Publications by authors named "Kenneth Chang"

Cell death plasticity is crucial for modulating tissue homeostasis and immune responses, but our understanding of the molecular components that regulate cell death pathways to determine cell fate remains limited. Here, a CRISPR screen of acute myeloid leukemia cells identifies protein tyrosine phosphatase non-receptor type 23 (PTPN23) as essential for survival. Loss of PTPN23 activates nuclear factor-kappa B, apoptotic, necroptotic, and pyroptotic pathways by causing the accumulation of death receptors and toll-like receptors (TLRs) in endosomes.

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Introduction: Barrett esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC). We aimed to assess performance, safety, and tolerability of the EsoGuard (EG) assay on samples collected nonendoscopically with the EsoCheck (EC) device (EG/EC) for BE detection in the intended-use population meeting American College of Gastroenterology guideline criteria (chronic gastroesophageal reflux disease and 3+ additional risk factors).

Methods: We performed a prospective, multicenter study (NCT04293458) to assess EG performance (primary endpoint) on cells collected with EC, for detection of BE and EAC using esophagogastroduodenoscopy (EGD) and biopsies as the comparator.

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Background: To enhance the quality of care available for children with central nervous system (CNS) tumors across the world, a systematic evaluation of capacity is needed to identify gaps and prioritize interventions. To that end, we created the pediatric neuro-oncology (PNO) resource assessment aid (PANORAMA) tool.

Methods: The development of PANORAMA encompassed 3 phases: operationalization, consensus building, and piloting.

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Men taking antioxidant vitamin E supplements have increased prostate cancer (PC) risk. However, whether pro-oxidants protect from PC remained unclear. In this work, we show that a pro-oxidant vitamin K precursor [menadione sodium bisulfite (MSB)] suppresses PC progression in mice, killing cells through an oxidative cell death: MSB antagonizes the essential class III phosphatidylinositol (PI) 3-kinase VPS34-the regulator of endosome identity and sorting-through oxidation of key cysteines, pointing to a redox checkpoint in sorting.

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  • This study investigates tumor budding (TB) in intrahepatic cholangiocarcinoma (iCCA) patients, focusing on its impact on survival before and after neoadjuvant therapy (NAT).* -
  • Findings show that TB positivity is significantly linked to lower overall survival (OS) and recurrence-free survival (RFS) in patients, both before and after undergoing NAT.* -
  • The study concludes that evaluating TB using modified ITBCC criteria is crucial for prognostic assessment and should be included in standard pathological reports for iCCA patients.*
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  • TIF 2.0 is an advanced endoscopic procedure for treating GERD, showing high clinical success (94%) and significant symptom improvement in patients after one year.
  • In a study of 81 patients, most reported a dramatic increase in satisfaction from 8% to 79%, and many reduced their reliance on proton pump inhibitors from 81% to 80% post-procedure.
  • The procedure demonstrated safety with no serious adverse events reported, confirming its effectiveness as an outpatient treatment for appropriate GERD patients.
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Mitomycin C is an alkylating agent with the ability to suppress fibroblast proliferation and activity, making it a powerful antifibrotic. It has therefore become popular in glaucoma filtering surgeries, used both intraoperatively during bleb formation and postoperatively as an adjunct to bleb needling. This report presents a rare but serious risk of bleb needling with Mitomycin C at the slit lamp, where inadvertent movement of the patient resulted in an orbital injection.

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Metastasizing leiomyoma is a rare condition characterized by the development of benign-appearing smooth muscle neoplasms at extrauterine sites in patients with a history of uterine leiomyoma. These lesions occur most commonly in the lung, with the abdominopelvic and mediastinal lymph nodes being other reported sites. Malignant transformation of metastasizing leiomyoma is extremely rare, with only a few cases described in the literature.

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  • A 68-year-old woman had a concerning eye lesion initially thought to be an atypical fibroxanthoma, but it was later diagnosed as spindle cell carcinoma after a biopsy.
  • Spindle cell carcinoma is a rare and aggressive type of squamous cell carcinoma, highlighting the need for careful surgical technique and comprehensive analysis for accurate diagnosis.
  • The case contributes to limited research on this type of cancer affecting the eye, aiming to improve future diagnostic and treatment guidelines as more data becomes available.
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Background: Pleomorphic xanthoastrocytoma (PXA) is a rare brain tumor that accounts for <1% of all gliomas. An in-depth understanding of PXA's molecular makeup remains a work in progress due to its limited numbers globally. Separately, spontaneous intracranial hemorrhage (pICH) is an uncommon but potentially devastating emergency in young children, often caused by vascular malformations or underlying hematological conditions.

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  • * A case study on a 73-year-old man revealed a tumor initially thought to be a poorly differentiated carcinoma, but subsequent examination confirmed it as epithelioid angiosarcoma, with specific molecular characteristics identified through advanced testing methods.
  • * The findings highlight the need to consider epithelioid angiosarcoma as a differential diagnosis for high-grade salivary gland carcinomas, noting the potential for shared genetic alterations like TP53 mutations that complicate diagnosis.
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Osteosarcoma is the commonest malignant bone tumor of children and adolescents and is characterized by a high risk of recurrence despite multimodal therapy, especially in metastatic disease. This suggests the presence of clinically undetected cancer cells that persist, leading to cancer recurrence. We sought to evaluate the utility of peripheral blood exosomes as a more sensitive yet minimally invasive blood test that could aid in evaluating treatment response and surveillance for potential disease recurrence.

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  • This study aimed to evaluate the effectiveness and safety of two procedures—peroral endoscopic myotomy with septotomy (POEM+S) and without septotomy (POEM-S)—in treating symptomatic epiphrenic diverticula (ED) alongside motility disorders.
  • Conducted across 21 international centers from 2014 to 2023, the study included 85 patients, measuring clinical success primarily through the Eckardt score.
  • Results indicated that both procedures had similar clinical success rates (83% for POEM+S vs. 86.8% for POEM-S), technical success, and adverse event rates, but POEM-S patients had a longer hospital stay.
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The purpose of this article is to report a rare case of isolated superior ophthalmic vein thrombosis. A 74-year-old female presented to the emergency department with a sudden onset of eye pain and bulging. Ophthalmological examination was remarkable for proptosis and ptosis with chemosis of the OS.

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High-grade gliomas (HGG) are deadly diseases for both adult and pediatric patients. Recently, it has been shown that neuronal activity promotes the progression of multiple subgroups of HGG. However, epigenetic mechanisms that govern this process remain elusive.

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We report 2 cases of pediatric ocular myasthenia gravis. The first case was a 7-year-old girl who presented with bilateral ophthalmoplegia and ptosis that correlated with the onset of upper respiratory symptoms. Neuroimaging and acetylcholine receptor antibody testing were unremarkable.

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Background: The Hill classification characterizes the geometry of gastroesophageal junction and Hill grades (HGs) III and IV have a high association with pathologic reflux. This study aimed to understand the use of the Hill classification and correlate the prevalence of pathologic reflux across different HGs.

Study Design: A retrospective review of 477 patients who underwent upper endoscopy and BRAVO pH monitoring between August 2018 and October 2021 was performed.

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Background And Aims: Endoscopic liver "palpation" can be performed by indenting the liver surface under EUS. Indentation depth is measured with the use of sonographic calipers. We hypothesized that fibrotic livers are more difficult to indent, and that indentation can accurately predict liver fibrosis staging.

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Video 1Demonstration of gastric peroral endoscopic myotomy using a novel bipolar blade and the navigational tunnel technique.

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Congenital mesoblastic nephroma is considered a tumour with favourable clinical behaviour with only few reported cases of metastases. We report an infant who underwent complete resection and later developed pulmonary metastasis. Ten-month-old baby girl initially presented at 3 weeks of age with macroscopic haematuria, hypertension and a lumbar mass.

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