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Cancer Biology & Medicine 2015年第1期12卷 60-63页

作者： Mohan Hingorani Sanjay Dixit Pattu Pugazhenthi Simon Hawkyard Andrew Robertson Richard Khafagy Department of Clinical Oncology Castle Hill HospitalHull and East YorkshireNHS TrustCottinghamEast Riding of YorkshireHU16 5JQUK Department of Urology Scarborough District General Hospital

Palliative radiotherapy(pRT) is primarily employed for palliation of bone pain in patients with castrate-resistant prostate cancer(CRPC). However, evidence that p RT influences prostate-specific antigen response in patients with CRPC on systemic therapy is lacking. We describe three cases of CRPC progressing after treatment with docetaxel(n=2) and abiraterone(n=1), who responded unusually after p RT for bone pain with the development of a significant biochemical response and restoration of response to systemic therapy. The possibility of p RT influencing metastatic disease in CRPC has not been previously reported, and raises the possibility of radiation-induced modulation of anti-tumor immune response mechanisms that may play a role in the restoration of response to systemic treatment.

关键词： Prostate cancer palliative radiotherapy chemotherapy

Developments in Simulation Bronchoscopy Training

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Open Journal of Respiratory Diseases 2013年第4期3卷 154-163页

作者： Jack A. Kastelik Faiza Chowdhury Sega Pathmanathan Imran Aslam Joseph Hogg Jaymin B. Morjaria Department of Respiratory Medicine Castle Hill Hospital Hull and East Yorkshire Hospitals NHS Trust Hull York Medical School University of Hull Hull UK Department of Respiratory Medicine Castle Hill HospitalHull and East Yorkshire Hospitals NHS Trust Hull York Medical School University of Hull Hull UK

Flexible bronchoscopy is a common procedure. Training in bronchoscopy is a complex process involving learning technical skills, understanding indications and contraindications, risks and benefits of the procedure, working within the team and communicating with patients. It is expected that a competent bronchoscopist is able to maneuver the scope through the anatomically complex bronchial tree, take samples, manage the sedated patient and communicate with nursing staff. Learning the complex procedural skills in the clinical setting can be stressful, therefore current bronchoscopic training methodology should blend a number of learning methods including didactic lectures, web-based material, high and low fidelity simulators as well as supervised apprenticeship training. Simulation-based bronchoscopy training therefore has been explored as a mode of training bronchoscopy skills. In this article, the role of simulation-based bronchoscopy training is reviewed. The low fidelity and high fidelity virtual reality bronchoscopy models are described together with the evidence available to support the use of simulation for bronchoscopy training.

关键词： Bronchoscopy Simulation Training

Development and course of heart failure after a myocardial infarction in younger and older people

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Journal of Geriatric Cardiology 2014年第1期11卷 1-12页

作者： Azam Torabi John GF Cleland Alan S Rigby Nasser Sherwi Department of Cardiology Castle Hill Hospital Hull York Medical School University of Hull Kingston upon Hull HU16 5JQ United Kingdom

Background Acute myocardial infarction （AMI） is a common cause of heart failure （HF）, which can develop soon after AMI and may persist or resolve or develop late. HF after an MI is a major source of mortality. The cumulative incidence, prevalence and resolution of HF after MI in different age groups are poorly described. This study describes the natural history of HF after AMI according to age. Methods Patients with AMI during 1998 were identified from hospital records. HF was defined as treatment of symptoms and signs of HF with loop diuretics and was considered to have resolved if loop diuretic therapy could be stopped without recurrence of symptoms. Patients were cate- gorised into those aged 〈 65 years, 65-75 years, and 〉 75 years. Results Of 896 patients, 311,297 and 288 were aged 〈 65, 65-75 and 〉75 years and of whom 24%, 57% and 82% had died respectively by December 2005. Of these deaths, 24 （8%）, 68 （23%） and 107 （37%） oc- curred during the index admission, many associated with acute HF. A further 37 （12%）, 63 （21%） and 82 （29%） developed HF that persisted until discharge, of whom 15, 44 and 62 subsequently died. After discharge, 53 （24%）, 55 （40%） and 37 （47%） patients developed I-IF for the first time, of whom 26%, 62% and 76% subsequently died. Death was preceded by the development of HF in 35 （70%）, 93 （91%） and 107 （85%） in aged 〈 65 years, 65-75 years and 〉75 years, respectively. Conclusions The risk of developing HF and of dying after an MI in- creases progressively with age. Regardless of age, most deaths after a MI are preceded by the development of HF.

关键词： Myocardial infarction Heart failure Age

Targeted Therapy in the Management of Elderly Patients with Pancreatic Metastases from Renal Cell Carcinoma

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Journal of Cancer Therapy 2013年第9期4卷 15-21页

作者： Keith Chiu Abdul Razack Anthony Maraveyas Department of Radiology Hull and East Yorkshire NHS Trust Hull UK The Queen’s Centre for Oncology and Haematology Hull and York Medical School Castle Hill Hospital Hull UK

Background: The pancreas is an uncommon but recognizable site for metastases from renal cell carcinoma (RCC). Isolated pancreatic RCC metastases are still rarer and often present years after initial nephrectomy. Surgical resection has been the treatment of choice because of superior patient survival compared with traditional immunotherapy. In recent years, the advent of targeted therapy has transformed the outcomes of patients with metastatic RCC although little evidence is available on its effectiveness on this subset of patients. We report our experience of 6 patients with pancreatic RCC metastases. Patients and Methods: Between 2007 and 2012, 6 patients (2 men, 4 women;median age 78 years) were diagnosed to have pancreatic RCC metastases at our institute. The clinical features, treatment and outcomes were examined. Results: All 6 patients had a primary RCC of clear cell type. The median interval between initial curative nephrectomy and re-presentation with pancreatic metastases was 12.5 years. Four patients were asymptomatic at the time of diagnosis, one presented with obstructive jaundice and another with acute gastrointestinal bleed. Four patients had extra-pancreatic disease. All were deemed unsuitable or unfit for surgical metastasectomy. Five patients had a Memorial Sloan-Kettering Cancer Center (MSKCC) score of 1 (moderate risk) and the other patient had a score of 0 (good risk). Two patients were commenced on Sunitinib, one received Pazopanib and one received Temsirolimus. Two patients did not undergo further treatment. Of the 4 patients who underwent targeted therapy, the median follow up was 33 months with a median progression free survival of 16 months. One achieved complete response but recurred soon after treatment was stopped. Targetted therapy was recommenced and the disease remained stable. A second patient had long period of stable disease before disease progression. A third achieved partial response since started on targeted therapy and a fourth

关键词： Isolated Pancreatic Metastases Renal Cell Carcinoma Targeted Therapy

Interventional radiology in the management of malignant biliary obstruction

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World Journal of Gastrointestinal Oncology 2010年第3期2卷 146-150页

作者： Cherian George Oliver Richard Byass James Edmund Ian Cast Department of Radiology Hull and East Yorkshire NHS TrustCastle Hill HospitalCastle RoadCottinghamKingston-Upon-Hull

Malignant biliary obstruction is commonly due to pancreatic carcinoma,cholangiocarcinoma and metastatic disease which are often inoperable at presentation and carry a poor *** biliary drainage and stenting provides a safe and effective method of palliation in such patients,thereby improving their quality of *** may also be an adjunct to surgical management by improving hepatic and,indirectly,renal function before resection of the tumor.

关键词： Biliary tract Biliary tract neoplasms Jaundice Cholangiography Carcinoma Pancreatic ductal

Inadvertent cardiac phlebography

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World Journal of Cardiology 2017年第6期9卷 558-561页

作者： Konstantinos Aznaouridis Constantina Masoura Stylianos Kastellanos Albert Alahmar Cardiology Department Castle Hill HospitalHull and East Yorkshire NHS TrustCottingham HU16 5JQUnited Kingdom

We are reporting a case of a 80-year-old lady with effort angina who underwent coronary angiography through the right radial artery, using a dedicated radial multipurpose 5 French Optitorque Tiger catheter. The catheter was advanced into the left ventricle and a left ventriculogram was obtained, while the catheter appeared optimally placed at the centre of the ventricle and the pressure waveform was normal. A large posterior interventricular vein draining into the right atrium was opacified, presumably because the catheter's end hole inadvertently cannulated an endocardial opening of a small thebesian vein, with subsequent retrograde filling of the epicardial vein. Our case suggests that caution is needed when a dedicated radial catheter with both an end-hole and a side hole is used for a ventriculogram, as a normal left ventricular pressure waveform does not exclude malposition of the end-hole against the ventricular wall.

关键词： Thebesian vein Radial access Transradial Cardiac phlebography

Overview of coronary artery variants, aberrations and anomalies

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World Journal of Cardiology 2018年第10期10卷 127-140页

作者： Stylianos Kastellanos Konstantinos Aznaouridis Charalambos Vlachopoulos Eleftherios Tsiamis Evangelos Oikonomou Dimitris Tousoulis Cardiology Department Castle Hill HospitalHull and East Yorkshire NHS Trust Peripheral Vessels Unit and EKKAN (Unit for the athletes and for hereditary cardiovascular diseases) 1st Department of CardiologyHippokration HospitalMedical School of National and Kapodistrian University of Athens

Coronary artery anomalies and variants are relatively uncommon congenital disorders of the coronary artery anatomy and constitute the second most common cause of sudden cardiac death in young competitive athletes. The rapid advancement of imaging techniques, including computed tomography, magnetic resonance imaging, intravascular ultrasound and optical coherence tomography, have provided us with a wealth of new information on the subject. Anomalous origin of a coronary artery from the contralateral sinus is the anomaly most frequently associated with sudden cardiac death, in particular if the anomalous coronary artery has a course between the aorta and the pulmonary artery. However, other coronary anomalies, like anomalous origin of the left coronary artery from the pulmonary artery, atresia of the left main stem and coronary fistulae, have also been implicated in cases of sudden cardiac death. Patients are usually asymptomatic, and in most of the cases, coronary anomalies are discovered incidentally during coronary angiography or on autopsy following sudden cardiac death. However, in some cases, symptoms like angina, syncope, heart failure and myocardial infarction may occur. The aims of this article are to present a brief overview of the diverse coronary variants and anomalies, focusing especially on anatomical features, clinical manifestations, risk of sudden cardiac death and pathophysiologic mechanism of symptoms, as well as to provide valuable information regarding diagnostic workup, follow-up, therapeutic choices and timing of surgical treatment.

关键词： Ectopic coronary arteries Coronary artery anomalies Coronary fistulae Coronary artery variants Myocardial bridging Coronary artery anatomy Sudden cardiac death

Use of the multiplane internal mastopexy for ptosis correction revision-augmentation mammoplasty

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Plastic and Aesthetic Research 2015年第1期2卷 120-126页

作者： Umar Daraz Khan Muhammad Riaz Department of Aesthetic Surgery Reshape ClinicWest MallingKentME196QRUK Department of Plastic Surgery Hull and East Yorkshire NHS TrustCastle Hill HospitalCottinghamHU165JQUK

Aim:Augmentation mammoplasty is a commonly performed procedure with a high satisfaction *** pocket was described for simultaneous internal mastopexy and augmentation using inframammary crease incision for selected primary and secondary *** use of the technique is presented with a larger experience for correction of ptosis in a patient presenting for revision surgery following subglandular augmentation ***:A retrospectively collected data were analyzed using the Excel Spread Sheet.A total of 25 patients had multiplane augmentation with the internal mastopexy following augmentation mammoplasty in subglandular *** of 25 patients who had their revision surgery in multiplane were ***:The group included 25 patients with a mean age of 36.6 years(range:25-54 years)with mean implant duration of 6.4 years(range:1.5-13 years).Twenty-three of the patients were nonsmokers,1 smoker and 1 patient’s smoking status was not *** patients presented with grade I capsular contracture,3 patients with grade II contracture and 4 patients had a combination of grade I and II capsular *** was present in 6,class B ptosis in 6,A/B ptosis in 3,water-down deformity in 5 and rippling in 5 *** preoperative size of implant used initially was 334.4 mL(range:250-340 mL)and the mean implant size selected for revision surgery was 416 mL(range:260-525 mL).Mean follow-up time was 18 months(range:6-48 months).Of 25 patients,21 had a bilateral procedure whereas the technique was used unilaterally in 4 patients for the correction of *** patients had a single dose of intravenous antibiotics and followed by an oral course for 5 days,there was no infection noted in the *** the current series,no patient required revision surgery following the multiplane internal ***:Multiplane internal mastopexy can be useful in selected cases of revisionary augmentation mammoplasty.

关键词： Breast ptosis internal mastopexy mastopexy with augmentation revision‑augmentation mammoplasty

N-末端脑利钠肽作为筛查起搏器患者是否发生心力衰竭的工具

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世界核心医学期刊文摘（心脏病学分册） 2006年第6期2卷 52-53页

作者： Thackray S.D.R. Witte K. Ghosh J. 田志 Department of Academic Cardiology University of Hull Castle Hill Hospital Cottingham East Yorkshire United Kingdom

Aims: Assessment of N- terminal brain natriuretic peptide(NTBNP) as a screening tool for heart failure in patients with a permanent pacemaker. Methods and results: Consecutive patients undergoing a routine permanent pacemaker assessment were enrolled. Patients underwent medical history and examination, echocardiography and blood sampling for NT- BNP. Analysis was performed on 261 patients(132 DDD, 121 VVI, eight others), mean age 73± 12 years, range 34- 99 years. Seventy two subjects(27% ) had heart failure as defined by left ventricular ejection fraction(LVEF) ≤ 40% and symptoms of heart failure(NYHA class II, III, or IV). Screening with NT- BNP gave a sensitivity of 73% and specificity of 72% for detecting heart failure in all patients [area under the curve(AUC) 0.76, P< 0.001, 95% CI 0.69- 0.83]. This increased in subjects with a DDD type pacemaker(sensitivity 80% , specificity 66% , AUC=0.8, CI 0.7- 0.90) and reduced in subjects with a VVI type pacemaker(sensitivity 66% , specificity 61% , AUC 0.68 CI 0.57- 0.78). Conclusion: Symptoms of heart failure are common in patients with pacemakers. Screening with NT- BNP is feasible and assists in the detection of important cardiac co- morbidity, particularly in patients with a DDD type pacemaker.

关键词：永久性心脏起搏器植入筛查工具心力衰竭脑利钠肽 N-末端患者 DDD起搏器 VVI起搏器超声心动图检查 NYHA分级

Tumor heterogeneity and therapy resistance-implications for future treatments of prostate cancer

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Journal of Cancer Metastasis and Treatment 2017年第1期3卷 302-314页

作者： Fiona M.Frame Amanda R.Noble Sandra Klein Hannah F.Walker Rakesh Suman Richard Kasprowicz Vin M.Mann Matt S.Simms Norman J.Maitland Cancer Research Unit Department of BiologyUniversity of YorkHeslingtonNorth Yorkshire YO105DDUK Black Family Stem Cell Institute Icahn School of Medicine at Mount SinaiNew YorkNY 10029USA Phase Focus Limited Electric WorksSheffield Digital CampusSheffield S12BJUK Department of Urology Castle Hill Hospital(Hull and East Yorkshire Hospitals NHS Trust)Cottingham HU165JQUK hull York Medical School University of HullHull HU67RXUK.

Aim:To develop new therapies for prostate cancer,disease heterogeneity must be *** includes patient variation,multi-focal disease,cellular heterogeneity,genomic changes and epigenetic *** requires more representative models to be used in more innovative ***:This study used a panel of cell lines and primary prostate epithelial cell cultures derived from patient *** assays were used;alamar blue,colony forming assays,γH2AX and Ki67 immunofluorescence and comet *** quantitative phase imaging(QPI),a label-free imaging technique,combined with Cell Analysis Toolbox software,was implemented to carry out real-time analysis of cells and to retrieve morphological,kinetic and population ***:A combination of radiation and Vorinostat may be more effective than radiation *** prostate cancer stem-like cells are more resistant to etoposide than more differentiated *** of QPI images showed that cell lines and primary cells differ in their size,motility and proliferation rate.A QPI signature was developed in order to identify two subpopulations of cells within a heterogeneous primary ***:Use of primary prostate epithelial cultures allows assessment of therapies whilst taking into account cellular *** of rare cell populations and embracing novel techniques may ultimately lead to identifying and overcoming treatment resistance.

关键词： Prostate ptychography live-cell imaging primary cells quantitative phase imaging