Lilah Fran Morris-Wiseman
- Clinical Assistant Professor, Surgery - (Clinical Series Track)
- Tulane University School of Medicine, New Orleans, Arizona, United States
- Post-Baccalaureate Science Certificate
- University of California (UCLA), Los Angeles, California, United States
- University of California, Los Angeles, California
- Department of General Surgery, The University of Arizona (2017 - Ongoing)
- Department of Surgery, The University of Arizona (2017 - Ongoing)
- Department of Surgery, The University of Arizona (2017 - 2019)
- Northwest Medical Center (2015 - 2017)
- Northwest Allied Physicians (2015 - 2017)
- Northwest Allied Physicians (2013 - 2017)
- American Journal Experts (2010 - 2011)
- Cedars-Sinai Medical Center (1999 - 2000)
- Health Care Advisory Board, Advisory Board Company (1995 - 1997)
- Alumni Scholarship
- University of California, Berkeley, Spring 1993
- University of California, Berkeley, Spring 1991
- Dean's Scholarship
- University of California, Berkeley, Spring 1992
- American College of Surgeons, Fellow
- American College of Surgeons, Fall 2018
- Certificate of Appreciate in Recognition of 2016-2017 contribution to the General Surgery Resident Cadaver Lab
- University of Arizona, Spring 2017
- Cancer Survivorship Poster Competition Winner
- MD Anderson Trainee Research Day, Spring 2013
- Travel Award Recipient
- American Association of Clinical Endocrinologists, Spring 2012
- Wilma Miley Morton Award for Research Performed During Residency
- Spring 2011
- Best Interesting Case Presentation
- American Association of Endocrine Surgeons, Spring 2010
- Multidisciplinary Endocrine Surgery Educational Videoconference
- The Jesse H Jones Fellowship in Cancer Education, MD Anderson Cancer Center, Spring 2010
- Radioactive Ablation (131I) for Thyroid Cancer
- Boris Catz Fellowship in Nuclear Medicine, Cedars-Sinai Medical Center, Spring 2010
- Student Fellowship Award, Society for Nuclear Medicine, Spring 2010
- Outstanding Student Teaching Award
- UCLA School of Medicine, Fall 2008
- UCLA School of Medicine, Fall 2007
- Harold Cummins Senior Award
- Tulane University School of Medicine, Fall 2004
- Richard Freeman Leadership Prize
- Tulane University School of Medicine, Fall 2004
- Arnold P. Gold Foundation Humanism is Medicine Honor Society
- Spring 2003
- Award for Quality of Research and Writing
- History of Medicine Society Willard L. Marmelzat Foundation, Fall 2002
Licensure & Certification
- American Board of Surgery Certified, American Board of Surgery (2012)
- Active Drug Enforcement Administration, Drug Enforcement Administration (2014)
- Arizona State Medical License, The Medical Board of Arizona (2013)
- Texas State Medical License, The Medical Board of Texas (2011)
- California State Medical License, The Medical Board of California (2006)
- Fundamentals of Laparoscopic Surgery (2010)
- Basic Life Support/Advanced Cardiovascular Life Support (2017)
No activities entered.
Endocrine SurgerySURG 847B (Fall 2020)
Endocrine Surg OncologySURG 847B (Fall 2019)
- Morris, R., & Morris-Wiseman, L. (2017). Multiple Endocrine Neoplasia. In Surgery Review Illustrated(pp 297-312). McGraw-Hill.
- Tuttle, F., Morris-Wiseman, L., Huagen, B., Shah, J., Sosa, J., Rohren, E., Subremaniam, R., Hunt, J., & Perrier, N. (2017). Thyroid- Differentiated and Anaplastic Carcinoma. In American Joint Committee on Cancer Cancer Staging Manual 8th Edition(pp 873-890). Springer International Publishing.
- Morris-Wiseman, L., & Hines, O. (2012). Ileus and Bowel Obstruction. In Gut Instincts: A Clinician's Handbook of Digestive and Liver Diseases(pp 193-198). Thorofare, NJ: SLACK Incorporated.
- Wiseman, J., Morris-Wiseman, L., & Yeh, M. (2011). Thyroid Imaging. In The Handbook of Endocrine Surgery(pp 15-25). World Scientific.
- Morris-Wiseman, L., & Yeh, M. (2010). Parathyroidectomy. In Illustrative Handbook of General Surgery(pp 23-28). Springer. doi:10.1007/978-1-84882-089-0
- Morris-Wiseman, L. (2002). Acting Without Limits: Profiles of Three Physically Disabled Performers. In Peering Behind the Curtain: Disability and the Extraordinary Body in Contemporary Theater(pp 95-106). New York, NY: Routledge.
- Morris-Wiseman, L., & Braunstein, G. (2001). Impact of Pregnancy on Normal Pituitary Function. In Pituitary Tumors in Pregnancy(pp 1-32). Los Angeles, CA: Springer. doi:10.1007/978-1-4615-1435-0_4
- Arora, T. K., Dent, D., Morris-Wiseman, L., & Nfonsam, V. (2019). Diversity in the Last Decade of the Association of Program Directors in Surgery: A Descriptive Analysis of Leadership and Future Directions. Journal of surgical education, 76(6), e125-e131.More infoThe Association of Program Directors in Surgery Diversity and Inclusion Taskforce (APDS-DIT) was created in 2017 after the Executive Committee recognized low diversity in its membership. The DIT was charged to address gaps in diversity and inclusion at various phases of training and development from medical student to surgical leader. The aim of this study was to examine APDS demographics and determine the status of inclusion of women, racial and ethnic minorities, and nonuniversity surgeons.
- Kay, M. D., Morris-Wiseman, L. F., Beazer, A., Winegar, B. A., & Kuo, P. H. (2019). Primary nasolacrimal duct obstruction visualized on I pre-ablation scan for papillary thyroid carcinoma. Journal of nuclear medicine technology.More infoA 56-year old male received a total thyroidectomy, bilateral central and right lateral neck dissection for papillary thyroid carcinoma with lymph nodes metastases. Prior to radioiodine ablation the pre-therapy I scan established the diagnosis of primary nasolacrimal duct obstruction (dacryostenosis).
- Price, E. T., Coverley, C. R., Arrington, A. K., Nfonsam, V. N., Morris-Wiseman, L., & Riall, T. S. (2019). Are We Making an Impact? A Qualitative Program Assessment of the Resident Leadership, Well-being, and Resiliency Program for General Surgery Residents. Journal of surgical education.More infoAfter implementing a formal resident well-being and resiliency program in our surgery residency, we performed in-depth qualitative interviews to understand residents' perceptions of: (1) the impact and benefits, (2) the essential elements for success, and (3) the desired changes to the well-being program.
- Nixon, I. J., Wang, L. Y., Migliacci, J. C., Eskander, A., Campbell, M. J., Aniss, A., Morris, L., Vaisman, F., Corbo, R., Momesso, D., Vaisman, M., Carvalho, A., Learoyd, D., Leslie, W. D., Nason, R. W., Kuk, D., Wreesmann, V., Morris, L., Palmer, F. L., , Ganly, I., et al. (2016). An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer. Thyroid : official journal of the American Thyroid Association, 26(3), 373-80.More infoAge is a critical factor in outcome for patients with well-differentiated thyroid cancer. Currently, age 45 years is used as a cutoff in staging, although there is increasing evidence to suggest this may be too low. The aim of this study was to assess the potential for changing the cut point for the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) staging system from 45 years to 55 years based on a combined international patient cohort supplied by individual institutions.
- Lee, S., Ryu, H., Morris, L. F., Grubbs, E. G., Lee, J. E., Harun, N., Feng, L., & Perrier, N. D. (2014). Operative failure in minimally invasive parathyroidectomy utilizing an intraoperative parathyroid hormone assay. Annals of surgical oncology, 21(6), 1878-83.More infoMinimally invasive parathyroidectomy (MIP) is a targeted operation to cure primary hyperparathyroidism utilizing intraoperative parathyroid hormone monitoring (IOPTH). The purpose of this study was to quantify the operative failure of MIP.
- Morris, L. F., Lee, S., Warneke, C. L., Abadin, S. S., Suliburk, J. W., Romero Arenas, M. A., Lee, J. E., Grubbs, E. G., & Perrier, N. D. (2014). Fewer adverse events after reoperative parathyroidectomy associated with initial minimally invasive parathyroidectomy. American journal of surgery, 208(5), 850-5.More infoThis study compared reoperative complication rates after initial minimally invasive parathyroidectomy and standard cervical exploration.
- Morris, L. F., Romero Arenas, M. A., Cerny, J., Berger, J. S., Borror, C. M., Ong, M., Cayo, A. K., Graham, P. H., Grubbs, E. G., Lee, J. E., & Perrier, N. D. (2014). Streamlining variability in hospital charges for standard thyroidectomy: Developing a strategy to decrease waste. Surgery, 156(6), 1441-9; discussion 1449.More infoWe assessed the efficiency, consistency, and appropriateness of perioperative processes for standard (total) thyroidectomy and devised a valuable strategy to decrease variability and waste.
- Romero Arenas, M. A., Morris, L. F., Rich, T. A., Cote, G. J., Grubbs, E. G., Waguespack, S. G., & Perrier, N. D. (2014). Preoperative multiple endocrine neoplasia type 1 diagnosis improves the surgical outcomes of pediatric patients with primary hyperparathyroidism. Journal of pediatric surgery, 49(4), 546-50.More infoPrimary hyperparathyroidism (PHPT) is uncommon in children. The surgical management of PHPT in children has evolved over the past two decades.
- Romero Arenas, M. A., Ryu, H., Lee, S., Morris, L. F., Grubbs, E. G., Lee, J. E., & Perrier, N. D. (2014). The role of thyroidectomy in metastatic disease to the thyroid gland. Annals of surgical oncology, 21(2), 434-9.More infoWhether thyroidectomy for metastases to the thyroid is associated with a survival benefit remains debatable; in general, palliation and disease control are accepted goals in this setting. We evaluated the clinical features and overall survival of patients with thyroid metastasis treated by thyroid resection or nonoperatively.
- Alex, G., Morris, L., Pasieka, J., & Perrier, N. (2013). Nonclassical symptoms of primary hyperparathyroidism and their response to parathyroidectomy. The American surgeon, 79(4), 337-43.More infoAn estimated 100,000 new patients are diagnosed with primary hyperparathyroidism (PHPT) each year in the United States. In the past, patients with PHPT typically presented with "stones, bones, abdominal groans, and psychic moans" but today patients often present with more subtle symptoms and physiologic changes associated with earlier stages of disease. Patients without the classic symptoms of PHPT are often referred to as "asymptomatic." These patients frequently pose a conundrum for clinicians. Uncertainties remain as to which symptoms truly represent PHPT and which are related to comorbidities or the aging process. To address these uncertainties, we review most recent literature regarding the nonclassical manifestations of PHPT and their response to parathyroidectomy.
- Morris, L. F., Harris, R. S., Milton, D. R., Waguespack, S. G., Habra, M. A., Jimenez, C., Vassilopoulou-Sellin, R., Lee, J. E., Perrier, N. D., & Grubbs, E. G. (2013). Impact and timing of bilateral adrenalectomy for refractory adrenocorticotropic hormone-dependent Cushing’s syndrome. Surgery, 154(6), 1174-83; discussion 1183-4.More infoIn patients with refractory adrenocorticotropic hormone-dependent Cushing’s syndrome,we evaluated steroidogenesis inhibition (SI) and bilateral adrenalectomy (BA) to predict which patients might benefit most from each treatment modality.
- Morris, L. F., Iupe, I. M., Edeiken-Monroe, B. S., Warneke, C. L., Hansen, M. O., Evans, D. B., Lee, J. E., Grubbs, E. G., & Perrier, N. D. (2013). Pre-operative ultrasound identification of thyroiditis helps predict the need for thyroid hormone replacement after thyroid lobectomy. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 19(6), 1015-20.More infoTo evaluate whether pre-operative thyroiditis identified by ultrasound (US) could help predict the need for thyroid hormone replacement (THR) following thyroid lobectomy.
- Morris, L. F., Waguespack, S. G., Edeiken-Monroe, B. S., Lee, J. E., Rich, T. A., Ying, A. K., Warneke, C. L., Evans, D. B., Perrier, N. D., & Grubbs, E. G. (2013). Ultrasonography should not guide the timing of thyroidectomy in pediatric patients diagnosed with multiple endocrine neoplasia syndrome 2A through genetic screening. Annals of surgical oncology, 20(1), 53-9.More infoAmerican Thyroid Association (ATA) guidelines suggest that thyroidectomy can be delayed in some children with multiple endocrine neoplasia syndrome 2A (MEN2A) if serum calcitonin (Ct) and neck ultrasonography (US) are normal. We hypothesized that normal US would not exclude a final pathology diagnosis of medullary thyroid cancer (MTC).
- Morris, L. F., & Perrier, N. D. (2012). Advances in robotic adrenalectomy. Current opinion in oncology, 24(1), 1-6.More infoWe review the development of robotic adrenalectomy over the last decade, focusing on specific technical advances in the last 18 months.
- Morris, L. F., Loh, C., Ro, K., Wiseman, J. E., Gomes, A. S., Asandra, A., Wariri, S., & Yeh, M. W. (2012). Non-super-selective venous sampling for persistent hyperparathyroidism using a systemic hypocalcemic challenge. Journal of vascular and interventional radiology : JVIR, 23(9), 1191-9.More infoTo describe a new protocol employing an acute systemic hypocalcemic challenge (SHC) aimed at augmenting the parathyroid hormone (PTH) gradient to enable non-super-selective venous sampling (VS) in patients with persistent primary hyperparathyroidism (PHPT).
- Morris, L. F., Waguespack, S. G., Warneke, C. L., Ryu, H., Ying, A. K., Anderson, B. J., Sturgis, E. M., Clayman, G. L., Lee, J. E., Evans, D. B., Grubbs, E. G., & Perrier, N. D. (2012). Long-term follow-up data may help manage patient and parent expectations for pediatric patients undergoing thyroidectomy. Surgery, 152(6), 1165-71.More infoWe investigated the incidence and impact of postoperative complications in children who underwent total thyroidectomy (TTx).
- Quatromoni, J. G., Wang, Y., Vo, D. D., Morris, L. F., Jazirehi, A. R., McBride, W., Chatila, T., Koya, R. C., & Economou, J. S. (2012). T cell receptor (TCR)-transgenic CD8 lymphocytes rendered insensitive to transforming growth factor beta (TGFβ) signaling mediate superior tumor regression in an animal model of adoptive cell therapy. Journal of translational medicine, 10, 127.More infoTumor antigen-reactive T cells must enter into an immunosuppressive tumor microenvironment, continue to produce cytokine and deliver apoptotic death signals to affect tumor regression. Many tumors produce transforming growth factor beta (TGFβ), which inhibits T cell activation, proliferation and cytotoxicity. In a murine model of adoptive cell therapy, we demonstrate that transgenic Pmel-1 CD8 T cells, rendered insensitive to TGFβ by transduction with a TGFβ dominant negative receptor II (DN), were more effective in mediating regression of established B16 melanoma. Smaller numbers of DN Pmel-1 T cells effectively mediated tumor regression and retained the ability to produce interferon-γ in the tumor microenvironment. These results support efforts to incorporate this DN receptor in clinical trials of adoptive cell therapy for cancer.
- Hong, J. C., Morris, L. F., Park, E. J., Ituarte, P. H., Lee, C. H., & Yeh, M. W. (2011). Transient increases in intraoperative parathyroid levels related to anesthetic technique. Surgery, 150(6), 1069-75.More infoParathyroid hormone (PTH) secretion is partially regulated by circulating catecholamines. We examined the effect of different anesthetic techniques on intraoperative PTH (IOPTH) levels in patients undergoing parathyroidectomy for primary hyperparathyroidism.
- Jimenez, J. C., Nassoura, Z., Morris, L. F., & Hu, D. (2011). Late traumatic aneurysm of the superficial temporal artery. Journal of vascular surgery, 54(4), 1174.
- Jimenez, J. C., Rafidi, F., & Morris, L. (2011). True celiac artery aneurysm secondary to median arcuate ligament syndrome. Vascular and endovascular surgery, 45(3), 288-9.More infoMedian arcuate ligament syndrome (MALS) is a rare disorder associated with chronic, postprandial abdominal pain and radiographic evidence of celiac artery compression. True arterial aneurysms distal to sites of chronic vascular compression due to post-stenotic dilatation have been described in other anatomic locations such as thoracic outlet syndrome and popliteal entrapment syndrome. We present the case of a patient who presented to vascular surgery clinic with a 35 year history of epigastric abdominal pain and bloating and was found to have a large celiac artery aneurysm with severe compression by the MAL.
- Levin, O., Morris, L. F., Wah, D. T., Butch, A. W., & Yeh, M. W. (2011). Falsely elevated plasma parathyroid hormone level mimicking tertiary hyperparathyroidism. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 17(2), e8-11.More infoTo report a case of misdiagnosed tertiary hyperparathyroidism attributable to heterophile antibody interference in a parathyroid hormone (PTH) assay.
- Morris, L. F., Park, S., Daskivich, T., Churchill, B. M., Rao, C. V., Lei, Z., Martinez, D. S., & Yeh, M. W. (2011). Virilization of a female infant by a maternal adrenocortical carcinoma. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists, 17(2), e26-31.More infoTo describe a possible mechanism underlying the partial virilization of a 46, XX infant by a functional maternal adrenocortical carcinoma (ACC).
- Quatromoni, J. G., Morris, L. F., Donahue, T. R., Wang, Y., McBride, W., Chatila, T., & Economou, J. S. (2011). T cell receptor transgenic lymphocytes infiltrating murine tumors are not induced to express foxp3. Journal of hematology & oncology, 4, 48.More infoRegulatory T cells (Treg) that express the transcription factor Foxp3 are enriched within a broad range of murine and human solid tumors. The ontogeny of these Foxp3 Tregs - selective accumulation or proliferation of natural thymus-derived Treg (nTreg) or induced Treg (iTreg) converted in the periphery from naïve T cells - is not known. We used several strains of mice in which Foxp3 and EGFP are coordinately expressed to address this issue. We confirmed that Foxp3-positive CD4 T cells are enriched among tumor-infiltrating lymphocytes (TIL) and splenocytes (SPL) in B16 murine melanoma-bearing C57BL/6 Foxp3(EGFP) mice. OT-II Foxp3(EGFP) mice are essentially devoid of nTreg, having transgenic CD4 T cells that recognize a class II-restricted epitope derived from ovalbumin; Foxp3 expression could not be detected in TIL or SPL in these mice when implanted with ovalbumin-transfected B16 tumor (B16-OVA). Likewise, TIL isolated from B16 tumors implanted in Pmel-1 Foxp3(EGFP) mice, whose CD8 T cells recognize a class I-restricted gp100 epitope, were not induced to express Foxp3. All of these T cell populations - wild-type CD4, pmel CD8 and OTII CD4 - could be induced in vitro to express Foxp3 by engagement of their T cell receptor (TCR) and exposure to transforming growth factor β (TGFβ). B16 melanoma produces TGFβ and both pmel CD8 and OTII CD4 express TCR that should be engaged within B16 and B16-OVA respectively. Thus, CD8 and CD4 transgenic T cells in these animal models failed to undergo peripheral induction of Foxp3 in a tumor microenvironment.
- Hwang, R. S., Morris, L. F., Ro, K., Park, S., Ituarte, P. H., Hong, J. C., & Yeh, M. W. (2010). A selective, Bayesian approach to intraoperative PTH monitoring. Annals of surgery, 251(6), 1122-6.More infoTo determine if the performance of intraoperative parathyroid hormone monitoring (IPM) can be optimized by limiting its application to patients with weak preoperative localization.
- Morris, L. F., Zanocco, K., Ituarte, P. H., Ro, K., Duh, Q. Y., Sturgeon, C., & Yeh, M. W. (2010). The value of intraoperative parathyroid hormone monitoring in localized primary hyperparathyroidism: a cost analysis. Annals of surgical oncology, 17(3), 679-85.More infoMinimally invasive parathyroidectomy (MIP) is the preferred approach to primary hyperparathyroidism (PHPT) when a single adenoma can be localized preoperatively. The added value of intraoperative parathyroid hormone (IOPTH) monitoring remains debated because its ability to prevent failed parathyroidectomy due to unrecognized multiple gland disease (MGD) must be balanced against assay-related costs. We used a decision tree and cost analysis model to examine IOPTH monitoring in localized PHPT.
- Morris, L. F., Zelada, J., Wu, B., Hahn, T. J., & Yeh, M. W. (2010). Parathyroid surgery in the elderly. The oncologist, 15(12), 1273-84.More infoThe prevalence of primary hyperparathyroidism (PHPT) is expected to increase in developed nations as the aged population grows. This review discusses issues related to PHPT in the elderly population with a focus on differences in disease presentation, medical and surgical management, and outcomes.
- Begley, J., Vo, D. D., Morris, L. F., Bruhn, K. W., Prins, R. M., Mok, S., Koya, R. C., Garban, H. J., Comin-Anduix, B., Craft, N., & Ribas, A. (2009). Immunosensitization with a Bcl-2 small molecule inhibitor. Cancer immunology, immunotherapy : CII, 58(5), 699-708.More infoSeveral tumor immunotherapy approaches result in a low percentage of durable responses in selected cancers. We hypothesized that the insensitivity of cancer cells to immunotherapy may be related to an anti-apoptotic cancer cell milieu, which could be pharmacologically reverted through the inhibition of antiapoptotic Bcl-2 family proteins in cancer cells. ABT-737, a small molecule inhibitor of the antiapoptotic proteins Bcl-2, Bcl-w and Bcl-x(L), was tested for the ability to increase antitumor immune responses in two tumor immunotherapy animal models. The addition of systemic therapy with ABT-737 to the immunization of BALB/c mice with tumor antigen peptide-pulsed dendritic cells (DC) resulted in a significant delay in CT26 murine colon carcinoma tumor growth and improvement in survival. However, the addition of ABT-737 to either a vaccine strategy involving priming with TRP-2 melanoma antigen peptide-pulsed DC and boosting with recombinant Listeria monocytogenes expressing the same melanoma antigen, or the adoptive transfer of TCR transgenic cells, did not result in superior antitumor activity against B16 murine melanoma. In vitro studies failed to demonstrate increased cytotoxic lytic activity when testing the combination of ABT-737 with lymphokine activated killer (LAK) cells, or the death receptor agonists Fas, TRAIL-ligand or TNF-alpha against the CT26 and B16 cell lines. In conclusion, the Bcl-2 inhibitor ABT-737 sensitized cancer cells to the antitumor effect of antigen-specific immunotherapy in a vaccine model for the CT26 colon carcinoma in vivo but not in two immunotherapy strategies against B16 melanoma.
- Ribas, A., Comin-Anduix, B., Economou, J. S., Donahue, T. R., de la Rocha, P., Morris, L. F., Jalil, J., Dissette, V. B., Shintaku, I. P., Glaspy, J. A., Gomez-Navarro, J., & Cochran, A. J. (2009). Intratumoral immune cell infiltrates, FoxP3, and indoleamine 2,3-dioxygenase in patients with melanoma undergoing CTLA4 blockade. Clinical cancer research : an official journal of the American Association for Cancer Research, 15(1), 390-9.More infoCTL-associated antigen 4 (CTLA4)-blocking monoclonal antibodies induce long-term regression of metastatic melanoma in some patients, but the exact mechanism is unknown. In this study, biopsies of selected accessible tumor lesions from patients treated with tremelimumab were examined to further elucidate the mechanism of its antitumor activity.
- Vo, D. D., Prins, R. M., Begley, J. L., Donahue, T. R., Morris, L. F., Bruhn, K. W., de la Rocha, P., Yang, M. Y., Mok, S., Garban, H. J., Craft, N., Economou, J. S., Marincola, F. M., Wang, E., & Ribas, A. (2009). Enhanced antitumor activity induced by adoptive T-cell transfer and adjunctive use of the histone deacetylase inhibitor LAQ824. Cancer research, 69(22), 8693-9.More infoTumors grow in the presence of antigen-specific T cells, suggesting the existence of intrinsic cancer cell escape mechanisms. We hypothesized that a histone deacetylase (HDAC) inhibitor could sensitize tumor cells to immunotherapy because this class of agents has been reported to increase tumor antigen expression and shift gene expression to a proapoptotic milieu in cancer cells. To test this question, we treated B16 murine melanoma with the combination of the HDAC inhibitor LAQ824 and the adoptive transfer of gp100 melanoma antigen-specific pmel-1 T cells. The combined therapy significantly improved antitumor activity through several mechanisms: (a) increase in MHC and tumor-associated antigen expression by tumor cells; (b) decrease in competing endogenous lymphocytes in recipient mice, resulting in a proliferative advantage for the adoptively transferred cells; and (c) improvement in the functional activity of the adoptively transferred lymphocytes. We confirmed the beneficial effects of this HDAC inhibitor as a sensitizer to immunotherapy in a different model of prophylactic prime-boost vaccination with the melanoma antigen tyrosinase-related protein 2, which also showed a significant improvement in antitumor activity against B16 melanoma. In conclusion, the HDAC inhibitor LAQ824 significantly enhances tumor immunotherapy through effects on target tumor cells as well as improving the antitumor activity of tumor antigen-specific lymphocytes.
- Morris, L. F., Ragavendra, N., & Yeh, M. W. (2008). Evidence-based assessment of the role of ultrasonography in the management of benign thyroid nodules. World journal of surgery, 32(7), 1253-63.More infoAlthough ultrasonographic (US) evaluation is currently recommended for the workup of all palpable thyroid nodules, little guidance exists regarding the manner in which US data are to be used. Herein, we examine the available evidence and recommend how US can be used most effectively to predict malignancy. We discuss the role of US-guided fine needle aspiration (FNA) and other special topics regarding US evaluation and management of benign nodules.
- Morris, L., Ituarte, P., Zarnegar, R., Duh, Q. Y., Ahmed, L., Lee, J., Inabnet, W., Meyer-Rochow, G., Sidhu, S., Sywak, M., & Yeh, M. (2008). Laparoscopic adrenalectomy after prior abdominal surgery. World journal of surgery, 32(5), 897-903.More infoCompared with the open procedure, laparoscopic adrenalectomy (LA) is associated with decreased operative time, perioperative complications, and hospital stay. Some regard prior abdominal surgery as a contraindication to LA or suggest a retroperitoneoscopic approach. We studied the effect of prior abdominal surgery on the feasibility and safety of transabdominal LA.
- Morris, L. F., & Ribas, A. (2007). Therapeutic cancer vaccines. Surgical oncology clinics of North America, 16(4), 819-31, ix.More infoTherapeutic cancer vaccines target the cellular arm of the immune system to initiate a cytotoxic T-lymphocyte response against tumor-associated antigens. Immunotherapy offers one of the few therapeutic options that reproducibly leads to a subset of patients with long-term remissions (seemingly cures) of widely metastatic disease. Therapeutic cancer vaccines tested in clinical trials have included inactivated tumor cells administered in immunological adjuvants or after genetic modification to increase their immunogenicity. Other forms are heat shock protein vaccines and anti-ganglioside antibodies. Tumor-associated antigenic peptides have been fully characterized for some cancers. Finally, strategies to directly expand antitumor T lymphocytes and adoptively transfer them to patients with cancer have been developed and shown to induce objective tumor regressions.
- Morris, L. F., Waxman, A. D., & Braunstein, G. D. (2003). Thyroid stunning. Thyroid : official journal of the American Thyroid Association, 13(4), 333-40.More infoDebates regarding thyroid stunning-a phenomenon whereby a diagnostic dose of radioiodine decreases uptake of a subsequent therapeutic dose by remnant thyroid tissue or by functioning metastases-have been fueled by inconsistent research findings. Quantitative studies evaluating radioiodine uptake and qualitative studies using visual observations both compare thyroid function on the diagnostic scan (DxSCAN) versus the posttreatment whole-body scan (RxWBS). The variability of findings may be the result of a lack of consensus in clinical nuclear medicine regarding many parameters of radioiodine usage including the need to obtain a pretreatment diagnostic scan, appropriate therapeutic dose, time between therapy dose administration and DxSCAN, and how successful ablation is measured. In the studies considered in this review, those that used (123)I rather than (131)I for DxSCAN, allowed less time to elapse between diagnostic and therapy dose, and more time between therapy dose and RxWBS (at least 1 week), did not observe stunning. However, groups that recognized stunning did not demonstrate any difference in outcomes (determined by successful first-time ablation). Whether stunning is a temporary phenomenon whereby stunned tissue eventually rejuvenates, or whether observed stunning actually constitutes "partial ablation," is yet to be delineated.
- Morris, L. F., Waxman, A. D., & Braunstein, G. D. (2002). Interlaboratory comparison of thyroglobulin measurements for patients with recurrent or metastatic differentiated thyroid cancer. Clinical chemistry, 48(8), 1371-2.
- Morris, L. F., Waxman, A. D., & Braunstein, G. D. (2001). The nonimpact of thyroid stunning: remnant ablation rates in 131I-scanned and nonscanned individuals. The Journal of clinical endocrinology and metabolism, 86(8), 3507-11.More infoThyroid stunning has been reported as the temporary impairment of thyroid tissue after a 111-MBq or greater diagnostic 131I dose that decreases the final absorbed dose in ablative therapy. Concerns regarding the reality of stunning have arisen in part due to a flawed study design in prior reports. To assess whether a stunning effect has any impact on therapeutic outcomes, we compared initial treatment ablation rates in patients who received 111- to 185-MBq 131I diagnostic scans (n = 37) before ablative doses of 3700-7400 MBq with ablation rates in patients who did not receive any 131I before the initial treatment dose (n = 63). Ablation rates were 64.9% for scanned patients and 66.7% for nonscanned patients, a nonsignificant difference. Nonscanned patients with metastatic lesions (n = 23) were ablated at a higher rate (78.3%) than scanned patients (n = 9) (66.7%), but the difference was not significant (P = 0.50). It is possible that the reported stunning phenomenon, specifically its impact in temporarily impairing tissue, has been overemphasized.
- Morris, L. F., Wilder, M. S., Waxman, A. D., & Braunstein, G. D. (2001). Reevaluation of the impact of a stringent low-iodine diet on ablation rates in radioiodine treatment of thyroid carcinoma. Thyroid : official journal of the American Thyroid Association, 11(8), 749-55.More infoPrior analyses of the impact of stringent, preablative low-iodine diets (LIDs) on ablation in patients with differentiated thyroid cancer postthyroidectomy are dated. We retrospectively reviewed first-time, short-term ablation rates for 44 LID patients and 50 patients following a regular diet (RD) who were verbally instructed to avoid salt, seafood, and multivitamins containing iodine. Patients who had undergone ablation were given between 100 and 200 mCi of 131I, depending on the presence of metastases. We found a 68.2% ablation rate for LID patients, compared to a 62.0% rate for RD patients, a nonsignificant difference (p = 0.53). We observed a dose-response relationship for both patient groups, with higher ablation rates corresponding to higher doses of radioiodine administered. We also measured iodine levels in spot urine samples from 7 matched LID patients and 7 matched RD adherents (healthy volunteers) prediet and postdiet as well as 39 healthy volunteers. LID patients had a lower mean urinary iodine level postdiet (173.9 microg/L; range, 45-1,217 microg/L; standard deviation [SD] = 127.7) than the RD patients (mean, 381.4 microg/L; range, 140-630 microg/L; SD = 196.3) or the 39 normal controls (444.0 microg/L; range, 50-1,690 microg/L; SD = 413.4). Whereas the LID lowered urinary iodine levels by 69.4% from prediet values, the RD reduced urinary iodine by 23.6%. Although differences in the reduction of urinary iodine levels between the LID and the RD were substantial, both groups experienced equivalent outcomes. The level of iodine in the American diet has progressively decreased, and may be much lower now than when prior LID studies were conducted. We suggest that prescribing a refined, less stringent diet that avoids high-iodine-containing foods would offer equivalent outcomes with increased patient convenience.
- Morris, L. F., Waxman, A. D., & Braunstein, G. D. (2000). Accuracy considerations when using early (four- or six-hour) radioactive iodine uptake to predict twenty-four-hour values for radioactive iodine dosage in the treatment of Graves' disease. Thyroid : official journal of the American Thyroid Association, 10(9), 779-87.More infoAlthough literature has offered methods to predict 24-hour radioactive iodine uptake values from early (4- to 6-hour) measurements, the resultant dosage errors have not been examined. Potential errors include underdosage, overdosage, and a failure to recognize rapid turnover patients (early-to-late uptake ratios > or = 1) who are at high risk for treatment failure and full-body radiation exposure. We developed and tested a novel method for minimizing error involved in using a single early uptake measurement to derive late uptake. From a retrospective analysis of 203 Graves' disease patients, receiver operating characteristic (ROC) curve analysis enabled us to identify patients likely to experience rapid turnover and therefore should receive 24-hour studies. Twenty-four-hour uptake measurements are necessary with 77% or more 4-hour uptake values and 80% or more 6-hour values. After eliminating these patients, we developed linear regression equations to predict the 24-hour uptake from 4-hour (n = 61) and 6-hour (n = 22) rule groups, testing their efficacy on separate 4-hour (n = 61) and 6-hour (n = 21) patient groups. We also used our test population to measure error in four early-to-late uptake conversion formulas presented in the literature. Error involved in these predictions ranged from a 10.6% overestimate for 4-hour calculations to a 5.9% underestimate for 6-hour calculations. When applied to two dosage formulas incorporating gland size, absorbed dose, and 24-hour uptake, average dosage error was 7%. In comparison to the other sources of error radioactive iodine (131I) dosimetry, potential error in predicting 24-hour uptake from 4- or 6-hour uptake values is low.
- Chang, M., & Morris-Wiseman, L. (2019, October). Thyroid Cancer in Pregnancy. American Thyroid Association Interesting Cases Panel Discussion. Chicago, IL: American Thyroid Association.
- Riall, T. S., Morris-Wiseman, L., Nfonsam, V. N., Aullery, A., Arrington, A., Coverley, C., & Price, E. (2019, Apr 2019). Qualitative Assessment of a Wellbeing and Resiliency Program for General Surgery Residents: Are we making an impact?. 2019 Association for Surgical Education (ASE) Annual Meeting. Chicago, IL: Association for Surgical Education.
- Borbon, L., & Morris-Wiseman, L. (2018, September). An unusual case of hypertension. Arizona Chapter, American College of Surgeons. Phoenix, AZ: American College of Surgeons.More infoAn Unusual Case of Hypertension. Presented by Luis Borbon, MS4. Interesting Case Presentation. Arizona Chapter, American College of Surgeons Annual Symposium. September 22, 2018. Phoenix, AZ.
- Morris-Wiseman, L. (2018, March). Defining the Spectrum of Differentiated Thyroid Cancer: A Clinical Perspective. American Thyroid Association Satellite Symposium. Chicago, IL: American Thyroid Association.
- Morris-Wiseman, L. (2018, October). Considerations of Neck Dissection in Differentiated Thyroid Cancer. E. Chester Ridgway Trainee Conference. Washington DC: American Thyroid Association.
- Morris-Wiseman, L. (2017, April 1). Life After Fellowship: Expanding Horizons. American Association of Endocrine Surgeons. Orlando, FL.
- Morris-Wiseman, L. (2014, April 28). Streamlining Variability in Hospital Charges for Standard Thyroidectomy: Developing a Waste-Reduction Strategy. American Association of Endocrine Surgeons. Boston, MA.
- Morris-Wiseman, L. (2013, April 15). Impact and Timing of Bilateral Adrenalectomy for Uncontrollable ACTH-Dependent Cushing Syndrome. American Association of Endocrine Surgeons. Chicago, IL.
- Morris-Wiseman, L. (2013, March 26). Fewer Adverse Events After Reoperative Parathyroidectomy Associated with Initial Minimally Invasive Parathyroidectomy. Southwestern Surgical Congress. Santa Barbara, CA.
- Morris-Wiseman, L. (2012, April 30). Long Term Follow Up Data May Help Manage Patient and Parent Expectations for Pediatric Patients Undergoing Thyroidectomy. American Associations of Endocrine Surgeons. Iowa City, IA.
- Morris-Wiseman, L. (2012, March 24). Ultrasound Should Not Guide the Timing of Thyroidectomy in Pediatric Patients Diagnosed with Multiple Endocrine Neoplasia Syndrome A through Genetic Screening. Society for Surgical Oncology. Orlando, FL.
- Morris-Wiseman, L. (2011, April). Transient Elevations in Intra-Operative PTH Levels Related to Anesthetic Technique. American Association of Endocrine Surgeons. Houston, TX.
- Morris-Wiseman, L. (2010, April). Tertiary Hyperparathyroidism?. American Association of Endocrine Surgeons. Pittsburgh, PA.
- Morris-Wiseman, L. (2009, February). Limited Value of Intraoperative PTH Monitoring in Localized Primary Hyperparathyroidism: A Cost Utility Analysis. Pacific Coast Surgical Associaiton. San Francisco, CA.
- Morris-Wiseman, L. (2008, April). Interesting Case Presentation. American Association of Endocrine Surgeons. Monterey, CA.
- Morris-Wiseman, L. (2012, May 26). Preoperative Ultrasonographic Thyroiditis Helps Predict the Need for Thyroid Hormone Replacement (THR) After Thyroid Lobectomy. American Association of Clinical Endocrinologists. Philadelphia, PA.
- Morris-Wiseman, L. (2009, May). When Should Intraoperative Parathyroid Hormone Monitoring Be Used? Always? Never, or Sometimes?. American Association or Endocrine Surgeons. Madison, WI.