29 results on '"Gui Han Lee"'
Search Results
2. PTU-37 To scope or not to scope: outcomes of endoscopy surveillance in older adults
- Author
-
Hoda Amar, Katie Schwab, Mohamed Assal, and Gui Han Lee
- Subjects
medicine.medical_specialty ,Scope (project management) ,medicine.diagnostic_test ,business.industry ,medicine ,Intensive care medicine ,business ,Endoscopy - Published
- 2021
3. Sarcopenia and Myosteatosis Predict Adverse Outcomes After Emergency Laparotomy: A Multi-center Observational Cohort Study
- Author
-
Katherine Pearson, Denny Z. H. Levett, Thakshyanee Bhuvanakrishna, David P. Berry, Rachel Carten, Timothy J. Underwood, Simon Toh, Jenny McLachlan, Zeeshan Khawaja, Frances Howse, Kate Nicholls, John N. Primrose, Gui Han Lee, Richard Booth, Anastasia Benjafield, Marjolein A P Ligthart, Brendan Moran, Peter May-Miller, Duncan Chambler, Nicholas Baylem, Heather Davis, Eva Sorensen, James Ward, Michael Terry, Victoria Morrison Jones, James P. Byrne, Samantha Body, Paul Robinson, Camilla Hickish, Stuart Mercer, Noori Suhail, Jack Broadhurst, Mark R Edwards, Philip H. Pucher, Amanda Bond, Benjamin M Stubbs, Louise Alder, Saqib Rahman, Michael P.W. Grocott, Alex H. Mirnezami, Steven W.M. Olde Damink, Nathan Curtis, Malcolm A. West, Nader K. Francis, Paul Froggatt, Alexios Tzivanakis, Prashan Kangesu, Clizia Airofarulla, Chui Lee, Jieyun Lee, RS: NUTRIM - R2 - Liver and digestive health, Surgery, and MUMC+: MA Heelkunde (9)
- Subjects
Male ,medicine.medical_specialty ,Sarcopenia ,Adverse outcomes ,medicine.medical_treatment ,Lumbar vertebrae ,MUSCLE RADIATION ATTENUATION ,Cohort Studies ,MORBIDITY ,myosteatosis ,Internal medicine ,Laparotomy ,ABDOMINAL-SURGERY ,Medicine ,Humans ,COMPUTED-TOMOGRAPHY ,Multi centre ,Muscle, Skeletal ,ELDERLY-PATIENTS ,FRAILTY ,emergency ,business.industry ,MORTALITY ,Mortality rate ,Cancer ,medicine.disease ,SOLID TUMORS ,PREVALENCE ,medicine.anatomical_structure ,Surgery ,Female ,DEPLETION ,business ,Tomography, X-Ray Computed ,Cohort study - Abstract
Objective: To determine the relationship between body composition (BC), specifically low skeletal muscle mass (sarcopenia) and poor muscle quality (myosteatosis) and outcomes in emergency laparotomy patients. Background: Emergency laparotomy has one of the highest morbidity and mortality rates of all surgical interventions. BC objectively identifies patients at risk of adverse outcomes in elective cancer cohorts, however evidence is lacking in emergency surgery. Methods: An observational cohort study of patients undergoing emergency laparotomy at ten English hospitals was performed. BC analyses were performed at the third lumbar vertebrae level using pre-operative CT images to quantify skeletal muscle index (SMI) and skeletal muscle radiation attenuation (SM-RA). Sex-specific SMI and SM-RA were determined, with the lower tertile splits defining sarcopenia (low SMI) and myosteatosis (low SM-RA). Accuracy of mortality risk prediction, incorporating SMI and SM-RA variables into risk models was assessed with regression modelling. Results: Six hundred and ten patients were included. Sarcopenia and myosteatosis were both associated with increased risk of morbidity (52.1% vs. 45.1%, p = 0.028; 57.5% vs. 42.6%, p = 0.014), 30-day (9.5% vs. 3.6%, p = 0.010; 14.9% vs. 3.4%, p < 0.001), and 1-year mortality (27.4% vs. 11.5%, p < 0.001; 29.7% vs.12.5%, p < 0.001). Risk-adjusted 30-day mortality was significantly increased by sarcopenia (OR 2.56 (95%CI 1.12-5.84), p = 0.026) and myosteatosis (OR 4.26 (2.01-9.06), p < 0.001), similarly at 1-year (OR 2.66 (95%CI 1.57-4.52), p < 0.001; OR 2.08 (95%CI 1.26-3.41), p = 0.004). BC data increased discrimination of an existing mortality risk-prediction model (AUC 0.838, 95%CI 0.835-0.84). Conclusion: Sarcopenia and myosteatosis are associated with increased adverse outcomes in emergency laparotomy patients.
- Published
- 2021
4. Long non-coding RNAs within the tumour microenvironment and their role in tumour-stroma cross-talk
- Author
-
Alex H. Mirnezami, Graham Packham, George A. Calin, Emre Sayan, Gareth J. Thomas, Filippo Del Vecchio, Martin Pichler, Joamir Hawezi, Gui Han Lee, Marc D. Bullock, John N. Primrose, Rahul Bhome, and Sian Alexandra Pugh
- Subjects
0301 basic medicine ,Cancer Research ,Stromal cell ,Angiogenesis ,Cancer ,Biology ,medicine.disease ,Microvesicles ,Long non-coding RNA ,Malignant transformation ,Extracellular Matrix ,03 medical and health sciences ,030104 developmental biology ,Oncology ,Stroma ,Neoplasms ,Cancer cell ,Cancer research ,medicine ,Disease Progression ,Tumor Microenvironment ,Humans ,RNA, Long Noncoding ,Stromal Cells ,Signal Transduction - Abstract
Long non-coding RNAs (lncRNAs) are a diverse class of RNA transcripts which have limited protein coding potential. They perform a variety of cellular functions in health, but have also been implicated during malignant transformation. A further theme in recent years is the critical role of the tumour microenvironment and the dynamic interactions between cancer and stromal cells in promoting invasion and disease progression. Whereas the contribution of deregulated lncRNAs within cancer cells has received considerable attention, their significance within the tumour microenvironment is less well understood. The tumour microenvironment consists of cancer-associated stromal cells and structural extracellular components which interact with one another and with the transformed epithelium via complex extracellular signalling pathways. LncRNAs are directly and indirectly involved in tumour/stroma cross-talk and help stimulate a permissive tumour microenvironment which is more conducive for invasive tumour growth. Furthermore, lncRNAs play key roles in determining the phenotype of cancer associated stromal cells and contribute to angiogenesis and immune evasion pathways, extracellular-matrix (ECM) turnover and the response to hypoxic stress. Here we explore the multifaceted roles of lncRNAs within the tumour microenvironment and their putative pathophysiological effects.
- Published
- 2017
5. Low-Grade Dysplasia in Ulcerative Colitis: Risk Factors for Developing High-Grade Dysplasia or Colorectal Cancer
- Author
-
Morgan Moorghen, Brian P. Saunders, Ailsa Hart, Alan Askari, Gui Han Lee, Janindra Warusavitarne, Trevor A. Graham, Siwan Thomas-Gibson, Matthew D. Rutter, Ana Ignjatovic-Wilson, and Chang-Ho Ryan Choi
- Subjects
Male ,medicine.medical_specialty ,Colon ,Colorectal cancer ,education ,Colonic Polyps ,Colonoscopy ,Constriction, Pathologic ,Gastroenterology ,Internal medicine ,medicine ,Humans ,Colitis ,Hepatology ,medicine.diagnostic_test ,Proportional hazards model ,business.industry ,High grade dysplasia ,Retrospective cohort study ,Colon/Small Bowel ,medicine.disease ,Ulcerative colitis ,digestive system diseases ,Dysplasia ,Colitis, Ulcerative ,Female ,Colorectal Neoplasms ,business - Abstract
OBJECTIVES: The aim of this study was to identify risk factors associated with development of high-grade dysplasia (HGD) or colorectal cancer (CRC) in ulcerative colitis (UC) patients diagnosed with low-grade dysplasia (LGD). METHODS: Patients with histologically confirmed extensive UC, who were diagnosed with LGD between 1993 and 2012 at St Mark's Hospital, were identified and followed up to 1 July 2013. Demographic, endoscopic, and histological data were collected and correlated with the development of HGD or CRC. RESULTS: A total of 172 patients were followed for a median of 48 months from the date of initial LGD diagnosis (interquartile range (IQR), 15–87 months). Overall, 33 patients developed HGD or CRC (19.1% of study population; 20 CRCs) during study period. Multivariate Cox proportional hazard analysis revealed that macroscopically non-polypoid (hazard ratio (HR), 8.6; 95% confidence interval (CI), 3.0–24.8; P
- Published
- 2015
6. Forty-Year Analysis of Colonoscopic Surveillance Program for Neoplasia in Ulcerative Colitis: An Updated Overview
- Author
-
Gui Han Lee, Brian P. Saunders, Morgan Moorghen, Trevor A. Graham, Siwan Thomas-Gibson, Matthew D. Rutter, Janindra Warusavitarne, Alan Askari, Chang-Ho Ryan Choi, and Ailsa Hart
- Subjects
Adult ,Male ,medicine.medical_specialty ,Colon ,Coloring agents ,Colonoscopy ,Kaplan-Meier Estimate ,Gastroenterology ,Risk Factors ,Internal medicine ,medicine ,Humans ,Mass Screening ,Colitis ,Coloring Agents ,Early Detection of Cancer ,Mass screening ,Proportional Hazards Models ,Retrospective Studies ,Hepatology ,medicine.diagnostic_test ,business.industry ,Incidence ,General surgery ,Inflammatory Bowel Disease ,Disease progression ,Retrospective cohort study ,medicine.disease ,Ulcerative colitis ,United Kingdom ,digestive system diseases ,Cell Transformation, Neoplastic ,Population Surveillance ,Disease Progression ,Colitis, Ulcerative ,Female ,Colorectal Neoplasms ,business - Abstract
Objectives: This study provides an overview of the largest and longest-running colonoscopic surveillance program for colorectal cancer (CRC) in patients with long-standing ulcerative colitis (UC). Methods: Data were obtained from medical records, endoscopy, and histology reports. Primary end points were defined as death, colectomy, withdrawal from surveillance, or censor date (1 January 2013). Results: A total of 1,375 UC patients were followed up for 15,234 patient-years (median, 11 years per patient). CRC was detected in 72 patients (incidence rate (IR), 4.7 per 1,000 patient-years). Time-trend analysis revealed that although there was significant decrease in incidence of colectomy performed for dysplasia (linear regression, R=−0.43; P=0.007), IR of advanced CRC and interval CRC have steadily decreased over past four decades (Pearson's correlation, −0.99; P=0.01 for both trends). The IR of early CRC has increased 2.5-fold in the current decade compared with past decade (χ2, P=0.045); however, its 10-year survival rate was high (79.6%). The IR of dysplasia has similarly increased (χ2, P=0.01), potentially attributable to the recent use of chromoendoscopy that was twice more effective at detecting dysplasia compared with white-light endoscopy (χ2, P
- Published
- 2015
7. The prognostic significance and relationship with body composition of CCR7-positive cells in colorectal cancer
- Author
-
Stella C. Knight, Hafid O. Al-Hassi, John T. Jenkins, Alexandra I. F. Blakemore, David Bernardo, Morgan Moorghen, George Malietzis, and Gui Han Lee
- Subjects
Oncology ,medicine.medical_specialty ,Pathology ,Tumor microenvironment ,Multivariate analysis ,business.industry ,Lymphovascular invasion ,Colorectal cancer ,C-C chemokine receptor type 7 ,General Medicine ,medicine.disease ,Immune system ,Internal medicine ,Carcinoma ,Medicine ,Immunohistochemistry ,Surgery ,business - Abstract
Background and Objectives The host local immune response (LIR) to cancer is a determinant of cancer outcome. Regulation of this local response is largely achieved through chemokine synthesis from the tumor microenvironment such as C-Chemokine-Receptor-7 (CCR7). We examined the LIR measured as CCR7 expression, in colorectal cancers (CRC) and explored relationships with body composition (BC) and survival. Methods A study of paraffin-embedded tissue specimens was carried out in 116 patients with non-metastatic CRC. CCR7 expression was determined by immunohistochemistry. Analysis of computer tomography scans was used to calculate BC parameters. Survival analyses and multivariate regression models were used. Results High CCR7+ cell density within the tumor stroma and at the margin was significantly associated with increased age, the presence of lymphovascular invasion, higher tumor stage, lymph node metastasis, high Klintrup-Makinen immune score, and myosteatosis. High CCR7+ cell density in the tumor margin was significantly associated with shorter disease-free (DFS) and overall survival (OS) (P
- Published
- 2015
8. Immature myeloid cells directly contribute to skin tumor development by recruiting IL-17–producing CD4+ T cells
- Author
-
Thomas Condamine, Myrna L. Ortiz, Morgan Moorghen, Laxminarasimha Donthireddy, Stella C. Knight, Noreen Luetteke, Brianna Lenox, Dmitry I. Gabrilovich, Anna Martner, Esteban Celis, Sridevi Mony, Vinit Kumar, John T. Seykora, George Malietzis, and Gui Han Lee
- Subjects
CD4-Positive T-Lymphocytes ,Chemokine ,Skin Neoplasms ,Immunology ,CD33 ,Mice, Transgenic ,Inflammation ,medicine.disease_cause ,Article ,S100A9 ,CCL5 ,Immune system ,medicine ,Animals ,Calgranulin B ,Humans ,Immunology and Allergy ,Myeloid Cells ,Chemokine CCL4 ,integumentary system ,biology ,Colitis ,3. Good health ,Cell Transformation, Neoplastic ,Cancer research ,biology.protein ,Tetradecanoylphorbol Acetate ,Female ,Interleukin 17 ,medicine.symptom ,Carcinogenesis - Abstract
Ortiz et al. report the accumulation of immature myeloid cells in skin tissue of patients with inflammatory conditions, which predisposes to the development of cancer., Evidence links chronic inflammation with cancer, but cellular mechanisms involved in this process remain unclear. We have demonstrated that in humans, inflammatory conditions that predispose to development of skin and colon tumors are associated with accumulation in tissues of CD33+S100A9+ cells, the phenotype typical for myeloid-derived suppressor cells in cancer or immature myeloid cells (IMCs) in tumor-free hosts. To identify the direct role of these cells in tumor development, we used S100A9 transgenic mice to create the conditions for topical accumulation of these cells in the skin in the absence of infection or tissue damage. These mice demonstrated accumulation of granulocytic IMCs in the skin upon topical application of 12-O-tetradecanoylphorbol-13-acetate (TPA), resulting in a dramatic increase in the formation of papillomas during epidermal carcinogenesis. The effect of IMCs on tumorigenesis was not associated with immune suppression, but with CCL4 (chemokine [C-C motif] ligand 4)-mediated recruitment of IL-17–producing CD4+ T cells. This chemokine was released by activated IMCs. Elimination of CD4+ T cells or blockade of CCL4 or IL-17 abrogated the increase in tumor formation caused by myeloid cells. Thus, this study implicates accumulation of IMCs as an initial step in facilitation of tumor formation, followed by the recruitment of CD4+ T cells.
- Published
- 2015
9. Compartment-specific immunity in the human gut: properties and functions of dendritic cells in the colon versus the ileum
- Author
-
J. Landy, Alyssa Parian, Stella C. Knight, Nicholas R. English, Xuhang Li, Simon T. Peake, Gui Han Lee, Ailsa Hart, T Elliott, Henning Spranger, Elizabeth R. Mann, Mark Lazarev, Steven R. Brant, Hafid O. Al-Hassi, David Bernardo, and Ripple Man
- Subjects
0301 basic medicine ,Receptors, CCR7 ,Receptors, CCR4 ,Colon ,T-Lymphocytes ,GUT IMMUNOLOGY ,T cell ,Receptors, Cell Surface ,chemical and pharmacologic phenomena ,Ileum ,C-C chemokine receptor type 7 ,Biology ,T-Lymphocytes, Regulatory ,Immune tolerance ,Flow cytometry ,Molecular Imprinting ,Receptors, CCR ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Antigens, CD ,medicine ,Humans ,Receptors, Immunologic ,Membrane Glycoproteins ,medicine.diagnostic_test ,Gastroenterology ,Interleukin ,FOXP3 ,Dendritic Cells ,Flow Cytometry ,Molecular biology ,MUCOSAL IMMUNOLOGY ,Microscopy, Electron ,GASTROINTESTINAL IMMUNE RESPONSE ,030104 developmental biology ,medicine.anatomical_structure ,Immunology ,Cytokines ,Lymphocyte Culture Test, Mixed ,Gut Immunity ,Integrin alpha Chains ,030215 immunology - Abstract
Objective Dendritic cells (DC) mediate intestinal immune tolerance. Despite striking differences between the colon and the ileum both in function and bacterial load, few studies distinguish between properties of immune cells in these compartments. Furthermore, information of gut DC in humans is scarce. We aimed to characterise human colonic versus ileal DC. Design Human DC from paired colonic and ileal samples were characterised by flow cytometry, electron microscopy or used to stimulate T cell responses in a mixed leucocyte reaction. Results A lower proportion of colonic DC produced pro-inflammatory cytokines (tumour necrosis factor-α and interleukin (IL)-1β) compared with their ileal counterparts and exhibited an enhanced ability to generate CD4 + FoxP3 + IL-10 + (regulatory) T cells . There were enhanced proportions of CD103 + Sirpα − DC in the colon, with increased proportions of CD103 + Sirpα + DC in the ileum. A greater proportion of colonic DC subsets analysed expressed the lymph-node-homing marker CCR7, alongside enhanced endocytic capacity, which was most striking in CD103 + Sirpα + DC. Expression of the inhibitory receptor ILT3 was enhanced on colonic DC. Interestingly, endocytic capacity was associated with CD103 + DC, in particular CD103 + Sirpα + DC. However, expression of ILT3 was associated with CD103 − DC. Colonic and ileal DC differentially expressed skin-homing marker CCR4 and small-bowel-homing marker CCR9, respectively, and this corresponded to their ability to imprint these homing markers on T cells. Conclusions The regulatory properties of colonic DC may represent an evolutionary adaptation to the greater bacterial load in the colon. The colon and the ileum should be regarded as separate entities, each comprising DC with distinct roles in mucosal immunity and imprinting.
- Published
- 2015
10. Cumulative burden of inflammation predicts colorectal neoplasia risk in ulcerative colitis: a large single-centre study
- Author
-
Chang-Ho Ryan, Choi, Ibrahim, Al Bakir, Nik-Sheng John, Ding, Gui-Han, Lee, Alan, Askari, Janindra, Warusavitarne, Morgan, Moorghen, Adam, Humphries, Ana, Ignjatovic-Wilson, Siwan, Thomas-Gibson, Brian P, Saunders, Matthew D, Rutter, Trevor A, Graham, and Ailsa L, Hart
- Subjects
Adult ,Male ,Colonoscopy ,Kaplan-Meier Estimate ,Risk Assessment ,Severity of Illness Index ,Young Adult ,Risk Factors ,Population Surveillance ,Humans ,Colitis, Ulcerative ,Female ,Colorectal Neoplasms ,Follow-Up Studies ,Retrospective Studies - Abstract
Ulcerative colitis (UC) is a dynamic disease with its severity continuously changing over time. We hypothesised that the risk of colorectal neoplasia (CRN) in UC closely follows an actuarial accumulative inflammatory burden, which is inadequately represented by current risk stratification strategies.This was a retrospective single-centre study. Patients with extensive UC who were under colonoscopic surveillance between 2003 and 2012 were studied. Each surveillance episode was scored for a severity of microscopic inflammation (0=no activity; 1=mild; 2=moderate; 3=severe activity). The cumulative inflammatory burden (CIB) was defined as sum of: average score between each pair of surveillance episodes multiplied by the surveillance interval in years. Potential predictors were correlated with CRN outcome using time-dependent Cox regression.A total of 987 patients were followed for a median of 13 years (IQR, 9-18), 97 (9.8%) of whom developed CRN. Multivariate analysis showed that the CIB was significantly associated with CRN development (HR, 2.1 per 10-unit increase in CIB (equivalent of 10, 5 or 3.3 years of continuous mild, moderate or severe active microscopic inflammation); 95% CI 1.4 to 3.0; P0.001). Reflecting this, while inflammation severity based on the most recent colonoscopy alone was not significant (HR, 0.9 per-1-unit increase in severity; 95% CI 0.7 to 1.2; P=0.5), a mean severity score calculated from all colonoscopies performed in preceding 5 years was significantly associated with CRN risk (HR, 2.2 per-1-unit increase; 95% CI 1.6 to 3.1; P0.001).The risk of CRN in UC is significantly associated with accumulative inflammatory burden. An accurate CRN risk stratification should involve assessment of multiple surveillance episodes to take this into account.
- Published
- 2017
11. The Role of CD40 Expression in Dendritic Cells in Cancer Biology; A Systematic Review
- Author
-
Stella C. Knight, Gui Han Lee, Alan Askari, George Malietzis, Hafid O. Al-Hassi, Susan K. Clark, and David Bernardo
- Subjects
Cancer Research ,medicine.medical_treatment ,Down-Regulation ,Peripheral blood mononuclear cell ,Immune system ,Cancer immunotherapy ,Neoplasms ,Drug Discovery ,medicine ,Animals ,Humans ,Cytotoxic T cell ,CD40 Antigens ,Neoplasm Metastasis ,Pharmacology ,CD40 ,biology ,Cancer ,hemic and immune systems ,Dendritic Cells ,medicine.disease ,Neoplasm Proteins ,Oncology ,Immunology ,Cancer cell ,biology.protein ,Tumor necrosis factor alpha - Abstract
CD40 is a co-stimulatory molecule belonging to the tumor necrosis factor superfamily and is essential in activation of dendritic cells. Dendritic cells (DCs) are antigen-presenting cells capable of initiating cytotoxic T-lymphocyte immune response against cancer cells. However, there are few studies on the characterization of DCs in cancer, specifically their expression of CD40, despite its implication in cancer immunotherapy. We reviewed available data on the expression of CD40 on DCs in various cancers, and its implications for cancer immunotherapy. A systematic review on CD40 expression on DCs in cancer was performed with reference to preferred reporting items for systematic reviews and meta-analyses (PRISMA). Studies that satisfied the inclusion and exclusion criteria were 21 out of 927. Variations in type and status of the cancers, source of DCs and methodology for detecting CD40 expression amongst the studies resulted in contrasting results. DCs generally expressed low CD40 in tumor infiltrating DCs (tiDCs), in DCs derived by in vitro culture from blood monocytes using cytokine stimulation (MoDCs) and in DCs exposed in vitro to tumor cells lines; the studies suggested that CD40 expression in DCs is impaired in cancer particularly in metastatic disease. However, DCs identified in fresh peripheral blood mononuclear cells (PBMC) expressed higher numbers of CD40 positive cells in some cancer patients, which could be due to tumor-derived factors leading to partially-stimulated DCs. The results provide evidence that some cancer patients may show partial systemic DC activation and expression of increased CD40 in response to the presence of tumor but that such activity may become abortive in the presence of factors produced by the tumor. This review has thus identified key papers on CD40 expression on DCs in various cancers and discusses the limitations and contrasting results of these studies in relation to variations in methodology. The results highlight the need for further studies on the role of CD40-CD40 ligand pathway to inform cancer treatment.
- Published
- 2014
12. Infra-renal abdominal aortic aneurysm dilation ratio (AADR): A different measurement technique for intervention
- Author
-
Gui Han Lee, Yiannis P. Panayiotopoulos, Alan Askari, and Ali Kordzadeh
- Subjects
Aorta ,medicine.medical_specialty ,business.industry ,Retrospective cohort study ,medicine.disease ,Asymptomatic ,Abdominal aortic aneurysm ,Aneurysm ,Lower threshold ,medicine.artery ,cardiovascular system ,medicine ,Dilation (morphology) ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Female population - Abstract
Introduction To test the null hypothesis that the proposed abdominal aortic aneurysm (AAA) dilation ratio (AADR) obtained by dividing the widest diameter of the infra-renal AAA by the immediate native (normal) infra-renal aorta in millimetres, fails to provide accurate information about the risk of rupture in the female population, small or various sizes of infra-renal AAAs. Methods A retrospective study of 112 patients that underwent an infra-renal AAA repair on elective, urgent and or immediate basis with prior computed tomography angiogram (CTA) or computed tomography (CT). Results The mean AADR was 2.3 for asymptomatic group ( n =73) and 3.3 for symptomatic group ( n =28) ( p n =14) and 3.78 for the ruptured group ( n =14) ( p Conclusion Study suggests a lower threshold for female population that do not meet the interventional size. AADR≤2.8 could be a reasonable criteria for intervention irrespective of the aneurysm size. AADR can assist in doubtful or borderline scenarios, especially during the management of symptomatic patients as higher AADR>2.8 warrants an immediate operation. Finally, the AADR can be important in less privileged centres where ultrasonography (USS) and not repeated CT scan is permissible.
- Published
- 2013
13. Endoscopic thoracic sympathectomy for primary hyperhidrosis: A 16-year follow up in a single UK centre
- Author
-
Ali Kordzadeh, Michael Harvey, Alan Askari, and Gui Han Lee
- Subjects
medicine.medical_specialty ,business.industry ,Hyperhidrosis ,medicine.medical_treatment ,Endoscopic thoracic sympathectomy ,Incidence (epidemiology) ,Retrospective cohort study ,Surgery ,Patient satisfaction ,Sympathectomy ,medicine ,Young adult ,Family history ,medicine.symptom ,business - Abstract
Introduction Since the introduction of Endoscopic Thoracic Sympathectomy ( ETS ) by Kux in 1951, the procedure has been performed for treatment of primary hyperhidrosis (PH) of the upper limb. Despite its initial success and minimally invasive nature, the long-term results are yet to be established. The aim of this study is to evaluate the outcome of patients after ETS with particular emphasis on patient satisfaction and its effectiveness over a 16-year period. Methods A patient survey of fifty-one ( n = 51) patients who had ETS for PH of palms from 1995 to 2011 was conducted. The data on age, sex, site of the PH, family history, trigger, hospital stay, relief from symptoms, complications, refractory sweating and overall satisfaction with the procedure was analysed with SAS software version 9.1.3. Conclusion The mean follow-up was 77 months (range, 6–189 months) with equal gender distribution ( n = 24 males Vs n = 27 females) and mean age of 19 (range, 13–64 years). The hereditary prevalence was 55%. Forty-six patients (90.2%) reported an immediate (≤24 h) and four patients (7.8%) reported a delay (>24 h) in relief of symptoms. To the best of our knowledge this is longest duration of follow-up reported in the literature.
- Published
- 2013
14. Lectin-type oxidized LDL receptor-1 distinguishes population of human polymorphonuclear myeloid-derived suppressor cells in cancer patients
- Author
-
Jawahar L. Mehta, George A. Dominguez, Dmitry I. Gabrilovich, Evgenii N. Tcyganov, Anil K. Rustgi, Thomas Condamine, Gregory A. Masters, Xianwei Wang, Manuel A. Sepulveda, Xiaowei Xu, Cindy Lin, Simona Partlova, Gui Han Lee, Ayumi Hashimoto, Sridevi Mony, Evgeniy Eruslanov, Meenakshi Bewtra, Denis Smirnov, Kevin Alicea-Torres, Dan T. Vogl, Steven M. Albelda, Alfred L. Garfall, Yulia Nefedova, Je-In Youn, Robert L Witt, Brian Nam, Stella C. Knight, Andrew V. Kossenkov, Neil Hockstein, and George Malietzis
- Subjects
0301 basic medicine ,education.field_of_study ,business.industry ,Endoplasmic reticulum ,Immunology ,Population ,General Medicine ,Article ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Immune system ,Tumor progression ,030220 oncology & carcinogenesis ,Unfolded protein response ,OLR1 ,Cancer research ,Myeloid-derived Suppressor Cell ,Medicine ,business ,education ,Receptor - Abstract
Polymorphonuclear myeloid-derived suppressor cells (PMN-MDSC) are important regulators of immune responses in cancer and have been directly implicated in promotion of tumor progression. However, the heterogeneity of these cells and lack of distinct markers hampers the progress in understanding of the biology and clinical importance of these cells. Using partial enrichment of PMN-MDSC with gradient centrifugation we determined that low density PMN-MDSC and high density neutrophils from the same cancer patients had a distinct gene profile. Most prominent changes were observed in the expression of genes associated with endoplasmic reticulum (ER) stress. Surprisingly, low-density lipoprotein (LDL) was one of the most increased regulators and its receptor oxidized LDL receptor 1 OLR1 was one of the most overexpressed genes in PMN-MDSC. Lectin-type oxidized LDL receptor 1 (LOX-1) encoded by OLR1 was practically undetectable in neutrophils in peripheral blood of healthy donors, whereas 5–15% of total neutrophils in cancer patients and 15–50% of neutrophils in tumor tissues were LOX-1+. In contrast to their LOX-1− counterparts, LOX-1+ neutrophils had gene signature, potent immune suppressive activity, up-regulation of ER stress, and other biochemical characteristics of PMN-MDSC. Moreover, induction of ER stress in neutrophils from healthy donors up-regulated LOX-1 expression and converted these cells to suppressive PMN-MDSC. Thus, we identified a specific marker of human PMN-MDSC associated with ER stress and lipid metabolism, which provides new insight to the biology and potential therapeutic targeting of these cells.
- Published
- 2016
15. Body composition of the host influences dendritic cell phenotype in patients treated for colorectal cancer
- Author
-
Hafid O. Al-Hassi, John T. Jenkins, David Bernardo, Stella C. Knight, Robin H. Kennedy, Morgan Moorghen, Alexandra I. F. Blakemore, Gui Han Lee, George Malietzis, Biotechnology and Biological Sciences Research Cou, Biotechnology and Biological Sciences Research Council, and London North West Healthcare NHS Trust (LNWH)
- Subjects
0301 basic medicine ,Adult ,Male ,Myeloid ,CD36 ,C-C chemokine receptor type 7 ,Peripheral blood mononuclear cell ,Body composition ,Dendritic cells ,03 medical and health sciences ,Antigen ,Medicine ,Cytotoxic T cell ,Humans ,Oncology & Carcinogenesis ,Aged ,CD40 ,biology ,business.industry ,hemic and immune systems ,1103 Clinical Sciences ,General Medicine ,Dendritic cell ,Middle Aged ,Flow Cytometry ,Colorectal cancer ,030104 developmental biology ,medicine.anatomical_structure ,Phenotype ,Immunology ,Myopenia ,biology.protein ,Female ,business ,Colorectal Neoplasms ,Tomography, X-Ray Computed - Abstract
Dendritic cells (DCs) are antigen-presenting cells that can acquire tumour antigens and initiate cytotoxic T cell reactions. Obesity has been proposed as a cause for tumours escaping immune surveillance, but few studies investigate the impact of other body composition parameters. We examined the relationship of DC phenotype with computer tomography (CT)-defined parameters in patients with colorectal cancer (CRC). DCs were identified within peripheral blood mononuclear cells by flow cytometry as HLA-DR positive and negative for markers of other cell lineages in 21 patients. Analysis of CT scans was used to calculate lumbar skeletal muscle index (LSMI) and mean muscle attenuation (MA). Positive correlation between the LSMI and expression of CD40 in all DCs (r = 0.45; p = 0.04) was demonstrated. The MA was positively correlated with scavenger receptor CD36 [all DCs (r = 0.60; p = 0.01) and myeloid DCs (r = 0.63; p
- Published
- 2016
16. The prognostic significance and relationship with body composition of CCR7-positive cells in colorectal cancer
- Author
-
George, Malietzis, Gui Han, Lee, David, Bernardo, Alexandra I F, Blakemore, Stella C, Knight, Morgan, Moorghen, Hafid O, Al-Hassi, and John T, Jenkins
- Subjects
Male ,Receptors, CCR7 ,Prognosis ,Combined Modality Therapy ,Immunoenzyme Techniques ,Survival Rate ,Lymphatic Metastasis ,Biomarkers, Tumor ,Body Composition ,Humans ,Female ,Neoplasm Invasiveness ,Prospective Studies ,Colorectal Neoplasms ,Aged ,Follow-Up Studies ,Neoplasm Staging - Abstract
The host local immune response (LIR) to cancer is a determinant of cancer outcome. Regulation of this local response is largely achieved through chemokine synthesis from the tumor microenvironment such as C-Chemokine-Receptor-7 (CCR7). We examined the LIR measured as CCR7 expression, in colorectal cancers (CRC) and explored relationships with body composition (BC) and survival.A study of paraffin-embedded tissue specimens was carried out in 116 patients with non-metastatic CRC. CCR7 expression was determined by immunohistochemistry. Analysis of computer tomography scans was used to calculate BC parameters. Survival analyses and multivariate regression models were used.High CCR7(+) cell density within the tumor stroma and at the margin was significantly associated with increased age, the presence of lymphovascular invasion, higher tumor stage, lymph node metastasis, high Klintrup-Makinen immune score, and myosteatosis. High CCR7(+) cell density in the tumor margin was significantly associated with shorter disease-free (DFS) and overall survival (OS) (P 0.001). This was also significantly associated with shorter survival in multivariate analysis (HR = 8.87; 95%CI [2.51-31.3]; P 0.01 for OS and HR = 4.72; 95%CI (1.24-12.9); P = 0.02 for DFS).Our results suggest that a specific immune microenvironment may be associated with altered host's BC and tumor behavior, and that CCR7 may serve as a novel prognostic biomarker.
- Published
- 2015
17. Cumulative burden of inflammation predicts colorectal neoplasia risk in ulcerative colitis: a large single-centre study.
- Author
-
Chang-Ho Ryan Choi, Al Bakir, Ibrahim, Nik-Sheng (John) Ding, Gui-Han Lee, Askari, Alan, Warusavitarne, Janindra, Moorghen, Morgan, Humphries, Adam, Ignjatovic-Wilson, Ana, Thomas-Gibson, Siwan, Saunders, Brian P., Rutter, Matthew D., Graham, Trevor A., and Hart, Ailsa L.
- Subjects
ULCERATIVE colitis ,DISEASE duration - Published
- 2019
- Full Text
- View/download PDF
18. Is right-sided colon cancer different to left-sided colorectal cancer? - a systematic review
- Author
-
Susan K. Clark, Gui Han Lee, George Malietzis, Alan Askari, David Bernardo, and Hafid O. Al-Hassi
- Subjects
Oncology ,medicine.medical_specialty ,Colorectal cancer ,business.industry ,Colon ,Carcinoma ,Rectum ,General Medicine ,Environmental exposure ,medicine.disease ,Left sided ,Adenocarcinoma, Mucinous ,digestive system diseases ,Environmental risk ,Internal medicine ,Epidemiology ,medicine ,Humans ,Surgery ,Personalized medicine ,Tumor location ,business ,Colorectal Neoplasms - Abstract
Colorectal cancer (CRC) exhibits differences in incidence, pathogenesis, molecular pathways and outcome depending on the location of the tumor. This review focuses on the latest developments in epidemiological and scientific studies, which have enhanced our understanding on the underlying genetic and immunological differences between the proximal (right-sided) colon and the distal (left-sided) colorectum. The different ways in which environmental risk factors influence the pathogenesis of CRC depending on its location and the variations in surgical and oncological outcomes are also discussed in this review. In the current era of personalized medicine, we aim to reiterate the importance of tumor location in management of CRC and the implication on future clinical and scientific research.
- Published
- 2014
19. Constitutive gut-homing capacity on circulating myeloid dendritic cells in coeliac disease
- Author
-
S.C. Knight, Paul J. Ciclitira, Gui Han Lee, Hafid O. Al-Hassi, Carolina Sousa, D. Bernardo, J. Landy, Tanja Šuligoj, and Isabel Comino
- Subjects
Myeloid ,business.industry ,Gastroenterology ,Dendritic Cells ,General Medicine ,medicine.disease ,Coeliac disease ,Celiac Disease ,medicine.anatomical_structure ,Cell Movement ,Immunology ,medicine ,Humans ,lcsh:Diseases of the digestive system. Gastroenterology ,lcsh:RC799-869 ,business ,Homing (hematopoietic) - Published
- 2014
20. Altered human gut dendritic cell properties in ulcerative colitis are reversed by Lactobacillus plantarum extracellular encrypted peptide STp
- Author
-
Andrew J. Stagg, Nicholas R. English, Ripple Man, Borja Sánchez, Simon T. Peake, Abelardo Margolles, Stella C. Knight, Ailsa Hart, David Bernardo, Gui Han Lee, Elizabeth R. Mann, Jonathan Landy, Eduardo Arranz, Hafid O. Al-Hassi, Maria C. Urdaci, Luis Fernández-Salazar, José Antonio Garrote, Biotechnology and Biological Sciences Research Council (UK), St. Mark's Hospital Foundation, Association for International Cancer Research, and Junta de Castilla y León
- Subjects
Male ,Threonine ,Receptor expression ,T-Lymphocytes ,C-C chemokine receptor type 7 ,ComputingMilieux_LEGALASPECTSOFCOMPUTING ,Inflammatory bowel disease ,Dendritic cells ,Serine ,Receptors, Immunologic ,Receptor ,Membrane Glycoproteins ,STp ,biology ,Microbiota ,Toll-Like Receptors ,Middle Aged ,Immunohistochemistry ,Healthy Volunteers ,B7-1 Antigen ,Female ,Biotechnology ,Adult ,Langerin ,Receptors, Cell Surface ,Microbiology ,Antigens, CD ,medicine ,Extracellular ,Humans ,Lectins, C-Type ,CD40 Antigens ,Cell Proliferation ,CD40 ,Probiotics ,Dendritic cell ,Postbiotics ,medicine.disease ,Inflammatory Bowel Diseases ,Molecular biology ,Gastrointestinal Tract ,Mannose-Binding Lectins ,Ulcerative colitis ,Case-Control Studies ,Data_GENERAL ,biology.protein ,Colitis, Ulcerative ,Peptides ,Cell Adhesion Molecules ,Food Science ,Lactobacillus plantarum - Abstract
This is an open access article under the terms of the Creative Commons Attribution License.-- et al., [Scope]: The human/microbiota cross-talk is partially mediated by bacteria-derived peptides like Serine-Threonine peptide (STp), which is resistant to gut proteolysis, is found in the human healthy colon and induces regulatory properties on gut dendritic cells (DCs); here we characterized human gut DC in ulcerative colitis (UC) patients and studied the effect of STp on their properties. [Methods and results]: Human colonic DC from healthy controls and UC patients were isolated, conditioned for 24 h +/- STp and characterized by flow cytometry, immunohistochemistry, and electron microscopy. Expression of immature DC markers DC-SIGN and ILT3, and Toll-like receptors were increased on gut UC-DC. Langerin (involved in phagocytosis), lymph node homing marker CCR7, and activation markers CD40/CD80/CD86 were decreased in UC. Gut DC had restricted stimulatory capacity for T-cells in UC. Conditioning of DC with STp in vitro reduced Toll-like receptor expression, increased CD40 and CD80 expression, and restored their stimulatory capacity. [Conclusion]: Colonic DCs display an abnormal immature phenotype in UC, which was partially restored following STp treatment. Bacteria-derived metabolites, like STp, seem to have a role in gut homeostasis that is missing in UC so they might lead a new era of probiotic products setting the basis for nondrug dietary therapy in inflammatory bowel disease. © 2013 The Authors. Molecular Nutrition & Food Research published by Wiley-VCH Verlag GmbH & Co. KGaA Weinheim., The author(s) gratefully acknowledge the support of the Biotechnology and Biological Sciences Research Council (BBSRC), this research was funded by the BBSRC Institute Strategic Programme for Gut Health and Food Safety BB/J004529/1. The authors also thank the St Mark’s Hospital Foundation, The Association for International Cancer Research (AICR), Scotland, and the Junta de Castilla y León (GRS175/B/07).
- Published
- 2014
21. General surgery registrars cross-covering urology on-call: A survey of current training and experience in the management of cases of suspected testicular torsion
- Author
-
Janindra Warusavitarne, Gui Han Lee, Tou Pin Chang, and Myutan Kulendran
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,medicine ,Urology ,Testicular torsion ,Surgery ,General Medicine ,business ,medicine.disease - Published
- 2013
- Full Text
- View/download PDF
22. Dysregulated circulating dendritic cell function in ulcerative colitis is partially restored by probiotic strain lactobacillus casei shirota
- Author
-
J. Landy, Linda V. Thomas, Elizabeth R. Mann, Gui Han Lee, Hafid O. Al-Hassi, Simon T. Peake, Verena Horneffer-van der Sluis, Stella C. Knight, Parveen Yaqoob, Ailsa Hart, David Bernardo, Cheng T. Tee, and Jialu You
- Subjects
T-Lymphocytes ,CCR4 ,Lymphocyte Activation ,law.invention ,Probiotic ,DOUBLE-BLIND ,law ,MEMORY T-CELLS ,Transforming Growth Factor beta ,Homeostasis ,Cells, Cultured ,medicine.diagnostic_test ,biology ,integumentary system ,IMMUNE-RESPONSES ,EPITHELIAL-CELLS ,Flow Cytometry ,CROHNS-DISEASE ,Lacticaseibacillus casei ,1107 Immunology ,CHEMOKINE RECEPTOR ,Cytokines ,Life Sciences & Biomedicine ,Lactobacillus casei ,Research Article ,lcsh:RB1-214 ,Article Subject ,Immunology ,Flow cytometry ,Immune system ,MAINTAINING REMISSION ,medicine ,lcsh:Pathology ,Humans ,Colitis ,Cell Proliferation ,Inflammation ,Science & Technology ,Cell growth ,Probiotics ,ADHESION MOLECULE-1 ,Dendritic cell ,Cell Biology ,CYTOKINE PRODUCTION ,Dendritic Cells ,biology.organism_classification ,medicine.disease ,Colitis, Ulcerative ,INFLAMMATORY-BOWEL-DISEASE - Abstract
Background. Dendritic cells regulate immune responses to microbial products and play a key role in ulcerative colitis (UC) pathology. We determined the immunomodulatory effects of probiotic strainLactobacillus caseiShirota (LcS) on human DC from healthy controls and active UC patients.Methods. Human blood DC from healthy controls (control-DC) and UC patients (UC-DC) were conditioned with heat-killed LcS and used to stimulate allogeneic T cells in a 5-day mixed leucocyte reaction.Results. UC-DC displayed a reduced stimulatory capacity for T cells (P<0.05) and enhanced expression of skin-homing markers CLA and CCR4 on stimulated T cells (P<0.05) that were negative for gut-homing markerβ7. LcS treatment restored the stimulatory capacity of UC-DC, reflecting that of control-DC. LcS treatment conditioned control-DC to induce CLA on T cells in conjunction withβ7, generating a multihoming profile, but had no effects on UC-DC. Finally, LcS treatment enhanced DC ability to induce TGFβproduction by T cells in controls but not UC patients.Conclusions. We demonstrate a systemic, dysregulated DC function in UC that may account for the propensity of UC patients to develop cutaneous manifestations. LcS has multifunctional immunoregulatory activities depending on the inflammatory state; therapeutic effects reported in UC may be due to promotion of homeostasis.
- Published
- 2013
23. Lost therapeutic potential of monocyte-derived dendritic cells through lost tissue homing: stable restoration of gut specificity with retinoic acid
- Author
-
J. Landy, Gui Han Lee, Hafid O. Al-Hassi, N R English, Elizabeth R. Mann, Simon T. Peake, Ailsa Hart, David Bernardo, E. Ronde, Stella C. Knight, and Ripple Man
- Subjects
Male ,Receptors, CCR7 ,dendritic cell ,medicine.medical_treatment ,Cellular differentiation ,Immunology ,Retinoic acid ,CCR9 ,Tretinoin ,Biology ,Monocytes ,03 medical and health sciences ,chemistry.chemical_compound ,Receptors, CCR ,homing markers ,0302 clinical medicine ,Cell Movement ,medicine ,retinoic acid ,Immunology and Allergy ,Humans ,Fluorescein isothiocyanate ,Cells, Cultured ,030304 developmental biology ,ulcerative colitis ,0303 health sciences ,Cell Differentiation ,Immunotherapy ,Dendritic cell ,Dendritic Cells ,Original Articles ,3. Good health ,Gastrointestinal Tract ,chemistry ,Organ Specificity ,Colitis, Ulcerative ,Female ,immunotherapy ,Biomarkers ,030215 immunology ,medicine.drug ,Homing (hematopoietic) - Abstract
Summary Human monocyte-derived dendritic cells (DC) (MoDC) are utilized for immunotherapy. However, in-vitro immunological effects are often not mirrored in vivo. We studied the tissue-homing potential of MoDC. Circulating monocytes and DC expressed different tissue-homing markers and, during in-vitro development of MoDC, homing marker expression was lost resulting in a ‘homeless’ phenotype. Retinoic acid (RA) induced gut-homing markers (β7 and CCR9) and a regulatory phenotype and function [decreased human leucocyte antigen D-related (HLA-DR) and increased ILT3 and fluorescein isothiocyanate (FITC-dextran uptake) in MoDC]. RA-MoDC were less stimulatory and primed conditioned T cells with a gut-homing profile (β7+CLA−). Unlike the normal intestinal microenvironment, that from inflamed colon of ulcerative colitis (UC) patients did not induce regulatory properties in MoDC. However, RA-MoDC maintained their regulatory gut-specific properties even in the presence of UC microenvironment. Therefore, MoDC may be ineffectual for immunotherapy because they lack tissue-homing and tissue-imprinting specificity. However, MoDC rehabilitation with gut-homing potential by RA could be useful in promoting immunotherapy in pathologies such as UC.
- Published
- 2013
24. Ileal pouch anal anastomosis in pediatric familial adenomatous polyposis: A 24-year review of operative technique and patient outcomes
- Author
-
Andrew Latchford, Gui Han Lee, Warren Hyer, Jackie Hawkins, and Susan K. Clark
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,Pediatrics, Perinatology and Child Health ,medicine ,Surgery ,General Medicine ,business ,medicine.disease ,Ileal Pouch Anal Anastomosis ,Familial adenomatous polyposis - Published
- 2015
25. PWE-319 The relationship with body composition of ccr7-positive cells in colorectal cancer
- Author
-
Hafid O. Al-Hassi, David Bernardo, Stella C. Knight, John T. Jenkins, Gui Han Lee, Morgan Moorghen, and George Malietzis
- Subjects
Pathology ,medicine.medical_specialty ,business.industry ,Colorectal cancer ,Gastroenterology ,C-C chemokine receptor type 7 ,medicine.disease ,Immune system ,Interquartile range ,Cell density ,Medicine ,Immunohistochemistry ,business ,Tumor immunology ,Pathological - Abstract
Introduction Emerging data support the link between systemic inflammatory response (IR) and body composition alterations in cancer patients but limited information exists on how the local IR to the tumour is associated to these changes. Regulation of the local IR is largely achieved through chemokine synthesis from the tumour microenvironment such as C-Chemokine-Receptor-7 (CCR7). In the present study, we determined the expression of CCR7 in primary colorectal cancer (CRC) and also correlated the expression of CCR7 with the patients’ clinical and pathological parameters (including their body composition derived from computerised tomography (CT) analysis) to explore the relationship between body composition and tumour immunology in CRC. Method A study of paraffin-embedded tissue specimens was carried out in 116 patients with non-metastatic CRC. CCR7 expression was determined by immunohistochemistry. Analysis of computer tomography scans was used to calculate BC parameters. The relationship between CCR7 expression and other clinicopathological parameters was assessed using nonparametric statistics. Results The median tumour infiltrating CCR7+ cell density was 15.85% (Inter Quartile Range (IQR) 10.02–21.83%) in the tumour stroma, and 7.17% (IQR 3.90–12.37%) at the tumour margin. CCR7+ cell density of the two areas correlated positively (Spearman r = 0.77; p Conclusion We found that a high density of tumour-infiltrating CCR7+ cells was significantly associated with age, histological invasion, higher tumour stage, lymph node metastasis and myosteatosis that are adverse prognostic factors in CRC. These findings may therefore suggest a model whereby the stimulus for the local immune cell response is not only induced by the tumour but also influenced by host-related factors. We have now identified that myosteatosis is also related to an adverse local inflammatory response as measured by a high CCR7 density. To our knowledge these findings are novel and may support the hypothesis that host LIR may influence the development and persistence of myosteatosis. Disclosure of interest None Declared.
- Published
- 2015
26. PTU-007 Development Of A Smartphone App To Aid The Clinical Management Of Polyposis Syndromes
- Author
-
Susan K. Clark, Gui Han Lee, Andrew Latchford, and R. K. S. Phillips
- Subjects
Final version ,medicine.medical_specialty ,business.industry ,education ,Gastroenterology ,Alternative medicine ,Multidisciplinary team ,medicine.disease ,Clinical Practice ,Health care ,Smartphone app ,Medicine ,Medical emergency ,business ,Colorectal surgeons - Abstract
Introduction Smartphone “apps” are becoming increasingly used by health care professionals (HCPs) as a quick and easy guide for delivering evidence-based medicine. “Apps” are particularly effective in providing guidelines accessible from a smartphone with contents that can be updated frequently. The Polyposis Registry at our institution has spearheaded the formulation of guidelines for the management of inherited polyposis syndromes. We set out to develop these into “app” form. Methods Essential content of our institution’s guidelines (based on published guidelines) was selected by a multidisciplinary team and edited to suitable format for the “app” programmers, and a trial version was produced. This was tested by a group of HCPs (colorectal surgeons, gastroenterologists, nurse specialists). A questionnaire was sent out after the trial to determine the usefulness and effectiveness of the “app”. Results Eighteen HCPs trialled the “app”. 89% found it relevant and useful in their clinical practice, and would use it at least once a month. 83% said that it provided the information they required, and all would recommend it to a colleague. None considered it hard to use. Some improvements were suggested, which will be implemented in the final version offered externally. Conclusion We present an “app” which provides our evidence-based guidelines for the management of polyposis syndromes in an easily accessible and updatable form, and describe its development. Disclosure of Interest None Declared.
- Published
- 2014
27. Lectin-type oxidized LDL receptor-1 distinguishes population of human polymorphonuclear myeloid-derived suppressor cells in cancer patients.
- Author
-
Condamine, Thomas, Dominguez, George A., Je-In Youn, Kossenkov, Andrew V., Mony, Sridevi, Alicea-Torres, Kevin, Tcyganov, Evgenii, Ayumi Hashimoto, Nefedova, Yulia, Lin, Cindy, Partlova, Simona, Garfall, Alfred, Vogl, Dan T., Xiaowei Xu, Knight, Stella C., Malietzis, George, Gui Han Lee, Eruslanov, Evgeniy, Albelda, Steven M., and Xianwei Wang
- Published
- 2016
- Full Text
- View/download PDF
28. Dysregulated Circulating Dendritic Cell Function in Ulcerative Colitis Is Partially Restored by Probiotic Strain Lactobacillus casei Shirota.
- Author
-
Mann, Elizabeth R., Jialu You, Horneffer-van der Sluis, Verena, Bernardo, David, Al-Hassi, Hafid Omar, Landy, Jon, Peake, Simon T., Thomas, Linda V., Cheng T. Tee, Gui Han Lee, Hart, Ailsa L., Yaqoob, Parveen, and Knight, Stella C.
- Subjects
DENDRITIC cells ,ULCERATIVE colitis ,LACTOBACILLUS casei ,IMMUNE response ,CUTANEOUS manifestations of general diseases ,HOMEOSTASIS - Abstract
Background. Dendritic cells regulate immune responses to microbial products and play a key role in ulcerative colitis (UC) pathology. We determined the immunomodulatory effects of probiotic strain Lactobacillus casei Shirota (LcS) on human DC from healthy controls and activeUC patients. Methods. Human blood DC from healthy controls (control-DC) and UC patients (UC-DC) were conditioned with heat-killed LcS and used to stimulate allogeneic T cells in a 5-day mixed leucocyte reaction. Results. UC-DC displayed a reduced stimulatory capacity for T cells (P < 0.05) and enhanced expression of skin-homing markers CLA and CCR4 on stimulated T cells (P < 0.05) that were negative for gut-homing marker β7. LcS treatment restored the stimulatory capacity of UC-DC, reflecting that of control-DC. LcS treatment conditioned control-DC to induce CLA on T cells in conjunction with β7, generating a multihoming profile, but had no effects on UC-DC. Finally, LcS treatment enhanced DC ability to induce TGFβ production by T cells in controls but not UC patients. Conclusions. We demonstrate a systemic, dysregulated DC function in UC that may account for the propensity of UC patients to develop cutaneous manifestations. LcS has multifunctional immunoregulatory activities depending on the inflammatory state; therapeutic effects reported in UC may be due to promotion of homeostasis. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
29. Endoscopic thoracic sympathectomy for primary hyperhidrosis: A 16-year follow up in a single UK centre.
- Author
-
Askari, Alan, Kordzadeh, Ali, Gui Han Lee, and Harvey, Michael
- Subjects
- *
SYMPATHECTOMY , *SYMPATHETIC nervous system surgery , *HYPERHIDROSIS , *HYDROGEN-ion concentration , *ENDOSCOPY - Abstract
Introduction: Since the introduction of Endoscopic Thoracic Sympathectomy ( ETS ) by Kux in 1951, the procedure has been performed for treatment of primary hyperhidrosis (PH) of the upper limb. Despite its initial success and minimally invasive nature, the long-term results are yet to be established. The aim of this study is to evaluate the outcome of patients after ETS with particular emphasis on patient satisfaction and its effectiveness over a 16-year period. Methods: A patient survey of fifty-one (n = 51) patients who had ETS for PH of palms from 1995 to 2011 was conducted. The data on age, sex, site of the PH, family history, trigger, hospital stay, relief from symptoms, complications, refractory sweating and overall satisfaction with the procedure was analysed with SAS software version 9.1.3. Conclusion: The mean follow-up was 77 months (range, 6-189 months) with equal gender distribution (n = 24 males Vs n = 27 females) and mean age of 19 (range, 13-64 years). The hereditary prevalence was 55%. Forty-six patients (90.2%) reported an immediate (≤24 h) and four patients (7.8%) reported a delay (>24 h) in relief of symptoms. To the best of our knowledge this is longest duration of follow-up reported in the literature. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.