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| 1 | Appropriateness of systemic treatments in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors显示文摘AIM:To evaluate systemic treatment choices in unresectable metastatic well-differentiated pancreatic neuroendocrine tumors(PNETs)and provide consensus treatment recommendations.METHODS:Systemic treatment options for pancreatic neuroendocrine tumors have expanded in recent years to include somatostatin analogs,angiogenesis inhibitors,inhibitors of mammalian target of rapamycinand cytotoxic agents.At this time,there is little data to guide treatment selection and sequence.We therefore assembled a panel of expert physicians to evaluate systemic treatment choices and provide consensus treatment recommendations.Treatment appropriateness ratings were collected using the RAND/UCLA modified Delphi process.After studying the literature,a multidisciplinary panel of 10 physicians assessed the appropriateness of various medical treatment scenarios on a 1-9 scale.Ratings were done both before and after an extended discussion of the evidence.Quantitative measurements of agreement were made and consensus statements developed from the second round ratings.RESULTS:Specialties represented were medical and surgical oncology,interventional radiology,and gastroenterology.Panelists had practiced for a mean of15.5 years(range:6-33).Among 202 rated scenarios,disagreement decreased from 13.2%(26 scenarios)before the face-to-face discussion of evidence to 1%(2)after.In the final ratings,46.5%(94 scenarios)were rated inappropriate,21.8%(44)were uncertain,and30.7%(62)were appropriate.Consensus statements from the scenarios included:(1)it is appropriate to use somatostatin analogs as first line therapy in patients with hormonally functional tumors and may be appropriate in patients who are asymptomatic;(2)it is appropriate to use everolimus,sunitinib,or cytotoxic chemotherapy therapy as first line therapy in patients with symptomatic or progressive tumors;and(3)beyond first line,these same agents can be used.In patients with uncontrolled secretory symptoms,octreotide LAR doses can be titrated up to 60 mg every4 wk or up to 40 mg every 3 or 4 wk.CONCLUSION:Using the Delphi process allowed physician experts to systematically obtain a consensus on the appropriateness of a variety of medical therapies in patients with PNETs. | Jonathan R Strosberg George A Fisher Al B Benson Lowell B Anthony Bulent Arslan John F Gibbs Edward Greeno Renuka V Iyer Michelle K Kim William J Maples Philip A Philip Edward M Wolin Dasha Cherepanov Michael S Broder | 2015 | World Journal of Gastroenterology2015，21，8： | 2 |
| 2 | Assessment of the diagnostic performance and interobserver variability of endocytoscopy in Barrett's esophagus:A pilot ex-vivo study显示文摘AIM:To investigate a classification of endocytoscopy(ECS)images in Barrett’s esophagus(BE)and evaluate its diagnostic performance and interobserver variability.METHODS:ECS was applied to surveillance endoscopic mucosal resection(EMR)specimens of BE ex-vivo.The mucosal surface of specimen was stained with 1%methylene blue and surveyed with a catheter-type endocytoscope.We selected still images that were most representative of the endoscopically suspect lesion and matched with the final histopathological diagnosis to accomplish accurate correlation.The diagnostic performance and inter-observer variability of the new classification scheme were assessed in a blinded fashion by physicians with expertise in both BE and ECS and inexperienced physicians with no prior exposure to ECS.RESULTS:Three staff physicians and 22 gastroenterology fellows classified eight randomly assigned unknown still ECS pictures(two images per each classification)into one of four histopathologic categories as follows:(1)BEC1-squamous epithelium;(2)BEC2-BE without dysplasia;(3)BEC3-BE with dysplasia;and(4)BEC4-esophageal adenocarcinoma(EAC)in BE.Accuracy of diagnosis in staff physicians and clinical fellows were,respectively,100%and 99.4%for BEC1,95.8%and83.0%for BEC2,91.7%and 83.0%for BEC3,and95.8%and 98.3%for BEC4.Interobserver agreement of the faculty physicians and fellows in classifying each category were 0.932 and 0.897,respectively.CONCLUSION:This is the first study to investigate classification system of ECS in BE.This ex-vivo pilot study demonstrated acceptable diagnostic accuracy and excellent interobserver agreement. | Yutaka Tomizawa Prasad G Iyer Louis M Wongkeesong Navtej S Buttar Lori S Lutzke Tsung-Teh Wu Kenneth K Wang | 2013 | World Journal of Gastroenterology2013，19，46： | 2 |
| 3 | Contribution of angiotensin-(1-7) to blood pressure regulation in salt-depleted hypertensive rats显示文摘 | IYER S N AVERILL D B CHAPPELL M C | 2000 | Hypertension2000，36，3： | 1 |
| 4 | Estrogen receptor-[alpha] signaling in osteoblast progenitors stimulates cortical bone accrual显示文摘 | Almeida Maria Iyer Srividhya Martin-Millan Marta Bartell Shoshana M Han Li Ambrogini Elena Onal Melda Xiong Jinhu Weinstein Robert S Jilka Robert L O’Brien Charles A Manolagas Stavros C | 2013 | Journal of Clinical Investigation2013，，1： | 1 |
| 5 | Anti-inflammatory effects of mesenehymal stem cells: novel concept for future therapies显示文摘 | IYER S S ROJAS M | 2008 | Expert Opin Biol Ther2008，8，5： | 1 |
| 6 | The effect of emergency depart- ment crowding onpatient satisfaction for admitted patients 显示文摘 | Pines JM Iyer S Disbot M | 2008 | Acad Emerg Med2008，15，9： | 1 |
| 7 | Phenazine-1-carboxylic acid,a secondary metabolite of Pseudomonas aeruginosa,alters expression of immunomodulatory proteins by human airway epithelial cells显示文摘 | Denning G M Iyer S S Reszka K J | 2003 | Am J Physiol Lung Cell Mol Physiol2003，285，： | 1 |
| 8 | Targeting TGF beta signaling for cancer cancer therapy显示文摘 | Iyer S Wang Z Akhtari M | 2005 | Biol Ther2005，4，3： | 1 |
| 9 | Evaluation of pro- collagen I deposition after intense pulsed light treatments at varying parameters in a porcine model 显示文摘 | Iyer S Carranza D Kolodney M | 2007 | J Cosmet Laser Ther2007，9，2： | 1 |
| 10 | Social capital, economic growth and regional development 显示文摘 | Iyer S Kitson M Toh B | 2005 | Regional Studies2005，39，8： | 1 |
| 11 | Genome intruder scanning and modulation systems and transgene silencing显示文摘 | KUMPATLA S P CHANDRASEKHARAN M B IYER L M LI G HALL T C | 1998 | Trends Plant Science1998，3，3： | 1 |
| 12 | Extracranial vertebral artery stent placement:in-hospital and follow-up results显示文摘 | Chastain H D 2nd Campbell M S Iyer S | 1999 | J Neurosurg1999，91，4： | 1 |
| 13 | Morphology,thermomechanical properties, and biodegradability of low density polyethylene/starch blends 显示文摘 | Thakore I M Iyer S Desal A | 1999 | Journal of Applied Polymer Science1999，74，： | 1 |
| 14 | Ge- nome intruder scanning and modulation systems and trans gene silencing 显示文摘 | Kumpatla S P Chandrasekharan M B Iyer L M | 1998 | Trends in Plant Science1998，3，3： | 1 |
| 15 | Impact of immune escape mutations on HIV-1fitness in the context of the cognate transmitted/founder genome显示文摘 | Song H Pavlicek J W Cai F Bhattacharya T Li H Iyer S S Bar K J Decker J M Goonetilleke N Liu M K Berg A Hora B Drinker M S Eudailey J Pickeral J Moody M A Ferrari G McMichael A Perelson A S Shaw G M Hahn B H Haynes B F Gao F | 2012 | Retrovirology2012，9，： | 1 |
| 16 | Converting enzyme determines plasma clearance of angiotensin ( 1 7 )显示文摘 | Yamada K Iyer S N Chappell M C | 1998 | Hypertension1998，32，3： | 1 |
| 17 | Anti - inflammatory effects of mesenchymal stem cells: novel concept for future therapies 显示文摘 | Iyer S Roja M | 2008 | Expert Opin Biol Ther2008，8，： | 1 |
| 18 | Feature-based fuzzy classification for interpretation of mammograms显示文摘 | Iyer N S Kandel A Schneider M | 2000 | Fuzzy Sets and Systems2000，，114： | 1 |
| 19 | Long term switching to low-tar, low-nicotine cigarettes 显示文摘 | Russell M A S R Sutton R Iyer | 1982 | Br J Addict1982，77，： | 1 |
| 20 | Synthesis of Si1-yGey alloys by molecular beam epitaxy 显示文摘 | Iyer S S Eberl K Goorsky M S | 1992 | Appl Phys Lett1992，60，3： | 1 |
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