, patients with these implants are typically prevented from undergoing magnetic resonance imaging (MRI). We report a patient with a total submuscular breast TE who inadvertently underwent an MRI exam. She subsequently developed expander exposure, requiring explantation and autologous reconstruction. The safety profile of TEs with magnetic ports and the use of MRI in patients with these implants is surprisingly controversial. Therefore, we present our case report, a systematic literature review, and propose procedural guidelines to help ensure the safety of patients with TEs with magnetic ports that need to undergo MRI exams. [ABSTRACT FROM AUTHOR]
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- 2019
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19. Naringenin Promotes Thermogenic Gene Expression in Human White Adipose Tissue.
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Rebello, Candida J., Greenway, Frank L., Lau, Frank H., Lin, Yuan, Stephens, Jacqueline M., Johnson, William D., and Coulter, Ann A.
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NARINGENIN ,WHITE adipose tissue ,GENE expression ,WEIGHT gain ,CALORIC expenditure ,ADIPOSE tissues ,ANIMAL experimentation ,BODY temperature regulation ,MICE ,OBESITY ,FLAVANONES ,PHARMACODYNAMICS - Abstract
Objective: Naringenin, a citrus flavonoid, prevents diet-induced weight gain and improves glucose and lipid metabolism in rodents. There is evidence that naringenin activates brown fat and increases energy expenditure in mice, but little is known about its effects in humans. The goal of this study was to examine the effects of naringenin on energy expenditure in adipose tissue.Methods: Human white adipocyte cultures (hADSC) and abdominal subcutaneous adipose tissue (pWAT) were treated with naringenin for 7 to 14 days. Expression (quantitative real-time polymerase chain reaction, immunoblotting) of candidate genes involved in thermogenesis and glucose metabolism was measured. Oxygen consumption rate was measured in hADSC using a Seahorse flux analyzer.Results: In hADSC, naringenin increased expression of the genes associated with thermogenesis and fat oxidation, including uncoupling protein 1 and adipose triglyceride lipase, and key factors associated with insulin sensitivity, including glucose transporter type 4, adiponectin, and carbohydrate-responsive element-binding protein (P < 0.01). Similar responses were observed in pWAT. Basal, ATP-linked, maximal and reserve oxygen consumption rate increased in the naringenin-treated hADSC (P < 0.01).Conclusions: Naringenin increases energy expenditure in hADSC and stimulates expression of key enzymes involved in thermogenesis and insulin sensitivity in hADSC and pWAT. Naringenin may promote conversion of human white adipose tissue to a brown/beige phenotype. [ABSTRACT FROM AUTHOR]- Published
- 2019
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20. Survey Research: A Primer for Hand Surgery
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Lau, Frank H. and Chung, Kevin C.
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- 2005
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21. Phentermine: A Systematic Review for Plastic and Reconstructive Surgeons.
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Soobin Lim, Rogers, Lori K., Tessler, Oren, Mundinger, Gerhard S., Rogers, Camille, and Lau, Frank H.
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- 2018
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22. Variations in the Anterolateral Thigh Flap's Vascular Anatomy in African Americans.
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Soobin Lim, Atwi, Noah, Long, Sarah, Toshav, Aran, and Lau, Frank H.
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VASCULAR surgery ,PERFORATOR flaps (Surgery) ,SURGICAL complications ,COMPUTED tomography ,DEMOGRAPHIC surveys ,PREOPERATIVE period - Abstract
Background Variations in anterolateral thigh (ALT) arterial anatomy are well documented. Ethnicity is a known risk factor for vascular variation in several organ systems, but its impact on ALT anatomy has not been studied. Anecdotally, we observed frequent ALT arterial variation in African American (AA) patients.We thus hypothesized that AA patients have higher rates of anomalous branching. Materials and Methods A total of 277 computed tomography angiograms (513 lower extremities) captured between May 1, 2013 and May 31, 2015 at a tertiary academic medical center were retrospectively analyzed to determine ALT arterial branching. Patient records were examined to ascertain demographics. Data were analyzed using descriptive statistics and multinomial logistic regression. Results Males comprised 84.5%. Ethnic distribution was 55.2% AA and 36.5% Caucasian. The descending branch of the lateral circumflex femoral artery (dLCFA) originated from non-LCFA arteries (deep femoral, common femoral, or superficial femoral arteries) in 18.9% of Caucasian versus 9.1% of AA (odds ratio [OR]: 2.28; 95% confidence interval [CI]: 1.33-3.93, p < 0.01). An oblique branch was identified in 41.1% of Caucasian versus 51.9% of AA (OR: 1.56; 95% CI: 1.08-2.24, p = 0.02). Ethnicity was the only driving factor of dLCFA and oblique branch of the LCFA (oLCFA) anatomy (Wald chi-square: 14 and 11, p = 0.03 and 0.02, respectively). Conclusions Ethnicity significantly affects ALT arterial anatomy. AA aremore likely to have classical dLCFA branching with a fourth oLCFA branch. A flap with an unrecognized oLCFA-dominant supply places patients at a higher risk for flap failure and loss. We recommend preoperative imaging before undertaking an ALT flap reconstruction. [ABSTRACT FROM AUTHOR]
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- 2018
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23. Sandwiched White Adipose Tissue: A Microphysiological System of Primary Human Adipose Tissue.
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Lau, Frank H., Vogel, Kelly, Luckett, John P., Hunt, Maxwell, Meyer, Alicia, Rogers, Camille L., Tessler, Oren, Dupin, Charles L., St. Hilaire, Hugo, Islam, Kazi N., Frazier, Trivia, Gimble, Jeffrey M., and Scahill, Steven
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- 2018
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24. The Sternum-Nipple Distance is Double the Nipple-Inframammary Fold Distance in Macromastia.
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Steele, Thomas N., Pribaz, Julian J., and Lau, Frank H.
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- 2017
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25. A Time Study of Plastic Surgery Residents.
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Lau, Frank H., Sinha, Indranil, Wei Jiang, Lipsitz, Stuart R., and Eriksson, Elof
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- 2016
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26. Digital Photograph Security: What Plastic Surgeons Need to Know.
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Thomas, Virginia A., Rugeley, Patricia B., and Lau, Frank H.
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- 2015
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27. An efficient, low pressure fat aspiration system for lipofilling procedures
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Tan, Kian T., Manduskuie, Nancy, Menjivar, Luis, Lau, Frank H., and Pribaz, Julian J.
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- 2015
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28. The New Accreditation Council for Graduate Medical Education Next Accreditation System Milestones Evaluation System: What Is Expected and How Are Plastic Surgery Residency Programs Preparing?
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Sillah, Nyama M., Ibrahim, Ahmed M. S., Lau, Frank H., Shah, Jinesh, Medin, Caroline, Lee, Bernard T., and Lin, Samuel J.
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- 2015
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29. Wound healing in acutely injured fascia.
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Lau, Frank H. and Pomahac, Bohdan
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TRAUMA surgery , *FASCIAE (Anatomy) , *BIOLOGICAL products , *MEDICAL quality control , *OPERATIVE surgery , *WOUND healing , *WOUNDS & injuries , *TREATMENT effectiveness - Abstract
Fascial healing following acute injury, such as that occurring during surgical procedures, is defined functionally. For example, failure of fascial healing following celiotomy is only identified when incisional hernias are diagnosed. Such hernias incur billions of dollars per year in medical costs. Despite the importance of fascial healing, there is a paucity of data regarding the quality such healing. In clinical settings, the quantification of fascial wound healing is limited to a binary state: either there is no clinically apparent functional deficit and full fascia healing is assumed, or an incisional hernia or other functional failure is visible and the fascia did not heal. There are no clinical methods to isolate and functionally test fascia in patients. Recent studies have revealed unexpected findings regarding the recovery of tensile strength, specific surgical methods that optimize fascial healing, and the potential impact of biological pharmaceuticals in eliminating fascial healing failure. However, much remains unknown about the biology of fascial healing. [ABSTRACT FROM AUTHOR]
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- 2014
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30. Expression Analysis of Macrodactyly Identifies Pleiotrophin Upregulation.
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Lau, Frank H., Fang Xia, Kaplan, Adam, Cerrato, Felecia, Greene, Arin K., Taghinia, Amir, Cowan, Chad A., and Labow, Brian I.
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GENE expression , *PLEIOTROPHIN , *PHENOTYPES , *GENETICS , *BIOLOGY - Abstract
Macrodactyly is a rare family of congenital disorders characterized by the diffuse enlargement of 1 or more digits. Multiple tissue types within the affected digits are involved, but skeletal patterning and gross morphological features are preserved. Not all tissues are equally involved and there is marked heterogeneity with respect to clinical phenotype. The molecular mechanisms responsible for these growth disturbances offer unique insight into normal limb growth and development, in general. To date, no genes or loci have been implicated in the development of macrodactyly. In this study, we performed the first transcriptional profiling of macrodactyly tissue. We found that pleiotrophin (PTN) was significantly overexpressed across all our macrodactyly samples. The mitogenic functions of PTN correlate closely with the clinical characteristics of macrodactyly. PTN thus represents a promising target for further investigation into the etiology of overgrowth phenotypes. [ABSTRACT FROM AUTHOR]
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- 2012
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31. Programming human pluripotent stem cells into white and brown adipocytes.
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Ahfeldt, Tim, Schinzel, Robert T., Lee, Youn-Kyoung, Hendrickson, David, Kaplan, Adam, Lum, David H., Camahort, Raymond, Xia, Fang, Shay, Jennifer, Rhee, Eugene P., Clish, Clary B., Deo, Rahul C., Shen, Tony, Lau, Frank H., Cowley, Alicia, Mowrer, Greg, Al-Siddiqi, Heba, Nahrendorf, Matthias, Musunuru, Kiran, and Gerszten, Robert E.
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PLURIPOTENT stem cells ,FAT cells ,MESENCHYMAL stem cells ,TRANSGENE expression ,LIPID metabolism ,LABORATORY mice - Abstract
The utility of human pluripotent stem cells is dependent on efficient differentiation protocols that convert these cells into relevant adult cell types. Here we report the robust and efficient differentiation of human pluripotent stem cells into white or brown adipocytes. We found that inducible expression of PPARG2 alone or combined with CEBPB and/or PRDM16 in mesenchymal progenitor cells derived from pluripotent stem cells programmed their development towards a white or brown adipocyte cell fate with efficiencies of 85%-90%. These adipocytes retained their identity independent of transgene expression, could be maintained in culture for several weeks, expressed mature markers and had mature functional properties such as lipid catabolism and insulin-responsiveness. When transplanted into mice, the programmed cells gave rise to ectopic fat pads with the morphological and functional characteristics of white or brown adipose tissue. These results indicate that the cells could be used to faithfully model human disease. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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32. Efficient Culturing and Genetic Manipulation of Human Pluripotent Stem Cells.
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Schinzel, Robert T., Ahfeldt, Tim, Lau, Frank H., Lee, Youn-Kyoung, Cowley, Alicia, Shen, Tony, Peters, Derek, Lum, David H., and Cowan, Chad A.
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PLURIPOTENT stem cells ,TRANSPLANTATION of organs, tissues, etc. ,LENTIVIRUSES ,GENETIC transduction ,ELECTROPORATION - Abstract
Human pluripotent stem cells (hPSC) hold great promise as models for understanding disease and as a source of cells for transplantation therapies. However, the lack of simple, robust and efficient culture methods remains a significant obstacle for realizing the utility of hPSCs. Here we describe a platform for the culture of hPSCs that 1) allows for dissociation and replating of single cells, 2) significantly increases viability and replating efficiency, 3) improves freeze/thaw viability 4) improves cloning efficiency and 5) colony size variation. When combined with standard methodologies for genetic manipulation, we found that the enhanced culture platform allowed for lentiviral transduction rates of up to 95% and electroporation efficiencies of up to 25%, with a significant increase in the total number of antibiotic-selected colonies for screening for homologous recombination. We further demonstrated the utility of the enhanced culture platform by successfully targeting the ISL1 locus. We conclude that many of the difficulties associated with culturing and genetic manipulation of hPSCs can be addressed with optimized culture conditions, and we suggest that the use of the enhanced culture platform could greatly improve the ease of handling and general utility of hPSCs. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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33. Pattern Specification and Immune Response Transcriptional Signatures of Pericardial and Subcutaneous Adipose Tissue.
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Lau, Frank H., Deo, Rahul C., Mowrer, Gregory, Caplin, Joshua, Ahfeldt, Tim, Kaplan, Adam, Ptaszek, Leon, Walker, Jennifer D., Rosengard, Bruce R., and Cowan, Chad A.
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- *
CARDIOVASCULAR diseases , *FAT cells , *ADIPOSE tissues , *IMMUNE response , *DEATH (Biology) - Abstract
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States. Recent studies suggest that pericardial adipose tissue (PCAT) secretes inflammatory factors that contribute to the development of CVD. To better characterize the role of PCAT in the pathogenesis of disease, we performed a large-scale unbiased analysis of the transcriptional differences between PCAT and subcutaneous adipose tissue, analysing 53 microarrays across 19 individuals. As it was unknown whether PCAT-secreted factors are produced by adipocytes or cells in the supporting stromal fraction, we also sought to identify differentially expressed genes in isolated pericardial adipocytes vs. isolated subcutaneous adipocytes. Using microarray analysis, we found that: 1) pericardial adipose tissue and isolated pericardial adipocytes both overexpress atherosclerosis-promoting chemokines and 2) pericardial and subcutaneous fat depots, as well as isolated pericardial adipocytes and subcutaneous adipocytes, express specific patterns of homeobox genes. In contrast, a core set of lipid processing genes showed no significant overlap with differentially expressed transcripts. These depot-specific homeobox signatures and transcriptional profiles strongly suggest different functional roles for the pericardial and subcutaneous adipose depots. Further characterization of these inter-depot differences should be a research priority. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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34. Characterization of Bipolar Disorder Patient-Specific Induced Pluripotent Stem Cells from a Family Reveals Neurodevelopmental and mRNA Expression Abnormalities
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Madison, Jon M., Zhou, Fen, Nigam, Aparna, Hussain, Ali, Barker, Douglas D., Nehme, Ralda, van der Ven, Karlijn, Hsu, Jenny, Wolf, Pavlina, Fleishman, Morgan, O’Dushlaine, Colm, Rose, Sam, Chambert, Kimberly, Lau, Frank H., Ahfeldt, Tim, Rueckert, Erroll H., Sheridan, Steven D., Fass, Daniel M., Nemesh, James, Mullen, Thomas E., Daheron, Laurence, McCarroll, Steve, Sklar, Pamela, Perlis, Roy H., and Haggarty, Stephen J.
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bipolar disorder ,stem cell ,iPSC ,neurodevelopment ,corticogenesis ,neuroplasticity ,calcium channels ,ion channels ,lithium ,GSK3 - Abstract
Bipolar disorder (BD) is a common neuropsychiatric disorder characterized by chronic recurrent episodes of depression and mania. Despite evidence for high heritability of BD, little is known about its underlying pathophysiology. To develop new tools for investigating the molecular and cellular basis of BD we applied a family-based paradigm to derive and characterize a set of 12 induced pluripotent stem cell (iPSC) lines from a quartet consisting of two BD-affected brothers and their two unaffected parents. Initially, no significant phenotypic differences were observed between iPSCs derived from the different family members. However, upon directed neural differentiation we observed that CXCR4 (CXC chemokine receptor-4) expressing central nervous system (CNS) neural progenitor cells (NPCs) from both BD patients compared to their unaffected parents exhibited multiple phenotypic differences at the level of neurogenesis and expression of genes critical for neuroplasticity, including WNT pathway components and ion channel subunits. Treatment of the CXCR4+ NPCs with a pharmacological inhibitor of glycogen synthase kinase 3 (GSK3), a known regulator of WNT signaling, was found to rescue a progenitor proliferation deficit in the BD-patient NPCs. Taken together, these studies provide new cellular tools for dissecting the pathophysiology of BD and evidence for dysregulation of key pathways involved in neurodevelopment and neuroplasticity. Future generation of additional iPSCs following a family-based paradigm for modeling complex neuropsychiatric disorders in conjunction with in-depth phenotyping holds promise for providing insights into the pathophysiological substrates of BD and is likely to inform the development of targeted therapeutics for its treatment and ideally prevention.
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- 2014
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35. William Darrach, MD: His Life and His Contribution to Hand Surgery
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Lau, Frank H. and Chung, Kevin C.
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- 2006
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36. Abstract: Phentermine: A Systematic Review for Plastic & Reconstructive Surgeons.
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Lim, Soobin, Rogers, Lori K., Tessler, Oren, Mundinger, Gerhard S., Rogers, Camille L., and Lau, Frank H.
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- 2018
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37. Abstract 41.
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Lau, Frank H., Sinha, Indranil, and Eriksson, Elof
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- 2014
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38. Remission of Pain From Frostbite and Erythromelalgia With Epidural Infusion of Ropivacaine: Results of a Two-Year Follow-Up.
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Giaimo, Joseph D., Paulk, Kelly L., Phelan, Herbert A., Lau, Frank H., Grieshaber, Elizabeth B., and Carter, Jeffrey E.
- Abstract
The article focuses on a case study of a young man suffering from primary erythromelalgia who experienced remission of pain and symptoms through epidural infusion of ropivacaine, with the relief persisting for two years. Topics include the rarity of erythromelalgia cases in the United States, the genetic and secondary causes of the disease, and the challenges in pain control and treatment methods, including self-cooling practices that can lead to severe complications.
- Published
- 2023
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39. Dehydrated Human Amniotic-Chorionic Membrane Reduces Incisional Hernia Formation in an Animal Model.
- Author
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Yoo, Aran, Short, Celia, Lopez, Mandi J., Takawira, Catherine, Islam, Kazi N., Greiffenstein, Patrick, Hodgdon, Ian, Danos, Denise M., and Lau, Frank H.
- Subjects
- *
HERNIA , *ANIMAL models in research , *SALINE injections , *SPRAGUE Dawley rats , *RANDOMIZED controlled trials , *CELL sheets (Biology) - Abstract
Currently there are no standard of care treatment strategies for IH prevention (IHP). Dehydrated human amnion-chorion (dHACM) is a healing adjunct that elutes growth factors including several that have reduced IH in animal models. We therefore performed a double-blinded, prospective randomized controlled trial (RCT) to test the hypothesis that dHACM significantly reduces IH formation in a well-studied animal model of acute IH. Forty 16-week-old male Sprague-Dawley rats were randomized to one of four groups: No Treatment vs. dHACM Sheet (Group A), and Saline vs. dHACM Injection (Group B). Each animal underwent a 5-cm midline laparotomy which was incompletely closed with 5-0 plain gut sutures; this was performed by a surgeon blinded to treatment group (first blind). After 28 days, the primary endpoints of IH formation and hernia size were determined by study staff blinded to treatment (second blind). Secondary endpoints included healed fascia tensile strength as determined by tensiometry, systemic and local inflammatory markers as measured by ELISA, and fascial scar collagen I/III ratios per Western blotting. In Group A, No Treatment developed IH at 87.5% vs. 62.5% for Sheet (P = 0.28). Hernias that formed in the Sheet group were significantly smaller (P = 0.036). In Group B, Injection and Saline yielded identical IH rates of 77.8%. Molecular characterization of fascial scar demonstrated non-inferior tensile strength, collagen I/III ratios, and inflammatory markers in dHACM-treated animals. dHACM sheets significantly reduced the size of IH following laparotomy when compared to no treatment. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
40. Health Disparities in Incisional Hernia Presentation : An Analysis of HCUP-NIS Years 2012-2014.
- Author
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Mulloy, Clairissa D., Hoffman, Ryan D., Danos, Denise M., and Lau, Frank H.
- Subjects
- *
HEALTH equity , *SURGICAL emergencies , *HERNIA , *MEDICAL care costs , *MEDICALLY uninsured persons - Abstract
Introduction: Incisional hernias (IH) are iatrogenically created in 400 000 new patients annually. Without repair, IH-associated complications can result in major illness and death. The health disparities literature suggests that under-represented patients present more frequently with surgical emergencies. The health disparities associated with IH remain relatively unstudied.Methods: Inpatient admission data were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample for 2012-2014. Patients with IH International Classification of Diseases ninth revision were included. Analyses were completed using survey specific procedures (SAS v.9.4). Type of admission within groups was compared via Rao-Scott chi-square tests. The probability of an elective admission was modeled via SurveyLogistic Procedure.Results: Of 39 296 cases, 38.5% IH admissions were urgent or emergent (nonelective). The proportion of nonelective admission was statistically higher (P < .0001) in patients >65 (40.9%) and females (40.3%). Among insurance types, self-paying patients had the highest proportion of nonelective admissions (64.3%). Racial disparities remained significant after adjusting for age, sex, and insurance. Compared with white patients, the odds of an admission being nonelective were significantly higher for black (odds ratio [OR] [95% CI]: 1.65 [1.53-1.77]], Hispanic (OR [95% CI]: 1.39 [1.28-1.51]), and other (OR [95% CI]: 1.2 [1.06-1.37]) patients.Discussion: These data show that multiple at-risk patient populations are significantly more likely to require urgent admission for IH-related complications. These include older, female, non-white, and uninsured patients. Systematic efforts to ameliorate these disparities should be developed. [ABSTRACT FROM AUTHOR]- Published
- 2020
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41. Local Control of Pyoderma Gangrenosum Using Human Amniotic Membrane and Transcriptome Analysis.
- Author
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Maier MA, Dennis JR, Fontenot CJ, Taylor NA, Almukhtar R, Lau FHP, and Smith AA
- Abstract
Pyoderma gangrenosum (PG) is a rare, chronic, ulcerative disease characterized by non-healing wounds that worsen with debridement, a phenomenon called pathergy. No consensus regarding pathogenesis, diagnosis, or treatment exists for PG. A previous pilot study using dehydrated human amniotic/chorionic membrane (dHACM), following excisional debridement, augmented PG wound healing and allowed for subsequent wound closure through split-thickness skin grafting (STSG). In this clinical trial (NCT05120726), four patients with an established PG diagnosis were enrolled to undergo treatment with dHACM and characterize the pre- and post-treatment transcriptome profiles. RNA sequencing was used to isolate the total RNA from specimens. Genes of particular interest were quantified through real-time quantitative reverse transcription polymerase chain reaction. We observed varied changes to the local expression of inflammatory response, positive regulators of cellular proliferation, and extracellular matrix disassembly cytokines. All PG wounds produced granulation tissue following treatment and were closed using split-thickness skin grafts., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The corresponding author serves as a paid consultant for Aroa Biosurgery and is on the advisory board for Prytime Medical. Otherwise, the authors have no relevant conflicts of interest to disclose.
- Published
- 2024
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42. In Vitro Culture of White Adipose Tissue.
- Author
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Fontenot JJ and Lau FH
- Subjects
- Humans, Adipocytes, Signal Transduction, Adipose Tissue metabolism, Adipose Tissue, White, Obesity metabolism
- Abstract
White adipose tissue (WAT) plays a crucial endocrine organ that regulates blood glucose and lipid levels, satiety, and inflammation. Before the described technique, primary white adipocytes could not be stably cultured in vitro. The lack of a reliable primary culture model impeded research in WAT metabolism and drug development. We have developed a novel technique for WAT primary culture called "sandwiched white adipose tissue" (SWAT). SWAT overcomes the natural buoyancy of adipocytes by sandwiching minced WAT between sheets of adipose-derived stromal cells. The resulting constructs are viable for at least 8 weeks in culture. SWAT maintains the intact extracellular matrix, cell-to-cell contacts, and physical pressures of in vivo WAT conditions; additionally, SWAT maintains a robust transcriptional profile, sensitivity to exogenous chemical signaling, and whole tissue function. SWAT represents a simple, reproducible, and effective method of primary adipose culture. Potentially, it is a broadly applicable platform for research in WAT physiology, pathophysiology, metabolism, and pharmaceutical development., (© 2024. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2024
- Full Text
- View/download PDF
43. Targeting CaMKK2 Inhibits Actin Cytoskeletal Assembly to Suppress Cancer Metastasis.
- Author
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Mukherjee D, Previs RA, Haines C, Al Abo M, Juras PK, Strickland KC, Chakraborty B, Artham S, Whitaker RS, Hebert K, Fontenot J, Patierno SR, Freedman JA, Lau FH, Burow ME, Chang CY, and McDonnell DP
- Subjects
- Animals, Female, Humans, Mice, Actins metabolism, Cell Movement, Protein Kinases, Ovarian Neoplasms drug therapy, Triple Negative Breast Neoplasms
- Abstract
Triple-negative breast cancers (TNBC) tend to become invasive and metastatic at early stages in their development. Despite some treatment successes in early-stage localized TNBC, the rate of distant recurrence remains high, and long-term survival outcomes remain poor. In a search for new therapeutic targets for this disease, we observed that elevated expression of the serine/threonine kinase calcium/calmodulin (CaM)-dependent protein kinase kinase 2 (CaMKK2) is highly correlated with tumor invasiveness. In validation studies, genetic disruption of CaMKK2 expression or inhibition of its activity with small molecule inhibitors disrupted spontaneous metastatic outgrowth from primary tumors in murine xenograft models of TNBC. High-grade serous ovarian cancer (HGSOC), a high-risk, poor prognosis ovarian cancer subtype, shares many features with TNBC, and CaMKK2 inhibition effectively blocked metastatic progression in a validated xenograft model of this disease. Mechanistically, CaMKK2 increased the expression of the phosphodiesterase PDE1A, which hydrolyzed cyclic guanosine monophosphate (cGMP) to decrease the cGMP-dependent activity of protein kinase G1 (PKG1). Inhibition of PKG1 resulted in decreased phosphorylation of vasodilator-stimulated phosphoprotein (VASP), which in its hypophosphorylated state binds to and regulates F-actin assembly to facilitate cell movement. Together, these findings establish a targetable CaMKK2-PDE1A-PKG1-VASP signaling pathway that controls cancer cell motility and metastasis by impacting the actin cytoskeleton. Furthermore, it identifies CaMKK2 as a potential therapeutic target that can be exploited to restrict tumor invasiveness in patients diagnosed with early-stage TNBC or localized HGSOC., Significance: CaMKK2 regulates actin cytoskeletal dynamics to promote tumor invasiveness and can be inhibited to suppress metastasis of breast and ovarian cancer, indicating CaMKK2 inhibition as a therapeutic strategy to arrest disease progression., (©2023 The Authors; Published by the American Association for Cancer Research.)
- Published
- 2023
- Full Text
- View/download PDF
44. Ca 2+ /Calmodulin Dependent Protein Kinase Kinase-2 (CaMKK2) promotes Protein Kinase G (PKG)-dependent actin cytoskeletal assembly to increase tumor metastasis.
- Author
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Mukherjee D, Previs RA, Haines CN, Abo MA, Juras PK, Strickland KC, Chakraborty B, Artham S, Whitaker R, Hebert KL, Fontenot J, Patierno SR, Freedman JA, Lau FH, Burow M, Chang CY, and McDonnell DP
- Abstract
Triple-negative breast cancers (TNBCs) tend to become highly invasive early during cancer development. Despite some successes in the initial treatment of patients diagnosed with early-stage localized TNBC, the rate of metastatic recurrence remains high with poor long-term survival outcomes. Here we show that elevated expression of the serine/threonine-kinase, Calcium/Calmodulin (CaM)-dependent protein kinase kinase-2 (CaMKK2), is highly correlated with tumor invasiveness. We determined that genetic disruption of CaMKK2 expression, or inhibition of its activity, disrupted spontaneous metastatic outgrowth from primary tumors in murine xenograft models of TNBC. High-grade serous ovarian cancer (HGSOC), a high-risk, poor-prognosis ovarian cancer subtype, shares many genetic features with TNBC, and importantly, CaMKK2 inhibition effectively blocked metastatic progression in a validated xenograft model of this disease. Probing the mechanistic links between CaMKK2 and metastasis we defined the elements of a new signaling pathway that impacts actin cytoskeletal dynamics in a manner which increases cell migration/invasion and metastasis. Notably, CaMKK2 increases the expression of the phosphodiesterase PDE1A which decreases the cGMP-dependent activity of protein kinase G1 (PKG1). This inhibition of PKG1 results in decreased phosphorylation of Vasodilator-Stimulated Phosphoprotein (VASP), which in its hypophosphorylated state binds to and regulates F-actin assembly to facilitate contraction/cell movement. Together, these data establish a targetable CaMKK2-PDE1A-PKG1-VASP signaling pathway that controls cancer cell motility and metastasis. Further, it credentials CaMKK2 as a therapeutic target that can be exploited in the discovery of agents for use in the neoadjuvant/adjuvant setting to restrict tumor invasiveness in patients diagnosed with early-stage TNBC or localized HGSOC.
- Published
- 2023
- Full Text
- View/download PDF
45. Modeling Breast Cancer in Human Breast Tissue using a Microphysiological System.
- Author
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Brown LM, Hebert KL, Gurrala RR, Byrne CE, Burow M, Martin EC, and Lau FH
- Subjects
- Cell Differentiation, Female, Humans, Tumor Microenvironment, Breast pathology, Breast Neoplasms physiopathology
- Abstract
Breast cancer (BC) remains a leading cause of death for women. Despite more than $700 million invested in BC research annually, 97% of candidate BC drugs fail clinical trials. Therefore, new models are needed to improve our understanding of the disease. The NIH Microphysiological Systems (MPS) program was developed to improve the clinical translation of basic science discoveries and promising new therapeutic strategies. Here we present a method for generating MPS for breast cancers (BC-MPS). This model adapts a previously described approach of culturing primary human white adipose tissue (WAT) by sandwiching WAT between adipose-derived stem cell sheets (ASC)s. Novel aspects of our BC-MPS include seeding BC cells into non-diseased human breast tissue (HBT) containing native extracellular matrix, mature adipocytes, resident fibroblasts, and immune cells; and sandwiching the BC-HBT admixture between HBT-derived ASC sheets. The resulting BC-MPS is stable in culture ex vivo for at least 14 days. This model system contains multiple elements of the microenvironment that influence BC including adipocytes, stromal cells, immune cells, and the extracellular matrix. Thus BC-MPS can be used to study the interactions between BC and its microenvironment. We demonstrate the advantages of our BC-MPS by studying two BC behaviors known to influence cancer progression and metastasis: 1) BC motility and 2) BC-HBT metabolic crosstalk. While BC motility has previously been demonstrated using intravital imaging, BC-MPS allows for high-resolution time-lapse imaging using fluorescence microscopy over several days. Furthermore, while metabolic crosstalk was previously demonstrated using BC cells and murine pre-adipocytes differentiated into immature adipocytes, our BC-MPS model is the first system to demonstrate this crosstalk between primary human mammary adipocytes and BC cells in vitro.
- Published
- 2021
- Full Text
- View/download PDF
46. Quantifying Breast Cancer-Driven Fiber Alignment and Collagen Deposition in Primary Human Breast Tissue.
- Author
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Gurrala R, Byrne CE, Brown LM, Tiongco RFP, Matossian MD, Savoie JJ, Collins-Burow BM, Burow ME, Martin EC, and Lau FH
- Abstract
Solid tumor progression is significantly influenced by interactions between cancer cells and the surrounding extracellular matrix (ECM). Specifically, the cancer cell-driven changes to ECM fiber alignment and collagen deposition impact tumor growth and metastasis. Current methods of quantifying these processes are incomplete, require simple or artificial matrixes, rely on uncommon imaging techniques, preclude the use of biological and technical replicates, require destruction of the tissue, or are prone to segmentation errors. We present a set of methodological solutions to these shortcomings that were developed to quantify these processes in cultured, ex vivo human breast tissue under the influence of breast cancer cells and allow for the study of ECM in primary breast tumors. Herein, we describe a method of quantifying fiber alignment that can analyze complex native ECM from scanning electron micrographs that does not preclude the use of replicates and a high-throughput mechanism of quantifying collagen content that is non-destructive. The use of these methods accurately recapitulated cancer cell-driven changes in fiber alignment and collagen deposition observed by visual inspection. Additionally, these methods successfully identified increased fiber alignment in primary human breast tumors when compared to human breast tissue and increased collagen deposition in lobular breast cancer when compared to ductal breast cancer. The successful quantification of fiber alignment and collagen deposition using these methods encourages their use for future studies of ECM dysregulation in human solid tumors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Gurrala, Byrne, Brown, Tiongco, Matossian, Savoie, Collins-Burow, Burow, Martin and Lau.)
- Published
- 2021
- Full Text
- View/download PDF
47. Patient-Derived Xenografts as an Innovative Surrogate Tumor Model for the Investigation of Health Disparities in Triple Negative Breast Cancer.
- Author
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Matossian MD, Giardina AA, Wright MK, Elliott S, Loch MM, Nguyen K, Zea AH, Lau FH, Moroz K, Riker AI, Jones SD, Martin EC, Bunnell BA, Miele L, Collins-Burow BM, and Burow ME
- Abstract
Despite a decline in overall incidence rates for cancer in the past decade, due in part to impressive advancements in both diagnosis and treatment, breast cancer (BC) remains the leading cause of cancer-related deaths in women. BC alone accounts for ∼30% of all new cancer diagnoses in women worldwide. Triple-negative BC (TNBC), defined as having no expression of the estrogen or progesterone receptors and no amplification of the HER2 receptor, is a subtype of BC that does not benefit from the use of estrogen receptor-targeting or HER2-targeting therapies. Differences in socioeconomic factors and cell intrinsic and extrinsic characteristics have been demonstrated in Black and White TNBC patient tumors. The emergence of patient-derived xenograft (PDX) models as a surrogate, translational, and functional representation of the patient with TNBC has led to the advances in drug discovery and testing of novel targeted approaches and combination therapies. However, current established TNBC PDX models fail to represent the diverse patient population and, most importantly, the specific ethnic patient populations that have higher rates of incidence and mortality. The primary aim of this review is to emphasize the importance of using clinically relevant translatable tumor models that reflect TNBC human tumor biology and heterogeneity in high-risk patient populations. The focus is to highlight the complexity of BC as it specifically relates to the management of TNBC in Black women. We discuss the importance of utilizing PDX models to study the extracellular matrix (ECM), and the distinct differences in ECM composition and biophysical properties in Black and White women. Finally, we demonstrate the crucial importance of PDX models toward novel drug discovery in this patient population., Competing Interests: No competing financial interests exist., (© Margarite D. Matossian et al. 2020; Published by Mary Ann Liebert, Inc.)
- Published
- 2020
- Full Text
- View/download PDF
48. A Microphysiologic Platform for Human Fat: Sandwiched White Adipose Tissue.
- Author
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Scahill SD, Hunt M, Rogers CL, and Lau FH
- Subjects
- Humans, Adipose Tissue, White physiopathology, Obesity physiopathology
- Abstract
White adipose tissue (WAT) plays a crucial role in regulating weight and everyday health. Still, there are significant limitations to available primary culture models, all of which have failed to faithfully recapitulate the adipose microenvironment or extend WAT viability beyond two weeks. The lack of a reliable primary culture model severely impedes research in WAT metabolism and drug development. To this end we have utilized NIH's standards of a microphysiologic system to develop a novel platform for WAT primary culture called 'SWAT' (sandwiched white adipose tissue). We overcome the natural buoyancy of adipocytes by sandwiching minced WAT clusters between sheets of adipose-derived stromal cells. In this construct, WAT samples are viable over eight weeks in culture. SWAT maintains the intact ECM, cell-to-cell contacts, and physical pressures of in vivo WAT conditions; additionally, SWAT maintains a robust transcriptional profile, sensitivity to exogenous chemical signaling, and whole tissue function. SWAT represents a simple, reproducible, and effective method of primary adipose culture. Potentially, it is a broadly applicable platform for research in WAT physiology, pathophysiology, metabolism, and pharmaceutical development.
- Published
- 2018
- Full Text
- View/download PDF
49. Variations in the Anterolateral Thigh Flap's Vascular Anatomy in African Americans.
- Author
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Lim S, Atwi N, Long S, Toshav A, and Lau FH
- Subjects
- Adult, Analysis of Variance, Cross-Sectional Studies, Ethnicity, Female, Femoral Artery diagnostic imaging, Humans, Male, Middle Aged, Retrospective Studies, Thigh anatomy & histology, Thigh diagnostic imaging, White People, Black or African American, Computed Tomography Angiography, Femoral Artery anatomy & histology, Plastic Surgery Procedures education, Thigh blood supply
- Abstract
Background: Variations in anterolateral thigh (ALT) arterial anatomy are well documented. Ethnicity is a known risk factor for vascular variation in several organ systems, but its impact on ALT anatomy has not been studied. Anecdotally, we observed frequent ALT arterial variation in African American (AA) patients. We thus hypothesized that AA patients have higher rates of anomalous branching., Materials and Methods: A total of 277 computed tomography angiograms (513 lower extremities) captured between May 1, 2013 and May 31, 2015 at a tertiary academic medical center were retrospectively analyzed to determine ALT arterial branching. Patient records were examined to ascertain demographics. Data were analyzed using descriptive statistics and multinomial logistic regression., Results: Males comprised 84.5%. Ethnic distribution was 55.2% AA and 36.5% Caucasian. The descending branch of the lateral circumflex femoral artery (dLCFA) originated from non-LCFA arteries (deep femoral, common femoral, or superficial femoral arteries) in 18.9% of Caucasian versus 9.1% of AA (odds ratio [OR]: 2.28; 95% confidence interval [CI]: 1.33-3.93, p < 0.01). An oblique branch was identified in 41.1% of Caucasian versus 51.9% of AA (OR: 1.56; 95% CI: 1.08-2.24, p = 0.02). Ethnicity was the only driving factor of dLCFA and oblique branch of the LCFA (oLCFA) anatomy (Wald chi-square: 14 and 11, p = 0.03 and 0.02, respectively)., Conclusions: Ethnicity significantly affects ALT arterial anatomy. AA are more likely to have classical dLCFA branching with a fourth oLCFA branch. A flap with an unrecognized oLCFA-dominant supply places patients at a higher risk for flap failure and loss. We recommend preoperative imaging before undertaking an ALT flap reconstruction., Competing Interests: Drs. Toshav and Lau have no conflict of interest. No funding was received for this article., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Published
- 2018
- Full Text
- View/download PDF
50. Simplifying the Milestones.
- Author
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Sillah NM, Lau FH, and Lin SJ
- Abstract
Competing Interests: Disclosure: Dr. Lau and Dr. Lin are co-founders of Simple Milestones, the software platform discussed in this abstract. Dr. Sillah has no financial disclosures. The article processing charge for this abstract was paid for by the American Council of Academic Plastic Surgeons.
- Published
- 2015
- Full Text
- View/download PDF
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