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1. Tissue morphometric measurements do not predict survival following colorectal cancer surgery

Author: Krishanth Naidu, Pierre H. Chapuis, Charles Chan, Matthew J.F.X Rickard, Nicholas P. West, David G. Jayne, and Kheng-Seong Ng
Subjects: Quality of surgery, CME, CVL and tissue morphometry, Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background Ex vivo tissue morphometric (TM) measurements have been proposed as a quality marker for colorectal cancer (CRC) surgery. However, their survival associations require clarification. This study aimed to evaluate the feasibility of capturing TM measurements based on ex vivo fresh specimen images and explore the association between these TM measurements and survival outcomes. Methods A prospective cohort study at Concord Hospital, Sydney was conducted with Stage I to III CRC patients (2009–2019) who underwent an anterior resection (AR) or right hemicolectomy (RH). Using high-resolution digital photographs of fresh CRC specimens, ex vivo tissue morphometric (TM) measurements—resected mesentery area (TM A), distances from high vascular tie to tumour (TM B) and bowel wall (TM C), and bowel length (TM D)—were recorded using Image J. Overall survival (OS) and disease-free survival (DFS) estimates and their associations to clinicopathological variables were investigated with Kaplan–Meier and Cox regression analyses. Linear regression models tested association between TM measurements and lymph node (LN) yield. Results Of the 1,425 patients who underwent CRC surgery, TM measurements were performed on 312 patients, with an average age of 69.4 years (SD 12.3), of whom 52.9% were male. The majority had an AR (57.8%). Among AR patients, a 5-year OS rate of 77.4% and a DFS rate of 70.1% were observed, with TM measurements bearing no relationship to survival outcomes. Similarly, RH patients exhibited a 5-year OS rate of 67.2% and a DFS rate of 63.1%, with TM measurements again showing no association with survival. Only TM D (P = 0.02) measurements were associated with the number of LNs examined. Conclusion This study successfully demonstrates the feasibility of measuring TM measurements on photographs of ex vivo fresh specimens following CRC surgery. The lack of association with survival outcomes questions the utility of TM measurements as a quality metric of CRC surgery.
Published: 2024
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2. The use of adjuvant chemotherapy is not associated with recurrence or cancer-specific death following curative resection for stage III rectal cancer: a competing risks analysis

Author: Kheng-Seong Ng, Charles Chan, Matthew John Francis Xavier Rickard, Anil Keshava, Peter Stewart, and Pierre Henri Chapuis
Subjects: Rectal cancer, Adjuvant chemotherapy, Disease recurrence, Cancer-specific death, Competing risks analysis, Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background The role of adjuvant chemotherapy (AC) in stage III rectal cancer (RC) has been argued based on evidence from its use in colon cancer. Previous trials have analysed disease-free and overall survivals as endpoints, rather than disease recurrence. This study compares the competing risks incidences of recurrence and cancer-specific death between patients who did and did not receive AC for stage III RC. Methods Consecutive patients who underwent a potentially curative resection for stage III RC (1995–2019) at Concord Hospital, Sydney, Australia, were studied. AC was considered following multidisciplinary discussion. Primary outcome measures were the competing risks incidences of disease recurrence and cancer-specific death. Associations between these outcomes and use of AC (and other variables) were tested by regression modelling. Results Some 338 patients (213 male, mean age 64.4 years [SD12.7]) were included. Of these, 208 received AC. The use of AC was associated with resection year (adjusted OR [aOR] 1.74, 95%CI 1.27–2.38); age ≥75 years (aOR0.04, 95%CI 0.02–0.12); peripheral vascular disease (aOR0.08, 95%CI 0.01–0.74); and postoperative abdomino-pelvic abscess (aOR0.23, 95%CI 0.07–0.81). One hundred fifty-seven patients (46.5%) were diagnosed with recurrence; death due to RC occurred in 119 (35.2%). After adjustment for the competing risk of non-cancer death, neither recurrence nor RC-specific death was associated with AC (HR0.97, 95%CI 0.70–1.33 and HR0.72, 95%CI 0.50–1.03, respectively). Conclusion This study found no significant difference in either recurrence or cancer-specific death between patients who did and did not receive AC following curative resection for stage III RC.
Published: 2023
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3. Canadian multidisciplinary expert consensus on the use of biologics in upper airways: a Delphi study

Author: Andrew V. Thamboo, Melissa Lee, Mohit Bhutani, Charles Chan, Yvonne Chan, Ken R. Chapman, Christopher J. Chin, Lori Connors, Del Dorscheid, Anne K. Ellis, Richard M. Gall, Krystelle Godbout, Arif Janjua, Amin Javer, Shaun Kilty, Harold Kim, Gordon Kirkpatrick, John M. Lee, Richard Leigh, Catherine Lemiere, Eric Monteiro, Helen Neighbour, Paul K. Keith, George Philteos, Jaclyn Quirt, Brian Rotenberg, Juan C. Ruiz, John R. Scott, Doron D. Sommer, Leigh Sowerby, Marc Tewfik, Susan Waserman, Ian Witterick, Erin D. Wright, Cory Yamashita, and Martin Desrosiers
Subjects: Chronic rhinosinusitis, Chronic rhinosinusitis with nasal polyposis, Upper airway disease, Lower airway disease, Asthma, Biologics, Surgery, RD1-811
Abstract: Abstract Background Chronic rhinosinusitis with nasal polyposis (CRSwNP) often coexists with lower airway disease. With the overlap between upper and lower airway disease, optimal management of the upper airways is undertaken in conjunction with that of the lower airways. Biologic therapy with targeted activity within the Type 2 inflammatory pathway can improve the clinical signs and symptoms of both upper and lower airway diseases. Knowledge gaps nevertheless exist in how best to approach patient care as a whole. There have been sixteen randomized, double-blind, placebo-controlled trails performed for CRSwNP targeted components of the Type 2 inflammatory pathway, notably interleukin (IL)-4, IL-5 and IL-13, IL- 5R, IL-33, and immunoglobulin (Ig)E. This white paper considers the perspectives of experts in various disciplines such as rhinology, allergy, and respirology across Canada, all of whom have unique and valuable insights to contribute on how to best approach patients with upper airway disease from a multidisciplinary perspective. Methods A Delphi Method process was utilized involving three rounds of questionnaires in which the first two were completed individually online and the third was discussed on a virtual platform with all the panelists. A national multidisciplinary expert panel of 34 certified specialists was created, composed of 16 rhinologists, 7 allergists, and 11 respirologists who evaluated the 20 original statements on a scale of 1–9 and provided comments. All ratings were quantitively reviewed by mean, median, mode, range, standard deviation and inter-rater reliability. Consensus was defined by relative interrater reliability measures—kappa coefficient ( $$\kappa$$ κ ) value > 0.61. Results After three rounds, a total of 22 statements achieved consensus. This white paper only contains the final agreed upon statements and clear rationale and support for the statements regarding the use of biologics in patients with upper airway disease. Conclusion This white paper provides guidance to Canadian physicians on the use of biologic therapy for the management of upper airway disease from a multidisciplinary perspective, but the medical and surgical regimen should ultimately be individualized to the patient. As more biologics become available and additional trials are published we will provide updated versions of this white paper every few years. Graphical abstract
Published: 2023
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4. Abstract 88: Changes in Mouse Skeletal Progenitor Cells in a Model of Osteoporosis

Author: Tom Andrew, MBChB, MSc, Danielle Struck, BS, Michael Lopez, BS, Tatiana Boyko, MD, Michael Longaker, MD, Charles Chan, BS PhD, and George Yang, MD PhD
Subjects: Surgery, RD1-811
Published: 2018
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5. Splenic flexure cancer survival: a 25‐year experience and implications for complete mesocolic excision ( <scp>CME</scp> ) and central vascular ligation ( <scp>CVL</scp> )

Author: Krishanth Naidu, Pierre H. Chapuis, Kilian G. M. Brown, Charles Chan, Matthew J. F. X. Rickard, and Kheng‐Seong Ng
Subjects: Surgery, General Medicine
Published: 2023
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6. Recurrence and colon cancer‐specific death in patients with large bowel obstruction requiring urgent operation: a competing risks analysis

Author: Anil Keshava, Peter Stewart, Charles Chan, Michael Suen, Katie Adams, Owen F. Dent, Matthew J. F. X. Rickard, and Pierre H. Chapuis
Subjects: medicine.medical_specialty, business.industry, Colorectal cancer, Incidence (epidemiology), Confounding, Hazard ratio, Gastroenterology, medicine.disease, Risk Assessment, Surgery, Large bowel obstruction, Colonic Neoplasms, medicine, Humans, In patient, Neoplasm Recurrence, Local, business, Competing risks analysis, Pathological, Colectomy, Intestinal Obstruction
Abstract: AIM Clinical presentation with large bowel obstruction has been proposed as a predictor of poor long-term oncological outcomes after resection for colorectal cancer. This study examines the association between obstruction and recurrence and cancer-specific death after resection for colon cancer. METHOD Consecutive patients who underwent resection for colon cancer between 1995 and 2014 were drawn from a prospectively recorded hospital database with all surviving patients followed for at least 5 years. The outcomes of tumour recurrence and colon cancer-specific death were assessed by competing risks multivariable techniques with adjustment for potential clinical and pathological confounding variables. RESULTS Recurrence occurred in 271 of 1485 patients who had a potentially curative resection. In bivariate analysis, obstruction was significantly associated with recurrence [hazard ratio (HR) 2.23, CI 1.52-3.26, p
Published: 2021
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7. SP142 PD-L1 Scoring Shows High Interobserver and Intraobserver Agreement in Triple-negative Breast Carcinoma But Overall Low Percentage Agreement With Other PD-L1 Clones SP263 and 22C3

Author: Beena Kumar, David Clouston, Kate Harvey, Jia-Min B Pang, Jane Beith, Jane E. Armes, Sunil R. Lakhani, Shona Hendry, Christina I. Selinger, Stephen B. Fox, Charles Chan, Wendy A. Raymond, Wendy A Cooper, Samuel Roberts-Thomson, Marian L. Burr, Peter Button, David J Byrne, Sandra A O'Toole, Ewan K.A. Millar, Vanathi Sivasubramaniam, and Belinda Castles
Subjects: Adult, PD-L1, Oncology, medicine.medical_specialty, Concordance, Triple Negative Breast Neoplasms, B7-H1 Antigen, Pathology and Forensic Medicine, Breast cancer, Atezolizumab, Internal medicine, Biomarkers, Tumor, Humans, Medicine, Triple-negative breast cancer, Aged, Aged, 80 and over, Observer Variation, business.industry, BRCA mutation, Antibodies, Monoclonal, Original Articles, Middle Aged, medicine.disease, Immunohistochemistry, SP142, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, triple-negative breast cancer, Female, Surgery, Triple-Negative Breast Carcinoma, Anatomy, business, Breast carcinoma
Abstract: Supplemental Digital Content is available in the text., SP142 programmed cell death ligand 1 (PD-L1) status predicts response to atezolizumab in triple-negative breast carcinoma (TNBC). Prevalence of VENTANA PD-L1 (SP142) Assay positivity, concordance with the VENTANA PD-L1 (SP263) Assay and Dako PD-L1 IHC 22C3 pharmDx assay, and association with clinicopathologic features were assessed in 447 TNBCs. SP142 PD-L1 intraobserver and interobserver agreement was investigated in a subset of 60 TNBCs, with scores enriched around the 1% cutoff. The effect of a 1-hour training video on pretraining and posttraining scores was ascertained. At a 1% cutoff, 34.2% of tumors were SP142 PD-L1 positive. SP142 PD-L1 positivity was significantly associated with tumor-infiltrating lymphocytes (P
Published: 2021
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8. Apical Node Involvement Does Not Influence Prognosis After Potentially Curative Resection for Stage III Colorectal Cancer

Author: Peter Stewart, Kheng-Seong Ng, Anil Keshava, Charles Chan, R. C. Newland, Owen F. Dent, Matthew J. F. X. Rickard, and Pierre H. Chapuis
Subjects: Curative resection, Oncology, medicine.medical_specialty, business.industry, Incidence (epidemiology), Hazard ratio, Cancer, Prognosis, medicine.disease, Risk Assessment, digestive system diseases, Confidence interval, Metastasis, Internal medicine, medicine, Humans, Surgery, Stage (cooking), Colorectal Neoplasms, Competing risks analysis, business, neoplasms, Neoplasm Staging, Proportional Hazards Models
Abstract: Objective To examine the independent prognostic value of ALN status in patients with stage III CRC. Summary of background data Early CRC staging classified nodal involvement by level of involved nodes in the operative specimen, including both locoregional and apical node status, in contrast to the American Joint Committee on Cancer/tumor nodes metastasis (TNM) system where tumors are classified by the number of nodes involved. Whether ALN status has independent prognostic value remains controversial. Methods Consecutive patients who underwent curative resection for Stage III CRC from 1995 to 2012 at Concord Hospital, Sydney, Australia were studied. ALN status was classified as: (i) ALN absent, (ii) ALN present but not histologically involved, (iii) ALN present and involved. Outcomes were the competing risks incidence of CRC recurrence and CRC-specific death. Associations between these outcomes and ALN status were compared with TNM N status results. Results In 706 patients, 69 (9.8%) had an involved ALN, 398 (56.4%) had an uninvolved ALN and 239 (33.9%) had no ALN identified. ALN status was not associated with tumor recurrence [adjusted hazard ratio (HR) 1.02, 95% confidence interval (CI) 0.84-1.26] or CRC-specific death (HR 1.14, CI 0.91-1.43). However, associations persisted between TNM N-status and both recurrence (HR 1.58, CI 1.21-2.06) and CRC-specific death (HR 1.59, CI 1.19-2.12). Conclusions No further prognostic information was conferred by ALN status in patients with stage III CRC beyond that provided by TNM N status. ALN status is not considered to be a useful additional component in routine TNM staging of CRC.
Published: 2020
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9. Immunohistochemistry in screening for heritable colorectal cancer: what to do with an abnormal result

Author: Steven R. Paredes, Charles Chan, and Matthew J. F. X. Rickard
Subjects: Oncology, medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Molecular genetics, Cancer screening, medicine, Humans, Mass Screening, Genetic Testing, Early Detection of Cancer, business.industry, Molecular pathogenesis, General Medicine, medicine.disease, Colorectal Neoplasms, Hereditary Nonpolyposis, Immunohistochemistry, Polypectomy, Lynch syndrome, Colorectal surgery, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Surgery, Colorectal Neoplasms, business
Abstract: Recent developments in our understanding of molecular genetics have transformed screening and diagnostic practices for Lynch syndrome. The current standard involves universal tumour analysis of resected colorectal cancer (and ideally polypectomy) specimens using immunohistochemistry and molecular techniques. Patients with abnormal immunohistochemical findings are subsequently referred for definitive mutational testing. This review relates the molecular pathogenesis of Lynch syndrome to current immunohistochemistry-based screening strategies and discusses the interpretation and clinical implications of screening results.
Published: 2019
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10. Acellular Dermal Matrix Modulation of the Peri-Prosthetic Breast Microenvironment During Breast Reconstruction

Author: Charles Chan, Ruth Tevlin, Arash Momeni, Kerry Shefren, Michael Januszyk, Michelle Griffin, Derrick C. Wan, and Michael T. Longaker
Subjects: Pathology, medicine.medical_specialty, business.industry, Peri, medicine, Surgery, Breast reconstruction, Dermal matrix, business
Published: 2021
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11. Denervation During Mandibular Distraction Osteogenesis Results in Impaired Osteogenesis

Author: Michelle Griffin, Derrick C. Wan, Charles Chan, Ruth Tevlin, Michael T. Longaker, Michael Januszyk, and Ankit Salhotra
Subjects: Denervation, Orthodontics, Mandibular distraction, business.industry, Medicine, Surgery, business
Published: 2021
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12. Delayed Union of a Diaphyseal Forearm Fracture Associated With Impaired Osteogenic Differentiation of Prospectively Isolated Human Skeletal Stem Cells

Author: Malcolm R. DeBaun, Charles Chan, L. Henry Goodnough, Geoffrey D. Abrams, Michael J. Gardner, Julius A. Bishop, Holly Steininger, Thomas H. Ambrosi, and Timothy R. McAdams
Subjects: BONE CELLS, medicine.medical_specialty, INJURY/FRACTURE HEALING, Physical Injury - Accidents and Adverse Effects, Endocrinology, Diabetes and Metabolism, Nonunion, STROMAL, Case Report, Bone healing, Case Reports, Diseases of the musculoskeletal system, ORTHOPEDICS, Regenerative Medicine, FRACTURE HEALING, Bone cell, medicine, INJURY, Orthopedics and Sports Medicine, Orthopedic surgery, business.industry, medicine.disease, Stem Cell Research, Surgery, RC925-935, Musculoskeletal, Delayed union, Etiology, Stem cell, Forearm fracture, business, RD701-811, STROMAL/STEM CELLS, STEM CELLS
Abstract: Delayed union or nonunion are relatively rare complications after fracture surgery, but when they do occur, they can result in substantial morbidity for the patient. In many cases, the etiology of impaired fracture healing is uncertain and attempts to determine the molecular basis for delayed union and nonunion formation have been limited. Prospectively isolating skeletal stem cells (SSCs) from fracture tissue samples at the time of surgical intervention represent a feasible methodology to determine a patient's biologic risk for compromised fracture healing. This report details a case in which functional in vitro readouts of SSCs derived from human fracture tissue at time of injury predicted a poor fracture healing outcome. This case suggests that it may be feasible to stratify a patient's fracture healing capacity and predict compromised fracture healing by prospectively isolating and analyzing SSCs during the index fracture surgery. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Published: 2020

13. Pathological outcomes in rectal cancer following laparoscopic surgery

Author: Gillian L. Richardson, Charles Chan, Owen F. Dent, Anil Keshava, Christopher J. Young, and Henry Yan Chi Cheung
Subjects: Male, Laparoscopic surgery, medicine.medical_specialty, Multivariate analysis, Colorectal cancer, medicine.medical_treatment, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Prospective Studies, Pathological, Lymph node, Aged, Retrospective Studies, Univariate analysis, Rectal Neoplasms, business.industry, Open surgery, General Medicine, medicine.disease, Circumferential margin, Surgery, Treatment Outcome, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Female, Laparoscopy, 030211 gastroenterology & hepatology, business
Abstract: Aim This study examined pathological quality-of-surgery indicators in laparoscopic and open rectal cancer resection specimens. Methods Retrospective analysis of consecutive, prospectively recorded laparoscopic (LR) or open (OR) resections for rectal cancer. Indicators included integrity of the perirectal fascial envelope, circumferential margin clearance, lymph node yield and distal margin clearance. Results Between January 2007 and December 2013, 168 LR and 189 OR were performed. Univariate analysis showed that the presence of tumor within 1 mm of the circumferential margin was lower in LR (13/168 vs 28/189 cases, P = 0.039) as was a distal margin of clearance of
Published: 2017
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14. A Novel Method of Human Adipose-Derived Stem Cell Isolation with Resultant Increased Cell Yield

Author: Eun Young Seo, Elizabeth R. Zielins, Charles Chan, Kevin J. Paik, Christopher Duldulao, Michael T. Chung, Michael T. Longaker, Stephanie Vistnes, Adrian McArdle, Ruth Tevlin, Graham G. Walmsley, David Atashroo, Derrick C. Wan, and Elizabeth A. Brett
Subjects: 0301 basic medicine, Cell Survival, Cellular differentiation, Subcutaneous Fat, Adipose tissue, Cell Separation, Mesenchymal Stem Cell Transplantation, Article, Mice, 03 medical and health sciences, 0302 clinical medicine, Lipectomy, Stem Cell Isolation, Tissue engineering, Osteogenesis, Animals, Humans, Medicine, Cell yield, Cell Proliferation, Adipogenesis, Tissue Engineering, Cell growth, business.industry, Cell Differentiation, Mesenchymal Stem Cells, Anatomy, Cell biology, 030104 developmental biology, 030220 oncology & carcinogenesis, Female, Surgery, Stem cell, business
Abstract: BACKGROUND: The authors have developed a novel protocol for isolating adipose-derived stem cells from human lipoaspirate. In this study, they compare their new method to a previously published standard protocol. METHODS: Human adipose-derived stem cell isolation was performed using two methods to compare cell yield, cell viability, cell proliferation, and regenerative potential. The new and conventional isolation methods differ in two key areas: die collagenase digestion buffer constituents and the use of an orbital shaker. The osteogenic and adipogenic potential of adipose-derived stem cells isolated using both protocols was assessed in vitro, and gene expression analysis was performed. To assess the ability of the isolated cells to generate bone in vivo, die authors created critical-size calvarial defects in mice, which were treated with adipose-derived stem cells loaded onto hydroxyapatite-coated poly(lactic-co-glycolic acid) scaffolds. To test die ability of the isolated cells to enhance adipogenesis, die cells were added to lipoaspirate and placed beneath the scalp of immunocompromised mice. Fat graft volume retention was subsequently assessed by serial computed tomographic volumetric scanning. RESULTS: The new method resulted in a 10-fold increased yield of adipose-derived stem cells compared with die conventional method. Cells harvested using die new method demonstrated significantly increased cell viability and proliferation in vitro (p < 0.05). New method cells also demonstrated significantly enhanced osteogenic and adipogenic differentiation capacity in vitro (p < 0.05) in comparison with die conventional method cells. Both cell groups demonstrated equivalent osteogenic and adipogenic regenerative potential in mice. CONCLUSIONS: The authors have developed a protocol that maximizes the yield of adipose-derived stem cells derived from lipoaspirate. The new method cells have increased osteogenic and adipogenic potential in vitro and are not inferior to conventional method cells in terms of their ability to generate bone and fat in vivo. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
Published: 2016
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15. Trends in short-term outcomes after resection of colorectal cancer: 1971-2013

Author: Pierre H. Chapuis, Les Bokey, Owen F. Dent, Charles Chan, and R. C. Newland
Subjects: medicine.medical_specialty, medicine.diagnostic_test, Colorectal cancer, business.industry, Incidence (epidemiology), medicine.medical_treatment, General surgery, Colonoscopy, General Medicine, Bowel resection, medicine.disease, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, Surgery, 030212 general & internal medicine, Prospective cohort study, business, Survival rate, Colectomy
Abstract: BACKGROUND The aim of this study was to describe temporal trends in presentation, surgical management and immediate postoperative outcomes in patients recorded in a registry of colorectal cancer resections that was initiated at Concord Hospital, Sydney, Australia, in 1971. A companion paper describes tumour pathology and long-term recurrence and survival. METHODS This report is based on 5217 consecutive resections up to 2013, with no exclusions. Categories in variables examined were expressed as percentages over annual totals of relevant patients or annual mean values. The statistical significance of trends was examined by least squares regression. RESULTS The percentage of asymptomatic patients increased over time, whereas urgent presentations declined. Tumour size declined. The percentage of rectal cancers fell but the percentage of low rectal tumours rose. Initially, restorative rectal resections increased rapidly but later remained stable. There was no trend in medical complications, whereas surgical complications declined. Anastomotic leakage after restorative rectal resections declined but it was low and stable for colonic tumours. The rate of early reoperation remained stable, whereas 30-day mortality declined. Neoadjuvant radiotherapy for rectal cancer and adjuvant chemotherapy for stages B and C were introduced in 1992 and applied increasingly thereafter. CONCLUSION Our findings, based on a 43-year prospective study, indicate sustained trends towards the earlier diagnosis of colorectal cancer and favourable short-term outcomes following bowel resection.
Published: 2016
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16. Trends in pathology and long-term outcomes after resection of colorectal cancer: 1971-2013

Author: Charles Chan, Leslie Bokey, R. C. Newland, Pierre H. Chapuis, and Owen F. Dent
Subjects: Oncology, medicine.medical_specialty, Pathology, Adenoma, business.industry, Colorectal cancer, General Medicine, medicine.disease, Malignancy, Resection, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Statistical significance, Internal medicine, Long term outcomes, Medicine, 030211 gastroenterology & hepatology, Surgery, Stage (cooking), business, Survival rate
Abstract: BACKGROUND The aim of this study was to describe temporal trends in tumour pathology and long-term outcomes in 5217 patients recorded in a registry of colorectal cancer resections initiated at Concord Hospital, Sydney, Australia, in 1971. METHODS This report is based on consecutive resections up to December 2013, with no exclusions. Categories in variables examined were expressed as percentages over annual totals of relevant patients or annual mean values. The statistical significance of temporal trends was examined by least squares regression. RESULTS The percentages of patients with local spread beyond the muscularis propria, nodal metastasis, distant metastasis and tumour in a line of resection all declined significantly. In consequence, the percentage of stage D patients fell, whereas the percentage in stage A rose. Other tumour variables that increased significantly were polypoid morphology, contiguous adenoma and invasion of a free serosal surface. Tumours in which an adherent adjacent structure was partly or completely removed also increased. There were significant declines in high-grade malignancy, venous invasion and tumour size. The recurrence rate for rectal cancers declined significantly, whereas for rectal and colonic cancers combined, both the overall 5-year survival rate and the 5-year cancer-specific survival rate increased markedly. CONCLUSION These results show a reduction in adverse pathology findings and favourable trends in recurrence and survival after colorectal cancer resections in a high-incidence country over a period of 43 years.
Published: 2016
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17. Long-term results following an anatomically based surgical technique for resection of colon cancer: a comparison with results from complete mesocolic excision

Author: Les Bokey, Anil Keshava, Charles Chan, Owen F. Dent, Matthew J. F. X. Rickard, Pierre H. Chapuis, and Peter Stewart
Subjects: Adult, Male, medicine.medical_specialty, Colon, Colorectal cancer, medicine.medical_treatment, Kaplan-Meier Estimate, Time, Young Adult, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, Prospective Studies, Registries, Young adult, Prospective cohort study, Ligation, Lymph node, Survival rate, Colectomy, Aged, business.industry, Dissection, Gastroenterology, Middle Aged, medicine.disease, Combined Modality Therapy, Surgery, Survival Rate, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Colonic Neoplasms, Lymph Node Excision, Female, 030211 gastroenterology & hepatology, Lymph Nodes, business, Follow-Up Studies, Mesocolon
Abstract: Aim Complete mesocolic excision (CME) has been advocated as likely to improve the long-term oncological outcome of colon cancer resection, although there is a paucity of long-term results in the literature. The aim of this study was to supplement our previously published results on colon cancer resection based on a standardized technique of precise dissection along anatomical planes with high vascular ligation and to compare our long-term results with those of recent European studies of CME. Method Data were drawn from a prospective hospital registry of consecutive resections for colon cancer between 1996 and 2007, including follow-up to the end of 2012. The principal outcomes from potentially curative resections were 5-year Kaplan–Meier rates of local recurrence, systemic recurrence, overall survival and cancer-specific survival. Secondary outcomes for all resections were postoperative complications, number of lymph nodes retrieved and R0 status. Results For 779 potentially curative resections the local recurrence rate was 2.1% (95% CI 1.3–3.4), the systemic recurrence rate was 10.2% (95% CI 8.1–12.7), the 5-year overall survival rate was 76.2% (95% CI 73.0–79.0) and the cancer-specific survival rate was 89.8% (95% CI 87.3–91.9). For all 905 resections, rates of 14 surgical complications were low and not dissimilar to those in a comparable study. The median lymph node count was 15 (range 0–113). R0 status was confirmed in 883/905 patients (97.6%; 95% CI 96.4–98.5). Conclusion For colon cancer, meticulous dissection along anatomical planes together with high vascular ligation results in few complications, a high R0 rate, low recurrence and high survival.
Published: 2016
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18. Abstract 43: Embryonic Expression of Prrx1 Identifies the Fibroblast Responsible for Scarring in the Mouse Ventral Dermis

Author: Charles Chan, Ryan C. Ransom, Howard Y. Chang, Ulrike M. Litzenburger, Graham G. Walmsley, Julia T. Garcia, Peter H. Lorenz, Clement D. Marshall, Michael T. Longaker, Michael S. Hu, Alessandra L. Moore, Derrick C. Wan, Shamik Mascharak, and Tripp Leavitt
Subjects: 0301 basic medicine, Session 5: Basic/Translational Science, Friday, May 18, business.industry, lcsh:Surgery, lcsh:RD1-811, Embryonic stem cell, Cell biology, 03 medical and health sciences, 030104 developmental biology, medicine.anatomical_structure, Dermis, PSRC 2018 Abstract Supplement, medicine, Surgery, Fibroblast, business
Published: 2018

19. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals

Author: Jennifer Morrish, Emily J Robson, Georgina Ashfield, Karuna Kotur, Jashmin Maria, Charlotte Downes, Shweta Patro, Mark Scrutton, George Gladstone, Andy Burton, Paula Mulligan, Wei Lin Allen, Michael McCusker, Dee Leonard, James Edwards, Sarah Dolling, Katherine Pass, Hywel Garrard, Francis Young, Paul Edgar, Elaine Matthews, Douglas Findlay, Helen Whittle, Aillison MacLean, Chris Levett, Claire-Marie Agius, Kim Porter, Nurse Charlotte White, Bridget Campbell, Gemma Scotland, Patrick Haywood, Liz Shenton, Tom Hatton, Laura McAffrey, Jane Hunt, Jaime Carungcong, Sara Owen, Fiona Christie, Lesley Milne, Liza Tharakan, Ruth Smith, Henry Nash, Timothy Gould, Jodie Fitzgerald, Wael Zghaibe, Mark Gaskell, Dushyanthi Jayasekera, Elana Owen, Kinga Dwornik, Amr Ali, Donna Cotterill, Martyn Cain, Peter Wicks, Daniel West, Catriona Walker, Rebecca Lee, Amanda Isaac, Naresh Rajasekar, Sally Collins, Laura Hammon, Tim Hendra, Yemi Adelaja, Mike Pollard, Ellen L. Brown, Matt Clayton, Rachel Bown, Sally Moore, Keyury Desai, Tony Kinsey, Charlotte Dunn, Li Lian Loh, Emelia Passaro, Timothy Faccini, Stephen Linter, Sumant Shanbhag, David Lee, David Restall, Angela Cook, Simon Ripoll, Rachael Bird, Vicky Murray, Alex Wollaston, Daniel Yarwood, Sonia Bhangu, Sahar Biuk, Jenny Ferry, Alexander Michael Stewart, Ceri Lynch, Lucy Sheppard, Denise Webster, Jamie Allen, Merle Cohen, James Hanison, Shilpa Rawat, Prabhakaran Premraj, Gamunu Ratnayake, Clare Bird, Lorna Filby, Clare Allcock, Babak Sedghi, Celly Weegenaar, Dawn Collier, Sreekanth Rayalu Uppugonduri, Amanda Whileman, Su Ying Ong, Jack Carmichael, Victoria O'Loughlin, Barbara Linklater-Jones, Maria Lackmann, Vitul Manhas, Albert Brennan, Alasdair Waite, Andrew Smallwood, Salvatore Bruni, Catriona Barr, Thomas Murphy, Gemma Hudson, Khalid Hasan, Alison J. Campbell, Radu Chiravasuta, Charlotte Maden, Roddy Chapman, Jon Clark, Nauman Iftikhar, Sarah Hagyard, Denis O'Leary, Steven Forde, Joanne Webb, Ryan W Haines, Andrea Galloway, Richard Siviter, Heidi Lightfoot, Hew D.T. Torrance, Christopher Smith, Hollie Robinson-Perrie, Josh Wall, Carina Cruz, Andrew Song, Stephen T. Webb, Nurse Sara-Beth Sutherland, Carol-Ann Woolley, Susan Martin, S.L.M. Walker, George Koshy, Renee Ford, Mona Mubarak, Robert Stuart, Keshava Reddy Burijinti Chenna, Rizana Ghafoor, Katie Hanlon, Fiona Faulds, Hiba Khaled, Richard Jones, Karin Duckett, Cathryn Matthews, Charles Chan, Sanjeewa Ranaweera, Nurse Rebecca Hinch, Richard Shawyer, Jo Cudlip, Marion Ashe, Steve Harris, Ravi K. Alagar, Jonathan Hetherington, Sara Churchill, Yolanda Baird, Maria Tritean, Gabriela Wong, Dermot Moloney, Lee Tbaily, Jonathan Finnity, Norbert Bokor, Peter Indoe, Lucy Stelfox, Simon Marcus, Bryony Burrill, Ellie Roderick, Carina Lilley, Alex Yusaf, Lucy Corbett, Esther Neilly, Christine Ryan, Amon Wijunamai, Katie Atterbury, Abigail Clarke, Josh Patch, Otto Mohr, Ronan Mukherjee, Asokan Krishnaier, Chen Yun-Han, Prasan Panagoda, Polly Rice, Katherine Jones, James Hudson, Sophie Uren, Peter Sutton, Evangelia Poimenidi, Tracy Marsden, Veronica Barnes, Alice Drysdale, Tara Lawrence, Lisa Sharpe, John G. Francis, N. M. Wharton, Claire Kurasz, Marina Iaverdino, Caradog Thomas, Emma Gold, Raj McNab, Tom E.F. Abbott, Claire Dowse, Jane Hamilton, Tony Sutherland, Robert P. Jones, Peter Alston, Daniel Haslam, Philippa Marshall, Bernadette Tilley, Cathleen Chabo, Adam Carpenter, Steve Cole, Nicholas Hooper, Kate Arrow, Alka Shah, Rosie Furness, Susie Chapman, Sachini Dhamaratne, Constandinos Papageorgiou, Michael Girgis, Sandra Pearson, Andrew W. Wood, Jaya Nariani, Sonia White, Christopher Godden, Mary Bellamy, Indra Chadbourn, Laura Parker, Peter Knowlden, Cat Griffiths, Jeanette Smith, David Brooks, Jonathan Smith-Williams, Elizabeth Barnes, Sunil Jamadarkhana, Andrew Feneley, Maria Croft, Tom Disney, Paramesh Kumara, Anna Warrington, Seetal Aggarwal, Zackriah Badsha, Suman Biswas, Suzanne Shuttleworth, Ben Jones, Jose Lourtie, Mark Stubbington, Asya Mussad, Patrick Johnson, Sister Amanda Cowton, James Spargo, Kelly Hard, Annette Fraine, William Weston, Farrukh Ameer, Andrew Prenter, Lisa Bacon, Sunil kumar Chaurasia, Claire Nicholas, Amy Kitching, Sneha Prasad, Catriona Ferguson, Martin P. Huntley, Claire Cameron, Hugh Cutler, Anne Harrison, Kunal Joshi, Anna Cormack, Rebecca Jones, Martin Paul, Jean Bage, Stephen Cole, Usman Razaque, Robert Lewis, David O'Callaghan, Samantha Strong, Victoria Frost, Peter Ip, Victoria Male, Mat Molyneux, Christopher Worth, Michael Brett, Megan Smith, Shayan Arshed, Timothy McMillan, Lorri James, Frances Lay, Jennifer Bennett-Britton, Patrick Colhoun, Alison Shaw, Michael Stewart, Maie Templeton, Karin Gupwell, Mujeeb Khan, Elena Stanton, Chandini Chuni, Janette Brown, Mariam Latif, Rebecca L. Wilson, Felix Fombon, Jo Novaga, Cindy Persad, Matthew Thomas, Maryna Garmash, Metod Oblak, Sarah Maher, Rahul Muddanyake, Morgan Foster, Kris Parker, Tim Sutton, Ndi Ekwere, Samuel Armanious, Mohammad Bhatti, Steve Phillips, Maria Rivero-Bosch, Nick Spittle, David Harding, Henry Hammerbeck, Rose Buckley, Jonathan Hatton, Ahmed Gilani, Ali Watts, Neeraj Bhardwaj, Lesley McShane, Simon Ridler, Martin Murphy, Vandana Goel, S Ramani Moonesinghe, Sophie Scutt, Sanniah Hussain, Hannah Donaldson, Tom Bennett, Helen Boys, David Steven Davies, Bev Hammond, Bryan Yates, Victoria Hawley, Chris Gibb, Ulrika Winstone, Keith Couper, Benedict Williams, Louise Duncan, Georgina Wilson, Anil Hormis, Emily Dana, Jens Full, Amina Chohan, Amanda Ebejer, Sian McKillop, Tomas Bakonyi, Georgina Bird, George Davies, Christina Penny, Helen Thornley, Karen Jewers, Kingsin Ang, Mishell Cunningham, Conny Blunt, Ronald Carrera, Kay Finney, Alvin Soosay, Nagaraj Rao, Jason Mann, Carol Edwards, Richard Lowe, Paul Stevens, Hilary Ashton, Rachel Codling, Rhys Davies, Muthuraj Kanakaraj, Zoe Apple, Kirsty Meats, Tammy Smith, Charmaine Beirnes, John Gardner, Peter Featherstone, Claire Williams, Rohit Mittal, Emma Shinn, Alex Moore, Michael Whitear, Hannah Rose, Paul Kelly, Megan Thomas, Matthew Gibbins, Jack Reid, Caroline Clarke, Victoria Irvine, Bhavesh Pratap, Ella Buchanan, Nurse Francesca Wright, Vatsharlan Santhirapala, Richard Gould, Dionne Dervin, Behzad Sohail, Lauren Duraman, Thecla Scully, Adnaan Qureshi, Muditha Peiris, Thomas Ratcliffe-Law, Samuel J. Clark, Ben Vowles, Sam Keable, Hoda Abou Ghoneim, Becky Morris, Aidan Hulbert, Rachael Craven, Ashish Kundu, Emma M. Casely, Maya Kommer, Tom Poulton, Greg Nussbaum, Ahmad Huda, Caroline Davis, Suzanne Gleeson, Paul Clements, Matt Willis, Isobel Amey, David J. Perry, Rachel Harford, Bianca Hulance, Kirsty Baron, Charlotte Grove, Sergio Dominguez, Susanna Richie-Mclean, John Stones, Ioana Simionescu, Khaled Razouk, Cristina Niciu, Ben Hyams, Mark Doran, Carolyn Colvin, Jonathan Rivers, Raluca Ene, Rebecca Jackson, Jonathan Edgar, Ben Robinson, Lisa Wilkinson-Guy, Aji Mathew, Christopher Patrick, Gauhar Sharih, Ismail Tariq, Andrea Kay, Joshua O'Donnell, Dafydd Watterson, Lail Zaheer, Fiona Reed, Tom Johnson, Christopher Oscier, Mirain Phillips, Edmund Gerrans, Joanna Hackney, Sally M. Dunlop, Elizabeth Willetts, Jiang Yuchen, Lizzie Ashton, Theresa Cooper, Paul W. Davies, Carly Brown, James Small, Julie Lowe, Amarjeet Patil, Filipe Helder, Joshua Cuddihy, Faisal Sheikh, Hayley Tarft, Enid Leung, Adrian Percuin, Paolo Mazzone, Rochelle Rhodes, Jane Pilsbury, Kerry Cullis, Peter Brook, Helen McNamara, Carin Swanevelder, Claire Frith, Adrian Clarke, Stuart Watson, Glenn Vetuz, Zoe Riddell, Drew Welch, Geoff Warnock, Lalani Induruwage, Paul Mallett, Elizabeth Cervi, Santinder Dalay, Supriya Antrolikar, Sinead O'Kane, Toby Hoskins, Stephen Duberley, Sophie Parcell, Jayne Sutherland, Lynn Fairless, Dave Parkinson, Matron Beryl Davis, Abigail Patrick, Jithu Jayan, Nicola Harvey, Catherine Pitman, Donata Banni, Samuel Passey, Omar Alex Pemberton, Becky Sands, Hon Sum Liu, Alexandra Mudd, Sheldon Zhang, Ange Lise John-Baptiste, Thomas Clayton, Charlotte Marriot, Tom Reevell, Nicola Mackenzie, Temitope Aiyedun, Andy Cruickshanks, Jacqueline Gunn, Alison Moss, Martyn Clark, Swetha Rambhatla, Claire Matata, Ben Cracknell, Pauline Mercer, Matthew Morgans, Catrin Williams, Shareef Madhi, Jane Montgomery, George Kohler, Yasir Hameed, Muneeba Ahmed, Glenn Saunders, Anand Kulkarni, Craig Pinner, Lauren Pearce, Vishnu Bhardwa, Judi Ramsey, Meghna Sharma, Rob Hull, Srinivasan Perumal, Julia Critchley, Stephen Hill, Bethany Fitzmaurice, Robert Crichton, Cormac O'Connor, M. Dickinson, Alison Pearce-Smith, Julie Toms, Kathleen Horan, Ammy Dodd, Rachel Crone, Graeme Finnie, Suman Shrestha, Saul Sundayi, Shamini Sivakumaran, Robert Collin, Janine Musselwhite, Yuvaraj Kummur, Mariana Bernardo, Amrinda Sayan, Gabrielle De Selincourt, Laura Bridge, Melissa Rosbergen, Philip Barclay, Garry Davenport, Daniel Murrell, Andrew Drummond, Eireann Allen, Emma Fadden, Subha Arunachalam, David Robinson, Stephanie Dukes, Catherine Jardine, Sunny Bhat, Hemantha Shiva, Amy Kerr, Henry Elms, Anam Asif, Sandra Evans, Girish Rangaswamy, Laura Thomson, Asad Javed, Jenny Shuttleworth Davies, Maren Kleine-Brueggeney, Sian Edwards, Jean-Paul Zahra, Jo simpson, Priya Verma, Bhamini Tharmalingam, Matthew Edmunds, Stephen Adshead, Hannah Luckhurst, Lara Allen, Colin Merrill, Fiona Lyle, Falguni Choksey, Mohyman El Habishi, Holly Notman, Lisa Murthen, Christiana Georgiou, Georgina Singleton, Tim Cook, Melba Knighton, Shirley Pyke, Amit Gadre, Maria Rehnstrom, Helen Hothersall, Anja Kuttler, Anita Boltres, Sarah Williams, Sarah Welch, Yamuna Madhu, Pramod Nalwaya, Alistair Coleman, Jeanie Worthington, Jasmine Samuel, Rajashekar Gowni, Karen Burt, Shamim Haque, Reynard Knoetze, Hakeem Yusuff, Tom Taylor, Val Parkinson, Sheik Pahary, Jonathan Fortune, Natalie Long, David Gilhooly, Karthick Duraisamy, Duncan Baines, Shondipon Laha, Marie Appleby, Jyothi Hosahalli, Christine Catley, Jasmine Jose, Damien Mantle, Dinkar Gowda, Permendra Singh, Ramesh Khoju, Carol Bradbury, Sarah Hazeldine, Karan Kanal, Sonal Lodhi, James Craig, Rachel Wong, Teresa Ferreira, Charis Banks, Ben Chandler, Asia Sarwar, Sivaprakash Vaitheeswaran, Sam Bews, Katie Hunter, Sohan Bisonoothan, Lauren Hunt, Melony Hayes, Nilesh Chauhan, Janet Pickett, Sharon Dealing, Jamie Plumb, Thomas Hollins, Claire Hill, Claire Hindmoor, Nicolas Hooker, Hannah Davis, Laura Mee, Elizabeth Thomas, James Self, Jenny May-Ling Cheung, Jane Varin, Manish Kakkar, Anuj Wali, Omar Siddique, Sophie Earl, Elizabeth Longdon, Alison Meadows, Shafi Ahmed, David MacPherson, Shaima Elnour, Suzi Hale, Ramez Ibrahim, Fei Long, Orlanda Allen, Alice Groves, Mohammed Wahid, Angela Stevens, Carl Ilyas, Richard Robley, Nichola Bleasby, Peter Havalda, Ursula McHugh, Judith Brade, Georgia Monantera, Stuart Younie, Brian Johnston, Jamie Brookes, Linda Park, Graeme Wilson, Mark Greasley, Lohita Nanda, Vineetha Jayakumar, Ian M. Lyons, Ayman Abdu, Paul Athanasopoulos, Justin Woods, Kariem El-Boghdadly, Diane Simpson, Georgina Williamson, Jonathan McCarter, Anil Golhar, Alicia Waite, Claire Halligan, Sarah Anne Leir, Joanne Turner, Matthew O'Meara, Claire Atkinson, Adam Yarnold, Mark Fernie, Rhiann Marie O'Shaughnessy, Jamie Elwood, Laura Harvey, Ali Atrah, Helen Terrett, Sam Scholes, Rebecca E. Saunders, Vin Vyapury, Amir Rafi, Peter Bradley, Srikant Ganesh, Zehrin Nassa, Ulf Buhmann, Laura Carrick, Natalie Rogers, Said Seifalan, Ian Ryder, Jennifer Partridge, Tim Lovell, Martin Priestley, Caroline Wrey Brown, Joanna Moore, Vidhya Nagaratnam, Saba Iqbal, Francesca Mazzola, Samantha Weller, Laura Gould, Helen Johnston, Jenny Spimpolo, Carmen Scott, Stephen J. Brett, Paul Cripps, Amit Kurani, Alexander Knight, Nirav Shah, Pushkar Patankar, Fraser Waterson, Sarah Martindale, Johannes Mellinghoff, Joanne Wootton, Sarah McCormick, Sameer Somanath, Bilal Yasin, Christopher Skeoch, Toby Jacobs, Katrina Eaton, Lynne Connell, Harry Soar, Yvonne Bramma, Tom Gately, Renjith Joseph, Anish Gupta, Lucie Hobson, Charindri Wariyapola, Maryam Zaky, Nimu Varsani, Gerhardus Van Rensberg, Jackie Evans, Rosahn Saleh, William Sutcliffe, Louise Potter, Harvey Dymond, Catherine (Katie) Patton, Andrew Selman, Stephen Traynor, Kate Tizzard, Rumyana Nyathi, Caroline Reavley, Saima Hashmi, Kerry Hughes, Isabelle Sykes, Kate Slade, Anne Troy, David Castillo, Jennifer Quinton, Anne Adams, Joanne Gresty, Stella Wright, Victoria Christenssen, Iain Mooney, Fiqry Fadhlillah, Seema Pai, Gabor Debreceni, Aleinmar Winthein, Denise Griffin, Hannah Beadle, Elisa Kam, Marie Williams, Helen Howes, Tariq Tabiner, Saxon Prentice, James Bedford, Emma Craig, Peter Standen, Stephen Petley, Janaki Pearson, Cheryl Marriott, Harry Barclay, Alexandra Matson, Michael P.W. Grocott, Alison Thorne, Joanne Humphreys, Vishal Patil, Nick Greenwood, Richard Wassall, S.K. Harris, Valpuri Luoma, Dancho Ignatov, Rebecca Fry, Anamika Sehgal, Antonio Paredes-Guerra, Manjula Yadagiri, Yuvraj Doriaswami, Benjamin O'Donovan, Adam Mounce, Stephanie Wright, Linda Webber, Tracy Hazelton, Ethan Bateson, Theresa Garrett, Chris Honstvet, John Scriven, Rahul Dimber, Phillip Lo, Jenny Stead, Catherine Plowright, Rachel Morris, Pallavbhai Desai, Nicola Johnson, Neil Muchatuta, Vijayakumar Gopal, Sherma Turner, Karina Fitzgibbon, John B. Davis, Sarah Patch, Erica Jolly, Rob Gregory, Christopher Lochrin, Geoffrey Ryder, Sam Michlig, Liana Zucco, Susan Nimmo, Jessica Whiston, Sarah Goellner, Rohan Babla, Deborah Skelton, Lucy Mcmanoman, Darcy Pearson, Diane Forrest, Sanjeev Garg, Joanne Bradley-Potts, Joel Perfitt, Danny J.N. Wong, Mike Weisz, Caroline Lowrie, Timothy Alce, Alice Michell, Charlotte Soulsby, Dominic Hayes, Arnab Mandal, Stephanie Ridgway, Angela Willberry, Alka Grover, Simran Minhas, Kerwei Tan, Sharon Jones, Sam Marcangelo, Ben Millette, Hilary Thatcher, Greg Foster, Krishna Balachandar, Megan McAtear, Richard Shellard, Chris Littler, Thunga Setty, Kavita Sasi-Kumar, Theodore Floyd, Duncan Adshead, Stephen Hickey, South Yorkshire Hospitals Audit, Amy Barker, Ewen Cameron, Dawn Trodd, Wendy Nichols, Beth Farr, Mike Salmon, Naomi Fleming, Umairali Ikram, Ben Straughan, Peter J O'Brien, Laura Purandare, Janine Thomas, Elizabeth Wood, Kate Bosworth, Stewart Mckie, Samantha Evans, Tamilselvan Rajamanickam, Srinivasan Dhileepan, Paul Hindmarch, Colin Bergin, Sange Mansoor, Lisa Armstrong, Nagendra Natarajan, Irmeet Banga, Fiona Osborne, Lynne Williams, Pieter Bothma, Jade Woolley, Joanne Finn, Bernd Oliver Rose, Shaman Jhanji, Bennur Katyayani, Gillian Robertson, Laura Bird, Pauline Fitzell, Sally Anne Smith, Serena Yen, Stuart Clelland, Thomas Urwin, Luff Delme, Rocio Ochoa Ferraro, Nurse Cheryl Padilla Harris, Asad Naqvi, Andy Cumpstey, Natalie C. Wood, Samar Al-Rawi, Pulak Padhi, Claire Botfield, Bhavesh Raithatha, Michael Briskoe, Jolyon Cohen, Ben Gibbison, John John, Stephen Washington, Jayne Foot, Karen Chadwick, Naomi Cochrane, Sophie Spencer, Alexandra Gatehouse, Susan Smolen, Aaron D'Sa, John Sturrock, Christopher P Bourdeaux, Kumud Bhandari, Neil Kellie, Elizabeth Denman, Samson Tou, Laura Kettley, Alex Eros, Stuart McLellan, Nicola Ball, Emily Kirk, Sue Smyth, Kim Gibson, Oliver Barker, Mohammad Masood, Dabeeruddeen Ahmed, Geoff Thorning, Jennifer Van Ross, Esme Elloway, Kat Rhead, Sei Nishimura, Maximiliane Kellner, Benjamin Jacobs, Sanjoy Shah, Matthew Stubbs, Faye Moore, Greg Cox, Nishita Patel, Ashok Nair, Elizabeth Hawes, A Espinosa, Kavita Wankhade, Vladimir Bashliyski, Carina Bautista, Susan Lyjko, Michelle Rowe, Nikita Whotton, Julie Temple, Inthu Kangesan, Gemma McIntosh, Samir Nazir, R. N. Kumar, Jen Warren, Alex Coombs, Marilyn Boampomaa, Kaya Jeyarajah, Heather Savill, Claudette Jones, Vinayak Vanjari, Caroline Tierney, Santhana Kannan, Jennifer Aston, Helen Melsom, Valantine Woodham, Nichola White, Niraj Barot, Paolo Perella, Mayumi Vianzon, Padmanabhan Vatsala, Claire Boynton, Alexandra Edwards, Elisa Masoni, Jayne Edwards, Julie Edwards, Thomas Garth, Amanda Skinner, Kate Blethyn, Jonathan Chambers, Katie Ramm, Rosada Jackson, Thomas Coleman, Tracey White, Emma McKenna, Kanchan Umbarje, Thomas Sheppard, Deepa Jumani, Emma Murphy, Peter Lawley, David Howe, Daisy Alston, Ania Dean, Prasun Mukerjee, Julian Hood, Mahmoud Alkholany, Sarah Goff, Gillian Rennie, Bridget Fuller, Ciara Walker, Jonathan Pipe, Alex Eeles, Wai Soon, Catherine McMillan, Martha Wrigley, Neil Brown, Peter Sandbach, Claire McCahill, Anna Wilson Charlotte Yates, Paul Sampson, Natasha Muzengi, Colum Slorach, Moyra Hynd, Arjun Ardeshna, Trish Boateng, James C. Geoghegan, Rhys Williams, Karoline Middleton, Brian Campbell, Srikanth Chukkambotla, Daniel Leslie, Sherrie Samuels, Michael Allan, Ruth Clarke, Christopher Nutt, Kirsten Reid, Hannah Smith, Surabhi Jain, Stephanie Reed, Hywel Evans, Irene Gardner, Ben Griffiths, Guy Shinner, Marek Frenkiel, Jacek Zeber, Gary Minto, Simon Parrington, Louise Harrison, Carlos Kidel, Hawa Desai, Lois Steuart, Claire Hirst, Johann Harten, Marc Slorach, Angela Christofides, Claire Macey, Helen Moore, Chantal Busby, Andrew Robertson, Leanne Milner, Catherine Chapman, Rebecca Reeves, Lawrence Wilson, Alice Aarvold, Lizzie Irvine, Narayanan Suresh, Kirsteen Brown, James Dalton, Sam Miller, Yasir Rashid, Andrew Swain, Liliana Czukowska, Natasha Permall, Carys Durie, Peter Carroll, Lauren Cooper, Prerna Mehrotra, Sarah Clayton, Martina McMonagle, Sarah Buckley, Enoch Onya, Elizabeth Perritt, Domonique Georgiou, Manjeet Save, Lauren Friedman, David W. Hewson, Katherine McAndrew, Simon Morton, James Morgan, Susan Underwood, Helen Bowyer, Avninder Chana, Lucy Sootheran, Kieron Rooney, Pooja Patel, Jessica Summers, Laura Farmer, Kiran Keshvara, Victoria Richardson, Hannah Crowther, Geejo Rappai, Adam E. Green, Sarah Willcock, Smitangshu Mukherjee, Samuel Tyrrell, Geraldine Landers, Claire McAteer, Jennifer Awolesi, Sarah Higgin, Orla O'Neill, Chrissie Chevis, Paul Winwright, Vikram Malhotra, Jonathan Ogor, Maria Muelmenstaedt, Richard Stead, Lindsay Roughley, Sara Balliston, Nevena Kalcheva, Marc Wittenberg, Adrian Taylor, Lydia Shatanda, Anjali Soodan, Angela Moon, Sarah Elgarf, Matthew Roche, Sanchita Bhatia, Clare Howcroft, Emma Butterfield, Emily Gannon, Matthew Needham, Jacqueline McCormick, Daniel Bendel, Victoria Martinson, David Hall, Richard A. Armstrong, Lara Herbert, Beverly Kilner, Kathy Dent, Victoria Thwaites, Issy Thomas, Maggie Peat, Lisa Macbeth, Alex James, Rachel Flight, Nick Black, Elizabeth Boyd, Catherine Gedling, Suzanne Body, Nadine Farrell, Samantha Clayton, Paula Hiltout, Richard Haddon, Bethany Philpott, Victoria A Burgess, John Jackson, Anita Patil, Chris Platt, Lindsey Iles, Chrissy Braybrook, Katherine Morris, Emma Karsten, Minna Meritahti, Anastasia Lynn-Smith, Dorothy Hutchinson, Rebecca Darbyshire, Joanne Riches, Astri Luoma, Andy Gibson, Dushanthi Thurairasa, Roisin Baker, Xantha Holmwood, Alda Remegoso, Trusha Mistry, Sarah Hennell, Suganthi Joachim, Stephen Harris, Sam Eggleston, Melanie Morrison, Boon Ang, Natalie Jackson, Nicola Jones, Zena Haslam, Beata Iwanicka, Laura Graham, King Dhar, Melanie Kent, Daniel Wirth, Umakanth Kempanna, Laura Troth, Robert Orme, D. Campbell, Raquel Duarte, Muzaffar Sheik, Robert Maher, Jon Bramall, Rebecca Coates, Tracey Cosier, Sarah Vest, Kajan Kamalanathan, Graeme Foggo, Amanda Mohabir, Ritoo Kapoor, Precious Basvi, Jamie McCanny, Christian Frey, Bruce Emerson, Anantharaman Venkataraman, Karen Burns, Gail Pottinger, Mohamed Elwkhiee, Farkhunda Waqas, Alison Loftus, Amanda Kirrage, Ilma Songaile, Craig Smith, Jo Mullender, Hannah McPhee, Miriam Namih, Linda Gregson, Rachel K. Walker, Iain K. Moppett, Christine Adamson, Katie Flower, Tina Stoycheva, Beena Parker, Caroline Thompson, Kootharajan Kamraj, Vignesh Ashok, Ranjit Gidda, Istvan Koczka, Sadie Perkin, Vandita Ralhan, Arun Sengottaiyans, Ruth Hodgson, Peter Valentine, David Nunn, John Hickman, Molly Waldron, Lauren Elliott, Irene Echaveznaguicni, Lisa Dunlop, Julian Sonksen, Robert Fallon, Huw Griffiths, Thoy Ruth, Olivia Clancy, Lucy Dudgeon, Alicia Rodgers, Pamela Oracki, Phoebe Syme, Maria Newton, Stuart P. D. Gill, Julie Foxton, Jane Perez, Liam Gleeson, Richard Green, Sally Beer, Rohit Juneja, Loretta Barnett, Alex Bonner, Eunice Emeakaroha, Andrew V. Bradley, Ravishankar Jakkala Saibaba, Dipali Verma, J. Joseph Kinsella, Swee Ang Tung, Anju Raina, Verity Calder, Andrea Ortu, Chris Walmsley, Suneal Sharma, Michelle Reichman, Tom Stocks, Annika Smith, Ross Cruikshank, Sharon Storton, Matyas Andorka, Abhishek Kakkar, Allison Daniels, Priya Datar, Nichola Wakeford, Sheila Black, Usman Choudhry, Stephen Hackett, Huw Wilkins, Kirtida Mukherjee, Tim Green, Rebecca Hill, Ishan Dharmarathna, Jennifer Crooks, Serah Mungai, Luisa Howlett, Niveen El-Wahab, Linda Prasad, Amy Sadler, David Sharpley, Daphne Varveris, Victoria Ashton, Rajeev Jeevananthan, Safia Begum, Helen Anderson, Katherine Nahajski, Vanessa Linnett, Laura Morland, Stephen Mowat, Nenette Abano, Kathryn James, Ian Butler, Madelaine Ocampo, D. Williams, Gabriella Frunza, Wendy Deamer, Dominic Espitalier-Noel, Sian Liddle, Jane McConniffe, Anthony E. Pickering, Lisha Aju, Catherine Morgan, Hao Ern Tan, Jemma Tate, Emma Dooks, Anna Moore, Alison Hardwick, Liam Scott, Zak Rob, Rajeev Jha, Sujesh Bansal, Lynda Connor, Seliat Sanusi, Sophie Mason, Nipun Agarwal, James Woodier, Julian Giles, Lauren Collis, Jill Brown, Natalie Constable, Nichola Cahill, Anne Cowley, Mai Wakatsuki, Kelly Mintrim, Glenn Arnold, Donna Doyle, Ryhs Millington, Richard Dobson, Monica Serrano, Saqib Naji, Walid Hammad, Jacob Osbourne-Wylde, David Rollins, Claudia Paoloni, Nathan Anderson, Rachel Ingham, Alison Whitcher, Vicky Hills, Nina Toms, Jon Witby, Amy Nash, Marcus Fletcher, Jane Gibson, Martin Warin, Katherine McDowall, William Malein, Madhurima Das, Wael Abdelrhamen, Tom Neal, Sister Jenny Ritzema, James Collins, Chandana Rao, Joyce Yeung, Nadeem Shakir, Andrea Weigert, Atideb Mitra, Hari Arunachalam, Amy Morgan, Richard J. Jackson, Julie Chadwick, Debbie Callaghan, Frank Swinton, Lorraine Lock, Rahul Wakhle, Krish Kapoor, Ryan Humphries, Sarah Beavis, John-Paul Cutts, Julie Wilson, Keith Kelly, James Gill, Angela Loughlin, Rhys Rhidian, Christopher McGovern, Tom Hickish, Rachel Campbell, James Pennington, James Tozer, Philip Coakley, Lynn Fenner, Sally Tomkins, Lester Ribeiro, Shabir Qadri, Hristina Petkova, Christina Timmons, Katy Smith, Jonathan Perry, Stephen Crotty, Tanmay Patil, Mayavan Abayalingam, Ahmed Foly, Anna Wahed, Lewys Winfield-Young, Naomi Goodwin, Mark Verlander, Clare Donovan, Milena Vannahme, David Helm, Murali Vallabhaneni, Clare Ingram, Neil Moreland, Lorraine Stephenson, Jenny Jackson, Lindsay McOwat, Sathya Visvendra, Rhiannon Jones, Sarah Bird, M. H. Nathanson, Beryl Jones, Claire Davies, Beena David, Ian Sheldrake, Jeremy Guilford, Sister Bryony Storey, Rajeev Mishra, Irina Halfacree, Kiran Rait, Sameer Ahmed, Victoria Poyntz, Pamela Birks, Tom Kennedy, Angiy Michael, Michael McEvoy, Ian Davies, James Chan, Sajjad Ahmed, Laura Sweeney, Anne Whaley, Andrew Moores, Stella Gillies, Gearoid Crosbie, Antoinette Wilson, Iain Walker, Fiona Brailsford, Virginia Solanki, Elizabeth Turnbull, Lyndon Harkett, Sarah Ramsay, Thomas Syratt, Pushpaj Gajendragadkar, Cathal Small, Joanna Poole, Annabelle Whapples, Raghavendran Krishnaiyan, Elizabeth Smee, Richard Pierson, Taslima Rabbi, Alexandra Murphy, Angela Rooney, Sarah Crawford, Peter Bamford, Stephen Worthy, Sarah Munsie, Lucy Venyo, Henry Wang, Aditya Kuravi, Dennis Barnes, Ruth Han, Benjamin Gupta, Nurse Lynn Wren, Robert Hartley, Emma Edmunds, Laura Blood, Valerie J. Page, Thomas Judd, Puvan Suppiah, Emma Jenkins, Kate Gallagher, Fionnuala Lenehen, Rashidat Adeniba, Julius Cranshaw, Julie Wollaston, Kathryn Allison, Richard Kirkdale, Samantha Griffith-Norris, Jenna Kelly, Snehasish Guha, Stefan Schraag, Joy Dearden, Elizabeth Bell, Stephen Smith, Sarah Longhurst, Elizabeth Wilby, Annaliza Sevillano, Raksha Mistry, Aalisha Mariam Karimi, Kaung Pyae, Sarang Puranik, Maggie Collingborn, Karen Cranmer, Chandrashekhar Vaidyanath, M. Chincholkar, Narendra Siddaiah, Gillian Bell, Edward Rintoul, Nicki Devooght-Johnson, Tom Lovejoy, Eleanor Roscoe, Zoe Neilson, Joanne Hill, Kamal Sharif, Sharon Meehan, Bassey Nkanang, Thomas Georgiou, Martin Goodman, Prashant Kakodkar, Rebecca Martin, Philip Roddam, Evanna McEvoy, Peter Tsim, Janakan Anandarajah, Shub Gupta, Oliver Pratt, Yang Ng, Francesca Th'ng, Linda Kent, Graham Soulsby, Danielle Kirk, Ramana Govindaraju, Rebecca McClean, Samantha Harkett, Obaid Tarin, Shalini Chinna, Susan Gallagher, Laura Gardiner, Marc Turnbull, James Briscoe, Anna McSkeane, Melanie Claridge, Gillian Fleming, Thomas Huttley, Elaine Spruce, Lianne Hufton, Susan Hendy, Adrian Barry, Jeremy Drake, Cody Allen, James Hillier, Manju Patel, C. Gray, Nasreen Iqbal, Karen Markwell, Linzi Heaton, Michelle Nicholas, Gary Lau, Laura Catchpole, Nurse Sonia Walia, Kerry Elliott, Jake Hartford-Beynon, Amee Samani, Kathryn King, José William Martínez, Skylar Paulich, Ifan Patchell, Killian McCourt, Rebekah Rodgers, Christine Wood, Richard Wan, Karan Verma, H. W. Cain, Eleonore Quinn, Lisa Richardson, Muhammad Usman Latif, Nicholas Hingley, Rajesh Gilla, Roopa McCrossan, Mayeth Recto, Russell Hedley, Lucy McClelland, Suzie Marriott, Deepak Seharawat, Gururaj Mudimadagu, Claire Jones, Michelle Yare, Sophia Henderson, Rupinder Kaur, Emily Spence, David Wright, Bhaskar Dutta, Tom Pettigrew, Vikki Atkinson, Lorna Sissons, Segun Oladele, Sue Thomas, Hani Ali, Rebecca Robson, David Buckley, Kevin Hamilton, Amanda Hall, Anaesthetic Audit, Anna Watkin, Donna Kelly, Graham White, Sarah Sanders, Henry Boyle, Joao Galente, Thomas Williams, Justin Ang, Sarah Horton, Abdelrahman Soliman, Vijay Jeganath, Kavita Upadhyaya, Plamen Stoyanov, Murray Geddes, Alan Pope, Khaled Ellisy, Thomas Walker, Emma Finlay, Penny Parsons, McDonald Mupudzi, Adam Duffen, James Goodwin, Rob Penson, Laura O'Sullivan, Vinesh Mistry, Ravindra Mallavalli, Krzysztos Guz, Deepti Bhuwanee, Eleanor Andrews, Justine Burns, Sarah Kirk, Faith Kibutu, Sam Stafford, Julia Blackburn, Joellene Mitchell, Robert Spencer, Helen Williams, Karen Riley, Gabbie Young, Tom Williams, James Wu, Emma Wheatley, Alistair Johnstone, Rachel Stoeter, Timothy Cominos, Guy Coady, Ruth Mawhinney, Sam Spinney, ruthy Arumugam, Myura Nagendram, Jason Lie, Sian Hughes, Linda Bairkdar, Peter Evans, Daniel Pygall, Graeme Brown, Susan Livingstone, Norbert Skarbit, Amit Pruthi, Zakaulla Belagodu, Ben Linton-Willoughby, Richard A Cowan, Helena Prady, Mike Raffles, Sonia Rasoli, Katherine Cullen, Jessica Lees, Peter Lax, Ashok Puttapa, Fran Millinchamp, Aneta Oborska, Benita Adams, Kathryn Newton, Mrutyunjaya Rao Rambhatla, Sunny Nayee, Madlena Ivanova Vrazhalska, Jonathan Clarke, Aariana Sohal, Siobhan King, James Bain, Jessica Wilson, Anthony Carver, Jack Davies, Lucy Connolly, Samuel Morrish, Robyn Lee, Lucia Stancombe, Satyanarayan Jakkampudi, Kath Rosedale, Philip Hopkins, Clovis Rau, Katherine Hunter, Amy Farrow, Kathleen Holding, Elizabeth Vassell, Oliver Boney, Julia Icke, Ewa Prusack, Osi Egole, Fiona Linton, Suresh Eapen, Wendy Goddard, Ayda Borjian Boroojeny, Simon J. Davies, Jackie Terry, Fiona Graham, Thomas Pratt, Hanzla Naeem, Viv Colclough, Yeng Yap, Tejuswi Patel, Susan Midgley, Mark MacGregor, Ben Marshall, Talitha Devries, Cheng Ong, Katie Molloy, Kat Walker, Katy Irwin, Abbas Majeed, Mark Pinkerton, Nicki Russell, Sibtain Anwar, Ian A Jenkins, Lucy Allen, Elaine Coulborn, Ganesh Nair, Stewart Brown, Melissa Addy, Matt Milner, Amr Hassan, Victoria Millar, Sarah Turner, Gary Baigel, Amanda Lyle, Simon Young, Kathy Malinovszky, Heather Short, Mary Newmarch, Colin McAdam, Andrew Robert Bailey, Kevin Draper, Michael Agyemang, Kieran Oglesby, Clare Mewies, Ruth Ugochukwu, Shibu Jacob, Susan O'Connell, Charlotte Topham, Xiao Zhao, Shay Willoughby, Ossian Aukland Child, Manish Torne, Ben Wetherell, Divya Veluvolu, Dominic Wu, Elizabeth Evans, Daniel Eden, Suzannah Peggler, Lucy Emmett, Romit Samanta, Ravi Parekh, Jane Hermanowski, Will Shankey-Smith, Sam Papadopoullos, Julie Camsooksai, Sara Mistry, James Wigley, Anna Todd, Bally Purewal, Natalie Baldry, Kate Wilkinson, Aalia Sange, Kirsty Baillie, Joanne Topliffe, Denise McSorland, Saheli Das, Nikki Staines, Catherine Harris, Anna-Marie Boniface, Gemma Milne, Tessa Rowlands, Leanne Quinn, Svetlana Kulikouskaya, Christopher Bull, Angus Sutherland, Mihir Desai, Hannah Goodhand, Meenal Rana, John Bugo, Maria Chazapis, Sarah Kent, Sarah Siew, Marcin Pachucki, Tim Forsyth-Jones, John McKenna, Sarah Driscoll, Laura Hunter, Penny Bedoes, Natasha Santana-Vaz, Sandra Latham, Robert Coe, Sharon Christie, Lawrence R Kidd, Katy Redington, Alastair Sawyer, Abdalla Ali, Rekha Jayapal, Manfred Staber, Emma Pearson, Stuart Reilley, Tom Bird, Kristofor Inkpin, Annette Haines, Manish Verma, Naomi Wee, Ozerah Choudhry, Daniel Tucker, Euan Campbell, Aaron Stokes, Ashley Allan, Emma Reeves, Helen Fenner, Melanie Cockroft, Tom Nicholls, Sinan Bahlool, Sharon Drake, Nalini Sethia, Lesley Jordan, Martin Northey, Paul Glyn Jones, Lara Jeanes, Emma Simpson, Julia Brown, Samantha Coetzee, James Nicholas, Adam Samways, Ritesh Ganesh, Martin Ward Platt, Mizan Khondoker, Helen Wibberley, Lauren Simmonds, Sunita Agarwal, Linda Titinchi, Fran O'Higgins, David Pritchard, Laura Beard, Yvonne Lester, Charlotte Hirst, Louise Wills, Kevin Windsor, Haren Jyothiraj, Carmela Martella, Stephanie Bell, Christopher Nwaefulu, Hemamangala Venkatesh, Camilla Stagg, Soumi Ghosh, Thomas Dawes, Jennifer Lockhart, Stavros Papadopoulos, Nanci Doyle, Gillian Whalley, Rachael Britton, James Goddin, Maggie Dawson, Carole Holder, Elaine Morsman, Rachel Lovatt, Venu Mehta, John J.B. Allen, Anna Perham, Stephanie Wallis, Dmitry Zabauski, Peter Hart, Tracy Sharp, Martin Pope, Jo Knight, Jane Wright, Nageena Hussain, Josie Snell, Thomas Knight, Philippa Hill, Nic Martins, Robin Williams, Beverley Stidolph, Beth Peers, Brian Lafferty, Alicja A'Court, Joanna Collins, Charlie Kennedy, Andy Bates, Graham Walkden, Mia Marsden, Lauren Shillito, Poonam Bopanna, Raheel Ahmed, Ada Ezihe-Ejiofor, Kate Driver, Mevan Gooneratne, Carolyn Smith, Caroline Abernethy, Kathy Shammas, Chanice Alcock, Yin Yong Choo, Mark Vertue, Ratna Makker, Victoria C. Smith, Sachin Mehta, Clare Denford, Wint Mon, Jose Miguel Sabugueiro, Liz Varghese, Mohamed Ahmed, Rebekah Chan, Alexandra Williams, Stephanie Pauling, Maria Faulkner, Ryan Wilkins, Sara Stevenson, Kathryn Simpson, Moiz Alibhai, Patricia Williams, Pascal Defeyter, Siva Sangaralingham, Lucy Evans, Shirley Cocks, Simon Dyer, William Rea, Caroline Renton, Karl Braid, Ranjit Bains, Holly Owen, Sue Brixey, Calum Taylor, Laura Coleman, Andrew Peeling, Daniel Solomon, Christopher Perman, Roisin McCallum, Helen Church, Martin Watson, Amy Bamford, Elizabeth Bradshaw, Elizabeth Turner, Owen Vale, Suneetha Ramani Moonesinghe, Preeti Mahidik, Lynsey Cubitt, Catherine Hunter, Eleanor Warwick, Sam McAleer, Suresh Singaravelu, James Hilton, Rebecca Aspinall, Icel Souleimanova, Muna Elsheikh Idris, Wei Teo, Sarah El-Sheika, Adrienne Stewart, Sadia Habib, Emily Wade, Liesl Despy, Sharmin Shohelly, Colin Williams, Louise Shaw, Shree Voralia, Dafydd Lloyd, Barbara A. Crooks, Laura D Howe, Una Gunter, Edward Hare, Louise Nimako, Ruth Young, Helen Doherty, Sock Huang Koh, Stephen Merron, Martina Coulding, Agilan Kaliappan, Clare Bolton-Hill, Jill Wain, Maria O'Callaghan, Catherine Cartmell, Nicola Pemberton, Hannah Bennett, Lynda Garcia, Riquella Abbott, Sally Jeffrey, Thomas McLoughlin, Andrew Gratrix, Christopher Harrison, Matt Mackenzie, Jayshree Gracey, Chris Moore, Benjamin Parsons, Nehal Patel, Stephanie Brooks, Catherine Riley, Jemma Gilmore, Ilya Kantsedikas, Simon Whiteley, Emily Pallister, Angie Organ, Yohinee Rajendran, Gopinath Selvraj, Priya Thorat, Ilona Schmidt, Pauline Austin, Nitin Madhukar Sadavarte, James Haddock, Alastair Duncan, Richard Bateman, Elaine Chinery, Martin Gray, Felicity Corcoran, Shanelle Tharuka Wijesuria, Bryany Bond, Charlene Otieno, Sion Lewis, Cieron Roe, Dan Freshwater-Turner, Annette Bolger, Sarah Steynberg, Louie Saclot, Charlotte Busby, Jack Roberts, Richard Dagnan, Jasna Comara, Krishnakar Melachuri, Sian Gibson, Joanne Taylor, Manju Agarwal, Mark Sheils, Matthew Bell, Rosemary Anna Lewis, Kiran Patel, Mansoor Siddiqui, Christopher J. Groves, Mini Thankachen, Sharon Turney, Viral Dalal, Pele Banugo, Andrew Baird, Euan Kerr, Simon Tomlins, Laura Osbourne, Nicola Pattison, Stuart Joy, Susan Merotra, Lorna Ryan, Lisa-Jayne Cottam, Chye Siaw, Keelan Jerram, Nurse Diane Scarletta, Carole Paley, Jennie Smith, Will Gatfield, Stephen Alderson, Claire Swarbrick, Amelia van Manen, Stephan Clements, Sophia Strong-Sheldrake, Jake Drinkwater, John McLenachan, Lucinda Williams, Dianne Heaton, Sandor Orosz, Chloe O'Hara, Nina Barratt, Justine Elliot, Michael Gardner, Nicola Crowther, Bharati Rajdev, Linda Hall, Youssef Girgis, Michael Kinsella, Alison Potter, Matthew Martin, Rosie Reece-Anthony, Richard Pugh, Tracey Taylor, Esme Marshall, Wendy Stoker, Helen Worrell, Kay Housley, Rebecca Leslie, Helen Jewitt, Sandeep Sharma, Maire Gallagher, Jon Fenn, Jade Harrison, Hannah Watson, Natalie Morris, Lewis Schofield, Nisha Pattni, Charlotte Thomas, Eleanor Walshe, Richard Snooks, Ruth Murphy, Emily Pickford, Gnanshree Krishnamurthy, Donna McIntosh, Rachel Dolan, Emma Stoddard, Kelly Goffin, Shady Elhallous, Adrian Butler, Ildiko Nemeth, Hannah Wilson, James Sylvester, Melanie Sahni, James Wardlow, Ann Lachana, Emma Barr, Kayleigh Gilbert, Yazzim Hammoud, Peter Csabi, Maqsood Bajwa, James D Turner, Alex Hunt, Samantha Moore, Stephanie Hii, Philip Atkinson, Michelle Walter, Elizabeth Bailey, Frances Tait, Annie Newby, Jane Martin, Greg Forshaw, Bert Quartermain, Sally Humphreys, Aoife Hegarty, Caroline Bennett, Satyajeet Ghatge, Charles Prior, Kribashnie Nundlall, Priaykam Chowdhury, Jill Fitchett, Daiva Bernotaitis, Sandeep Varma, Alex Dunn, Rebecca Dooley, Mahamed Mostafa, Shelly Wood, James Humphreys, Anna Celnik, John Bailes, Mark Snazelle, Christina McCarroll, Matthew Govier, Emert White, Matthew Taylor, Alastair Rose, Brigid Hairsine, Natalie Whybro, Allen George, Robin Wilson, Filipe Vieira, Leon Cohen, Jonathan Womack, Thomas Woodward, Nimali Lochanie, Ben Howes, Joshua Nelson, Preea Gill, Gayle Clifford, Lushani Suntharanathan, Duncan Wagstaff, Steve Pryn, Lalindra Bandara, Sneh Shah, Nowfal Rahman, Iolo Roberts, Mirriam Sangombe, Shaik Subhani, Hannah Phelan, William Udall, Katy Allan, Nicola Zondo, Tim J Peters, James Roe, Catherine Addleton, Angus McKnight, James McCaul, Flora Kormendy, Anil Rao, Luke Vamplew, Andrew Rees, Jeanette Gilbert, Mandy Austin, Thomas Hunt, Sian Birch, Catherine Lloyd, Stewart D'Sylva, Jill Smith, Wendy Lum Hee, Michael Munro, Jean Denton, Julia Hindle, Alice Brown, Ursula Kirwan, Dinithi Yogya, Maria Mclaughlin, Nurse Louise Moran, Larysa Duniec, Sophie Benoliel, Gail Evans, Linda Bailey, Colin Hall, Katie Rowland, Krupali Patel, Ashwini Keshkamat, Zorba Begum, Resti Varquez, Victoria Apps, Giles Bond-Smith, Shirin Dastur, Andy Chapman, Amy Smith, Sarada Gurung, Ruth Delascasas, Nicole Issit, Pauline Sibley, Jaina Parmar, George Madden, Eveliina Nurmi, Katja van de Snepscheut-Jones, Louise Peacock, Vanja Srbljak, Kellie Allen, Andy Chamberlain, Suhail Zaidi, Andrew Boyle, Daniel Stolady, Rita Saha, Mark Clayton, Mitul Patel, Emily King, Hannah Oliver, Ewa Werpachowska, Holly Coles, John Dereix, Agnieszka Kubisz-Pudelko, Clare Watkinson, David Rogerson, Laurence Inman, Jaspreet Rayet, Jenny Finch, Emma Stewart, K. E. Wilson, Emma Tyson, Asif Gani, Reni Jacob, Neil Smith, Johnny Holland, Max Richardson, Mark Chen, Richard George, Helen Laycock, Anoushka Winton, Emily Hignell, Li Fang, Emma Welfare, Rochelle Velho, Fayaz Baba, Finbar O'Sullivan, Lisa Zeidan, N. Beauchamp, Neil Rasburn, Guy Rousseau, Victoria Roberts, Hollie Bancroft, Holly Maguire, Mechele Couch-Upite, Rahul Kumar, Chandra Bhimarasetty, Matt Lovell, Sujata Anipindi, Charlotte Small, Matthew Faulds, Alex Mattin, Alice O'Donnell, James Jack, Richard Boulding, Tarek Mostafa, Rhian Bull, Corinne Pawley, Ruth Killen, Jessica Lowe, Frances Taylor, Ethel Black, Michael F. M. James, Jenny Child, Lisa Emery, Kim Hoyland, David Hay, Janet Cotta, Josephine Stewart, Sue Spearritt, Laura MacNally, Fatma Lahloub, Katie Welham, Sanjoy Bhattacharyya, Shanteela McCooty, Heena Bidd, Hugo Buckley, Ervin Shpuza, Zaid Ahmed, Emily Craven, Amanda Cook, Caroline Dixon, Tara Pauley, Tariq Azad, Helena Barcraft-Barnes, Sindy Lee, Kate Penhaligon, Bernice Dudkowsky, Karen Ellis, Laura Montague, Ching Pang, Elsie Bickmore, Veronica Marsh, Toby Winterbottom, Marta Campbell, Rhys Hughes, Issie Gardner, Elizabeth Steel, Ramai Santhirapala, Katie Sweet, Michelle Scott, John Ekpa, Bhavia Janardhana, Catriona Frankling, Julia Ottaway, Alexander Middleditch, Elna Cifre, Annabel Pearson, Amanda Cotterill, Sarah Raut, Hannah Blanshard, Sara Eddy, Garry Henry, Elizabeth Hood, Maria Loy, Matthew Campbell, Marc Gimenez, Jessica Thrush, Jeremy Henning, Vlad Kushakavsky, Nikolaos Makris, Deborah Fradkin, Karen Fan, Fiona Hammonds, Kathryn Jackson, John Hadfield, Pyda Venkatesh, David Read, Daniel Zeinali, Ryan Hynd, James Carvell, Richard McCormick, Emily Dodds, Sana Rizvi, Amelia Daniel, Dan Sellers, Thomas E. Miller, Daniel Haigh, Nicky Moss, Patrick Dill-Russell, Priya Shekar, Teresa Melody, Randeep Dhaliwal, Nigel Hollister, Andrew Burtenshaw, Adrian Wagstaff, Ben Scoones, Eduardo Osorio, Joanna Allison, Lucy Willsher, Carol McArthur, Stephan Dalchow, Elaine Winkley, Eleanor Reeves, Ben Eden Green, Andrea Ingham, Mohammad Auldin, Freda Amoakwa-Adu, Jonathan Adams, Fiona Oglesby, Charlotte Steeds, Nurse Sara Greig, Obla Suganthi, Puja Chhaniyara, Clare De'Ath, Chandrakant Gosavi, Bart Ordys, Adele Flowerdew, Doug Tunney, Rachel Alexander, Oliver Griffith, Thomas Saunders, Matthew Maton-Howarth, Gabi Metiu, Akmal Shakoor, Elizabeth Willard, Katherine Russell, Matthew Robinson, Emma O'Kane, Meera Raja, Phillippa Falkner, Kerry Colling, Natasha Joshi, Laura Pearse, Tim J. Smith, Anitha James, Mona Mohamed, Richard Kennedy, Samson Ma, Tasmeen Ghafoor, Matthew N. Davies, Henry Lewith, Samuel Mindel, Sarah-Jane Dunn, Hemangini Barot, Sadie Diamond-Fox, Jenny Macallan, Arun Menon, Helen Farrah, Emma Plunkett, Brendon Spooner, Sorana White, Katie Samuel, David Crabtree, Katherine Cheshire, Gareth Harrop, Dionne Wortley, Tim Warrener, Joanne Mullen, Peter Taysum, John Whitaker, Kathy Wilkinson, Jean Dent, Nicola Farmer, Thelma Darian, Guru Hosdurga, Phillipa Wakefield, Christopher W Horner, Julie Steen, Elena Teh, Helen Gerrish, Betty Travasso, Mhairi Jhugursing, Michelle Gardener, Alexandra Crook, Edward W. Miles, Patricia Doble, Ashok Raj, Hanna Wong, Kay Protheroe, Chiraag Talati, Banher Sandhu, Cara Marshall, Matt Holl, Julie Sheriff, Frances Forrest, Adam Mitchell, Hindusha Keerthikumar, Mohamad Mahmoud, Simon Ben-Nathan, Janice Hartley, Danielle Ormandy, Hayleigh Morris, Steven Tran, Imogen Hayes, Trudy Smith, Kirsty Duell, Jennifer Cunningham, Richard Appleton, Lucy Pippard, Debroah Beeby, Hayley Bridger, Manuel Pinto, Susan Beames, Huiqi Wang, Cain Hunter, Flora Darch, Debbie Weller, Jonathan Hulme, Jacqueline Howes, Michael Kriger, Badrinath Manikundalam, D.J.N. Wong, Tim Arnold, Belinda Wroath, Rachel McKendry, Harry Knight, Caroline Bushell, Victoria Siddons, Louise Humphries, Joanne Vere, Vinanti Cherian, Janine Birch, Kate Blyth, Tatyana Bolonenkova, Meredith Harris, Alice Sisson, Sarah Clark, Sandeep Saxena, Samira Green, Amit Ranjan, Gillian Bennett, Chris Smales, Laura Ferguson, Ash Bharti, Francisca Mautadin, Katherine Brown, Lydia Jones, Christopher Adeney, Nikkita Carden, Sanjay Behl, Sonia Sathe, Elizabeth Neale, Helen French, Charlotte Mundy, Anna Batchelor, David Morris, Nithin Roy, Evelyn Philip, P.A.-A. Marc Hastie, Andrea Cole, Edmund Quak, Claire Totten, Karen McIntosh, Fiona Davis, Søren Kudsk-Iversen, Vanessa Unsworth, Andrew McIndoe, Jeremy Bewley, Sarbpreet Sarao, Laura Wood, Elaine Walker, Egidio Da Silva, Danielle Gilmour, Richard Yardley, Zara Eagle, Vijay Ragothaman, Sean Rayappu, Moira Tait, Alex Hamilton, Chris Gillett, Adeel Majeed, John Elton, Arlo Whitehouse, Fiona Robertson, Tim Martindale, Kin So, Kathryn Dixon, Toby Shipway, Fiona Mcneela, Simon Cousins, Brian Conway, Merate Place, Phil Duggleby, Rhian Morgan, Racquel Carpio, Carina Casey, Edward Mew, Jo Han Gan, Caroline Clark, Natasha Sharma, Kay Anne Mak, Gahan Bose, Chris Ford, Ruoling Yan, Anand Sathiapillai, Panagiotis Sgardelis, Sue Redhead, Arjun Alva, Cathy Jones, Vincent Hamlyn, Gemma Squires, Karen Smallshaw, John Whitwell, Sarah Shaw, Paul Watson, Michelle Cheeseman, Kimberley Netherton, Juneenath Karattuparambil, Niyesa Ranasinghe, Jeet Patel, Rob Lyons, Gemma Bown, Helen Bromhead, Zhana Ignatova, Kudakwashe Nyangoni, Linden Baxter, Thomas Moody, Sachin Valap, Esme Sleap, Mario Fernandes, Kinga Bodo, Jane Silk, Charlie Pope, Donna Ferraioli, Chloe Billingham, Rachel Butterworth, Andrew Kelly, Lesley Hawkins, Issac Gill, Hannah Greenlee, Sue Kirby, Jessica Giles, Anna Pierson, Roxana Sandhar, Claire Smyth, Rhona Younger, Ciara Coary, Arif Qureshi, Tahir Abbas, Corinne Rimmer, James Evans, Ida Ponce, Fenner Christoper, Buzz Shephard, Sophie Tang, Lauren Milian, Joanne Hiden, Dhania Haron, Jamie Calderwood, David Freeman, Virginia McTaggart, Carla Lewis, Chai Obeysekera, Alan H. Cohen, Melvin Leong, Jenni Law, Noor Elahi, Kim Holland, Victor Maduekwe, James Garwood, Lizzie Dawson, Virginia Iqbal, Thomas J Craig, Daniel Shuttleworth, Anand Perumal, Mahmood Saad, Seema Charters, Bethany Tookey, P Gunning, Suresh Panchakshariah, I.J. Wrench, Mayur Murali, Susan McInerney, Paul Foley, Charlotte Perkins, Marie-Louise Svensson, Karen Birnie, Samantha Hagan, Emily Hetherington, Anna-Marie Love, Annette Woods, Karen Green, Steve Hillier, Hannah Conway, Rebecca Reilly, Laura Bubb, Amy Ashford, Andrew Savva, Melody MacGregor, Stephen Lord, Ahmed Hassanin, Ramdas Howard, Laura Ashton, Arihant Jain, Simon Williams, Michael Shaw, Jill Deane, Abbie Singleton, Catriona Routley, Christopher Hall, Robin Webber, Tressy Pitt-Kerby, Stuart M. White, Shannon Gawley, Nick Heseltine, Christina Lalani, Claudia Dulea, Arindam Biswas, Rebecca Harris, Aislinn Brown, Nicholas Francis, Ben Holst, Ryan Perry, Cathie Melvin, Mark Darbyshire, Stephen Mulvany, Amy Ashton, Petrus Fourie, Emma Temlett, Jason Cupitt, Vanisha Patel, Alice Trimble, Andrew Brammar, Sarah Grayland, Eleanor Pett, Tom Standley, Carly Webb, Manamohan Rangaiah, Laura Peltola, Leanne Darwin, Yvonne Grimes, Elizabeth Brodier, Scott Berwick, Adam Janeczko, Madeleine McKee, Katherine Davidson, Jan Woodward, Saurabh Mehotra, Tara Keogh, Kofi Mensah, Joyce Guy, James King, Matt Aldridge, Nicolas Price, Alaine Done, Teresa Jones, Julia Sampson, Smita Bapat, Lauren Perkins, Tamas Szelei, Ryan Kingan, Suleman Mulla, Celia Montgomery, Alex Belcher, Salma Kadiri, Bryan Singizi, Peter Chater-Lea, Jennifer Claire Taylor, Lauren Oswald, Stephanie L. Lee, Rhys Griffiths, Samuel Pestell, John Livesy, Sarah Ciechanowicz, Alexander Stephen Harrison, Richard Partridge, Alex Daniels, Beth Penhaligan, Lyndsay Bibb, Jonathan Little, Margaret Cullen, Anya Eijk, Charlotte Earnshaw, Elena Lynes, Nicholas Jenkins, Inthekab Mohammed Ali, Madhu Balasubramaniam, Vusumuzi Shabangu, Paul-Simon Whitney, Rebecca Denyer, Kathryn Potts, Andrew Ray, Jonny Guy, Mike (Stephen) Kinsella, Pearl Baker, Olga Fernandez, Julian Berry, Callum Forbes, Southcoast Peri-operative Audit, Rebecca Rice, Lisa Horner, Sally Pitts, Kirat Panesar, Joe Stevens, Timothy Molitor, Oon Chiu, Piers Murphy, Sudeshkumar Muniyappa, David George, Jonathan Veitch, Shifa Yaruk, Lynn O'Donohoe, Theresa Murray, Laura Tasker, Johanna Wales, Diane Mellers, Robert Sparrow, Olivia Ward, Emma Shacklock, Janet Middle, Sarah MacLennan, Martin Knight, Lindsay Dawson, Teodora Orasanu, Jo Fletcher, Sarah Martin, Pnt Laloë, Gregor Imrie, Harriet Pudge, Tamsin Gregory, Andrea Wood, Colin Christie, James Penketh, Mia Andrews, Nicky Ford, Ellie Fisher, Sophie Robin, Richard Stewart, Steve Williams, Harriet Gardiner, Alison Evans, Guanmei Luo, Urmila Ratnasabapathy, Ruth Joslyn, R. Sneyd, John Westwood, Naomi Cassells, Olivia Kay, Jordi Margalef, S Butler, Hari Nageswaran, Chloe Searles, Geoffrey Wright, Thomas Potter, Drew Norwood-Green, Jonathan Ramsden, Sarah Bean, Emma Sadler, Anaesthetic Trainees, Stephanie Lewis, Kevin E. Thorpe, Sarah MacLean, Paul Ogle, Mary O'Sullivan, Diane Whitehouse, Mandy Oakley, Rachel Coathup, Harisg Venkatesh, Lisa Burgess, Daniela Smith, Kimberley Plummer, Hilary Robb, Jeanette Grocott, Rebecca Mairs, Helen Gilfillan, Moira Morrison, Sharon Garner, and Tammy Towers
Subjects: Adult, medicine.medical_specialty, Adolescent, State Medicine, Cohort Studies, 03 medical and health sciences, Young Adult, 0302 clinical medicine, 030202 anesthesiology, Pregnancy, Risk Factors, Neoplasms, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Young adult, Prospective cohort study, health care economics and organizations, Aged, Aged, 80 and over, Health Facility Size, Postoperative Care, Models, Statistical, business.industry, Incidence (epidemiology), Incidence, Health services research, Operating room management, Odds ratio, Middle Aged, Confidence interval, United Kingdom, Surgery, Obstetrics, Anesthesiology and Pain Medicine, Hospital Bed Capacity, General Surgery, Female, business, Emergency Service, Hospital, human activities, Cohort study
Abstract: Background: cancellation of planned surgery impacts substantially on patients and health systems. This study describes the incidence and reasons for cancellation of inpatient surgery in the UK NHS. Methods: we conducted a prospective observational cohort study over 7 consecutive days in March 2017 in 245 NHS hospitals. Occurrences and reasons for previous surgical cancellations were recorded. Using multilevel logistic regression, we identified patient- and hospital-level factors associated with cancellation due to inadequate bed capacity. Results: we analysed data from 14 936 patients undergoing planned surgery. A total of 1499 patients (10.0%) reported previous cancellation for the same procedure; contemporaneous hospital census data indicated that 13.9% patients attending inpatient operations were cancelled on the day of surgery. Non-clinical reasons, predominantly inadequate bed capacity, accounted for a large proportion of previous cancellations. Independent risk factors for cancellation due to inadequate bed capacity included requirement for postoperative critical care [odds ratio (OR)=2.92; 95% confidence interval (CI), 2.12–4.02; PConclusions: a significant proportion of patients presenting for surgery have experienced a previous cancellation for the same procedure. Cancer surgery is relatively protected, but bed capacity, including postoperative critical care requirements, are significant risk factors for previous cancellations.
Published: 2018

20. Management of Osteochondritis Dissecans of the Femoral Condyle: A Critical Analysis Review

Author: Steven L. Frick, Charles Chan, Connor G. Richmond, and Kevin G. Shea
Subjects: 030222 orthopedics, medicine.medical_specialty, Poor prognosis, business.industry, FEMORAL CONDYLE, 030229 sport sciences, medicine.disease, Osteochondritis dissecans, Osteochondritis Dissecans, 03 medical and health sciences, 0302 clinical medicine, Medicine, Treatment strategy, Humans, Orthopedics and Sports Medicine, Surgery, Radiology, Femur, business
Abstract: Osteochondritis dissecans of the femoral condyle remains poorly understood, with an unclear etiology.Lesions that separate have a poor prognosis, thus making treatment strategies that promote healing and prevent separation attractive.Magnetic resonance imaging is the preferred imaging modality and c
Published: 2018

21. Role of the Skeletal Stem Cell in Achilles Tendon to Bone Interface Healing

Author: Matthew P. Murphy, Charles Chan, Kiana S. Robertson, Michael T. Longaker, Deshka S. Foster, Ankit Salhotra, Genesis V. Lucero, Sid Menon, Ruth Ellen Jones, and Ashley L. Titan
Subjects: Achilles tendon, medicine.anatomical_structure, business.industry, Interface (Java), Medicine, Surgery, Stem cell, business, Biomedical engineering
Published: 2019
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22. Reporting in studies of protein biomarkers of prognosis in colorectal cancer in relation to the REMARK guidelines

Author: Mark P. Molloy, Pierre H. Chapuis, Charles Chan, Viive M. Howell, Stephen Clarke, Lucy Jankova, and Owen F. Dent
Subjects: Proteomics, medicine.medical_specialty, Colorectal cancer, business.industry, medicine.medical_treatment, Clinical Biochemistry, Comparability, Guidelines as Topic, Prognosis, medicine.disease, Surgery, Research Design, Interquartile range, Biomarkers, Tumor, Adjuvant therapy, medicine, Humans, Biomarker (medicine), Clinical significance, Generalizability theory, Colorectal Neoplasms, Intensive care medicine, business, Neoadjuvant therapy
Abstract: Purpose The REMARK guidelines give authors comprehensive and specific advice on the complete and transparent reporting of studies of prognostic tumor markers. The aim of this study was to use the REMARK guidelines to evaluate the quality of reporting in a sample of studies assessing tissue-based protein markers for survival after resection of colorectal cancer. Experimental design Eighty pertinent articles were scored according to their conformity to 26 items derived from the REMARK criteria. Results Overall, on a scale of adequacy of reporting that potentially ranged from 26 to 78, the median for these studies was 60 (interquartile range 54–64) and several criteria were adequately covered in a large proportion of studies. However, others were either not dealt with or inadequately covered, including description of the study design (35%), definition of survival endpoints (48%), adjuvant therapy (54%), follow-up procedures and time (59%), neoadjuvant therapy (63%), inclusion/exclusion criteria (73%), multivariable modeling methods and results (74%), and discussion of study limitations (85%). Conclusions and clinical relevance Inadequacies in presentation militate against comparability among protein marker studies and undermine the generalizability of their findings. The quality of reporting could be improved if journal editors were to require authors to ensure that their work satisfied the REMARK criteria.
Published: 2015
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23. The Role and Regulation of Osteoclasts in Normal Bone Homeostasis and in Response to Injury

Author: Ruth Tevlin, Graham G. Walmsley, Adrian McArdle, Michael T. Longaker, Owen Marecic, Charles Chan, and Derrick C. Wan
Subjects: business.industry, Bone pathology, Osteoclasts, Bone healing, Bone remodeling, Cell biology, Fractures, Bone, Haematopoiesis, medicine.anatomical_structure, Osteoclast, Animals, Homeostasis, Humans, Medicine, Surgery, Bone Remodeling, Bone Resorption, business, Bone regeneration, Function (biology)
Abstract: Bone is a dynamic tissue, with a range of diverse functions, including locomotion, protection of internal organs, and hematopoiesis. Optimum treatment of fractures and/or bone defects requires knowledge of the complex cellular interactions involved with bone healing and remodeling. Emerging data have underscored the importance of osteoclasts in this process, playing a key role both in normal bone turnover and in facilitating bone regeneration. In this review, the authors discuss the basic principles of osteoclast biology, including its cellular origins, its function, and key regulatory mechanisms, in addition to conditions that arise when osteoclast function is altered.
Published: 2015
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24. The Role of Skeletal Stem Cells in the Reconstruction of Bone Defects

Author: Matthew P. Murphy, Alessandra L. Moore, Michael Lopez, Dre Irizarry, Charles Chan, Ryan C. Ransom, Derek C. Wan, and Michael T. Longaker
Subjects: 0301 basic medicine, Bone Regeneration, Bone healing, Regenerative medicine, Article, Extracellular matrix, 03 medical and health sciences, Bone cell, Medicine, Humans, Craniofacial, Bone regeneration, Craniofacial surgery, Tissue Scaffolds, business.industry, Guided Tissue Regeneration, Skull, General Medicine, Plastic Surgery Procedures, 030104 developmental biology, Otorhinolaryngology, Surgery, Stem cell, business, Neuroscience, Stem Cell Transplantation
Abstract: Craniofacial surgery, since its inauguration, has been the culmination of collaborative efforts to solve complex congenital, dysplastic, oncological, and traumatic cranial bone defects. Now, 50 years on from the first craniofacial meeting, the collaborative efforts between surgeons, scientists, and bioengineers are further advancing craniofacial surgery with new discoveries in tissue regeneration. Recent advances in regenerative medicine and stem cell biology have transformed the authors' understanding of bone healing, the role of stem cells governing bone healing, and the effects of the niche environment and extracellular matrix on stem cell fate. This review aims at summarizing the advances within each of these fields.
Published: 2017

25. Translational Approach Using Trimodal Manipulation of Resident Skeletal Stem Cells for Articular Cartilage Repair

Author: Owen Marecic, Michael A. Lopez, Charles Chan, Rachel E. Brewer, Ryan C. Ransom, Michael T. Longaker, Mimi R. Borrelli, Lauren S. Koepke, and Matthew P. Murphy
Subjects: Pathology, medicine.medical_specialty, business.industry, Articular cartilage repair, Medicine, Surgery, Stem cell, business
Published: 2018
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26. Pharmacological rescue of diabetic skeletal stem cell niches

Author: Fan Yang, Zeshaan N. Maan, Derrick C. Wan, Andrey V. Malkovskiy, Philip A. Beachy, Michael T. Longaker, Jayakumar Rajadas, Adrian McArdle, Bryan Zimdahl, Xiyan Li, Michael Lopez, Xinming Tong, Rachel M. Morganti, Kevin J. Paik, Stuart B. Goodman, Kshemendra-Senarath Yapa, Ruth Tevlin, Melanie Rodrigues, Rahul Sinha, Irving L. Weissman, Christopher Duldulao, Eun Young Seo, Owen Marecic, Charles Chan, Michael Snyder, Ryan C. Ransom, Taylor Wearda, Geoffrey C. Gurtner, Gunsagar S. Gulati, Michael Januszyk, and Allison Nguyen
Subjects: 0301 basic medicine, medicine.medical_specialty, Indian hedgehog, 030209 endocrinology & metabolism, Cell Separation, Bone healing, Bone and Bones, Diabetes Mellitus, Experimental, Mice, 03 medical and health sciences, 0302 clinical medicine, Osteogenesis, medicine, Animals, Humans, Hedgehog Proteins, Stem Cell Niche, Progenitor cell, Cell Proliferation, Fracture Healing, biology, Cell growth, Mesenchymal stem cell, Mesenchymal Stem Cells, General Medicine, Flow Cytometry, biology.organism_classification, Hedgehog signaling pathway, Surgery, Mice, Inbred C57BL, 030104 developmental biology, Cancer research, Female, Stem cell, Signal transduction, Femoral Fractures, Signal Transduction
Abstract: Diabetes mellitus (DM) is a metabolic disease frequently associated with impaired bone healing. Despite its increasing prevalence worldwide, the molecular etiology of DM-linked skeletal complications remains poorly defined. Using advanced stem cell characterization techniques, we analyzed intrinsic and extrinsic determinants of mouse skeletal stem cell (mSSC) function to identify specific mSSC niche-related abnormalities that could impair skeletal repair in diabetic (Db) mice. We discovered that high serum concentrations of tumor necrosis factor-α directly repressed the expression of Indian hedgehog (Ihh) in mSSCs and in their downstream skeletogenic progenitors in Db mice. When hedgehog signaling was inhibited during fracture repair, injury-induced mSSC expansion was suppressed, resulting in impaired healing. We reversed this deficiency by precise delivery of purified Ihh to the fracture site via a specially formulated, slow-release hydrogel. In the presence of exogenous Ihh, the injury-induced expansion and osteogenic potential of mSSCs were restored, culminating in the rescue of Db bone healing. Our results present a feasible strategy for precise treatment of molecular aberrations in stem and progenitor cell populations to correct skeletal manifestations of systemic disease.
Published: 2017
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27. Competing risks analysis of microsatellite instability as a prognostic factor in colorectal cancer

Author: James Wei Tatt Toh, Charles Chan, Leslie Bokey, Owen F. Dent, Pierre H. Chapuis, and Kevin J. Spring
Subjects: 0301 basic medicine, Oncology, Male, medicine.medical_specialty, Prognostic variable, Palliative care, Colorectal cancer, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Adjuvant therapy, Humans, Aged, Postoperative Care, Cancer Death Rate, business.industry, Hazard ratio, Palliative Care, Microsatellite instability, Cancer, medicine.disease, Prognosis, Tumor Burden, 030104 developmental biology, 030220 oncology & carcinogenesis, Surgery, Female, Microsatellite Instability, Neoplasm Recurrence, Local, business, Colorectal Neoplasms, Epidemiologic Methods
Abstract: Background Despite an extensive literature suggesting that high microsatellite instability (MSI-H) enhances survival and protects against recurrence after colorectal cancer resection, such effects remain controversial as many studies show only a weak bivariate association or no multivariable association with outcome. This study examined the relationship between MSI status and colorectal cancer outcomes with adjustment for death from other causes as a competing risk. Methods A hospital database of patients following colorectal cancer resection was interrogated for clinical, operative, pathology, adjuvant therapy and follow-up information. MSI-H status was determined by immunohistochemistry for mismatch repair protein deficiency. The cumulative incidence of recurrence and colorectal cancer-specific death was evaluated by competing risks methods. Results Among 1009 patients who had a resection between August 2002 and December 2008, and were followed to at least December 2013, there were 114 (11·3 per cent) with MSI-H (72·8 per cent aged at least 70 years; 63·2 per cent women). After potentially curative resection, with adjustment for non-colorectal cancer death as a competing risk and adjustment for 22 clinical, operative and pathological variables, there was no association between MSI-H and recurrence (hazard ratio (HR) 0·81, 95 per cent c.i. 0·42 to 1·57) or colorectal cancer-specific death (HR 0·73, 0·39 to 1·35) in this patient population. For palliative resections, there was no association between MSI-H and colorectal cancer-specific death (HR 0·65, 0·21 to 2·04). MSI-H was associated with non-colorectal cancer death after both curative (HR 1·55, 1·04 to 2·30) and palliative (HR 3·80, 1·32 to 11·00) resections. Conclusion Microsatellite instability status was not an independent prognostic variable in these patients.
Published: 2016

28. Rescue of Del1 Knock Out Phenotype in Bone Fracture Healing in Mice

Author: Xinming Tong, Tatiana Boyko, Michael T. Longaker, Michael A. Lopez, Charles Chan, Owen Marecic, Elly Seo, and George P. Yang
Subjects: Pathology, medicine.medical_specialty, business.industry, medicine, Surgery, Bone healing, business, Phenotype
Published: 2017
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29. Cellular Mechanisms Underlying Regeneration in Mandibular Distraction Osteogenesis

Author: Tripp Leavitt, Leandra A. Barnes, Clement D. Marshall, Charles Chan, Derrick C. Wan, Matthew P. Murphy, Ryan C. Ransom, Michael Lopez, Michael T. Longaker, and Owen Marecic
Subjects: Orthodontics, Mandibular distraction, business.industry, Regeneration (biology), Medicine, Surgery, business
Published: 2017
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30. Discussion

Author: Charles Chan, Matthew P. Murphy, and Michael T. Longaker
Subjects: 0301 basic medicine, 03 medical and health sciences, Pathology, medicine.medical_specialty, 030104 developmental biology, 0302 clinical medicine, business.industry, Regeneration (biology), medicine, Surgery, Diploic space, business, 030217 neurology & neurosurgery
Published: 2017
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31. Method of Isolating and Transplanting the Hematopoietic Stem Cell with Its Microenvironment Which Improves Functional Hematopoietic Engraftment

Author: Gunsagar S. Gulati, Matthew P. Murphy, Rahul Sinha, Aaron M. Newman, Michael A. Lopez, Charles Chan, Michael T. Longaker, Jan Sokol, Irving L. Weissman, and Mimi R. Borrelli
Subjects: Haematopoiesis, medicine.anatomical_structure, business.industry, medicine, Cancer research, Hematopoietic stem cell, Surgery, Transplanting, business
Published: 2018
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32. IN-VITRO ANTIFUNGAL POTENTIAL OF dsRNA MOLECULES ON FUSARIUM ACTIN RELATED PROTEIN 2/3, DNA POLYMERASE DELTA SUBUNIT AND ADENYLASE CYCLASE ESSENTIAL GENES ON COLLAR ROT AND WILT PATHOGENS OF PASSIONFRUIT.

Author: Florence Nassimbwa, Enock Matovu, Andrew Kiggundu, Charles Changa, Francis Mumbanza, and John Adriko
Subjects: Antifungal potential, actin related protein, adenlylase cyclase, dsRNA, PCR, polymerase delta subunit, General works, R5-130.5, Infectious and parasitic diseases, RC109-216, Surgery, RD1-811, Public aspects of medicine, RA1-1270
Abstract: BACKGROUND: In Uganda two fungal diseases have become economically important; Fusarium wilt which is caused by.Fusarium oxysporum. f.sp passiflorae (Fop) and collar rot caused by Fusarium solani (Fs). The aim of this study was to determine antifungal activity of synthetic dsRNA constructed to silence essential genes; Actin Related Protein 2/3 (D6), DNA Polymerase delta subunit (J6), and Adenylase cyclase (K6), in Fusarium from banana on Fusarium sp from passionfruit. METHODS: In this study, pathogenic samples which were previously isolated from 3 districts in Central Uganda i.e. Wakiso, Mpigi, and Mukono were tested to determine and explore RNAi as an anti-fungal control strategy for spore germination. Sample materials obtained were subjected to DNA extraction from pure mycelia and PCR was performed. Antifungal dsRNA assays were run to test the efficiency relying on the reduction in a number of fungal colonies on PDA. RESULTS: Previous results showed that wilting was associated with one specific species of Fusarium oxysporum and collar rot with one species of Fusarium solani. Anti-fungal assay tests in this study included PCRs targeting the Fusarium actin related protein 2/3 (D6), DNA polymerase delta subunit (J6) as well as adenylase cyclase (K6) results showed that % spore germination inhibition on Fop ranged from 61.9-93.9% and Fs ranged from -69-87.3%. CONCLUSION: These results show that an environmentally friendly control measure for the above diseases is possible through the development of resistant plants which express dsRNA for a specified gene_ Fusarium Actin Related Protein 2/3. RECOMMENDATION: RNAi would be a promising target gene for RNAi –mediated resistance in passion fruit against the target fungal diseases.
Published: 2023
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33. PATHOLOGY REPORTING OF RESECTED COLORECTAL CANCERS IN NEW SOUTH WALES IN 2000

Author: David C. Leong, Charles Chan, Katie Armstrong, Bruce K. Armstrong, Owen F. Dent, Allan D. Spigelman, B. P. C. Lin, Dianne L. O'Connell, and Pierre H. Chapuis
Subjects: Male, medicine.medical_specialty, Colorectal cancer, Tumour stage, Resection, Clinical information, Humans, Medicine, Registries, Neoplasm Metastasis, Pathology reporting, Neoplasm Staging, National health, Medical Audit, business.industry, General surgery, Nodal metastasis, General Medicine, medicine.disease, Surgery, Cancer registry, Female, New South Wales, Colorectal Neoplasms, business
Abstract: Background: The aim of this study was to determine the extent to which pathology reporting of colorectal cancers notified to the New South Wales Central Cancer Registry during 2000 conformed to guidelines promulgated by the National Health and Medical Research Council. Methods: De-identified reports for 2233 resected specimens of primary invasive colorectal carcinoma were coded according to a standardized system to compile information on 28 clinical and pathology features. An overall score for each report was calculated by computing the number out of 13 essential features specified in the guidelines for which data had been recorded explicitly and unambiguously in the report. Results: The overall score ranged from 3 to 13 features with a mean of 9. No more than 7 features were reported explicitly in just less than one quarter of the reports and no more than 10 in three quarters. There were only 110 reports (4.9%) that included all features. Information on direct spread and nodal metastasis was well reported; resection margins less so. Many reports lacked information on metastases beyond the operative field, the involvement of deep or circumferential resection margins and tumour stage. Conclusion: In some respects pathology reports of resected colorectal cancer specimens displayed a high level of completeness. Some important features, however, were poorly described. Reporting could be improved if surgeons were to use a standardized form to convey clinical information to the pathologist and if pathologists were to report in a structured or synoptic format, explicitly recording the presence or absence of each feature in a standard list.
Published: 2007
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34. The significance of involvement of a free serosal surface for recurrence and survival following resection of clinicopathological stage B and C rectal cancer

Author: B. P. C. Lin, Anil Keshava, E. L. Bokey, Charles Chan, Pierre H. Chapuis, and Owen F. Dent
Subjects: Adult, Male, Risk, medicine.medical_specialty, Colorectal cancer, Gastroenterology, Resection, Serous Membrane, Recurrence, Internal medicine, Statistical significance, Odds Ratio, medicine, Adjuvant therapy, Humans, Neoplasm Metastasis, Stage (cooking), Aged, Proportional Hazards Models, Rectal Neoplasms, business.industry, Hazard ratio, Middle Aged, medicine.disease, Confidence interval, Surgery, Treatment Outcome, Chemotherapy, Adjuvant, Female, business, Exact probability
Abstract: Objective To determine whether the presence of tumour at a free serosal surface was independently associated with pelvic recurrence or survival in patients who had a resection for clinicopathological stage B or stage C rectal cancer and who had not received adjuvant therapy. Method Data were drawn from a comprehensive, prospective hospital registry of all resections for rectal cancer from January 1971 to December 1998 with follow up to December 2003. Statistical analysis employed the χ2 test or Fisher's exact probability, Kaplan–Meier estimation and proportional hazards regression, with a significance level of ≤0.05 and 95% confidence intervals (CI). Results In 665 patients with stages B or C tumour, 35 (5.3%; CI 3.7–7.2%) had tumour at a free serosal surface. These comprised 6/332 (1.8%; CI 0.8–3.7%) patients with stage B tumour and 29/333 (8.7%; CI 6.1–12.2%) with stage C tumour. After adjustment for other relevant variables, involvement of a free serosal surface was significantly associated with pelvic recurrence [hazard ratio (HR) 2.7; CI 1.3–5.5] and diminished survival (HR 1.6; CI 1.1–2.4) but not with systemic (only) recurrence. Conclusion This study has confirmed that direct tumour spread to a free serosal surface independently predicts pelvic recurrence and diminished survival after resection of clinicopathological stage B and C rectal cancer. This feature should always be sought by the pathologist and reported when present, and noted by the surgeon and oncologist. Serosal involvement should be evaluated further for its utility in selecting patients for adjuvant therapy.
Published: 2007
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35. Polymer-Based, Paclitaxel-Eluting TAXUS Liberté Stent in De Novo Lesions

Author: Chiung-Jen Wu, Charles Chan, John A. Ormiston, Lazar Mandinov, Charles O'Shaughnessy, Mark Webster, Gregory J. Mishkel, Louis Cannon, Donald S. Baim, Mark Turco, Thomas F. McGarry, Jack J. Hall, Tift Mann, Joerg Koglin, and Jeffrey J. Popma
Subjects: medicine.medical_specialty, biology, business.industry, medicine.medical_treatment, Stent, biology.organism_classification, Surgery, chemistry.chemical_compound, Paclitaxel, chemistry, Taxus, Drug-eluting stent, medicine, business, Cardiology and Cardiovascular Medicine, Mace
Abstract: Polymer-Based, Paclitaxel-Eluting TAXUS Liberte Stent in De Novo Lesions: The Pivotal TAXUS ATLAS TrialMark A. Turco, John A. Ormiston, Jeffrey J. Popma, Lazar Mandinov, Charles D. O’Shaughnessy, T...
Published: 2007
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36. Assessing the evidence for an association between circumferential tumour clearance and local recurrence after resection of rectal cancer

Author: Owen F. Dent, S. K C. Wong, E. L. Bokey, Charles Chan, Pierre H. Chapuis, N. Haboubi, and B. P. C. Lin
Subjects: medicine.medical_specialty, Rectal Neoplasms, business.industry, Colorectal cancer, medicine.medical_treatment, Gastroenterology, Prognosis, medicine.disease, Objective Evidence, Surgery, Resection, Radiation therapy, Risk Factors, Margin (machine learning), medicine, Adjuvant therapy, Humans, Radiotherapy, Adjuvant, Neoplasm Recurrence, Local, Stage (cooking), Risk factor, business, Neoplasm Staging
Abstract: Objective Circumferential resection margin involvement (CRMI) after resection of rectal cancer is regarded as a risk factor for local recurrence. We have been able to identify only nine peer-reviewed English-language publications which focus primarily on this association, and they report widely differing rates of local recurrence. The aims of this study were to review possible reasons for this variability and to assess the evidence for the micrometrically measured threshold defining CRMI. Method Methodological and statistical evaluation of relevant literature. Results Several factors which could account for this variability are discussed including the nature of the patient series, surgical technique, curative vs palliative resections, pathology technique, the definition of CRMI, adjuvant therapy, tumour stage, definition and ascertainment of local recurrence, length of follow-up and method of analysis. The objective evidence for the conventional definition of CRMI as tumour 1 mm or less from a circumferential margin is considered along with the evidence supporting a recent proposal that the margin be extended to 2 mm or less. The evidence is numerically weak in both cases and we believe that neither definition should be set in concrete at this stage. Conclusion Pending further research, we recommend that routine pathology reports should record frank tumour transection, if present, or otherwise report the histological width of the margin between the tumour and the nearest circumferential line of resection in millimetres. The definition of CRMI should be simply histological evidence of tumour in a line of resection, that is, a margin of 0 mm. The definition of CRMI as a margin of 1 mm should not be adopted as a basis for assessing the quality of surgery.
Published: 2007
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37. Acute and long-term clinical and angiographic outcome after S-Stent implantation: S-Stent multicenter safety and efficacy trial

Author: Yean-Leng Lim, Teguh Santoso, Damras Tresukosol, Shinjo Sonoda, Peter J. Fitzgerald, Yean-Teng Lim, and Charles Chan
Subjects: Male, medicine.medical_specialty, Time Factors, Percutaneous, medicine.medical_treatment, Myocardial Infarction, Coronary Artery Disease, Coronary Angiography, Prosthesis Design, Coronary Restenosis, Restenosis, Internal medicine, medicine, Humans, Stent implantation, Radiology, Nuclear Medicine and imaging, Hospital Mortality, Prospective Studies, Myocardial infarction, Angioplasty, Balloon, Coronary, Asia, Southeastern, Target lesion revascularization, Aged, business.industry, Coronary Thrombosis, Coronary stenting, Stent, General Medicine, Middle Aged, medicine.disease, United States, Surgery, Catheter, Treatment Outcome, Research Design, Cardiology, Feasibility Studies, Female, Stents, Cardiology and Cardiovascular Medicine, business
Abstract: The purpose of this study is to demonstrate safety and effectiveness of the S-Stent in de novo coronary lesions treated with conventional percutaneous coronary balloon angioplasty. Between January 2000 and June 2001, 120 patients were prospectively enrolled at four study centers. Patients were treated with coronary stenting in a total of 137 lesions. Procedural success was achieved in 100% of 137 attempted lesions. Clinical success was 99.8%. In-hospital mortality was 0.8%; myocardial infarction occurred in 0.8% and stent thrombosis in 0.8%. After stent implantation, the minimal lumen diameter increased from 0.92 ± 0.43 to 2.74 ± 0.36 mm (P < 0.0001) and the percent diameter stenosis decreased from 68.0 ± 16.2 to 4.5 ± 12.0 (P < 0.0001). At 6-month follow-up, the percent diameter stenosis was 33.5 ± 21.3 and the angiographic restenosis rate was 16.5%. Target lesion revascularization was required in 12 patients (10.1%). We conclude that the use of S-Stent for coronary intervention resulted in a high procedural success rate and low angiographic restenosis at 6 months after implantation. Catheter Cardiovasc Interv 2004;62:439–444. © 2004 Wiley-Liss, Inc.
Published: 2004
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38. Fatal brain stem event complicating acute pancreatitis

Author: Charles Chan, Geoffrey K. Herkes, Tim Harrington, K Prelog, and J Fryer
Subjects: Male, Pathology, medicine.medical_specialty, Pancreatic disease, Encephalopathy, Brain Edema, Autopsy, Central nervous system disease, Fatal Outcome, Physiology (medical), medicine, Humans, Cerebral Hemorrhage, business.industry, Brain, Electroencephalography, Lipase, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Forearm, Pancreatitis, Neurology, Acute Disease, Amylases, Arteriovenous Fistula, Acute disseminated encephalomyelitis, Kidney Failure, Chronic, Central pontine myelinolysis, Acute pancreatitis, Surgery, Neurology (clinical), Radiology, business, Peritoneal Dialysis
Abstract: Acute pancreatitis, developing in a patient with chronic renal failure, was complicated by a fatal neurological illness during which MRI showed pontine and extrapontine changes consistent with pontine and extrapontine myelinolysis. At post mortem, acute pancreatitis was confirmed but the neuropathological findings were more in keeping with an unusual presentation of acute haemorrhagic leucoencephalitis, perhaps even representing a form of 'pancreatic encephalopathy'. Although the development of CT and MRI scanning has greatly increased the resolution of neuroimaging and facilitated diagnosis during life, the value of autopsy examination is confirmed in cases such as this. Sometimes the findings may raise more questions than may have been answered - this too is an important function!
Published: 2003
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39. Shifting Skeletal Stem Cell Dynamics Underlie Skeletal Aging in Mice

Author: Charles Chan, Owen Marecic, Adrian McArdle, Matthew P. Murphy, Gunsagar S. Gulati, Ruth Tevlin, Michael T. Longaker, Elly Seo, Irving L. Weissman, and Michael Lopez
Subjects: Pathology, medicine.medical_specialty, business.industry, Dynamics (mechanics), Medicine, Surgery, Stem cell, business, Neuroscience
Published: 2017
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40. Activation of the Mouse Resident Skeletal Stem Cell for Articular Cartilage Repair

Author: Gunsagar S. Gulati, Michael T. Longaker, Michael Lopez, Charles Chan, Ryan C. Ransom, Owen Marecic, and Matthew P. Murphy
Subjects: Pathology, medicine.medical_specialty, business.industry, Articular cartilage repair, Medicine, Surgery, Stem cell, business, Stem cell transplantation for articular cartilage repair
Published: 2017
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41. Identity of Fusarium species associated with collar rot and wilt in passion fruit (Passiflora edulis)

Author: Florence Nassimbwa, Enock Matovu, Andrew Kiggundu, Charles Changa, Godfrey Sseremba, Francis Mumbanza, and John Adriko
Subjects: Mean disease index, pathogenic fungi, passion fruit orchard, polymerase chain reaction, relative disease damage, General works, R5-130.5, Infectious and parasitic diseases, RC109-216, Surgery, RD1-811, Public aspects of medicine, RA1-1270
Abstract: Background: Despite the immense contribution of passion fruits to people’s livelihood on a global scale, the crop’s productivity remains low owing to fungal diseases causing up to 100% loss. Fungi are highly variable and the identity of species or variates responsible for recently devastating passion fruit wilt and collar rot diseases had not been characterized. This study was aimed at identifying pathogens causing wilt and collar rot symptoms in passion fruits. Methodology: Fungi were isolated from diseased samples collected from three locations in Central Uganda to identify Fusarium spp associated with collar rot and wilting of passion fruit. This was established by differentiating mycelium pigmentation on Potato Dextrose Agar (PDA), examining slides at X40 magnification under a light microscope for specific macro and microconidia, and amplification with specific Transcription Elongation Factor-1α, TEF 1α primers for identification of Fusarium spp. Results: It was revealed that wilting was associated with a single species, out of 6 selected isolates from the suspected wilted plant, 3 were Fusarium spp associated with the disease in the field but only one of these isolates was proved to be a pathogenic type Fusarium oxysporium. Collar rot was associated with one pathogenic Fusarium spp out of the 6 selected isolates. Conclusion: The results indicate that collar rot and Fusarium wilt are each caused by specific strains of Fusarium pathogens. Recommendation: The identification of pathogenic Fusarium in farmers’ orchards is a starting point for designing effective disease management measures against the predominant fungal pathogenic variants in passion fruits.
Published: 2022
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42. Preoperative neutrophil/lymphocyte ratio predicts overall survival but does not predict recurrence or cancer-specific survival after curative resection of node-positive colorectal cancer

Author: Charles Chan, Lucy Jankova, Stephen Clarke, Pierre H. Chapuis, and Owen F. Dent
Subjects: Oncology, Male, Cancer Research, medicine.medical_specialty, Prognostic variable, Prognostic biomarker, Survival, Colorectal cancer, Neutrophils, Lymphocyte, Leukocyte Count, Surgical oncology, Internal medicine, Genetics, medicine, Overall survival, Humans, Lymphocytes, Registries, Stage (cooking), Aged, Aged, 80 and over, Proportional hazards model, business.industry, Cancer, Middle Aged, medicine.disease, Surgery, medicine.anatomical_structure, ROC Curve, Lymphatic Metastasis, Neutrophil/lymphocyte ratio, Preoperative Period, Competing risks Cox regression, Female, Lymph Nodes, Neoplasm Recurrence, Local, business, Colorectal Neoplasms, Follow-Up Studies, Research Article
Abstract: Background The preoperative ratio of neutrophils to lymphocytes (NLR) has been proposed as a marker of poor outcome in patients having a resection for colorectal cancer (CRC). This study investigated the association between NLR and overall survival, cancer-specific survival and recurrent cancer in patients who had a potentially curative resection for node-positive CRC. Methods Data on 322 patients were drawn from a prospectively recorded registry operated on between 1999 and 2007. Analyses of survival involved the Kaplan-Meier method, Cox regression and competing risks Cox regression. Results Increasing NLR as a continuous variable was independently though weakly associated with diminishing overall survival after adjustment for other prognostic variables (HR 1.06, 95% CI 1.01-1.11, p = 0.013). Receiver operating characteristic analysis to dichotomize NLR as a predictor of overall survival yielded relatively poor sensitivity (55%), specificity (66%) and positive predictive value (56%, CI 47%-64%). Competing risks regression also showed that NLR was not independently associated with recurrence at any site (HR 1.04, CI 0.97-1.11, p = 0.241) or CRC-specific mortality (HR 1.02, CI 0.92-1.12, p = 0.782) but was associated with non-CRC mortality (HR 1.09, CI 1.03-1.15, p = 0.004). Conclusion In patients with stage C tumor the weak link between NLR and overall mortality was not specific to CRC but apparently arose because patients with an elevated inflammatory status preoperatively were likely to progress to earlier death but not necessarily because of their cancer.
Published: 2013

43. Heterochronic Parabiosis Rejuvenates Aged Bones

Author: Michael T. Longaker, Owen Marecic, Michael Snyder, Irving L. Weissman, Ruth Tevlin, Charles Chan, Adrian McArdle, Taylor Wearda, Kshemendra Senarath-Yapa, and Graham G. Walmsley
Subjects: Pathology, medicine.medical_specialty, business.industry, Parabiosis, Cartilage, Bone healing, medicine.disease, Skeletal tissue, medicine.anatomical_structure, Stroma, Diabetes mellitus, Medicine, Surgery, Progenitor cell, business, Heterochrony
Abstract: INTRODUCTION: Diabetes mellitus is associated with an increased incidence of non-union, delayed union and mal-union of fractures. The mechanism(s) leading to impaired fracture healing remain to be elucidated. Recruitment of tissue stem and progenitor cells is vital to restoring injured bones. Our laboratory has recently identified a clonal precursor of bone, cartilage and stroma (BCSP) that generates mature skeletal tissue through a series of functionally characterized cellular intermediates. We hypothesize that impaired recruitment of this BCSP and its downstream progenitors contributes to poor fracture healing in diabetes.
Published: 2014
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44. Fascin expression predicts survival after potentially curative resection of node-positive colon cancer

Author: Owen F. Dent, Charles Chan, Lucy Jankova, Stephen Clarke, Caroline L S Fung, Pierre H. Chapuis, Candice Clarke, B. P. C. Lin, Graham R. Robertson, and Leslie Bokey
Subjects: Oncology, Male, medicine.medical_specialty, Pathology, Colorectal cancer, Colon, macromolecular substances, Kaplan-Meier Estimate, Adenocarcinoma, Pathology and Forensic Medicine, Immunoenzyme Techniques, Text mining, Internal medicine, Biomarkers, Tumor, Medicine, Humans, Fluorescent Antibody Technique, Indirect, Fascin, Aged, biology, business.industry, Proportional hazards model, Hazard ratio, Microfilament Proteins, Australia, Cancer, Anatomical pathology, medicine.disease, Prognosis, Survival Rate, Lymphatic Metastasis, Colonic Neoplasms, biology.protein, Surgery, Female, Lymph Nodes, Anatomy, business, Carrier Proteins, Immunostaining
Abstract: Fascin, an actin-bundling protein, is expressed in many neoplasms including colorectal cancer. It is considered to be a mediator of tumor cell invasion and an indicator of aggressive phenotype; however, there are few reports on the association between fascin and prognosis in colorectal cancer. The aims of this study were to: (a) investigate the expression of fascin in the central part of the tumor and at the invasive front in patients who had a potentially curative resection for node-positive colonic carcinoma; (b) examine the method of scoring fascin expression; and (c) investigate the association between fascin expression and overall survival and other clinicopathologic features. Fascin expression was assessed by immunostaining ofmicroarrays from archived tissue of 470 patients who were followed for a minimum of 5 years after resection. Other clinicopathologic data had been recorded prospectively according to a standardized protocol. Analysis of overall survival was by the Kaplan-Meier method and Cox regression. For both central tumor tissue and the invasive front, it was found that the percentage of stained cells was a sufficient measure of fascin expression in relation to survival, with staining intensity providing no significant additional information. At both levels, there was a significant independent association between high fascin expression and diminished survival, although this association was much stronger in the central region (adjusted hazard ratio 1.6, P < 0.001) than at the invasive front (adjusted hazard ratio 1.1, P = 0.044). Fascin expression predicted overall survival but did not displace other routinely collected clinicopathologic predictors.
Published: 2010

45. Correlates and outcomes of tumor adherence in resected colonic and rectal cancers

Author: Owen F. Dent, Amir Darakhshan, Charles Chan, B. P. C. Lin, Pierre H. Chapuis, and Les Bokey
Subjects: Male, medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, Adhesion (medicine), Adenocarcinoma, Gastroenterology, Internal medicine, medicine, Humans, Neoplasm Invasiveness, Prospective Studies, Prospective cohort study, Survival analysis, Colectomy, Aged, Neoplasm Staging, business.industry, Rectal Neoplasms, Background data, Cancer, medicine.disease, Prognosis, Survival Analysis, Treatment Outcome, Colonic Neoplasms, Surgery, Female, business
Abstract: The aims of this study were to examine the associations between tumor adherence and other operative findings, postoperative complications, recurrence, and survival after resection of colorectal cancer.The prognostic importance of tumor adherence to other organs or structures, either by direct invasion (T4) or simply by inflammatory adhesions, is yet to be clearly defined as earlier studies have been limited in size or have not used contemporary multivariable statistical techniques.Data were drawn from a comprehensive, prospective hospital registry of all resections for colorectal cancer between January 1971 and December 2000 with follow-up to December 2005. Statistical analysis employed the chi test, Kaplan-Meier estimation, and proportional hazards regression with a significance level of0.05 and 95% confidence intervals (CI).Tumor adherence was identified in 268 of 2504 resections (10.7%). Adherent tumors were more likely than nonadherent tumors to be spontaneously or surgically perforated or transected, to have nodal metastases and to be poorly differentiated. Venous invasion was more frequent in adherent colonic but not rectal tumors. Adherence was associated with only 5 of 16 medical and surgical complications considered. In rectal cancer, adherence was independently associated with pelvic recurrence (hazard ratio 1.8, 95% CI 1.2-2.7) and diminished survival (hazard ratio 1.6, 95% CI 1.3-2.0) after adjustment for other variables.In rectal cancer, tumor adherence indicates a poor prognosis after adjustment for other prognostic factors, regardless of whether actual tumor invasion of the adherent structure has occurred. However, adherence is not associated with survival after resection of colonic cancer.
Published: 2008

46. Impairment in Fracture Healing in a Mouse Model of Type 2 Diabetes Is Driven by Skeletal Stem Cell Niche Dysregulation

Author: Adrian Mc Ardle, Geoffrey C. Gurtner, Michael T. Longaker, Eun Young Seo, Ruth Tevlin, Charles Chan, Xinming Tong, Fan Yang, Michael Januszyk, and Irving L. Weissman
Subjects: Oncology, medicine.medical_specialty, Endocrinology, business.industry, Internal medicine, medicine, Surgery, University medical, Bone healing, Type 2 diabetes, medicine.disease, business, Stem cell niche
Abstract: Impairment in Fracture Healing in a Mouse Model of Type 2 Diabetes Is Driven by Skeletal Stem Cell Niche Dysregulation Ruth Tevlin, MB, BCh, MRCSI*, Eun Young Seo, Adrian Mc Ardle, MB, BCh, MRCSI, Xinming Tong, PhD, Michael Januszyk, MD, PhD, Fan Yang, PhD, Geoffrey C Gurtner, MD, FACS, Charles KF Chan, PhD, Irving L Weissman, MD, Michael T Longaker, MD, MBA, FACS Stanford University Medical School, Stanford, CA
Published: 2015
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47. Skeletal Stem Cell Niche Aberrancies Underlie Impaired Fracture Healing in a Mouse Model of Type 2 Diabetes

Author: Owen Marecic, Taylor Wearda, Mc Ardle A, M.S. Hu, Charles Chan, Gunsagar S. Gulati, Geoffrey C. Gurtner, Ruth Tevlin, G G Walmsley, Michael Januszyk, Young Seo E, Zeshaan N. Maan, Irving L. Weissman, and Michael T. Longaker
Subjects: business.industry, medicine, Surgery, Bone healing, Type 2 diabetes, Bioinformatics, medicine.disease, business, Stem cell niche
Published: 2015
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48. Risk factors for tumour present in a circumferential line of resection after excision of rectal cancer

Author: B. P. C. Lin, Charles Chan, Owen F. Dent, Pierre H. Chapuis, and E. L. Bokey
Subjects: Male, medicine.medical_specialty, Neoplasm, Residual, Colorectal cancer, Perforation (oil well), Resection, Risk Factors, medicine, Neoplasm, Humans, Venous Invasion, Prospective Studies, Risk factor, Prospective cohort study, Aged, business.industry, Rectal Neoplasms, medicine.disease, Confidence interval, Surgery, Treatment Outcome, Regression Analysis, Female, Neoplasm Recurrence, Local, business
Abstract: Background Transected tumour in a circumferential line of resection after excision of rectal cancer carries a high likelihood of local recurrence. The aim of this study was to identify independent risk factors for transected tumour and to examine their temporal variability. Methods Data were drawn from a comprehensive, prospective hospital registry of all resections for rectal cancer from January 1971 to July 2004. Transected tumour was defined as tumour present histologically in a line of resection and was assessed in all specimens. Results Transection occurred in 129 of 1613 patients (8·0 (95 per cent confidence interval 6·7 to 9·4) per cent). The following variables were independently associated with transected tumour: tumour perforation, a non-restorative operation, tumour adherence, non-standardized operative technique, preoperative radiotherapy, male sex, histological involvement of an adjacent organ or tissue, high-grade tumour and venous invasion. The mean number of risk factors per patient per year and the annual percentage of patients with transection varied distinctly over the history of the database. Conclusion The varying prevalence of risk factors, both within and between hospitals and patient series, should be taken into account if the rate of transection is to be regarded as an index of the quality of surgery.
Published: 2006

49. Twelve-month outcomes with a paclitaxel-eluting stent transitioning from controlled trials to clinical practice (the WISDOM Registry)

Author: Huay-Cheem Tan, Julio Lopez-Cuellar, Efrain Gaxiola, Nakul Sinha, Saligram Ramesh, Alfredo E. Rodriguez, Yean-Teng Lim, Tejas Patel, Upendra Kaul, Charles Chan, Mary E. Russell, and Alexandre Abizaid
Subjects: Target lesion, Male, medicine.medical_specialty, Paclitaxel, medicine.medical_treatment, Coronary Disease, law.invention, Diabetes Complications, Randomized controlled trial, law, medicine, Humans, Myocardial infarction, Prospective Studies, Registries, Survival rate, Randomized Controlled Trials as Topic, Interventional cardiology, business.industry, Stent, Middle Aged, medicine.disease, Tubulin Modulators, Surgery, Clinical trial, Survival Rate, Treatment Outcome, Drug-eluting stent, Female, Stents, Cardiology and Cardiovascular Medicine, business, Follow-Up Studies
Abstract: The WISDOM Registry tracked clinical outcomes in patients receiving a slow-release, polymer-based, paclitaxel-eluting stent during the transition from randomized trials to commercial use in everyday interventional cardiology practice. Although randomized trials of drug-eluting stents have demonstrated the safety and effectiveness of these devices in less complicated, de novo lesions, observation of long-term clinical outcomes is required to monitor safety as use of this revolutionary technology expands to broader patient populations. In total, 778 patients were enrolled at 22 sites in 9 countries where the TAXUS paclitaxel-eluting stent first received market approval. Patients with de novo or restenotic coronary lesions eligible for stenting were enrolled. Clinical follow-up was conducted by telephone at 3, 6, 9, and 12 months after the procedure to capture reported stent thrombosis and major cardiac events (death, myocardial infarction, and reintervention on the target lesion). Clinical follow-up at 12 months was completed for 92% of patients. The 12-month rate of physician-reported major cardiac events was 5.2%, with a target lesion reintervention rate of 2.0%. The low overall stent thrombosis rate of 0.6% included no stent thromboses30 days after the index procedure. Low target lesion reintervention rates were also observed in the high-risk subgroups: patients with diabetes (4.0%), vessels2.5 mm (2.5%), lesions20 mm (3.6%), and multiple stents in a lesion (1.4%). In conclusion, the paclitaxel-eluting TAXUS slow-release stent exhibits long-term safety and efficacy in uncomplicated and higher risk patients and lesions seen in everyday clinical practice.
Published: 2006

50. Six- and twelve-month results from first human experience using everolimus-eluting stents with bioabsorbable polymer

Author: Peter J. Fitzgerald, Alexandra J. Lansky, Saibal Kar, Yasuhiro Honda, Fumiaki Ikeno, Shinjo Sonoda, Charles Chan, Eberhard Grube, and Ulrich Gerckens
Subjects: Male, Polymers, medicine.medical_treatment, Myocardial Infarction, Comorbidity, Coronary Angiography, law.invention, Restenosis, Randomized controlled trial, Coated Materials, Biocompatible, law, Single-Blind Method, Prospective Studies, Drug Implants, Middle Aged, Growth Inhibitors, Treatment Outcome, Cineangiography, Female, Stents, Animal studies, medicine.symptom, Cardiology and Cardiovascular Medicine, Immunosuppressive Agents, medicine.drug, medicine.medical_specialty, Polyesters, Catheterization, Lesion, Coronary Restenosis, Physiology (medical), Angioplasty, medicine, Humans, Everolimus, Lactic Acid, Ultrasonography, Interventional, Aged, Sirolimus, Hyperplasia, business.industry, Coronary Stenosis, Stent, Anticoagulants, medicine.disease, Stainless Steel, Surgery, business, Tunica Intima, Follow-Up Studies
Abstract: Background— Everolimus, an active immunosuppressive and antiproliferative agent of the same family as sirolimus (rapamycin), has demonstrated significant reduction of neointimal proliferation in animal studies. The First Use To Underscore restenosis Reduction with Everolimus (FUTURE) I trial was the first in-human experience to evaluate the safety and efficacy of everolimus-eluting stents (EES), coated with a bioabsorbable polymer, compared with bare metal stents (BMS). Methods and Results— FUTURE I was a prospective, single-blind, randomized trial that enrolled 42 patients with de novo coronary lesions (EES 27, BMS 15). Patient and lesion characteristics were comparable between the groups. Major adverse cardiac event rates were low at 30 days and 6 months, without any early or late stent thrombosis for either group ( P =NS). Between 6 and 12 months, there were no additional reports of major adverse cardiac events. The 6-month angiographic in-stent restenosis rate was 0% versus 9.1% (1 patient) ( P =NS), with an associated late loss of 0.11 mm versus 0.85 mm ( P P =NS) for EES and BMS, respectively. Intravascular ultrasound analysis revealed a significant reduction of percent neointimal volume in EES compared with BMS (2.9±1.9 mm 3 /mm versus 22.4±9.4 mm 3 /mm, P Conclusions— In this initial clinical experience, EES with bioabsorbable polymer demonstrated a safe and efficacious method to reduce in-stent neointimal hyperplasia and restenosis.
Published: 2004

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