Bio

Clinical Focus


  • Obstetrics and Gynecology

Education & Certifications


  • Residency:Stanford University Obstetrics and Gynecology Residency (2019) CA
  • Medical Education:University of California at San Francisco School of Medicine (2015) CA
  • MD, University of California, San Francisco (2015)
  • MBA, Duke University - Fuqua School of Business (2014)
  • BA, University of California, Berkeley, Political Economy of Industrial Societies & Public Health (2007)

Publications

All Publications


  • Peroxisome proliferator-activated receptor gamma agonist as a novel treatment for interstitial cystitis: A rat model. Investigative and clinical urology Mahal, A., Young-Lin, N., Dobberfuhl, A., Estes, J., Comiter, C. V. 2018; 59 (4): 257?62

    Abstract

    Purpose: To understand the therapeutic potential of pioglitazone, a peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonist with a propensity to cause bladder mucosal proliferation, on interstitial cystitis (IC) in a rat model.Materials and Methods: Using a previously described animal model for IC, Sprague-Dawley rats were treated with biweekly cyclophosphamide injections (35 mg/kg) to induce cystitis. Animals were divided into 4 groups (n=6 for each group): IC plus daily sham saline gavage (IC+Pio-), IC plus daily pioglitazone gavage (15 mg/kg) (IC+Pio+), normal rats with daily pioglitazone (IC-Pio+), and normal rats with neither IC nor pioglitazone (IC-Pio- or Control). At the end of four weeks, urinary frequency and bladder capacity were measured. Histologic examination of urothelial integrity was also performed.Results: Average voids per hour were significantly lower in IC+Pio+ (4.01.9) vs. IC+Pio- (10.02.4) rats (p<0.01) and were similar to IC-Pio+ (6.01.4) and IC-Pio- (6.01.5) controls. Cystometric capacity was significantly higher in IC+Pio+ (0.9450.122 mL) vs. IC+Pio- rats (0.5880.165 mL, p=0.01) and was comparable to IC-Pio- capacity (0.8170.196 mL) and IC-Pio+ capacity (0.9410.188 mL). Urothelial structural integrity was improved in IC+Pio+ rats versus IC+Pio- rats upon histologic observation.Conclusions: Pioglitazone, a PPAR-gamma agonist, improved bladder function in cyclophosphamide-induced cystitis by both observed urinary frequency and measured cystometric capacity. Urothelial structural integrity was also improved. Pioglitazone, due to a propensity to cause bladder mucosal proliferation, may prove useful for treating IC, and deserves further investigation.

    View details for PubMedID 29984341

  • THE PREVALENCE OF PELVIC FLOOR DISORDERS IN ACTIVE DUTY FEMALE SOLDIERS: DATA FROM THE STANFORD MILITARY DATA REPOSITORY Rogo-Gupta, L., Nelson, D., Young-Lin, N., Shaw, J., Kurina, L. WILEY. 2018: S567?S568
  • Fetal intolerance to labor in pregnancies complicated by marginal and eccentric cord insertion Young-Lin, N., Lutz, A., Leon-Martinez, D., Ye, C., Torosis, M., Jazayeri, Y., Pugh, B., Bianco, K. MOSBY-ELSEVIER. 2018: S285
  • The economic impact of surgical care for morbidly obese endometrial cancer patients: a nationwide study. American journal of obstetrics and gynecology Brooks, R. A., Blansit, K., Young-Lin, N., Usach, I., Chen, L. M., Yu, X., Kapp, D. S., Chan, J. K. 2016; 214 (4): 498 e1-6

    Abstract

    Obesity significantly impacts the cost of cancer treatment, yet the impact of morbid obesity on inpatient hospital charges related to endometrial cancer treatment is not well-defined.The purpose of this study was to determine the charges that are associated with inpatient surgery, hospitalization, and postoperative care of morbidly obese patients with endometrial cancer.Data were obtained from the National Inpatient Sample from 2010. Chi-square test, t-test, and linear regression were used for statistical analyses.Six thousand five hundred sixty patients who underwent hysterectomy for endometrial cancer were identified. Mean age was 62 years (range, 22-99 years). The majority were white (78%), and the remainder were black (10%), Hispanic, (8%), Asian (3%), and Native American (1%). Insurance types were private (45%), Medicare (45%), Medicaid (5%), and uninsured (7%). One thousand eighty-eight of these patients (17%) were coded as morbidly obese. The mean postoperative stay for the morbidly obese was 4.0 days (range, 0-46 days) compared with 3.5 days (range, 0-81 days) for the non-morbidly obese patients (P< .01). Morbidly obese patients required more intensive care with mechanical ventilation (5.5% vs 1.6%; P < .01). The median hospital charges were higher for morbidly obese patients compared with their counterparts ($46,654 vs $41,164; P < .01). After adjustment for charges that were associated with insurance type, hospital type, and the surgery that was performed, the incremental increase in hospital charges that were associated with treating the morbidly obese patient was $5096 per patient (95% confidence interval, $2593-$7598; P<.01).In this economic analysis, the health care charges that were associated with inpatient endometrial cancer treatment in the morbidly obese patient was significantly higher compared the non-morbidly obese patient. Resources are needed to support the needs of this population, and programs to encourage weight loss and optimize general health should be encouraged.

    View details for DOI 10.1016/j.ajog.2015.10.015

    View details for PubMedID 26478102

  • The Economic Impact of Surgical Care for Morbidly Obese Endometrial Cancer Patients: A Nationwide Study EDITORIAL COMMENT OBSTETRICAL & GYNECOLOGICAL SURVEY Brooks, R. A., Blansit, K., Young-Lin, N., Usach, I., Chen, L., Yu, X., Kapp, D. S., Chan, J. K. 2016; 71 (2): 78?79
  • TYPE I UTERINE CANCER IN US-BORN ASIANS VERSUS IMMIGRANT ASIANS Young-Lin, N., Simons, E., Blansit, K., Tsuei, T., Brooks, R., Ueda, S., Kapp, D. S., Chan, J. K. ELSEVIER SCI LTD. 2014: E66
  • Applications for Oncologic Drugs: A Descriptive Analysis of the Oncologic Drugs Advisory Committee Reviews ONCOLOGIST Chan, J. K., Kiet, T. K., Monk, B. J., Young-Lin, N., Blansit, K., Kapp, D. S., Amanam, I. 2014; 19 (3): 299-304

    Abstract

    Despite advances in cancer research, the majority of drug applications submitted to the U.S. Food and Drug Administration (FDA) are not approved. It is important to identify the concerns of the Oncologic Drugs Advisory Committee (ODAC) from rejected applications.All applications referred to the ODAC from 2001 to 2012 were reviewed.Of 46 applications, 31 (67%) were for full and 15 (33%) were for supplemental approval, 34 (74%) were for solid and 12 (26%) were for hematologic tumors. In all, 22 (48%) were not approved. ODAC comments addressed missing or inadequate data (65%), excessive toxicity (55%), inappropriate study endpoints (45%), poor study design (40%), and insufficient sample size (30%). To define efficacy, 19 applications used response rates (RR) (median = 38%), and 19 applications used hazard ratios (HR) (median = 0.67). For all organ systems combined, the median cumulative grade 3 or 4 toxicity was 64%. Drugs with higher RR, lower HR, and lower toxicity were more likely to be approved versus other drugs (89% vs. 45%; p = .02). Over time (2001-2004, 2005-2008, 2009-2012), there was an increase in the following: number of applications submitted for review (from 11 to 12 to 23, respectively), number of approvals (from 6 to 6 to 12, respectively), and proportion of trials using progression-free survival as a primary endpoint (from 0% to 50% to 70%, respectively; p = .01).Of all applications, common ODAC concerns included inadequate data, excessive toxicity, and inappropriate study endpoints. Over time, there was an approximate doubling of FDA application submissions and approved oncology drugs.

    View details for DOI 10.1634/theoncologist.2013-0276

    View details for PubMedID 24599479

  • Applications for oncologic drugs - Lessons from the oncologic drug advisory committee Amanam, I., Kiet, T., Young-Lin, N., Chen, L., Brooks, R., Ueda, S., Monk, B., Kapp, D., Hoth, D., Chan, J. ACADEMIC PRESS INC ELSEVIER SCIENCE. 2012: S13
  • Trends and progress of oncology drug development - An analysis of the FDA oncologic drug advisory committee reviews Amanam, I., Kiet, T., Young-Lin, N., Chen, L., Brooks, R., Ueda, S., Monk, B., Kapp, D., Hoth, D., Chan, J. ACADEMIC PRESS INC ELSEVIER SCIENCE. 2012: S11?S12
  • Predictive model for cancer drug approval - An analysis of FDA drug submissions over the last decade Amanam, I., Kiet, T., Young-Lin, N., Chen, L., Brooks, R., Ueda, S., Monk, B., Kapp, D., Hoth, D., Chan, J. ACADEMIC PRESS INC ELSEVIER SCIENCE. 2012: S13?S14
  • PROGRESS AND TRENDS FOR CANCER DRUG APPROVAL - AN ANALYSIS OF FDA ADVISORY COMMITTEE 37th Congress of the European-Society-for-Medical-Oncology (ESMO) Chan, J. K., Amanam, I., Kiet, T. K., Young-Lin, N., Hoth, D., Kapp, D. S., Monk, B. J. OXFORD UNIV PRESS. 2012: 460?460
  • An economic analysis of robotic versus laparoscopic surgery for endometrial cancer: Costs, charges and reimbursements to hospitals and professionals GYNECOLOGIC ONCOLOGY Venkat, P., Chen, L., Young-Lin, N., Kiet, T. K., Young, G., Amatori, D., Dasverma, B., Yu, X., Kapp, D. S., Chan, J. K. 2012; 125 (1): 237-240

    Abstract

    To determine the actual costs, charges, and reimbursements associated with robotic vs. laparoscopic surgery for endometrial cancer.Data were collected from hospital billing records, MD professional group billing records, tumor registry, and medical records on operations performed by a single surgeon from one institution between 2008 and 2010. For comparison, surgical groups were matched based on age, histology, and stage of disease over the same time period.Of 54 patients, 27 underwent robotic surgery (RS) and 27 had laparoscopic surgery (LS). The median age was 57 years. There were no statistically significant differences between the groups based on age, stage, and histology. The hospital charges for RS were higher at $64,266 vs. $55,130 for LS (p=0.036). However, the reimbursement to the hospital was not statistically different at $13,003 for RS and $10,245 for LS (p=0.29). Operating suite, room and board, anesthesia, post anesthesia care unit, and pathology accounted for over 90% of hospital charges. The surgeon charges for RS and LS were $6824 and $6327, respectively (p=0.033) and the anesthesiologist charges were $4049 and $2985, respectively (p=0.001). However, there were no differences in reimbursement to the surgeon (p=0.74) and anesthesiologist (p=0.84) between the two operative approaches.Our data showed that the direct costs and charges associated with robotic surgery were higher compared to laparoscopic surgery. However, actual reimbursements to the hospital, surgeon, and anesthesiologist were not significantly different between the two surgical approaches.

    View details for DOI 10.1016/j.ygyno.2011.11.036

    View details for Web of Science ID 000301879600042

    View details for PubMedID 22120176

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