ORCID Profile
0000-0002-6697-3775
Current Organisation
Concord Repatriation General Hospital
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Publisher: Elsevier BV
Date: 10-2023
Publisher: Wiley
Date: 05-2022
DOI: 10.1111/IMJ.15774
Publisher: IOP Publishing
Date: 11-01-2011
DOI: 10.1088/1752-7155/5/1/011001
Abstract: Exhaled breath condensate (EBC) analysis is a non-invasive method to repeatedly evaluate airway inflammation. Dissolved carbon dioxide contributes to lowering EBC pH which is reversed by degassing with argon. Hypothetically, argon may also improve biomarker stability by removing reactive gases, since many markers are pH sensitive or easily oxidized. In this study, the influence of two degassing methods was assessed on (i) the volume of EBC, (ii) the EBC pH, and (iii) the concentration of H₂O₂ in EBC. EBC was collected from 13 healthy subjects and 12 chronic obstructive pulmonary disease subjects over 20 min, then aliquoted and either left on ice or de-aerated with argon by bubbling or surface delivery at 400 ml min(-1) for 0 to 600 s, to quantify the EBC volume loss and the efficiency of pH equilibration. Biomarker stability was measured by H₂O₂ concentration. Both degassing methods reached a pH equilibrium by 300 s. Bubbling reached pH equilibrium faster (60 s versus 300 s), while having significantly less EBC volume loss (bubbling 3.32 ± 1.31% versus surface 10.74 ± 1.46%, p < 0.0001). The H₂O₂ concentration was higher in non-degassed s les (0.47 ± 0.18 µM, p = 0.017) but similar in the bubbling and surface degassed s les (0.30 ± 0.08 µM versus 0.31 ± 0.10 µM, p = 0.54). The optimal degassing methods were to bubble the aliquots with argon at 400 ml min(-1) for 60 s or surface degassing for 300 s. Both methods resulted in significantly less EBC volume loss than the commonly adopted method of bubbling for 10 min. There was a significant difference in the H₂O₂ concentration between the degassed and the non-degassed s les.
Publisher: Informa UK Limited
Date: 06-2010
DOI: 10.1586/EPR.10.9
Abstract: Asthma, chronic obstructive pulmonary disease (COPD) and lung cancer cause extensive mortality and morbidity worldwide. However, the current state-of-the-art diagnosis and management schemes of these diseases are suboptimal as the incidence of asthma has risen by 250% over the last two decades and the 5-year mortality rate of lung cancer remains at 88%. Proteomic analysis is at the frontier of medical research and demonstrates tremendous potential in the early detection, diagnosis and staging, as well as providing novel therapeutic targets for improved management of smoking-related lung diseases. Advances in analytical tools, such as 2D gel electrophoresis, mass spectrometry, protein arrays and improved bioinformatics, allow sensitive and specific biomarker rotein profile discoveries and the infusion of new knowledge towards the molecular basis of lung diseases and their progression. Significant hurdles still stand between these laboratory findings and their applications in clinical practice. One of the challenges is the difficulty in the selection of s les that provide scope into the specific disease entity. Induced sputum, bronchoalveolar lavage, exhaled breath and exhaled breath condensate are methods of s ling airway and lung fluids that can serve as a window to assess the microenvironment of the lungs. With better study design standardization and the implementation of novel technologies to reach the optimal research standard, there is enough reason be optimistic about the future of proteomic research and its clinical implications.
Publisher: Georg Thieme Verlag KG
Date: 28-09-2022
DOI: 10.1055/A-1952-2135
Abstract: Background and study aims The increase in hepaticojejunostomies has led to an increase in benign strictures of the anastomosis. Double balloon enteroscopy-assisted ERCP (DBE-ERCP) and percutaneous transhepatic biliary drainage (PTBD) are treatment options however, there is lack of long-term outcomes, with no consensus on management. We performed a retrospective study assessing the outcomes of patients referred for endoscopic management of hepaticojejunostomy anastomotic strictures (HJAS). Patients and methods All consecutive patients at a tertiary institution underwent endoscopic intervention for suspected HJAS between 2009 and 2021 were enrolled. Results Eighty-two subjects underwent DBE-ERCP for suspected HJAS. The technical success rate was 77 % (63/82). HJAS was confirmed in 41 patients. The clinical success rate for DBE-ERCP ± PTBD was 71 % (29/41). DBE-ERCP alone achieved clinical success in 49 % of patients (20/41). PTBD was required in 49 % (20/41). Dual therapy was required in 22 % (9/41). Those with liver transplant had less technical success compared to other surgeries (72.1 % vs 82.1 % P = 0.29), less clinical success with DBE-ERCP alone (40 % vs 62.5 % P = 0.16) and required more PTBD (56 % vs 37.5 % P = 0.25). All those with ischemic biliopathy (n = 9) required PTBD for clinical success, required more DBE-ERCP (4.4 vs 2.0, P = 0.004), more PTBD (4.7 vs 0.3, P 0.0001), longer treatment duration (181.6 vs 99.5 days P = 0.12), and had higher rates of recurrence (55.6 % vs 30.3 % P = 0.18) compared to those with HJAS alone. Liver transplant was the leading cause of ischemic biliopathy (89 %). The overall adverse event rate was 7 %. Conclusions DBE-ERCP is an effective diagnostic and therapeutic tool in those with altered gastrointestinal anatomy and is associated with low complication rates.
Publisher: Society of Gastrointestinal Intervention
Date: 31-07-2020
DOI: 10.18528/IJGII200019
Publisher: Springer International Publishing
Date: 2021
Publisher: Georg Thieme Verlag KG
Date: 10-10-2022
DOI: 10.1055/A-1936-3243
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2019
Publisher: Georg Thieme Verlag KG
Date: 10-2019
DOI: 10.1055/A-0950-9554
Abstract: Background and study aims Diagnostic sensitivity for indeterminate biliary lesions remains suboptimal. Cytology techniques may mitigate the impediment of small cholangioscopic specimens. Our primary aim was to compare cell block cytology (CB) with standard histology for foregut SpyBite (SB) specimens. Our secondary aim was to assess CB in biliary SB biopsies. Patients and methods This was a two-phase prospective pilot study. In phase one, a prospective pilot study, foregut SB specimens from three sites (4 per site per patient per processing technique) were allocated to CB or histology, and assessed by a single, blinded pathologist. The gold standard comprised two standard forceps (CFB) histological specimens per site per patient. Specimen ease of processing, size and number, adequacy for diagnosis and artefact were evaluated. In phase two, CB was used for consecutive patients with indeterminate biliary lesions, and compared with phase one CB results. Results In phase one, 240 SB foregut biopsies were performed in 10 patients, 227 specimens recorded by pathologist. Specimen origin was identified in 100 % and 97 % of histology and CB batches respectively. Specimens were significantly larger in the histology group (2.02 mm vs 1.49 mm, P 0.05). There was a trend to less crush artifact with CB, and no difference in processing difficulty. In phase two, 11 patients (63.0 ±12.7 years, 91 % female) underwent SpyGlass (SG) assessment of suspected indeterminate stricture (n = 8) or mass (n = 3), and six underwent SB. All CB specimens were adequate for diagnosis. Specimen parameters were not significantly different from luminal CB outcomes. Conclusions In this pilot study, cell block cytology showed similar results as histological analysis of SpyBite specimens in the analysis of biliary stricture.
Publisher: Wiley
Date: 06-2022
DOI: 10.1111/IMJ.15807
Publisher: Springer Science and Business Media LLC
Date: 20-03-2021
Publisher: Public Library of Science (PLoS)
Date: 30-01-2013
Publisher: BMJ
Date: 12-2021
DOI: 10.1136/BMJGAST-2021-000806
Abstract: Ménétrier’s disease (MD) is a rare gastropathy characterised by giant rugal folds which can present with nausea, vomiting, abdominal pain and protein losing gastropathy. We report a 21-year-old woman with comorbid MD and ulcerative colitis (UC). Management was complicated by limited treatment options for MD, significant symptom burden, worsening nutrition and difficulty determining which disease was the predominant cause of symptoms. Since age 18 the patient experienced recurrent UC flares characterised by diarrhoea, persistent vomiting and corticosteroid dependence. Endoscopic assessment demonstrated concurrent MD and active UC. Octreotide and cetuximab were trialled given persistent hypoalbuminaemia and suspicion for MD associated protein-losing gastropathy. UC management comprised dose-optimised infliximab and methotrexate. Repeat endoscopic assessment demonstrated improvement in UC without corresponding improvement in symptoms or hypoalbuminaemia. Nasojejunal feeding and parenteral nutrition failed to significantly improve nutritional status and accordingly the patient proceeded to radical total gastrectomy. Postoperatively, MD-associated symptoms and hypoalbuminemia resolved completely.
No related grants have been discovered for Mark Bonnichsen.