72 results on '"Nicholas E. Tawa"'
Search Results
2. Malignant Cutaneous Adnexal Tumors and Role of SLNB
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Alessandra Storino, Nicholas E. Tawa, and Reed E. Drews
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Male ,medicine.medical_specialty ,Skin Neoplasms ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Risk Assessment ,Amputation, Surgical ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Papillary adenocarcinoma ,Surgical oncology ,Interquartile range ,medicine ,Mohs surgery ,Humans ,Survival rate ,Aged ,Retrospective Studies ,Sentinel Lymph Node Biopsy ,business.industry ,Wide local excision ,Middle Aged ,Mohs Surgery ,medicine.disease ,Lymphatic disease ,Survival Rate ,Lymphatic Metastasis ,030220 oncology & carcinogenesis ,Lymph Node Excision ,Female ,Neoplasms, Adnexal and Skin Appendage ,030211 gastroenterology & hepatology ,Surgery ,Radiology ,Neoplasm Recurrence, Local ,business - Abstract
Background Malignant cutaneous adnexal tumors (MCATs) are rare and their natural history is poorly understood. Available literature indicates aggressive behavior with a significant risk of metastasis. Study Design Retrospective review of our institutional surgical oncology databases was performed for patients diagnosed with MCATs (2001-2020). We hypothesized that most patients have a low risk of lymph node involvement, recurrence, and death. Kaplan-Meier statistical analysis was used to assess risk of recurrence and 5-year survival. Results We identified 41 patients diagnosed with MCATs (median age 59 years, 68% were men). Most patients had long-standing cutaneous lesions (median 24 months) and no palpable adenopathy. Most patients had stage I or II disease (98%). Primary tumors were treated with wide local excision (n = 28 [68%]), Mohs surgery (n = 5 [12%]), or amputation (n = 8 [19%]). Of 25 patients who underwent SLNB (61%), 1 had lymphatic metastasis. These include apocrine carcinoma (1 of 3), digital papillary adenocarcinoma (0 of 8), porocarcinoma (0 of 4), and additional MCAT sub-types (0 of 10). Three patients (7%) had disease recurrence at a median interval of 3.6 years (interquartile range 1.5 to 4.4 years). Five patients (12%) died at a median interval of 7 years (interquartile range 6.7 to 9.2 years), but only 1 patient was known to have succumbed to MCAT. Overall 5-year survival rate was 96% (95% CI, 75% to 99%). Conclusions Despite the historical impression that MCATs have a high metastatic potential, most patients have low recurrence rates and excellent 5-year survival rates. Lymphatic disease identified after SLNB in early-stage tumors is rare and the value of this staging procedure in MCAT remains unclear. more...
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- 2021
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Catalog
3. Clinicopathologic features correlated with paradoxical outcomes in stage IIC versus IIIA melanoma patients
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Nicholas E. Tawa, Virginia Seery, Lauren C. Strazzulla, Caroline C. Kim, Haili Dunbar, Michael B. Atkins, Xiaoxue Li, Sandra J. Lee, Sally Tan, Mee-Young Lee, Julie Najita, Elizabeth I. Buchbinder, and David F. McDermott more...
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Adult ,Male ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Skin Neoplasms ,Adolescent ,Dermatology ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Adjuvant therapy ,Humans ,Medicine ,Neoplasm Metastasis ,Stage (cooking) ,Young adult ,Melanoma ,Survival rate ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Retrospective cohort study ,Middle Aged ,Sentinel node ,medicine.disease ,Survival Rate ,Exact test ,030104 developmental biology ,030220 oncology & carcinogenesis ,Female ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Under current AJCC staging criteria, stage IIC patients paradoxically have worse outcomes than IIIA patients despite the lack of nodal metastatic disease. This study sought to identify additional clinicopathologic characteristics correlated with worse patient outcomes. Retrospective chart review of stage IIC and IIIA melanoma patients were evaluated between 1995 and 2011 with clinical follow-up through 2015. Records were reviewed for demographics, clinical characteristics, and tumor pathology. Fisher's exact test and Wilcoxon's rank-sum test were used to assess group differences. Clinicopathologic features were evaluated relative to overall survival (OS), time to distant metastases, and local/regional recurrence. Overall, 128 patients were included (45 stage IIC and 83 stage IIIA) with a median follow-up time of 5.7 years. Compared with stage IIIA patients, stage IIC patients were older, and their melanomas were more likely to be nodular, amelanotic, thicker, have higher mitotic rate, tumor lymphocytic infiltrate, no radial growth phase, and less likely to have associated precursor lesions. Stage IIC patients had shorter OS and time to distant metastases; multivariate regression revealed that older age (>55 years) and mitotic rate (>5 mitoses/mm) were independent predictors of OS. Melanomas in stage IIC disease may be biologically distinct from those that are seen in stage IIIA. While sentinel node biopsies remain the standard-of-care, these results suggest that clinicians may want to assess the clinicopathologic characteristics described above to aggressively counsel, screen for distant disease, and consider adjuvant therapy, in particular for older patients and higher mitotic rates in thicker primary tumors, regardless of nodal status. more...
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- 2019
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4. Percutaneous versus Cut-Down Technique for Indwelling Port Placement
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Sing Chau Ng, Gyulnara G. Kasumova, Omidreza Tabatabaie, Jennifer F. Tseng, Nicholas E. Tawa, Mario Matiotti-neto, Jonathan F. Critchlow, Lindsay A. Bliss, Mariam F. Eskander, and Blanche Murphy
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Cephalic vein ,medicine.medical_specialty ,Percutaneous ,business.industry ,Retrospective cohort study ,General Medicine ,Odds ratio ,030230 surgery ,Confidence interval ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,030220 oncology & carcinogenesis ,medicine ,business ,Complication ,Subclavian vein - Abstract
The superiority of surgical cut-down of the cephalic vein versus percutaneous catheterization of the subclavian vein for the insertion of totally implantable venous access devices (TIVADs) is debated. To compare the safety and efficacy of surgical cut-down versus percutaneous placement of TIVADs. This is a single-institution retrospective cohort study of oncologic patients who had TIVADs implanted by 14 surgeons. Primary outcomes were inability to place TIVAD by the primary approach and postoperative complications within 30 days. Multivariate analysis was performed by logistic regression. Secondary outcomes included operative time. Two hundred and forty-seven (55.9%) percutaneous and 195 (44.1%) cephalic cut-down patients were identified. The 30-day complication rate was 5.2 per cent: 14 patients (5.7%) in the percutaneous and nine (4.6%) in the cut-down group. The technique was not a significant predictor of having a 30-day complication (odds ratio = 0.820; 95% confidence interval 0.342–1.879). Implantation failure was observed in 16 percutaneous patients (6.5%) and 28 cut-down patients (14.4%) (adjusted odds ratio for cephalic vs cut-down = 2.387; 95% confidence interval 1.275–4.606). The median operative time for percutaneous patients was 46 minutes (interquartile range = 35, 59) versus 37.5 minutes (interquartile range = 30, 49) for cut-down patients(P < 0.0001). Both the percutaneous and cut-down technique are safe and effective for TIVAD implantation. Operative times were shorter and the odds of implantation failure higher for cephalic cut-down. As implantation failure is common, surgeons should familiarize themselves with both techniques. more...
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- 2017
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5. Recurrence and Survival for 'Aggressive' Adnexal Cutaneous Tumors: Single Center Experience
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Nicholas E. Tawa and Alessandra Storino Gonzalez
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medicine.medical_specialty ,Cutaneous tumors ,business.industry ,medicine ,Surgery ,Radiology ,Single Center ,business - Published
- 2020
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6. Percutaneous
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Mario, Matiotti-Neto, Mariam F, Eskander, Omidreza, Tabatabaie, Gyulnara, Kasumova, Lindsay A, Bliss, Sing Chau, Ng, Nicholas E, Tawa, Blanche, Murphy, Jonathan F, Critchlow, and Jennifer F, Tseng
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Male ,Catheterization, Central Venous ,Operative Time ,Venous Cutdown ,Middle Aged ,Subclavian Vein ,Catheters, Indwelling ,Postoperative Complications ,Treatment Outcome ,Arm ,Humans ,Female ,Vascular Patency ,Aged ,Retrospective Studies - Abstract
The superiority of surgical cut-down of the cephalic vein versus percutaneous catheterization of the subclavian vein for the insertion of totally implantable venous access devices (TIVADs) is debated. To compare the safety and efficacy of surgical cut-down versus percutaneous placement of TIVADs. This is a single-institution retrospective cohort study of oncologic patients who had TIVADs implanted by 14 surgeons. Primary outcomes were inability to place TIVAD by the primary approach and postoperative complications within 30 days. Multivariate analysis was performed by logistic regression. Secondary outcomes included operative time. Two hundred and forty-seven (55.9%) percutaneous and 195 (44.1%) cephalic cut-down patients were identified. The 30-day complication rate was 5.2 per cent: 14 patients (5.7%) in the percutaneous and nine (4.6%) in the cut-down group. The technique was not a significant predictor of having a 30-day complication (odds ratio = 0.820; 95% confidence interval 0.342-1.879). Implantation failure was observed in 16 percutaneous patients (6.5%) and 28 cut-down patients (14.4%) (adjusted odds ratio for cephalic vs cut-down = 2.387; 95% confidence interval 1.275-4.606). The median operative time for percutaneous patients was 46 minutes (interquartile range = 35, 59) versus 37.5 minutes (interquartile range = 30, 49) for cut-down patients(P0.0001). Both the percutaneous and cut-down technique are safe and effective for TIVAD implantation. Operative times were shorter and the odds of implantation failure higher for cephalic cut-down. As implantation failure is common, surgeons should familiarize themselves with both techniques. more...
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- 2018
7. Totally Implantable Venous Access Devices: A Review of Complications and Management Strategies
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Mariam F. Eskander, Jennifer F. Tseng, Gyulnara G. Kasumova, Jonathan F. Critchlow, Nicholas E. Tawa, and Omidreza Tabatabaie
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Cancer Research ,medicine.medical_specialty ,Catheterization, Central Venous ,business.industry ,Decision Trees ,MEDLINE ,Safety margin ,030204 cardiovascular system & hematology ,Venous access ,03 medical and health sciences ,0302 clinical medicine ,Catheters, Indwelling ,Postoperative Complications ,Oncology ,030220 oncology & carcinogenesis ,Medicine ,Central Venous Catheters ,Humans ,business ,Intensive care medicine - Abstract
Totally implantable venous access devices (portacaths, or "ports"), are widely used for intermittent central venous access especially for cancer patients. Although ports have a superior safety margin compared with other long-term venous access devices, there are a number of complications associated with their use.This is a narrative review. We searched PubMed and Google Scholar for articles about complications related to the use of portacaths. "Similar articles" feature of PubMed and reference list of the existing literature were also reviewed for additional relevant studies.In this review, we provide the latest evidence regarding the most common ones of these adverse events and how to diagnose and treat them. Immediate complications including pneumothorax, hemothorax, arterial puncture, and air embolism as well as late complications such as port infection, malfunction, and thrombosis are covered in detail.Physicians should be familiar with port complications and their diagnosis and management. more...
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- 2017
8. Effect of Melanoma on Immune Function in the Regional Lymph Node Basin
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Wei Wang, John T. Mullen, Lucy Mandato, Adam Polivy, Nicholas E. Tawa, Mustaqueem Siddiqui, Benjamin Negin, Steven R. Tahan, David J. Panka, James W. Mier, and Michael B. Atkins
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Adult ,Male ,Cancer Research ,Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Sentinel lymph node ,Receptors, Antigen, T-Cell ,Lymphocyte Activation ,Antigens, CD ,Biopsy ,medicine ,Humans ,Melanoma ,Lymph node ,Aged ,Neoplasm Staging ,Tumor microenvironment ,medicine.diagnostic_test ,Reverse Transcriptase Polymerase Chain Reaction ,Sentinel Lymph Node Biopsy ,business.industry ,Wide local excision ,T-cell receptor ,Membrane Proteins ,Middle Aged ,medicine.disease ,Gene Expression Regulation, Neoplastic ,medicine.anatomical_structure ,Oncology ,Cytokines ,Female ,Lymph Nodes ,Lymph ,business - Abstract
Purpose: To determine if melanoma within the tumor microenvironment will result in immunosuppression within the draining lymph node as measured by down-regulation of T-cell receptor ζ (TCR ζ) expression.Experimental Design: Patients with clinical stage I to III melanoma undergoing wide local excision and sentinel lymph node biopsy or therapeutic lymph node dissection were consented to have a portion of their lymph node sampled. Lymph nodes were classified as macroscopically involved (TI), microscopically involved (MI), noninvolved with positive wide excision (NI+), or noninvolved with negative wide excision (NI−). Lymphocytes were stained using antibodies to TCR ζ and other immune cells and analyzed via flow cytometer. Reverse transcription-PCR was used to assess for mediators of immunosuppression.Results: Fifty patient lymph node samples (15 TI, 7 MI, 9 NI+, and 19 NI−) were evaluated. Increasing involvement of tumor in the lymph node was associated with decreasing TCR ζ chain expression (TI 56%, MI 76%, and NI− 89%). Differences between TI and MI (P = 0.005), TI and NI− (P = 0.0001), and MI and NI− (P = 0.019) were statistically significant. There was also a significant difference between TCR ζ chain expression of NI+ and NI− (73% versus 89%; P = 0.0016). A trend toward increased arginase expression in tumor-involved lymph nodes was detected by reverse transcription-PCR.Conclusions: Melanoma involvement of regional nodes is associated with loss of TCR ζ expression that is inversely related to tumor burden. Residual melanoma within the wide local excision specimen is associated with TCR ζ loss in noninvolved sentinel lymph nodes, suggesting that immune modulation precedes tumor spread. more...
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- 2008
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9. Carcinoid tumors in the breast
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Nicholas E. Tawa, Laura C. Collins, Sareh Parangi, and J. Nalinee Upalakalin
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Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Carcinoid tumors ,Mammary gland ,Breast Neoplasms ,Carcinoid Tumor ,Mastectomy, Segmental ,Biopsy ,medicine ,Humans ,Combined Modality Therapy ,skin and connective tissue diseases ,Neoplasm Staging ,Chemotherapy ,medicine.diagnostic_test ,business.industry ,Primary sites ,Biopsy, Needle ,General Medicine ,Middle Aged ,medicine.disease ,digestive system diseases ,Radiation therapy ,Treatment Outcome ,medicine.anatomical_structure ,Chemotherapy, Adjuvant ,Female ,Radiotherapy, Adjuvant ,Surgery ,Tomography, X-Ray Computed ,business ,Mastectomy ,Follow-Up Studies ,Mammography - Abstract
Background Carcinoid tumors in the breast are rare. Most represent metastases from other primary sites, but commonly are mistaken for primary breast lesions. Methods A literature search of the English language found 59 cases of carcinoid tumors in the breast, 21 (36%) of which were metastases. Results We present an additional 3 cases of carcinoid tumors metastatic to the breast and discuss the clinical, radiologic, and pathologic manifestations. Conclusions It is important to differentiate between primary breast carcinoid tumor and metastatic disease to the breast because of differences in treatment. All palpable breast masses and mammographically detected lesions should undergo a biopsy examination. In those patients with a known history of carcinoid tumor, pertinent clinical history, and previous surgical specimens should be reviewed to avoid an unnecessary mastectomy. If there is no history of a prior carcinoid tumor, a thorough work-up to look for an occult primary tumor elsewhere should be performed. more...
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- 2006
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10. [Untitled]
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Lalita Khaodhiar, Mario Ollero, Nicholas E. Tawa, Mary Keane-Ellison, Pei-Ra Ling, Karen C. McCowen, Bruce R. Bistrian, and Ann Thibault
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chemistry.chemical_classification ,medicine.medical_specialty ,Triglyceride ,Physiology ,Linoleic acid ,Gastroenterology ,Fatty acid ,Biology ,Enteral administration ,chemistry.chemical_compound ,Parenteral nutrition ,Endocrinology ,chemistry ,Essential fatty acid ,Mead acid ,Internal medicine ,medicine ,Arachidonic acid - Abstract
Patients receiving home total parenteral nutrition (HTPN) are at risk for the development of essential fatty acid deficiency (EFAD). This study examined the essential fatty acid status of patients on long-term HTPN for gut failure. Serum phospholipid and triglyceride fatty acids were measured in 11 patients and 10 healthy volunteers. Patients had similar levels of linoleic acid (18:2w6) in serum triglyceride fatty acids but significantly lower levels of 18:2w6 in serum phospholipids compared to controls. Although there was accumulation of Mead acid (20:3w9) in both fatty acid fractions, the ratio of 20:3w9 to arachidonic acid (20:4w6) remained less than 0.2, reflecting an adequate essential fatty acid status in these patients. There were, however, substantial increases in 20:4w6 content in both triglyceride and phospholipid fractions in serum despite the lower levels of 18:2w6 in serum phospholipids, suggesting that an accelerated hepatic conversion of 18:2w6 to 20:4w6 occurs in HTPN patients, as well as the 20-carbon members of w3 (20:3w3) and w9 (20:3w9) families. The determination of optimal parenteral fat intakes should be investigated further as important priority in patients receiving long term HTPN. more...
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- 2002
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11. Dempster, William Richardson
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Nicholas E. Tawa
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- 2014
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12. [Untitled]
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Bruce R. Bistrian, Pei-Ra Ling, Lalita Khaodhiar, Mary Keane-Ellison, Nicholas E. Tawa, and Ann Thibault
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medicine.medical_specialty ,biology ,Physiology ,business.industry ,C-reactive protein ,Gastroenterology ,Albumin ,Case-control study ,Urine ,Hepatology ,Short bowel syndrome ,medicine.disease ,Parenteral nutrition ,Endocrinology ,Internal medicine ,medicine ,biology.protein ,Interleukin 6 ,business - Abstract
This study was designed to examine circulating and urine cytokine levels in patients receiving long-term home total parenteral nutrition (TPN) support. Twelve patients who had been receiving home TPN for more than 1 year (range, 1.3-19.5 years) were enrolled for study. To avoid the potential confounding effects of intercurrent infection, patients were studied during periods of clinical stability without clinical evidence of infection. Ten normal healthy volunteers served as controls. Serum levels of albumin and C-reactive protein, temperature, body weight, and blood white cell counts were determined. The levels of soluble tumor necrosis factor receptor II (sTNF-RII) and interleukin 6 (IL-6) were measured in serum and 24-hr urine. The results showed that the concentrations of sTNF-RII and IL-6 in 24-hr urine and serum were significantly higher in patients, indicating that long-term home TPN may be associated with a persistent low-grade inflammatory state. more...
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- 2001
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13. Effect of a fish oil-containing beverage on changes in plasma lipid fatty acids in patients with malabsorption
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Pei-Ra Ling, Karen C. McCowen, Mario Ollero, Bruce R. Bistrian, and Nicholas E. Tawa
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Adult ,Male ,medicine.medical_specialty ,Parenteral Nutrition ,Malabsorption ,Medicine (miscellaneous) ,Blood lipids ,Pilot Projects ,Article ,Beverages ,chemistry.chemical_compound ,Malabsorption Syndromes ,Internal medicine ,Fatty Acids, Omega-3 ,medicine ,Humans ,Phospholipids ,Triglycerides ,Aged ,chemistry.chemical_classification ,Nutrition and Dietetics ,Arachidonic Acid ,business.industry ,Fatty acid ,Middle Aged ,medicine.disease ,Fish oil ,Short bowel syndrome ,Diarrhea ,Endocrinology ,Parenteral nutrition ,chemistry ,Dietary Supplements ,Arachidonic acid ,Female ,medicine.symptom ,Inflammation Mediators ,business - Abstract
The aim of this pilot study was to assess tolerance of a beverage containing ω-3 fatty acids (fish oil) in patients with malabsorption receiving chronic parenteral nutrition (PN). The authors wanted to determine whether fish oil could be absorbed and incorporated into plasma fatty acids and reduce markers of inflammation.This was a small intervention study in home-dwelling PN-dependent patients with chronic malabsorption. Ten patients were provided a drink containing 1.5 g of fish oil per day for 12 weeks. Baseline and post-supplement serum fatty acid profiles were compared.Five of 10 patients withdrew from the study because of GI side effects, principally worsened diarrhea, associated with the supplement. Modest increases were found in 20:5ω-3, 22:5ω-3, and 22:6ω-3 levels in both phospholipids and triglycerides in plasma (all P.05). In phospholipids, a reduced arachidonic acid level was seen (P = .02). These changes were not sufficient to effect improvements in serum tumor necrosis factor-alpha (TNFα), soluble TNF receptor, C-reactive protein, or interleukin-6.Some patients with severe malabsorption can absorb oral ω-3 fatty acid supplements and incorporate these fatty acids into serum phospholipids and triglycerides. However, side effects are very common, and no anti-inflammatory effect was found, presumably related to the modest level of fatty acid change. more...
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- 2010
14. Dietary protein deficiency reduces lysosomal and nonlysosomal ATP-dependent proteolysis in muscle
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Isis do Carmo Kettelhut, Alfred L. Goldberg, and Nicholas E. Tawa
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Male ,medicine.medical_specialty ,Normal diet ,Physiology ,Endocrinology, Diabetes and Metabolism ,Proteolysis ,Cathepsin B ,Adenosine Triphosphate ,Protein Deficiency ,Physiology (medical) ,Internal medicine ,Lysosome ,medicine ,Animals ,chemistry.chemical_classification ,biology ,medicine.diagnostic_test ,Muscles ,Skeletal muscle ,Rats, Inbred Strains ,Calpain ,Rats ,Protein catabolism ,Enzyme ,medicine.anatomical_structure ,Endocrinology ,chemistry ,biology.protein ,Calcium ,Dietary Proteins ,Lysosomes ,Peptide Hydrolases - Abstract
When rats are fed a protein deficient (PD) diet for 7 days, rates of proteolysis in skeletal muscle decrease by 40-50% (N. E. Tawa, Jr., and A. L. Goldberg. Am. J. Physiol. 263 (Endocrinol. Metab. 26): E317-325, 1992). To identify the underlying biochemical adaptations, we measured different proteolytic processes in incubated muscles. The capacity for intralysosomal proteolysis, as shown by sensitivity to methylamine or lysosomal protease inhibitors, fell 55-75% in muscles from PD rats. Furthermore, extracts of muscles of PD rats showed 30-70% lower activity of many lysosomal proteases, including cathepsins B, H, and C, and carboxypeptidases A and C, as well as other lysosomal hydrolases. The fall in cathepsin B and proteolysis was evident by 3 days on the PD diet, and both returned to control levels 3 days after refeeding of the normal diet. In muscles maintained under optimal conditions, 80-90% of protein breakdown occurs by nonlysosomal pathways. In muscles of PD rats, this ATP-dependent process was also 40-60% slower. Even though overall proteolysis decreased in muscles of PD rats, their capacity for Ca(2+)-dependent proteolysis increased (by 66%), as did the activity of the calpains (+150-250%). Thus the lysosomal and the ATP-dependent processes decrease coordinately and contribute to the fall in muscle proteolysis in PD animals. more...
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- 1992
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15. Reviews
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Anne C. Shreffler, Nicholas E. Tawa, Tim Carter, Victoria Lindsay Levine, Robert Walser, Ewan West, Thomas Torino, John C. Schmidt, Robert Skinner, John Eaton, and Joseph Auner
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Music - Published
- 1992
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16. Reoperative Surgery for Melanoma
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Nicholas E. Tawa and Mark P. Callery
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medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Melanoma ,medicine.medical_treatment ,Soft tissue metastasis ,Medicine ,Lymphadenectomy ,Reoperative surgery ,business ,medicine.disease ,Surgery ,Parotid gland - Published
- 2008
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17. Severe hemodynamic instability during general anesthesia in a professional bodybuilder
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Feroze Mahmood, Robina Matyal, Philip M. Knight, Nicholas E. Tawa, and Peter Panzica
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Male ,medicine.medical_specialty ,Weight Lifting ,Hemodynamics ,Blood Pressure ,Anesthesia, General ,Anabolic Agents ,Heart Rate ,Internal medicine ,Monitoring, Intraoperative ,Heart rate ,medicine ,Humans ,Heart Function Tests ,Thoracic Neoplasm ,business.industry ,Sarcoma ,Middle Aged ,Thoracic Neoplasms ,medicine.disease ,Anesthesiology and Pain Medicine ,Blood pressure ,Anesthesia ,Cardiology ,Steroids ,Cardiology and Cardiovascular Medicine ,business ,Echocardiography, Transesophageal ,Hemodynamic instability - Published
- 2007
18. Factors associated with worse outcome for patients with AJCC stage IIC relative to stage IIIA melanoma
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Lana X. Tong, Sandra J. Lee, Robert A. Frankenthaler, David F. McDermott, Virginia Seery, Caroline C. Kim, Michael B. Atkins, Sally Tan, Julie Najita, Nicholas E. Tawa, Mee-Young Lee, Elizabeth I. Buchbinder, Haili Dunbar, Sowmya Varada, and Jennifer Fuller more...
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Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Melanoma ,Sentinel lymph node ,Ajcc stage ,Ajcc staging ,medicine.disease ,Surgery ,Internal medicine ,medicine ,Stage (cooking) ,Stage IIIa ,business - Abstract
9078 Background: Sentinel lymph node (SLN) status is used in melanoma AJCC staging to distinguish between stage I or II and stage III disease. However patients (pts) with stage IIC (Breslow > 4 mm,... more...
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- 2015
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19. IKKbeta/NF-kappaB activation causes severe muscle wasting in mice
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Dongsheng, Cai, J Daniel, Frantz, Nicholas E, Tawa, Peter A, Melendez, Byung-Chul, Oh, Hart G W, Lidov, Per-Olof, Hasselgren, Walter R, Frontera, Jongsoon, Lee, David J, Glass, and Steven E, Shoelson
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Male ,Cachexia ,Ubiquitin ,Body Weight ,NF-kappa B ,Mice, Transgenic ,Organ Size ,Protein Serine-Threonine Kinases ,Salicylates ,Cell Line ,Hindlimb ,I-kappa B Kinase ,Enzyme Activation ,Survival Rate ,Mice ,Muscular Atrophy ,Phenotype ,Animals ,Cytokines ,Humans ,Female ,Enzyme Inhibitors ,Muscle, Skeletal ,Neoplasm Transplantation ,Signal Transduction - Abstract
Muscle wasting accompanies aging and pathological conditions ranging from cancer, cachexia, and diabetes to denervation and immobilization. We show that activation of NF-kappaB, through muscle-specific transgenic expression of activated IkappaB kinase beta (MIKK), causes profound muscle wasting that resembles clinical cachexia. In contrast, no overt phenotype was seen upon muscle-specific inhibition of NF-kappaB through expression of IkappaBalpha superrepressor (MISR). Muscle loss was due to accelerated protein breakdown through ubiquitin-dependent proteolysis. Expression of the E3 ligase MuRF1, a mediator of muscle atrophy, was increased in MIKK mice. Pharmacological or genetic inhibition of the IKKbeta/NF-kappaB/MuRF1 pathway reversed muscle atrophy. Denervation- and tumor-induced muscle loss were substantially reduced and survival rates improved by NF-kappaB inhibition in MISR mice, consistent with a critical role for NF-kappaB in the pathology of muscle wasting and establishing it as an important clinical target for the treatment of muscle atrophy. more...
- Published
- 2004
20. Iron deficiency anemia in patients receiving home total parenteral nutrition
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Peter A. Burke, Ann Thibault, Mary Keane-Ellison, Lalita Khaodhiar, Nicholas E. Tawa, and Bruce R. Bistrian
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Adult ,Male ,Short Bowel Syndrome ,medicine.medical_specialty ,Time Factors ,Anemia ,Gastrointestinal Diseases ,Iron ,Medicine (miscellaneous) ,Gastroenterology ,Internal medicine ,Medicine ,Humans ,Infusions, Intravenous ,Aged ,Aged, 80 and over ,Gastrointestinal tract ,Nutrition and Dietetics ,Anemia, Iron-Deficiency ,business.industry ,Incidence (epidemiology) ,Iron deficiency ,Middle Aged ,Short bowel syndrome ,medicine.disease ,Surgery ,Parenteral nutrition ,Iron-deficiency anemia ,Parenteral Nutrition, Home Total ,Female ,business ,Complication ,Gastrointestinal Hemorrhage - Abstract
Certain patients receiving home total parenteral nutrition (HPN) are likely to develop iron-deficiency anemia because of inadequate absorption or chronic iron loss from gastrointestinal lesions. The objective of this study was to examine the incidence and prevalence of iron deficiency anemia in patients on long-term HPN (6 months) and to investigate both the efficacy of and rate of adverse reactions to parenteral iron dextran therapy.The records of 55 patients treated with HPN for6 months between January 1, 1994 and December 31, 1999 were examined.Thirty patients (55%) had evidence of iron-deficiency anemia. Ten patients were diagnosed at the initiation of HPN, and in 20 patients, iron deficiency developed after receiving HPN. The time between initiation of HPN and development of anemia ranged from 2 to 97 months (mean 28.8+/-26.2 months). Mild iron loss from the gastrointestinal tract seemed to be the predominant reason for iron deficiency. Regular treatment with small amounts of iron in HPN appeared to be safe and efficacious, with no reported side effects. Total dose infusion of iron was associated with adverse reactions in as many as 25% of these patients, although all reactions were mild and self-limited.Iron-deficiency anemia is common in patients receiving chronic HPN. Regular small doses of iron in HPN formula, rather than total dose infusion, is the preferred treatment. more...
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- 2002
21. Seguin [née Childe], Anne
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Nicholas E. Tawa
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- 2002
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22. Association between mitotic rate and lymph node metastasis in thin melanoma in the general population
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Robert A. Frankenthaler, Nicholas E. Tawa, Chung Yuan Hu, Mee-Young Lee, Elizabeth I. Buchbinder, Yan Xing, Caroline C. Kim, Virginia Seery, and David F. McDermott
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Cancer Research ,education.field_of_study ,Pathology ,medicine.medical_specialty ,business.industry ,Melanoma ,Population ,Mitotic rate ,Lymph node metastasis ,medicine.disease ,Oncology ,Cutaneous melanoma ,Medicine ,In patient ,business ,education ,neoplasms ,Staging system - Abstract
e20039 Background: Mitotic rate was incorporated into the AJCC 7th edition staging system for cutaneous melanoma because of its prognostic impact on melanoma-specific survival in patients with thin... more...
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- 2014
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23. Totally implantable venous access device use in pancreatic cancer: A national analysis
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Sing Chau Ng, Elan R. Witkowski, Jonathan F. Critchlow, Jennifer F. Tseng, Nicholas E. Tawa, Catherine J. Yang, Rebecca A. Miksad, and Lindsay A. Bliss
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Cancer Research ,medicine.medical_specialty ,business.industry ,Device placement ,food and beverages ,Device use ,medicine.disease ,Surgery ,Venous access ,Oncology ,Pancreatic cancer ,medicine ,Intensive care medicine ,business - Abstract
e15188 Background: Totally implantable venous access devices (ports) can be used in pancreatic cancer treatment. Long-term device placement facilitates agent infusion and reduces discomfort from re... more...
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- 2014
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24. Nonviral transfer of the gene encoding coagulation factor VIII in patients with severe hemophilia A
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David A. Roth, Douglas A. Treco, Nicholas E. Tawa, Richard F. Selden, and Joanne M. O'Brien
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Adult ,medicine.medical_specialty ,Biopsy ,Hemorrhage ,Hemophilia A ,Transfection ,Gastroenterology ,Transplantation, Autologous ,hemic and lymphatic diseases ,Internal medicine ,Coagulopathy ,medicine ,Humans ,Aged ,Skin ,Factor VIII ,medicine.diagnostic_test ,business.industry ,General Medicine ,Genetic Therapy ,Fibroblasts ,Middle Aged ,medicine.disease ,Interim analysis ,In vitro ,Clone Cells ,Transplantation ,Coagulation ,Immunology ,Skin biopsy ,Laparoscopy ,business ,Omentum ,Plasmids - Abstract
We tested the safety of a nonviral somatic-cell gene-therapy system in patients with severe hemophilia A.An open-label, phase 1 trial was conducted in six patients with severe hemophilia A. Dermal fibroblasts obtained from each patient by skin biopsy were grown in culture and transfected with a plasmid containing sequences of the gene that encodes factor VIII. Cells that produced factor VIII were selected, cloned, and propagated in vitro. The cloned cells were then harvested and administered to the patients by laparoscopic injection into the omentum. The patients were followed for 12 months after the implantation of the genetically altered cells. An interim analysis was performed.There were no serious adverse events related to the use of factor VIII-producing fibroblasts or the implantation procedure. No long-term complications developed, and no inhibitors of factor VIII were detected. In four of the six patients, plasma levels of factor VIII activity rose above the levels observed before the procedure. The increase in factor VIII activity coincided with a decrease in bleeding, a reduction in the use of exogenous factor VIII, or both. In the patient with the highest level of factor VIII activity, the clinical changes lasted approximately 10 months.Implantation of genetically altered fibroblasts that produce factor VIII is safe and well tolerated. This form of gene therapy is feasible in patients with severe hemophilia A. more...
- Published
- 2001
25. Kelley, Edgar Stillman
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Katherine K. Preston and Nicholas E. Tawa
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- 2001
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26. Mason family (ii)
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Harry Eskew, Carol A. Pemberton, William E. Boswell, Boris Schwarz, and Nicholas E. Tawa
- Published
- 2001
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27. Winner, Septimus
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Nicholas E. Tawa
- Published
- 2001
- Full Text
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28. Cadman, Charles Wakefield
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David E. Campbell and Nicholas E. Tawa
- Published
- 2001
- Full Text
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29. Seguin, Arthur
- Author
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Nicholas E. Tawa
- Published
- 2001
- Full Text
- View/download PDF
30. Harris, Roy (12 February 1898–01 October 1979), composer
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Nicholas E. Tawa
- Published
- 2000
- Full Text
- View/download PDF
31. Barber, Samuel (1910-1981), composer
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Nicholas E. Tawa
- Published
- 2000
- Full Text
- View/download PDF
32. Donaldson, Walter (1893-1947), popular-song composer, lyricist, and publisher
- Author
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Nicholas E. Tawa
- Published
- 2000
- Full Text
- View/download PDF
33. Coots, J. Fred (1897-1985), composer of popular songs
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Nicholas E. Tawa
- Published
- 2000
- Full Text
- View/download PDF
34. Wilder, Alec (1907-1980), composer and music arranger
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Nicholas E. Tawa
- Published
- 2000
- Full Text
- View/download PDF
35. Piston, Walter (1894-1976), composer of art music
- Author
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Nicholas E. Tawa
- Published
- 2000
- Full Text
- View/download PDF
36. Inhibitors of the proteasome reduce the accelerated proteolysis in atrophying rat skeletal muscles
- Author
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Alfred L. Goldberg, Nicholas E. Tawa, and R Odessey
- Subjects
Male ,medicine.medical_specialty ,Proteasome Endopeptidase Complex ,Leupeptins ,Proteolysis ,Diaphragm ,Biology ,Cysteine Proteinase Inhibitors ,chemistry.chemical_compound ,Multienzyme Complexes ,Internal medicine ,MG132 ,medicine ,Protein biosynthesis ,Animals ,Muscle, Skeletal ,Denervation ,medicine.diagnostic_test ,Leupeptin ,Skeletal muscle ,Proteins ,Rats, Inbred Strains ,General Medicine ,Rats ,Protein catabolism ,Cysteine Endopeptidases ,Kinetics ,Endocrinology ,medicine.anatomical_structure ,chemistry ,Proteasome ,Atrophy ,Research Article - Abstract
Several observations have suggested that the enhanced proteolysis and atrophy of skeletal muscle in various pathological states is due primarily to activation of the ubiquitin-proteasome pathway. To test this idea, we investigated whether peptide aldehyde inhibitors of the proteasome, N-acetyl-leucyl-leucyl-norleucinal (LLN), or the more potent CBZ-leucyl-leucyl-leucinal (MG132) suppressed proteolysis in incubated rat skeletal muscles. These agents (e.g., MG132 at 10 microM) inhibited nonlysosomal protein breakdown by up to 50% (P < 0.01), and this effect was rapidly reversed upon removal of the inhibitor. The peptide aldehydes did not alter protein synthesis or amino acid pools, but improved overall protein balance in the muscle. Upon treatment with MG132, ubiquitin-conjugated proteins accumulated in the muscle. The inhibition of muscle proteolysis correlated with efficacy against the proteasome, although these agents could also inhibit calpain-dependent proteolysis induced with Ca2+. These inhibitors had much larger effects on proteolysis in atrophying muscles than in controls. In the denervated soleus undergoing atrophy, the increase in ATP-dependent proteolysis was reduced 70% by MG132 (P < 0.001). Similarly, the rise in muscle proteolysis induced by administering thyroid hormones was reduced 40-70% by the inhibitors. Finally, in rats made septic by cecal puncture, the increase in muscle proteolysis was completely blocked by MG132. Thus, the enhanced proteolysis in many catabolic states (including denervation, hyperthyroidism, and sepsis) is due to a proteasome-dependent pathway, and inhibition of proteasome function may be a useful approach to reduce muscle wasting. more...
- Published
- 1997
37. Suppression of muscle protein turnover and amino acid degradation by dietary protein deficiency
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Alfred L. Goldberg and Nicholas E. Tawa
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Normal diet ,Physiology ,Endocrinology, Diabetes and Metabolism ,Proteolysis ,Glutamine ,Muscle Proteins ,Growth ,Biology ,Protein degradation ,Physiology (medical) ,Internal medicine ,Protein Deficiency ,medicine ,Protein biosynthesis ,Animals ,Amino Acids ,chemistry.chemical_classification ,Alanine ,medicine.diagnostic_test ,Muscles ,Metabolism ,Organ Size ,Amino acid ,Rats ,Endocrinology ,chemistry ,Dietary Proteins ,Leucine - Abstract
To define the adaptations that conserve amino acids and muscle protein when dietary protein intake is inadequate, rats (60-70 g final wt) were fed a normal or protein-deficient (PD) diet (18 or 1% lactalbumin), and their muscles were studied in vitro. After 7 days on the PD diet, both protein degradation and synthesis fell 30-40% in skeletal muscles and atria. This fall in proteolysis did not result from reduced amino acid supply to the muscle and preceded any clear decrease in plasma amino acids. Oxidation of branched-chain amino acids, glutamine and alanine synthesis, and uptake of alpha-aminoisobutyrate also fell by 30-50% in muscles and adipose tissue of PD rats. After 1 day on the PD diet, muscle protein synthesis and amino acid uptake decreased by 25-40%, and after 3 days proteolysis and leucine oxidation fell 30-45%. Upon refeeding with the normal diet, protein synthesis also rose more rapidly (+30% by 1 day) than proteolysis, which increased significantly after 3 days (+60%). These different time courses suggest distinct endocrine signals for these responses. The high rate of protein synthesis and low rate of proteolysis during the first 3 days of refeeding a normal diet to PD rats contributes to the rapid weight gain ("catch-up growth") of such animals. more...
- Published
- 1992
38. Effect of melanoma on immune function in regional lymph nodes (LN)
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Adam Polivy, B. P. Negin, Nicholas E. Tawa, David J. Panka, James W. Mier, Michael B. Atkins, Lucy Mandato, John T. Mullen, Steven R. Tahan, and Wei Wang
- Subjects
Cancer Research ,Immune system ,Oncology ,Metastatic melanoma ,business.industry ,Melanoma ,Immunology ,Medicine ,Lymph ,business ,medicine.disease - Abstract
8000 Background: Metastatic melanoma is associated with various measures of systemic and local immune suppression. We hypothesized that immune suppression in the regional LN basin exists and may facilitate melanoma progression. Methods: We collected portions of regional LNs from tumor uninvolved sentinel LNs (USLN) (remote from primary melanoma removal) and from macroscopically involved nodes (TILN) from therapeutic node dissections in successive melanoma patients. Lymphocytes were extracted, stained using surface and internal antibodies to T cell receptor zeta chain (TCRζ), T regulatory cells (CD4+CD25+ Fox 3p+) (Tregs) and tumor associated myeloid cells (CD11b+ CD14- CD15+) (TAMC), and analyzed via flow cytometer. Results from USLN specimens were compared with TILN. Results: 30 LNs (14 USLN/16 TILN) from 30 patients were evaluated. Median age of patients was 48 years (range 30–83); 20 were male. USLN patients were stage IB (12) or IIA (2); TILN patients were stage IIIB (5), IIIC (5), and IV (6). 7 patients with TILN and none with USLN have progressed. TILN had significantly less TCRζ chain expression than SLN (62% vs. 85%; p = 0.0001). This amounts to a localized decrease of 23% of TCRζ expression (95% CI 13%; 34%). No significant relationship between lymph node involvement and Treg or TAMC was documented. Conclusion: Regional LN involvement with melanoma is associated with a significant reduction in lymphocyte TCRζ expression indicating immune suppression. The mechanism for this is uncertain, but does not appear to be related to changes in Tregs or TAMC (arginase producing cells). We plan to further investigate TCRζ expression in microscopically involved SLNs and SLNs removed at time of primary excision to see if immune changes precede macroscopic tumor involvement. Supported by Harvard Skin SPORE Project 5 and Immune Monitoring Core P50CA93683–01 No significant financial relationships to disclose. more...
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- 2006
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39. Dietary protein deficiency reduces expression of multiple components of the ATP-dependent proteolytic pathway in muscle
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Jamie Mitchell and Nicholas E. Tawa
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biology ,Catabolism ,business.industry ,Protein degradation ,Muscle atrophy ,Cell biology ,Dietary protein ,Proteasome ,Ubiquitin ,biology.protein ,medicine ,Surgery ,medicine.symptom ,business - Published
- 2005
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40. Sequential Decitabine and Dacarbazine in the Treatment of Melanoma
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David J. Panka, Kim Stegmaier, David F. McDermott, Nicholas E. Tawa, Charles Famoyin, Michael B. Atkins, Henry B. Koon, Yoo-J Ko, and James W. Mier
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Pharmacology ,Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Melanoma ,Dacarbazine ,Immunology ,Decitabine ,medicine.disease ,Internal medicine ,Immunology and Allergy ,Medicine ,business ,medicine.drug - Published
- 2004
- Full Text
- View/download PDF
41. High-Minded and Low-Down: Music in the Lives of Americans 1800-1861
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Victor Greene and Nicholas E. Tawa
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Archeology ,History ,Museology - Published
- 2001
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42. New World Symphonies: How American Culture Changed European Music
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Jack Sullivan and Nicholas E. Tawa
- Subjects
Literature ,Culture of the United States ,business.industry ,media_common.quotation_subject ,Symphony ,Art ,Library and Information Sciences ,business ,Music ,media_common - Published
- 1999
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43. American Composers and Their Public: A Critical Look
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Wallace C. McKenzie and Nicholas E. Tawa
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Media studies ,Sociology ,Library and Information Sciences ,Social science ,Music - Published
- 1996
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44. The Kairn of Koridwen, a Dance-Drama in 2 Scenes (1916-1917) [For Flute, 2 Clarinets, 2 Horns, Celesta, Harp, and Piano]
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Nicholas E. Tawa and Charles Tomlinson Griffes
- Subjects
Dance ,Speech recognition ,media_common.quotation_subject ,Piano ,Flute ,Art ,Library and Information Sciences ,Music ,Drama ,media_common ,Visual arts ,HARP - Published
- 1995
- Full Text
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45. Serious Songs of the Early Nineteenth Century. Part 2: The Meaning of the Early Song Melodies
- Author
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Nicholas E. Tawa
- Subjects
Literature ,Melody ,business.industry ,media_common.quotation_subject ,Sorrow ,Innocence ,Art ,Lyrics ,Tone (literature) ,The Symbolic ,Repetition (music) ,business ,Music ,media_common ,Strophic form - Abstract
In an earlier article I examined the depictions and deeper meanings of lyrics attached to a large group of serious American songs popular in the decades before the Civil War.' There I attempted to establish the symbolic nature of many lyrics as they traced humankind's passage through life-from an arcadian childhood and innocence to an adult world full of strife, sorrow, and aloneness and finally to a permanent home in Heaven (guided by the spirits of loved ones). In what follows I attempt to do the same for the music, particularly the melodies. To that end, the focus of part 2 of "Serious Songs of the Early Nineteenth Century" centers on what the music in these songs is intended to express and those practices and attitudes that invest this expression. To consider the melodies associated with these song lyrics as mere successions of single tones that are organized rhythmically and designed for strophic repetition at a moderately slow tempo tells us little about their purpose. To maintain that tone is apparently connected to tone, that a simplistic sense of flow and anticipation of the melody does ensue, and that a perception of the start and finish of the phrase and strain is planted firmly in the auditor's mind tells us nothing about any inner significance the music might have had for nineteenth-century Americans. We can agree that a melody will alter the "music" residing more...
- Published
- 1995
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46. Songs of the Early Nineteenth Century Part 1: Early Song Lyrics and Coping with Life
- Author
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Nicholas E. Tawa
- Subjects
Literature ,Painting ,Aside ,business.industry ,media_common.quotation_subject ,Art ,Temptation ,Lyrics ,Personal development ,Agrarian society ,Popular music ,Afterlife ,business ,Music ,media_common - Abstract
This is a study of serious American songs written primarily in the four decades before the Civil War and meant to reach a wide audience, an audience that made no particular distinctions between what we now classify as the art song versus the popular song. These are works that exhibit a grave and pensive frame of mind and examine a grave if not somber subject. They are not satirical, nor do they feature gaiety or hints at light-heartedness. Their themes revolve about home, loved ones, the beloved, the adversities of adult life, death, and the hope for an afterlife. Part I of the investigation, published in this issue, focuses entirely upon the lyrics, not the music, of these songs. Part II, which will follow in a later issue of American Music, will concern itself with the melodies, their meaning, and relation to the lyrics. One should avoid the temptation of painting the views of antebellum men and women in stark black or white. Despite the forbidding questions that divided Americans during the three decades before the Civil War--slavery, states' rights, agrarian versus industrial intereststhere were significant values that the public held in common. Aside from divisive issues, such as those just cited, antebellum American society shared the belief, for example, that a person's full personal development required an assent to commonly accepted standards of right and wrong. more...
- Published
- 1995
- Full Text
- View/download PDF
47. Book Review Atlas of Breast Surgery By Samuel A. Wells, Jr., V. Leroy Young, and Dorothy A. Andriole. 387 pp., illustrated. St. Louis, Mosby-Year Book, 1993. $125. 0-8151-9216-9
- Author
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Nicholas E. Tawa
- Subjects
medicine.anatomical_structure ,business.industry ,Atlas (anatomy) ,Breast surgery ,medicine.medical_treatment ,medicine ,Art history ,General Medicine ,business ,St louis - Published
- 1994
- Full Text
- View/download PDF
48. The Complete Published Songs of Louis Moreau Gottschalk with a Selection of Other Songs of Mid-Nineteenth-Century America
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Richard Jackson and Nicholas E. Tawa
- Subjects
History ,Library and Information Sciences ,Music ,Selection (genetic algorithm) ,Genealogy - Published
- 1994
- Full Text
- View/download PDF
49. The Coming of Age of American Art Music: New England's Classical Romanticists
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Victor Fell Yellin and Nicholas E. Tawa
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Library and Information Sciences ,Music - Published
- 1992
- Full Text
- View/download PDF
50. The Way to Tin Pan Alley: American Popular Song, 1866-1910
- Author
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Lawrence Gushee and Nicholas E. Tawa
- Subjects
Popular music ,media_common.quotation_subject ,Performance art ,Gender studies ,Art ,Library and Information Sciences ,Alley ,Music ,Visual arts ,media_common - Published
- 1992
- Full Text
- View/download PDF
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