Bio

Clinical Focus


  • Anesthesia

Academic Appointments


Professional Education


  • Residency: Stanford University Anesthesiology Residency (2020) CA
  • Internship: Stanford University Internal Medicine Residency (2017) CA
  • Medical Education: University of Southern California Keck School of Medicine Registrar (2016) CA
  • BS, Johns Hopkins University, Public Health (2012)

Publications

All Publications


  • Anesthesia considerations for robotic thoracic surgery VIDEO-ASSISTED THORACIC SURGERY Ruan, A., Kulkarni, V. 2020; 5
  • Multipoint Kras oncogene mutations potentially indicate mucinous carcinoma on the entire spectrum of mucinous ovarian neoplasms ONCOTARGET Lee, Y., Lee, M., Ruan, A., Chen, C., Liu, H., Wang, C., Chao, W., Han, C. 2016; 7 (50): 82097-82103

    Abstract

    Kras mutation is a common phenomenon in many human neoplasms. We aimed to assess the Kras mutational status along the histological continuum from normal ovaries to the development of benign, borderline and malignant ovarian mucinous neoplasms. We analyzed 41 cases of malignant, 10 cases of borderline, 7 cases of benign mucinous ovarian tumors and 7 cases of normal ovarian tissue. The prevalence of Kras mutations in the normal ovary was 0.00% (n=0/7), while the prevalence in benign, borderline and malignant mucinous neoplasms was 57.14% (n=4/7), 90.00% (n=9/10) and 75.61% (n=31/41), respectively. Multiple Kras mutations were detected in 6 cases of mucinous carcinoma, including 5 double mutations with G13D/V14I (n=1), G12V/G13S (n=1), G12D/G13S (n=3) and one triple mutation with A11V/G13N/V14I (n=1). We identified six cases with 3 novel Kras mutations not previously described in the COSMIC database, which included A11V (n=3) and V14I (n=2) in mucinous carcinomas, and A11T (n=1) in a mucinous borderline tumor. In conclusion, Kras mutation appears to be one of the imperative events in the ovarian mucinous adenoma-borderline tumor-carcinoma sequence, as increased numbers of Kras mutations have been shown to be the strongest predictor of unequivocal malignancy in ovarian mucinous neoplasms.

    View details for DOI 10.18632/oncotarget.13449

    View details for Web of Science ID 000391352800014

    View details for PubMedID 27888800

    View details for PubMedCentralID PMC5347677

  • Brief Report: Macrophage Activation in HIV-Infected Adolescent Males Contributes to Differential Bone Loss by Sex: Adolescent Trials Network Study 021. Journal of acquired immune deficiency syndromes (1999) Ruan, A., Tobin, N. H., Mulligan, K., Rollie, A., Li, F., Sleasman, J., Aldrovandi, G. M. 2016; 72 (4): 372?75

    Abstract

    Accumulating evidence suggests that rates of low bone mass are greater in HIV-infected males than females. Of 11 biomarkers assessed by sex and HIV-status, HIV-infected males had increased levels of soluble CD14 which inversely correlated with bone mineral content and bone mineral density measures, suggesting macrophage activation as a possible mechanism of differential bone loss.

    View details for DOI 10.1097/QAI.0000000000000953

    View details for PubMedID 26885808

    View details for PubMedCentralID PMC4925249

  • A promising hypothesis of c-KIT methylation/ expression paradox in c-KIT (+) squamous cell carcinoma of uterine cervix ----- CTCF transcriptional repressor regulates c-KIT proto-oncogene expression. Diagnostic pathology Chang, S. W., Chao, W. R., Ruan, A., Wang, P. H., Lin, J. C., Han, C. P. 2015; 10: 207

    Abstract

    We recently reported one interesting case showing mutation-free c-KIT proto-oncogene overexpression and paradoxical hypermethylation in 54 cases of primary squamous cell carcinoma of uterine cervix (SCC). However, its molecular mechanisms still remain unknown. We propose the hypothesis that increased methylation at the CpG islands on the promoter near the first exon region might interfere with the binding of CTCF repressor with c-KIT promoter that regulates c-KIT proto-oncogene expression in such case. Further studies focusing on the status of epigenetic modifications of mutation-free c-KIT (+) tumors are encouraged.

    View details for DOI 10.1186/s13000-015-0438-2

    View details for PubMedID 26607501

    View details for PubMedCentralID PMC4660683

  • Assessment of HER2 Status Using Immunohistochemistry (IHC) and Fluorescence In Situ Hybridization (FISH) Techniques in Mucinous Epithelial Ovarian Cancer: A Comprehensive Comparison between ToGA Biopsy Method and ToGA Surgical Specimen Method. PloS one Chao, W. R., Lee, M. Y., Ruan, A., Sheng, H. P., Hsu, J. D., Han, C. P., Koo, C. L. 2015; 10 (11): e0142135

    Abstract

    We aimed to compare the assay performance characteristics of HER2 status in mucinous epithelial ovarian cancer (EOC) by ToGA (Trastuzumab for Gastric Cancer) biopsy versus ToGA surgical specimen methods. Forty-nine tissue microarray (TMA) samples of mucinous EOC from Asian women were analyzed by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) tests using ToGA trial HER2 scoring methods. The overall concordance between IHC and FISH by the ToGA surgical specimen method is 97.56% and by the ToGA biopsy specimen method is 97.14%. The agreements of HER2 IHC results under both biopsy and surgical specimen methods were nearly perfect (weighted kappa = 0.845). Additionally, the percentage of Her2 FISH amplification showed increasing trend with increasing HER2 IHC ordinals (negative, equivocal, positive) by both TOGA biopsy (P<0.001) and surgical specimen method (P<0.001). After excluding equivocal cases, the sensitivity (100%), PPV (88.89%) and NPV (100%) of HER2 IHC were unchanged under either surgical specimen method or biopsy method. However, the specificity (96.97%) and accuracy (97.56%) of HER2 IHC was slightly higher under the surgical specimen method than those (specificity 96.30%, accuracy 97.14%) under the biopsy method. Of the total 49 cases, the number (n = 14) of HER2 IHC equivocal results under the ToGA biopsy method was 1.75-fold higher than those (n = 8) under the ToGA surgical specimen method (28.57% vs. 16.32%). Therefore, compared to ToGA surgery specimen method, the ToGA biopsy method caused more equivocal IHC cases to be referred to FISH testing and did not increase the detection rates of Her2 FISH amplification.

    View details for DOI 10.1371/journal.pone.0142135

    View details for PubMedID 26566289

    View details for PubMedCentralID PMC4643932

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