Mei‐Hsiu Chen

Binghamton University

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The National Lung Screening Trial: Overview and Study Design

Radiology (2010)

Constantine A. Gatsonis Denise R. Aberle Christine D. Berg William C. Black Timothy R. Church

The National Lung Screening Trial (NLST) is a randomized multicenter study comparing low-dose helical computed tomography (CT) with chest radiography in the screening of older current and former heavy smokers for early detection of lung cancer, which is the leading cause of cancer-related death in the United States. Five-year survival rates approach 70% with surgical resection of stage IA disease; however, more than 75% of individuals have incurable locally advanced or metastatic disease, the latter having a 5-year survival of less than 5%. It is plausible that treatment should be more effective and the likelihood of death decreased if asymptomatic lung cancer is detected through screening early enough in its preclinical phase. For these reasons, there is intense interest and intuitive appeal in lung cancer screening with low-dose CT. The use of survival as the determinant of screening effectiveness is, however, confounded by the well-described biases of lead time, length, and overdiagnosis. Despite previous attempts, no test has been shown to reduce lung cancer mortality, an endpoint that circumvents screening biases and provides a definitive measure of benefit when assessed in a randomized controlled trial that enables comparison of mortality rates between screened individuals and a control group that does not undergo the screening intervention of interest. The NLST is such a trial. The rationale for and design of the NLST are presented.

Overdiagnosis

Clinical endpoint

10.1148/radiol.10091808

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Citations (1,160)

Adherence to Antiretroviral Therapy Among HIV-Infected Methadone Patients: Effect of Ongoing Illicit Drug Use^*

The American Journal of Drug and Alcohol Abuse (2000)

Michael D. Stein Josiah D. Rich Jina Maksad Mei‐Hsiu Chen Ping Hu

Methadone maintenance patients infected with human immunodeficiency virus (HIV) currently receiving antiretroviral therapy had HIV RNA testing and were surveyed regarding their adherence to their treatment regimens. Adherence was measured using self-report on four questions relating to medication use in the last day and last month and whether the patient took "drug holidays." Of the patients (N = 42), 52% were receiving two-drug antiretroviral therapy and 48% were receiving triple therapy that included a protease inhibitor. Persons on triple therapy reported higher rates of adherence on all measures and were more likely to have undetectable HIV RNA levels than persons on dual therapy (60% vs. 50%). Ongoing illicit drug injection was the only factor significantly associated (p <. 05) with multiple measure nonadherence; however, it was not associated with undetectable HIV RNA level. Levels of nonadherence were comparable to estimates from other chronic diseases, but this finding has important implications for patients receiving highly active antiretroviral therapy.

Protease inhibitor (pharmacology)

Drug holiday

Pharmacotherapy

10.1081/ada-100100600

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Citations (105)

A prospective, randomized trial of butyl cyanoacrylate injection versus band ligation in the management of bleeding gastric varices

Hepatology (2001)

Gin‐Ho Lo Kwok-Hung Lai Jin-Shiung Cheng Mei‐Hsiu Chen Hung‐Ting Chiang

Gastric variceal bleeding is a catastrophic event. Both cyanoacrylate injection and banding ligation have been proven to be effective in the management of bleeding gastric varices. This study was performed to compare the efficacy and complications of both the modalities. Cirrhotic patients with a history of gastric variceal bleeding were randomized to 2 groups. The group receiving endoscopic obturation (group A) comprised 31 patients and the group receiving band ligation (group B) comprised 29 patients. Butyl cyanoacrylate and pneumatic–driven ligator were applied, respectively. Treatment was repeated regularly until obliteration of gastric varices. Active bleeding occurred in 15 patients in group A and 11 patients in group B. Initial hemostatic rate (defined as no bleeding for 72 hours after treatment) was 87% in group A and 45% in group B ( P = .03). The sessions required to achieve variceal obliteration and obliteration rates were similar in both the groups. However, rebleeding rates were significantly higher in group B (54%) than group A (31%) ( P = .0005). Treatment–induced ulcer bleeding occurred in 2 patients (7%) in group A and 8 patients (28%) in group B ( P = .03). The amount of blood transfusions required were also higher in group B than group A (4.2 ± 1.3 vs. 2.6 ± 0.9 units, respectively) ( P < .01). Nine patients of group A and 14 patients of group B died ( P = .05). In conclusion, endoscopic obturation using cyanoacrylate proved more effective and safer than band ligation in the management of bleeding gastric varices.

Gastric varices

Varix

Group B

10.1053/jhep.2001.24116

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Citations (472)

Late-stage Calcific Aortic Valve Disease Within an Aortic Valve-on-a-chip Model

Structural Heart (2021)

Melissa Mendoza Mei‐Hsiu Chen Bruce T. Murray Peter Huang Gretchen J. Mahler

Objective: Calcific aortic valve disease (CAVD) is a progressive disease ranging from aortic sclerosis to severe aortic stenosis. Current treatments include total valve replacement and drug interventions tailored to other cardiovascular diseases. In late-stage CAVD, glycosaminoglycans (GAGs), such as chondroitin sulfate (CS), deposit in the fibrosa layer. Here we utilize 3D microfluidic devices to study the effects of shear stress, CS, and endothelial cells on calcification in an aortic valve fibrosa model to understand CAVD progression.Methods: Valve-on-a-chip devices were fabricated utilizing a wafer mold, soft lithography, and corona discharge. Devices have a flow channel and 3D matrix reservoir of collagen-only healthy controls or with 1mg/mL or 20mg/mL CS. Porcine aortic valve interstitial cells (PAVIC) are embedded within and endothelial cells (PAVEC) seeded onto the matrix. Steady shear stress at 1dyne/cm2 and 20dyne/cm2 was applied using a peristaltic pump at 37°C and 5%CO2. Alizarin Red S (ARS) was used to assess calcific nodule formation after 14-day cultures.Results: PAVIC/PAVEC co-cultures with increasing shear stress and GAGs exhibit increased calcification compared to static controls (Figure 1). Quantitatively, ARS increased as shear stress increased, regardless of GAGs. In the presence of CS, analysis of nodules indicated that nodule size decreased with shear stress, however it increased the total average percent area stained. Valve-on-a-chip models with PAVIC-only show decreased calcium deposition when compared to co-cultures.Late-stage Calcific Aortic Valve Disease Within an Aortic Valve-on-a-chip ModelAll authorsMelissa Mendoza, Mei-Hsiu Chen, Bruce Murray, Peter Huang & Gretchen Mahlerhttps://doi.org/10.1080/24748706.2021.1900702Published online:09 April 2021Display full sizeConclusions: In vitro calcification increases in the presence of shear stress, PAVEC, and increased concentrations of GAGs. Further studies will identify the chemical composition of nodules and to understand early-CAVD pathophysiology. Given that CAVD has no targeted therapies, the creation of a physiologically-relevant test-bed of the aortic valve will lead to contributions in new therapeutics.

10.1080/24748706.2021.1900702

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Citations (0)

¹H HR‐MAS spectroscopy for quantitative measurement of choline concentration in amniotic fluid as a marker of fetal lung maturity: Inter‐ and intraobserver reproducibility study

Journal of Magnetic Resonance Imaging (2008)

Bonnie N. Joe Kiarash Vahidi Andrew S. Zektzer Mei‐Hsiu Chen Matthew S. Clifton

Abstract Purpose To determine the intra‐ and interobserver reproducibility of human amniotic fluid metabolite concentration measurements (including potential markers of fetal lung maturity) detectable by MR spectroscopy. Materials and Methods 1 H high‐resolution magic angle spinning (HR‐MAS) spectroscopy was performed at 11.7T on 23 third‐trimester amniotic fluid samples. Samples were analyzed quantitatively using 3‐(trimethylsilyl)propionic‐2,2,3,3‐d 4 acid (TSP) as a reference. Four observers independently quantified eight metabolite regions (TSP, lactate doublet and quartet, alanine, citrate, creatinine, choline, and glucose) twice from anonymized, randomized spectra using a semiautomated software program. Results Excellent inter‐ and intraobserver reproducibility was found for all metabolites. Intraclass correlation as a measure of interobserver agreement for the four readers ranged from 0.654 to 0.995. A high correlation of 0.973 was seen for choline in particular, a major component of surfactant. Pearson correlation as a measure of intraobserver reproducibility ranged from 0.478 to 0.999. Conclusion Quantification of choline and other metabolite concentrations in amniotic fluid by high‐resolution MR spectroscopy can be performed with high inter‐ and intraobserver reproducibility. Demonstration of reproducible metabolite concentration measurements is a critical first step in the search for biomarkers of fetal lung maturity. J. Magn. Reson. Imaging 2008;28:1540–1545. © 2008 Wiley‐Liss, Inc.

Choline

10.1002/jmri.21592

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Citations (17)

p53 mutations do not predict response to paclitaxel in metastatic nonsmall cell lung carcinoma

Cancer (2000)

Thomas C. King Wallace Akerley Alice C. Fan Todd T. Moore Shamlal Mangray

BACKGROUND In vitro data and animal studies suggest that paclitaxel may have a unique ability to activate tumor cell apoptosis in the absence of wild-type p53 function. The authors previously demonstrated that response to paclitaxel and concurrent radiation was not affected by p53 mutations in nonsmall cell lung carcinoma (NSCLC). We sought to determine whether p53 mutations affect response to paclitaxel alone in patients with metastatic NSCLC. METHODS Twenty-five patients with metastatic NSCLC who participated in Brown University Oncology Group protocols utilizing single-agent weekly paclitaxel had tumor tissue that was adequate for p53 analysis. Tumor tissue was evaluated for p53 gene mutations in exons 5 through 8 by single-strand conformation polymorphism analysis. Mutations were confirmed by direct sequencing of altered mobility polymerase chain reaction products. RESULTS Mutations in p53 were found in 8 of 25 patients (32%). The response rates of 75% for patients with tumors with p53 mutations and 47% for patients with wild-type p53 do not differ significantly (P = 0.12). The 1-year survival rates for patients with and without p53 mutation after treatment with weekly paclitaxel were 63% (95% confidence interval [CI], 31–100%) and 53% (95% CI, 33–86%), respectively. CONCLUSIONS p53 mutations do not adversely affect response to paclitaxel as a single agent in metastatic NSCLC. These results provide clinical support for in vitro observations that paclitaxel can bypass mutant p53 and lead to tumor cell death by alternate pathway(s). Paclitaxel should be considered as a component of treatment for patients with metastatic NSCLC with tumors that have p53 mutations. Cancer 2000;89:769–73. © 2000 American Cancer Society.

10.1002/1097-0142(20000815)89:4<769::aid-cncr8>3.0.co;2-6

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Citations (37)

Iron nutrition and COVID-19 among Nigerian healthcare workers

Evolution Medicine and Public Health (2024)

Katherine Wander Olayinka O. Ogunleye Evelyn N. Nwagu Uche Unigwe Amelia Ngozi Odo

Abstract Background and objectives The optimal iron hypothesis (OIH) posits that risk for infection is lowest at a mild level of iron deficiency. The extent to which this protection results from arms race dynamics in the evolution of iron acquisition and sequestration mechanisms is unclear. We evaluated the OIH with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an emerging infectious agent. Methodology We tested 304 healthcare workers at baseline for iron deficiency (zinc protoporphyrin:heme), anemia (hemoglobin), and SARS-CoV-2 (salivary PCR), and followed them for ~3 months with biweekly SARS-CoV-2 tests. We fit logistic regression models based on Akaike Information Criterion. Results Adequate data were available for 199 participants. Iron replete (OR: 2.87, 95% CI: 0.85, 9.75) and anemia (OR: 2.48; 95% CI: 0.82, 7.85) were associated with higher risk for SARS-CoV-2 infection after control for covariates. Logistic regression and Cox proportional hazards models of the SARS-CoV-2 outcome were similar. Anemia (OR: 1.81; 95% CI: 0.88, 3.71) was associated with respiratory symptoms regardless of SARS-CoV-2 infection. Conclusions and implications These findings provide partial support for the OIH: SARS-CoV-2 infection risk was elevated at the high end of the range of iron availability; however, the elevated risk among those with anemia was not, as expected, specific to severe iron deficiency. Narrowly, for COVID-19 epidemiology, these findings accord with evidence that SARS-CoV-2’s ability to establish infection is enhanced by access to iron. More broadly, these findings suggest that the OIH does not hinge on a long history of evolutionary arms race dynamics in access to host iron.

2019-20 coronavirus outbreak

Pandemic

10.1093/emph/eoae034

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Citations (0)

ACRIN CT Colonography Trial: Does Reader’s Preference for Primary Two-dimensional versus Primary Three-dimensional Interpretation Affect Performance?

Radiology (2011)

Amy K. Hara Meridith Blevins Mei‐Hsiu Chen Abraham H. Dachman Mark Kuo

To determine whether the reader's preference for a primary two-dimensional (2D) or three-dimensional (3D) computed tomographic (CT) colonographic interpretation method affects performance when using each technique.

10.1148/radiol.11100250

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Citations (16)

Can Radiologist Training and Testing Ensure High Performance in CT Colonography? Lessons From the National CT Colonography Trial

American Journal of Roentgenology (2010)

Joel G. Fletcher Mei‐Hsiu Chen B. Herman C. Daniel Johnson Alicia Y. Toledano

Can Radiologist Training and Testing Ensure High Performance in CT Colonography? Lessons From the National CT Colonography TrialJoel G. Fletcher1, Mei-Hsiu Chen2, Benjamin A. Herman2 3, C. Daniel Johnson1, Alicia Toledano2, Abraham H. Dachman4, Amy K. Hara5, Jeff L. Fidler1, Christine O. Menias6, Kevin J. Coakley7, Mark Kuo8, Karen M. Horton9, Jugesh Cheema10, Revathy Iyer11, Bettina Siewert12, Judy Yee13, Richard Obregon14, Peter Zimmerman15, Robert Halvorsen16, Giovanna Casola17 and Martina Morrin12Audio Available | Share

10.2214/ajr.09.3659

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Citations (41)

PSA-based outcome analysis after radiation therapy for prostate cancer: a new definition of biochemical failure after intervention

Urology (1999)

Ashesh B. Jani Mei‐Hsiu Chen Florin Vaida Lani Ignacio A. Awan

Smoothing

Univariate

10.1016/s0090-4295(99)00229-0

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Citations (15)