Searched for: Department/Unit:Otolaryngology
CONGENITAL NEPHROTIC SYNDROME AND PNEUMOCOCCAL ANTIBODIES DEFICIENCY [Meeting Abstract]
Teodoro, AB; Johnson, V; Herzog, R
ISI:000327055500321
ISSN: 1534-4436
CID: 1529132
ALLERGY TO FISH ROE: A CASE REPORT [Meeting Abstract]
Baum, D; Herzog, R
ISI:000327055500338
ISSN: 1534-4436
CID: 1529122
Recognition of a Natural WT1 Epitope by a Modified WT1 Peptide-specific T-Cell Receptor (vol 32, pg 5201, 2012) [Correction]
Mourad, Waleed F; Shasha, Daniel; Blakaj, Dukagjin M; Khorsandi, Azita S; Budach, Volker; Shourbaji, Rania A; Glanzman, Jonathan; Kabarriti, Rafi; Young, Rebekah; Patel, Shyamal; Katsoulakis, Evangelia; Gamez, Mauricio; Woode, Rudolph; Lazarus, Cathy; Concerti, Catherine; Hu, Kenneth S; Harrison, Louis B
ISI:000328801900069
ISSN: 1791-7530
CID: 1500722
Trimodality approach for ceruminous mucoepidermoid carcinoma of the external auditory canal [Case Report]
Mourad, W F; Hu, K S; Shourbaji, R A; Harrison, L B
BACKGROUND: Ceruminous mucoepidermoid carcinoma of the external auditory canal is extremely rare. This paper highlights the impact of concurrent chemoradiotherapy on the outcomes of this disease. CASE REPORT: A 47-year-old female presented with a 2-month history of otalgia and a mass in her right ear. Biopsy revealed high grade ceruminous mucoepidermoid carcinoma. She underwent surgical excision of the right external auditory canal and right upper neck dissection. Pathological analysis of tumour-node-metastasis staging revealed a T2 N0 (stage II) tumour. One year later, computed tomography scanning of the temporal bone showed tumour recurrence. Biopsy revealed recurrent ceruminous mucoepidermoid carcinoma. The patient underwent salvage resection. Pathology revealed that the tumour was diffusely invading nearby structures, with perineural invasion, lymphatic spread and extracapsular extension. Pathological analysis of tumour-node-metastasis staging revealed a T3 N1 M0 (recurrent stage IV) tumour. RESULTS: The patient subsequently received concurrent chemoradiotherapy. There was no evidence of disease at 37 months' follow up. CONCLUSION: The trimodality approach, using surgery plus concurrent chemoradiotherapy, provided reasonable loco-regional control with tolerable toxicity. Further detailed case reports are warranted to optimise the management of this rare malignancy.
PMID: 23318008
ISSN: 0022-2151
CID: 1499252
The impact of computed tomography on early glottic cancer outcomes
Mourad, Waleed F; Hu, Kenneth S; Shourbaji, Rania A; Ishihara, Dan; Lin, Wilson; Kumar, Mahesh; Blakaj, Dukagjin M; Harrison, Louis B
PURPOSE: Aim of this study was to evaluate the impact of computed tomography (CT)-based simulation and planning on early glottic cancer outcomes and toxicity. METHODS: This is a single-institution retrospective study of 253 patients with T1-2 glottic cancer who underwent radiation therapy (RT) from January 1998-2010. Group A (80%) underwent 2-dimensional RT (2DRT) and group B (20%) 3-dimensional RT (3DRT). 76% of patients in group A and 84% in group B had T1 cancer. The median dose and fraction size were 63 Gy and 2.25 Gy, respectively. RESULTS: With a median follow-up of 83, 93, and 30 months for the whole cohort, group A and B, respectively, the loco-regional control (LRC) was 97.6%. The rate of LRC for T1 disease was 99.5% and for T2 disease 91%. According to the RT modality, rates of LRC were 99.4 and 100% in groups A and B for T1, and 89.8 and 100% for T2. Long-term toxicity was negligible in both groups. Kaplan-Meier Curve showed the 5-year cause-specific survival to be 100%. Chi-square and multivariate analysis tests showed a significant relationship between CT simulation (3DRT) and LRC (p < 0.0001). CONCLUSION: CT-based simulation and planning provided better LRC and less acute side effects compared to 2DRT.
PMID: 23485994
ISSN: 0378-584x
CID: 1499092
Phase 1b, multicenter, single blinded, placebo-controlled, sequential dose escalation study to assess the safety and tolerability of topically applied AG013 in subjects with locally advanced head and neck cancer receiving induction chemotherapy
Limaye, Sewanti Atul; Haddad, Robert I; Cilli, Fiona; Sonis, Stephen T; Colevas, A Dimitrios; Brennan, Michael T; Hu, Kenneth S; Murphy, Barbara A
BACKGROUND: Oral mucositis (OM) is a significant toxicity of induction chemotherapy for locally advanced head and neck cancer (LAHNC). The safety and tolerability of AG013, an oral rinse containing recombinant Lactococcus lactis secreting mucosal protectant human trefoil factor 1 (hTFF1), was evaluated in a phase 1b study in LAHNC subjects who received induction with cisplatin, 5-fluorouracil, with or without docetaxel. Preliminary efficacy data were also obtained. METHODS: A total of 25 of 52 LAHNC subjects who were followed during induction cycle 1 developed ulcerative oral mucositis (UOM; World Health Organization grade > 2) and were randomized to AG013:placebo (5:2 ratio) for cycle 2. Dosing schedules of 1, 3, or 6 times daily were evaluated (2 x 10(11) , 6 x 10(11) , and 1.2 x 10(12) colony forming units per day, respectively). OM was evaluated daily from cycle 2, day 1 through 14, using World Health Organization criteria. Pharmacokinetic assessment was also conducted. RESULTS: AG013 bacteria were not detected in blood. Oral live AG013 bacterial and hTFF1 levels in saliva and oral mucosa were equivalent among treatment groups. The most frequently occurring adverse events were nausea, oral pain, fatigue, diarrhea, and mucosal inflammation. Only 12% (3 of 25 adverse events), mainly nausea, were attributed to the investigational medicinal product: AG013 or placebo. Efficacy analysis showed a 35% reduction in percentage of days with UOM in AG013-subjects versus placebo. All placebo subjects experienced >/= 2 days of UOM, whereas 29% of AG013 subjects had UOM for 0 or 1 day. AG013 use resulted in fewer unscheduled office and emergency room visits. No differences were noted in mouth and throat soreness, opioid use, or gastrostomy tube placement. CONCLUSIONS: AG013 was safe and well tolerated. Preliminary efficacy data support further study.
PMID: 24114811
ISSN: 0008-543x
CID: 1499022
Exploration of the role of radiotherapy in the management of early glottic cancer with complete carotid artery occlusion [Case Report]
Mourad, Waleed F; Hu, Kenneth S; Shourbaji, Rania A; Dolan, James; Blakaj, Dukagjin M; Shasha, Daniel; Harrison, Louis B
BACKGROUND: The aim of this study was to compare intensity-modulated radiation therapy (IMRT) vs. 2D and 3D radiotherapy (RT) in the treatment of T1 glottic squamous cell carcinoma in an effort to highlight the advantages of IMRT in this particular clinical situation. CASE REPORT: We present the case of an 82-year-old female patient with T1 left true vocal cord squamous cell carcinoma and complete occlusion of the left carotid artery resulting in multiple strokes. The patient underwent definitive RT with 63 Gy (28 x 2.25 Gy). 3 plans were generated: 2D RT, 3D RT, and IMRT. The right carotid artery (Rt.CA) mean dose was 865, 2,065, and 4,268 cGy for IMRT, 3D RT, and 2D RT, respectively. The inferior pharyngeal constrictor (IPC) mean dose was 5,341, 6,456, and 6,451 cGy for IMRT, 3D RT, and 2D RT, respectively. IMRT provided the best homogeneity but at a higher cost and with prolonged treatment time. CONCLUSION: IMRT provided the finest planning target volume coverage with minimal Rt.CA and IPC doses. IMRT is recommended in certain clinical scenarios which are not manageable with other techniques.
PMID: 23921763
ISSN: 0378-584x
CID: 1499082
Radiation therapy for Benign Lymphoepithelial Cysts of parotid glands in HIV patients
Mourad, Waleed F; Hu, Kenneth S; Shourbaji, Rania A; Lin, Wilson; Harrison, Louis B
OBJECTIVES/HYPOTHESIS: To report the long-term outcomes of radiation therapy (RT), and the impact of fractionation size and RT duration on HIV patients with Benign Lymphoepithelial Cysts (BLEC) of the parotid glands. METHODS: From January 2000 to 2011, 30 patients were eligible for our single institution retrospective study. Both parotids were treated with 24 Gy via RT. The median age at RT, HIV diagnosis, and duration of HIV seropositive was 45 years (28-64), 38 years (23-53), and 11 years (6-35), respectively. Patients were stratified into two groups. Group A and B received 2Gyx12 and 1.5Gyx16, respectively. RESULTS: After a median follow-up of 66 months (12-141), the overall response (OvR) was 93% of the patients. Specifically, complete response (CR) and partial response (PR) were 80% and 13%, respectively. In group A, 100% had CR. Treatment failure was 7% and all were in group B, which was mainly due to poor compliance. A Chi-square test showed significant relationship between OvR and RT duration (P <0.001), and a positive trend between CR and fraction size of 2 Gy (P = 0.053). All acute toxicities were grade = 2, specifically mucositis (48%), xerostomia (45%), skin erythema (41%), and altered taste (14%). Two patients (6.7%) experienced long-term grade 1 xerostomia. CONCLUSION: RT provides a sustained long-term cosmetic control for BLEC of the parotid glands in HIV patients. Failures are uncommon, and the late side effects have been negligible.
PMID: 23532713
ISSN: 0023-852x
CID: 1499072
Toxoplasma gondii rhoptry 16 kinase promotes host resistance to oral infection and intestinal inflammation only in the context of the dense granule protein GRA15
Jensen, Kirk D C; Hu, Kenneth; Whitmarsh, Ryan J; Hassan, Musa A; Julien, Lindsay; Lu, Diana; Chen, Lieping; Hunter, Christopher A; Saeij, Jeroen P J
Toxoplasma gondii transmission between intermediate hosts is dependent on the ingestion of walled cysts formed during the chronic phase of infection. Immediately following consumption, the parasite must ensure survival of the host by preventing adverse inflammatory responses and/or by limiting its own replication. Since the Toxoplasma secreted effectors rhoptry 16 kinase (ROP16) and dense granule 15 (GRA15) activate the JAK-STAT3/6 and NF-kappaB signaling pathways, respectively, we explored whether a particular combination of these effectors impacted intestinal inflammation and parasite survival in vivo. Here we report that expression of the STAT-activating version of ROP16 in the type II strain (strain II+ROP16I) promotes host resistance to oral infection only in the context of endogenous GRA15 expression. Protection was characterized by a lower intestinal parasite burden and dampened inflammation. Host resistance to the II+ROP16I strain occurred independently of STAT6 and the T cell coinhibitory receptors B7-DC and B7-H1, two receptors that are upregulated by ROP16. In addition, coexpression of ROP16 and GRA15 enhanced parasite susceptibility within tumor necrosis factor alpha/gamma interferon-stimulated macrophages in a STAT3/6-independent manner. Transcriptional profiling of infected STAT3- and STAT6-deficient macrophages and parasitized Peyer's patches from mice orally challenged with strain II+ROP16I suggested that ROP16 activated STAT5 to modulate host gene expression. Consistent with this supposition, the ROP16 kinase induced the sustained phosphorylation and nuclear localization of STAT5 in Toxoplasma-infected cells. In summary, only the combined expression of both GRA15 and ROP16 promoted host resistance to acute oral infection, and Toxoplasma may possibly target the STAT5 signaling pathway to generate protective immunity in the gut.
PMCID:3676013
PMID: 23545295
ISSN: 0019-9567
CID: 1499062
Cranial Nerves Contouring Among Patients Treated With IMRT for Base of Skull, Nasopharyngeal, and Paranasal Sinus Cancer
Mourad, W F; Hu, K S; Shourbaji, R A; Khorsandi, A; Harrison, L B
PMID: 24674554
ISSN: 1879-8500
CID: 1499232