Browsing by Author "Huang, Christina"

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    Answering the Call to Action: COVID-19 Curriculum Design by Students for Students
    (Wolters Kluwer, 2020-07-08) Roll, Rebekah; Chiu, Megan; Huang, Christina; Medicine, School of Medicine
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    Impact of Lung Parenchymal-Only Failure on Overall Survival in Early-Stage Lung Cancer Patients Treated With Stereotactic Ablative Radiotherapy
    (Elsevier, 2021) Elbanna, May; Shiue, Kevin; Edwards, Donna; Cerra-Franco, Alberto; Agrawal, Namita; Hinton, Jason; Mereniuk, Todd; Huang, Christina; Ryan, Joshua L.; Smith, Jessica; Aaron, Vasantha D.; Burney, Heather; Zang, Yong; Holmes, Jordan; Langer, Mark; Zellars, Richard; Lautenschlaeger, Tim; Radiation Oncology, School of Medicine
    Introduction: The impact of lung parenchymal-only failure on patient survival after stereotactic ablative body radiotherapy (SABR) for early-stage non-small-cell lung cancer (NSCLC) remains unclear. Patients and methods: The study population included 481 patients with early-stage NSCLC who were treated with 3- to 5-fraction SABR between 2000 and 2016. The primary study objective was to assess the impact of out-of-field lung parenchymal-only failure (OLPF) on overall survival (OS). Results: At a median follow-up of 5.9 years, the median OS was 2.7 years for all patients. Patients with OLPF did not have a significantly different OS compared to patients without failure (P = .0952, median OS 4.1 years with failure vs. 2.6 years never failure). Analysis in a 1:1 propensity score-matched cohort for Karnofsky performance status, comorbidity score, and smoking status showed no differences in OS between patients without failure and those with OLPF (P = .8). In subgroup analyses exploring the impact of time of failure on OS, patients with OLPF 6 months or more after diagnosis did not have significantly different OS compared to those without failure, when accounting for immortal time bias (P = .3, median OS 4.3 years vs. 3.5 years never failure). Only 7 patients in our data set experienced failure within 6 months of treatment, of which only 4 were confirmed to be true failures; therefore, limited data are available in our cohort on the impact of OLPF for ≤ 6 months on OS. Conclusion: OLPF after SABR for early-stage NSCLC does not appear to adversely affect OS, especially if occurring at least 6 months after SABR. More studies are needed to understand if OLPF within 6 months of SABR is associated with adverse OS. These data are useful when discussing prognosis of lung parenchymal failures after initial SABR.
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    Phyllodes Tumor vs Fibroadenoma: Diagnosis and Management
    (2020-03) Huang, Christina; Kathryn, Snyder; Wells, Lindsey; Brown, Lucy; Kem, Danielle; Ludwig, Kandice
    Case: The patient is a 71 year-old woman who presented with enlarging painful breast mass. She had history of previous excision of a fibroadenoma in her left breast in 1993. She underwent menopause at 52 and does not take estrogen. Diagnostic imaging revealed 4.7cm breast mass, which had increased from prior measurement of 2.8cm to 4.7cm. Core biopsy demonstrated a fibroepithelial neoplasm areas of hypercellular stroma and occasional stromal mitotic figures most consistent with phyllodes tumor. Lumpectomy was performed. Final pathology showed a 4.8cm well-demarcated tumor with mildly pleomorphic spindled cells in the stroma and up to 1 per 10 mitoses per high powered field, consistent with benign phyllodes. The patient was followed every 6 months with imaging for 2 years without recurrence. Conclusions: Phyllodes tumors are rare fibroepithelial tumors of varying metastatic potential that can be mistaken for benign fibroadenomas. Phyllodes tumors should be surgically excised with wide margins, needing radiation or chemotherapy only if recurrent or large (>10cm), whereas fibroadenomas can be managed expectantly if asymptomatic (Gnerlich, 2014). Phyllodes tumors are often diagnosed in women ages 35-55. The patient in this case was diagnosed at a more advanced age with benign disease, although older age is more often associated with increased histologic grade (Mishra, 2013) (Karim, 2009). Borderline and malignant tumors are more likely to recur within two years of resection; there is less data on recurrence rates of benign tumors. Clinical Significance: Phyllodes tumors should be suspected with rapid growth of a known fibroadenoma. Core biopsy should be performed rather than fine needle aspiration for accurate diagnosis. Although phyllodes tumors comprise less than 1% of all breast neoplasms, it is crucial that uncommon pathologies are diagnosed correctly so that patients receive appropriate treatment.
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    Prickle1 is required for EMT and migration of zebrafish cranial neural crest
    (Elsevier, 2019) Ahsan, Kamil; Singh, Noor; Rocha, Manuel; Huang, Christina; Prince, Victoria E.; Medicine, School of Medicine
    The neural crest—a key innovation of the vertebrates—gives rise to diverse cell types including melanocytes, neurons and glia of the peripheral nervous system, and chondrocytes of the jaw and skull. Proper development of the cephalic region is dependent on the tightly-regulated specification and migration of cranial neural crest cells (NCCs). The core PCP proteins Frizzled and Disheveled have previously been implicated in NCC migration. Here we investigate the functions of the core PCP proteins Prickle1a and Prickle1b in zebrafish cranial NCC development. Using analysis of pk1a and pk1b mutant embryos, we uncover similar roles for both genes in facilitating cranial NCC migration. Disruption of either gene causes pre-migratory NCCs to cluster together at the dorsal aspect of the neural tube, where they adopt aberrant polarity and movement. Critically, in investigating Pk1-deficient cells that fail to migrate ventrolaterally, we have also uncovered roles for pk1a and pk1b in the epithelial-to-mesenchymal transition (EMT) of pre-migratory NCCs that precedes their collective migration to the periphery. Normally, during EMT, pre-migratory NCCs transition from a neuroepithelial to a bleb-based and subsequently, mesenchymal morphology capable of directed migration. When either Pk1a or Pk1b is disrupted, NCCs continue to perform blebbing behaviors characteristic of pre-migratory cells over extended time periods, indicating a block in a key transition during EMT. Although some Pk1-deficient NCCs transition successfully to mesenchymal, migratory morphologies, they fail to separate from neighboring NCCs. Additionally, Pk1b-deficient NCCs show elevated levels of E-Cadherin and reduced levels of N-Cadherin, suggesting that Prickle1 molecules regulate Cadherin levels to ensure the completion of EMT and the commencement of cranial NCC migration. We conclude that Pk1 plays crucial roles in cranial NCCs both during EMT and migration. These roles are dependent on the regulation of E-Cad and N-Cad.