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Chen CC, Chang SC, Chang YY, Lin BW, Chen HH, Hsieh YY, Hsu HC, Hsieh MC, Ke TW, Kuan FC, Wu CC, Lu WC, Su YL, Liang YH, Chen JB, Huang HY, Tsai HL, Wang JY. Survival benefit of metastasectomy in first-line cetuximab therapy in patients with RAS wild-type metastatic colorectal cancer: a nationwide registry. Am J Cancer Res 2023; 13:6333-6345. [PMID: 38187069 PMCID: PMC10767339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024] Open
Abstract
This multicenter study aimed to explore the survival benefit of metastasectomy by first-line cetuximab-based chemotherapy in real-world patients with RAS wild-type metastatic colorectal cancer (mCRC). The primary endpoints were overall survival (OS) and progression-free survival (PFS). The secondary endpoints included objective response rate (ORR), disease control rate (DCR), and metastasectomy rate. The exploratory endpoint was the optimal treatment cycle for better OS and PFS. Receiver operating characteristic curve with the area under curve (AUC) was used to identify the optimal cut-off cycle for survival outcomes. A total of 758 mCRC patients were enrolled in this study, with a median OS of 35.1 months, median PFS of 14.6 months, and metastasectomy rate of 21.4%. Left-sided mCRC had a significantly higher DCR (88.9% vs. 73.1%, P<0.001) and better OS (36.4 vs. 19.6 months, P<0.001). There were no significant differences in PFS and metastasectomy rate between left-sided and right-sided mCRC. However, mCRC patients who underwent metastasectomy over the course of treatment had better OS (54.9 vs. 28.6 months, P<0.001) and PFS (21.0 vs. 13.1 months, P<0.001) than those who did not. Notably, right-sided mCRC who benefited from first-line cetuximab-based chemotherapy to underwent metastasectomy also had favorable outcomes, on a par with left-sided mCRC. The optimal treatment cycle was 14 cycles (AUC: 0.779, P<0.001). Patients who received ≥14 cycles had higher metastasectomy rates (27.5% vs. 13.5%, P<0.001), favorable OS (42.6 vs. 23.4 months, P<0.001) and PFS (18.1 vs. 8.6 months, P<0.001), and, importantly, had comparable adverse events compared with patients who received <14 cycles of treatment. Patients who underwent metastasectomy after or during first-line cetuximab therapy have an improved OS in both left-sided and right-sided mCRC. Furthermore, patients receive ≥14 cycles of treatment whenever possible to achieve a higher likelihood of metastasectomy was associated with favorable survival outcomes.
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Affiliation(s)
- Chou-Chen Chen
- Department of Surgery, Taichung Veterans General HospitalTaichung, Taiwan
| | - Shih-Ching Chang
- Division of Colon and Rectal Surgery, Department of Surgery, Veterans General HospitalTaipei, Taiwan
| | - Yu-Yao Chang
- Department of Colorectal Surgery, Changhua Christian HospitalChanghua, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing UniversityTaichung, Taiwan
| | - Bo-Wen Lin
- Division of Colon and Rectal Surgery, Department of Surgery, National Cheng Kung University HospitalTainan, Taiwan
| | - Hong-Hwa Chen
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial HospitalKaohsiung, Taiwan
| | - Yao-Yu Hsieh
- Division of Hematology and Oncology, Shuang Ho Hospital, Taipei Medical UniversityNew Taipei City, Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical UniversityTaipei, Taiwan
| | - Hung-Chih Hsu
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at LinkouTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Meng-Che Hsieh
- Division of Hematology Oncology, Department of Internal Medicine, E-Da Hospital, I-Shou UniversityKaohsiung, Taiwan
| | - Tao-Wei Ke
- Division of Colorectal Surgery, Department of Surgery, China Medical University HospitalTaichung, Taiwan
| | - Feng-Che Kuan
- Department of Hematology and Oncology, Chang Gung Memorial HospitalChiayi, Taiwan
| | - Chih-Chien Wu
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General HospitalKaohsiung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
| | - Wei-Chen Lu
- Department of Oncology, National Taiwan University Hospital Yunlin BranchYunlin, Taiwan
| | - Yu-Li Su
- Division of Hematology Oncology, Department of Internal Medicine, Chang Gung Memorial HospitalKaohsiung, Taiwan
| | - Yi-Hsin Liang
- Department of Oncology, National Taiwan University HospitalTaipei, Taiwan
| | - Joe-Bin Chen
- Department of Surgery, Chung Shan Medical University HospitalTaichung, Taiwan
| | - Hsuan-Yuan Huang
- Department of Colorectal Surgery, Changhua Christian HospitalChanghua, Taiwan
| | - Hsiang-Lin Tsai
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityKaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical UniversityKaohsiung, Taiwan
| | - Jaw-Yuan Wang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityKaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical UniversityKaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical UniversityKaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical UniversityKaohsiung, Taiwan
- Center for Cancer Research, Kaohsiung Medical UniversityKaohsiung, Taiwan
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Peyrin-Biroulet L, Allegretti JR, Rubin DT, Bressler B, Germinaro M, Huang KHG, Shipitofsky N, Zhang H, Wilson R, Han C, Feagan BG, Sandborn WJ, Panés J, Hisamatsu T, Lichtenstein GR, Sands BE, Dignass A, Abrahamovych O, Afanasieva H, Aitova L, Altintas E, Altwegg R, Andreev P, Aomatsu K, Augustyn M, Balestrieri P, Begun J, Brunatto L, Bulgheroni D, Bunkova E, Cabello M, Cao Q, Caprioli F, Cerqueira R, Chen B, Chen CC, Chen CP, Chiu CT, Choi CH, Cicala M, Datsenko O, Dewint P, Domenech E, Dutré J, Duvall G, Fernandez J, Filip R, Fogel R, Fowler S, Fujii T, Fukata M, Furumoto Y, Gasbarrini A, Gawdis-Wojnarska B, Gilletta C, Gionchetti P, Goldin E, Golovchenko O, Gonciarz M, Gonen C, Segura GG, Gridnyev O, Gyokeres T, Hébuterne X, Hedin C, Hellström P, Hilmi IN, Horný I, Horvat G, Hoshi N, Hrdlicka L, Ishihara S, Ivanishyn O, Jang BI, Junior O, Kagaya T, Kanmura S, Karakina M, Katsuhiko N, Kierkus J, Kim HJ, Kim TO, Kim YH, Kiss GG, Klaus J, Kleczkowski D, Klopocka M, Kobayashi T, Kobielusz-Gembala I, Koo JS, Kopon A, Kravchenko T, Kudo M, Kwon KA, Lago P, Laharie D, Lawrance I, Leszczyszyn J, Li Y, Lukas M, Maaser C, Maemoto A, Marusawa H, McBride M, Mendu S, Miheller P, Miyabayashi H, Mohl W, Moore G, Motoya S, Murali N, Naem M, Nakajima K, Nakamoto Y, Nancey S, Neto J, Onizawa M, Ono Y, Ono Y, Osada T, Osipenko M, Owczarek D, Patel B, Patel K, Petrova E, Poroshina E, Portela F, Prystupa L, Rivero M, Roblin X, Romatowski J, Rydzewska G, Saibeni S, Sakuraba H, Samaan M, Schultz M, Schulze J, Sedghi S, Seidler U, Shin SJ, Stanislavchuk M, Stokesberry D, Suzuki T, Taguchi H, Tankova L, Thin L, Tkachev A, Torrealba L, Tsarynna N, Tulassay Z, Ueo T, Valuyskikh E, Vasilevskaya O, Viamonte M, Wei SC, Weisshof R, Wojcik K, Ye BD, Yen HH, Yoon H, Yoshida K, Yurkiv A, Zaha O, Zhan Q. Guselkumab in Patients With Moderately to Severely Active Ulcerative Colitis: QUASAR Phase 2b Induction Study. Gastroenterology 2023; 165:1443-1457. [PMID: 37659673 DOI: 10.1053/j.gastro.2023.08.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND & AIMS The QUASAR Phase 2b Induction Study evaluated the efficacy and safety of guselkumab, an interleukin-23p19 subunit antagonist, in patients with moderately to severely active ulcerative colitis (UC) with prior inadequate response and/or intolerance to corticosteroids, immunosuppressants, and/or advanced therapy. METHODS In this double-blind, placebo-controlled, dose-ranging, induction study, patients were randomized (1:1:1) to receive intravenous guselkumab 200 or 400 mg or placebo at weeks 0/4/8. The primary endpoint was clinical response (compared with baseline, modified Mayo score decrease ≥30% and ≥2 points, rectal bleeding subscore ≥1-point decrease or subscore of 0/1) at week 12. Guselkumab and placebo week-12 clinical nonresponders received subcutaneous or intravenous guselkumab 200 mg, respectively, at weeks 12/16/20 (uncontrolled study period). RESULTS The primary analysis population included patients with baseline modified Mayo scores ≥5 and ≤9 (intravenous guselkumab 200 mg, n = 101; 400 mg, n = 107; placebo, n = 105). Week-12 clinical response percentage was greater with guselkumab 200 mg (61.4%) and 400 mg (60.7%) vs placebo (27.6%; both P < .001). Greater proportions of guselkumab-treated vs placebo-treated patients achieved all major secondary endpoints (clinical remission, symptomatic remission, endoscopic improvement, histo-endoscopic mucosal improvement, and endoscopic normalization) at week 12. Among guselkumab week-12 clinical nonresponders, 54.3% and 50.0% of patients in the 200- and 400-mg groups, respectively, achieved clinical response at week 24. Safety was similar among guselkumab and placebo groups. CONCLUSIONS Guselkumab intravenous induction was effective vs placebo in patients with moderately to severely active UC. Guselkumab was safe, and efficacy and safety were similar between guselkumab dose groups. CLINICALTRIALS gov number: NCT04033445.
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Affiliation(s)
- Laurent Peyrin-Biroulet
- Department of Gastroenterology, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France;; INSERM, NGERE, University of Lorraine, F-54000 Nancy, France;; INFINY Institute, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France;; FHU-CURE, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France;; Groupe Hospitalier privé Ambroise Paré-Hartmann, Paris IBD center, 92200 Neuilly sur Seine, France;; Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jessica R Allegretti
- Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - David T Rubin
- University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, USA
| | | | | | | | | | - Hongyan Zhang
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | - Chenglong Han
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | | | - Julian Panés
- Hospital Clínic de Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain
| | | | | | - Bruce E Sands
- Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Axel Dignass
- Department of Medicine I, Agaplesion Markus Hospital, Goethe University, Frankfurt, Germany.
| | - Orest Abrahamovych
- Communal Nonprofit Enterprise of Lviv Regional Council 'Lviv Regional Clinical Hospital', Lviv, Ukraine
| | - Halyna Afanasieva
- Municipal Institution 'Kherson City Clinical Hospital n.a. Y.Y.Karabelesh', Kherson, Ukraine
| | - Lilia Aitova
- City Clinical Hospital # 21, Ufa, Bashkortostan, Respublika, Russian Federation
| | - Engin Altintas
- Mersin University Medical Faculty Hospital, Mersin, Turkey
| | | | - Pavel Andreev
- NUZ 'Railway Clinical Hospital on Samara station of LLC 'Russian Railways', Samara, Samarskaya oblast, Russian Federation
| | | | | | | | - Jakob Begun
- Mater Hospital, South Brisbane, Queensland, Australia
| | | | | | - Elena Bunkova
- Medical University Reaviz, Multidisciplinary clinic, Samara, Samarskaya oblast', Russian Federation
| | | | - Qian Cao
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Flavio Caprioli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Rute Cerqueira
- Centro Hospitalar de Entre o Douro e Vouga, E.P.E, Santa Maria da Feira, Aveiro, Portugal
| | - Baili Chen
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chou-Chen Chen
- Taichung Veterans General Hospital, Taichung, Taiwan, Province of China
| | - Chou-Pin Chen
- Taichung Veterans General Hospital, Taichung, Taiwan, Province of China
| | - Cheng-Tang Chiu
- Chang-Gung Memorial Hospital, LinKou Branch, Taoyuan, Taiwan, Province of China
| | - Chang Hwan Choi
- Chung-Ang University Hospital, Seoul, Dongjak-gu, Republic of Korea
| | | | - Olena Datsenko
- Communal Nonprofit Enterprise 'City Clinical Hospital # 2 N.A. Prof. O.O. Shalimov', Kharkiv, Ukraine
| | | | - Eugeni Domenech
- Hosp. Univ. Germans Trias I Pujol, Badalona, Catalonia, Spain
| | - Joris Dutré
- Algemeen Ziekenhuis Jan Palfijn Merksem, Merksem, Belgium
| | - George Duvall
- Tyler Research Institute, LLC, Tyler, Texas, United States
| | - Juan Fernandez
- Harmony Medical Research Institute, Inc., Hialeah, Florida, United States
| | | | - Ronald Fogel
- Clinical Research Institute of Michigan, LLC, Chesterfield, Michigan, United States
| | - Sharyle Fowler
- Royal University Hospital, Saskatoon, Saskatchewan, Canada
| | - Toshimitsu Fujii
- Tokyo Medical and Dental University Hospital, Bunkyo-Ku, Tokyo, Japan
| | | | - Yohei Furumoto
- Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo, Japan
| | | | | | | | | | - Eran Goldin
- Shaare Zedek Medical Center, Jerusalem, Israel
| | - Oleksandr Golovchenko
- Medical Center Ltd 'Health Clinic', Department Of General Therapy, Vinnytsya, Ukraine
| | | | - Can Gonen
- Acibadem Kozyatagi Hospital, Istanbul, Turkey
| | | | - Oleksii Gridnyev
- SI 'L.T. Maloyi National Institute of Therapy of National Academy of Medical Sciences of Ukraine', Kharkiv, Ukraine
| | - Tibor Gyokeres
- Magyar Honvedseg Egeszsegugyi Kozpont, Budapest, Hungary
| | | | | | | | | | - Ivo Horný
- Nemocnice Strakonice, a.s., Strakonice, Czechia
| | | | | | | | | | - Olha Ivanishyn
- Lviv Clinical Hospital on Railway Transport of Affiliate Healthcare center of JSC Ukrainian Railway, Lviv, Ukraine
| | - Byung Ik Jang
- Yeungnam University Hospital, Daegu, Daegu Gwang'yeogsi, Republic of Korea
| | - Odery Junior
- CDC - Centro Digestivo de Curitiba, Curitiba, Brazil
| | - Takashi Kagaya
- National Hospital Organization Kanazawa Medical Center, Kanazawa, Ishikawa, Japan
| | - Shuji Kanmura
- Kagoshima University Hospital, Kagoshima City, Kagoshima, Japan
| | - Marina Karakina
- Medical Center Meditsinskie Tekhnologii, Ekaterinburg, Russian Federation
| | | | | | - Hyo Jong Kim
- KyungHee University Hospital, Seoul, Republic of Korea
| | - Tae-Oh Kim
- Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Young-Ho Kim
- Samsung Medical Center, Seoul, Republic of Korea
| | - Gyula G Kiss
- Vasutegeszsegugyi Nonprofit Kozhasznu Kft Debreceni Kozpont, Debrecen, Hajdú-Bihar, Hungary
| | - Jochen Klaus
- Universitaetsklinikum Ulm, Ulm, Baden-Württemberg, Germany
| | | | - Maria Klopocka
- Szpital Uniwersytecki nr 2 im. dr. Jana Biziela w Bydgoszczy, Bydgoszcz, Poland
| | - Taku Kobayashi
- Kitasato University Kitasato Institute Hospital, Minato-ku, Tôkyô, Japan
| | | | - Ja Seol Koo
- Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
| | - Adam Kopon
- GASTROMED Kopon, Zmudzinski i wspolnicy SP.j., Specjalistyczne Centrum Gastrologii i Endoskopii, Torun, Poland
| | | | | | - Kwang An Kwon
- Gachon University Gil Medical Center, Incheon, Incheon Gwang'yeogsi, Republic of Korea
| | - Paula Lago
- Centro Hospitalar do Porto, EPE, Porto, Portugal
| | | | - Ian Lawrance
- St John of God Subiaco Hospital, Subiaco, WA, Australia
| | | | - Yan Li
- Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | | | | | | | | | - Matthew McBride
- Digestive Disease Specialists Inc, Oklahoma City, Oklahoma, United States
| | - Shoba Mendu
- Gastroenterology Associates of Tidewater, Chesapeake, Virginia, United States
| | | | - Hideharu Miyabayashi
- National Hospital Organization Matsumoto Medical Center, Matsumoto, Nagano, Japan
| | - Wolfgang Mohl
- Zentrum für Gastroenterologie Saar MVZ GmbH, Saarbrücken, Germany
| | | | - Satoshi Motoya
- Hokkaido P.W.F.A.C. Sapporo-Kosei General Hospital, Sapporo, Japan
| | - Narayanachar Murali
- Gastroenterology Associates of Orangeburg, Orangeburg, South Carolina, United States
| | - Mohammed Naem
- Northshore Gastroenterology Research, LLC, Westlake, Ohio, United States
| | | | | | | | - Joaquim Neto
- Sociedade Campineira de Educacao e Instrucao-Hospital e Maternidade Celso Pierro, Campinas, São Paulo, Brazil
| | | | - Yohei Ono
- Imamura General Hospital, Kagoshima, Japan
| | - Yohei Ono
- Kagoshima IBD Gastroenterology Clinic, Kagoshima, Japan
| | - Taro Osada
- Juntendo University Hospital Urayasu, Chiba, Japan
| | - Marina Osipenko
- Medical Center SibNovoMed LLC, Novosibirsk, Russian Federation
| | | | - Bhaktasharan Patel
- Peak Gastroenterology Associates, Colorado Springs, Colorado, United States
| | - Kamal Patel
- St George's Hospital, London, United Kingdom and Northern Ireland
| | - Elina Petrova
- OOO MO New Hospital, Ekaterinburg, Russian Federation
| | | | - Francisco Portela
- Centro Hospitalar e Universitário de Coimbra, EPE, Coimbra, Portugal
| | - Lyudmyla Prystupa
- Sumy State University, Sumy Regional Clinical Hospital, Sumy, Ukraine
| | | | - Xavier Roblin
- CHU Saint-Etienne-Hôpital Nord, Saint-Priest en Jarez, France
| | - Jacek Romatowski
- Gastromed Kralisz Romatowski Stachurska Sp. j., Bialystok, Poland
| | | | - Simone Saibeni
- Azienda Ospedaliera G.Salvini Ospedale di Rho, Rho, Milan, Italy
| | | | - Mark Samaan
- Guy's and St Thomas' Hospital, London, United Kingdom and Northern Ireland
| | | | | | - Shahriar Sedghi
- Gastroenterolgy Associates of Central GA, Macon, Georgia, United States
| | - Ursula Seidler
- Medizinische Hochschule Hannover, Hannover, Niedersachsen, Germany
| | - Sung Jae Shin
- Ajou University Hospital, Suwon, Gyeonggido, Republic of Korea
| | | | - David Stokesberry
- Digestive Disease Specialists Inc, Oklahoma City, Oklahoma, United States
| | | | | | | | - Lena Thin
- Fiona Stanley Hospital, Murdoch, WA, Australia
| | | | | | - Nataliia Tsarynna
- Medical Center 'Ok Clinic' of LLC 'International Institute of Clinical Studies', Kyiv, Ukraine
| | - Zsolt Tulassay
- Semmelweis Egyetem, Ii. Belgyogyaszati Klinika, Budapest, Hungary
| | | | | | | | - Manuel Viamonte
- Columbus Clinical Services LLC, Miami, Florida, United States
| | - Shu-Chen Wei
- National Taiwan University Hospital, Taipei, Taiwan, Province of China
| | | | | | - Byong Duk Ye
- Asan Medical Center, Seoul, Seoul Teugbyeolsi, Republic of Korea
| | - Hsu-Heng Yen
- Chang-Hua Christian Hospital, Changhua, Taiwan, Province of China
| | - Hyuk Yoon
- Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Kosuke Yoshida
- National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Andriy Yurkiv
- Municipal Non-profit Enterprise 'Odesa Regional Clinical Hospital' Odesa Regional Council, Odesa, Ukraine
| | | | - Qiang Zhan
- Wuxi People's Hospital, Wuxi, Jiangsu, China
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Marshall DC, Shim A, Chen CC, Lin H, Yu F, Argiriadi P, Choi IJ, Chhabra AM, Simone CB. A Dosimetric Assessment of Sexual Organ Sparing Proton Radiotherapy in Female Pelvic Cancer Patients. Int J Radiat Oncol Biol Phys 2023; 117:e695. [PMID: 37786040 DOI: 10.1016/j.ijrobp.2023.06.2174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Optimizing treatment techniques for female patients undergoing curative treatment for pelvic cancers requires incorporating the goals of maximizing cure while maintaining quality of life. Optimizing treatment to maintain sexual quality of life has received little attention in female patients despite the presence of and toxicity risks to functional anatomic organs and their associated neurovasculature, including the bulboclitoris, vagina, and ovaries. Recent dosimetric data without employing sexual organ sparing suggest that mean VMAT dose to the bulboclitoris in low rectal cancer is around 3300 cGy, and in anal cancer, mean dose is around 2000 cGy to the external genitalia and 4500-5000 cGy to the bulboclitoris, all of which would be expected to result in clinically significant toxicity. Therefore, investigation of the avoidance of these important organs is needed and we hypothesize that proton techniques may achieve greater sparing than photon techniques. MATERIALS/METHODS In this study, we dosimetrically compare proton- vs. photon-based techniques in sparing functional sexual organs. The cohort consisted of four consecutive female pelvic cancer cases that had received 5000 cGy or greater. All cases were re-planned with VMAT and protons while optimizing dose to functional sexual organs and maintaining target coverage. Sexual organ structures assessed include the genitalia, vagina, ovaries, bulboclitoris and internal pudendal arteries. Given the small number of patients included in this demonstration study, statistical tests were not performed. RESULTS MRI was required to appropriately delineate soft tissue. In all cases, dosimetric sparing of sexual organs was improved with proton therapy without compromising target coverage. Mean doses were marginally decreased for structures within the PTV, while structures such as the bulboclitoris were spared substantially. Mean dose to the external genitalia was low with sparing using both VMAT (Median [IQR] (cGy): 852 [811, 1090]) and Proton techniques (Median [IQR] (cGy): 39.4 [11.9, 78.5]). Similarly, mean dose with sparing to the external genitalia was lower than would be expected without sparing, using both VMAT and Proton techniques (Median (IQR) Dmean (cGy) VMAT 3100 [2890, 3580] vs. Proton 1530 [1100, 2090]), with protons demonstrating greater sparing. In one case of a sacral chordoma, ovaries were substantially spared to below ablative thresholds (Dmean (cGy) VMAT 3598.8 and 3548.0 vs Proton 34.1 and 103.3). CONCLUSION Magnetic resonance imaging at simulation combined with proton radiotherapy for female sexual organ sparing may provide a technically feasible route to more equitable sexual outcomes for female patients. These results will guide future studies to optimize proton treatment techniques for female sexual organ sparing for future trials.
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Affiliation(s)
- D C Marshall
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Shim
- New York Proton Center, New York, NY
| | - C C Chen
- New York Proton Center, New York, NY
| | - H Lin
- New York Proton Center, New York, NY
| | - F Yu
- New York Proton Center, New York, NY
| | - P Argiriadi
- Icahn School of Medicine at Mount Sinai, Department of Radiology, New York, NY
| | - I J Choi
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
| | - A M Chhabra
- New York Proton Center, New York, NY; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - C B Simone
- New York Proton Center, New York, NY; Memorial Sloan Kettering Cancer Center, New York, NY
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Chang YT, Chen CC, Chang SC, Chang YY, Lin BW, Chen HH, Hsieh YY, Hsu HC, Hsieh MC, Kuan FC, Wu CC, Lu WC, Su YL, Liang YH, Chen JB, Huang SY, Huang CW, Wang JY. Efficacy and Safety of a Parenteral Nutrition Program for Patients with RAS Wild-Type Metastatic Colorectal Cancer Administered First-Line Cetuximab Plus Chemotherapy: A Propensity Score Matching Study. Nutrients 2023; 15:2971. [PMID: 37447297 DOI: 10.3390/nu15132971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Malnutrition is a common problem in patients with metastatic colorectal cancer (mCRC) receiving targeted therapy plus chemotherapy, resulting in severe toxicity and decreased survival rates. This retrospective study employing propensity score matching (PSM) examined the efficacy and safety of a supplemental home parenteral nutrition (HPN) program for patients with RAS wild-type mCRC receiving cetuximab plus chemotherapy. This retrospective nationwide registry study included data from 14 medical centers/hospitals across Taiwan, and the data period ranged from November 2016 to December 2020. Patients with RAS wild-type mCRC receiving cetuximab plus chemotherapy as their first-line therapy were included and divided into HPN and non-HPN program groups. HPN was initiated based on patient-specific factors, such as baseline nutritional status, treatment-related toxicities, and comorbidities. Clinical outcomes were evaluated using response to therapy, duration of response (DoR), progression-free survival (PFS), and overall survival (OS). This study recruited 758 patients, of whom 110 and 648 were included in the HPN and non-HPN program groups, respectively. After 1:3 PSM, the data of 109 and 327 patients from the HPN and non-HPN program groups were analyzed, respectively. The HPN program group had a higher metastasectomy rate (33.9% vs. 20.2%, p = 0.005), and longer duration of treatment and DoR than the non-HPN program group (13.6 vs. 10.3 and 13.6 vs. 9.9 months, p = 0.001 and < 0.001, respectively). The HPN program group tended to have a longer median PFS (18.2 vs. 13.9 months, p = 0.102). Moreover, we noted a significant improvement in the median OS in the same group (53.4 vs. 34.6 months, p = 0.002). Supplemental HPN programs may be recommended for select patients with mCRC receiving targeted therapy plus chemotherapy to improve oncological outcomes.
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Affiliation(s)
- Yu-Tang Chang
- Division of Pediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chou-Chen Chen
- Department of Surgery, Taichung Veterans General Hospital, Taichung 40705, Taiwan
| | - Shih-Ching Chang
- Division of Colon and Rectal Surgery, Department of Surgery, Veterans General Hospital, Taipei 11217, Taiwan
| | - Yu-Yao Chang
- Department of Colorectal Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Bo-Wen Lin
- Department of Surgery, National Cheng Kung University Hospital, Tainan 70457, Taiwan
| | - Hong-Hwa Chen
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Yao-Yu Hsieh
- Division of Hematology and Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Division of Hematology and Oncology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hung-Chih Hsu
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 33305, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan
| | - Meng-Che Hsieh
- Division of Hematology-Oncology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 84001, Taiwan
| | - Feng-Che Kuan
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
| | - Chih-Chien Wu
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 30010, Taiwan
| | - Wei-Chen Lu
- Department of Oncology, National Taiwan University Hospital Yunlin Branch, Yunlin 64041, Taiwan
| | - Yu-Li Su
- Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung 33305, Taiwan
| | - Yi-Hsin Liang
- Department of Oncology, National Taiwan University Hospital, Taipei 10002, Taiwan
| | - Joe-Bin Chen
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Shuan-Yuan Huang
- Department of Colorectal Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Ching-Wen Huang
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Jaw-Yuan Wang
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Pingtung Hospital, Ministry of Health and Welfare, Pingtung 90054, Taiwan
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5
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Abstract
Enhanced recovery after surgery (ERAS) and minimally invasive surgery are two important development directions of modern surgery in the 21st century. They provide new clinical treatment methods and theoretical basis for the rapid recovery of surgical patients and more rational utilization of medical resources. They are two hot topics in clinical research and academic exchange of surgery-related subjects, and promote the rapid development and clinical application of surgery. ERAS covers a range of preoperative, intraoperative, and postoperative optimization measures, of which minimally invasive surgery is an important part of intraoperative optimization. The quality of surgery, especially minimally invasive surgery, plays a key role in postoperative recovery, which is the most important one of all ERAS measures. With good surgical quality and no postoperative complications, patients will recover quickly. Therefore, minimally invasive surgery plays a central role in the ERAS concept. The combination of ERAS with minimally invasive surgery is not only safe and feasible, but is also better than these two clinical therapies alone for postoperative recovery, and improves short-term and long-term outcome and accelerates the recovery of patients. For surgical diseases treated with minimally invasive surgery as far as possible, using the ERAS management for patients will result in reduced traumatic stress, better surgical tolerance, less postoperative pain, smaller incision, earlier ambulation, better organ function, and less morbidity of complications. In short, ERAS and minimally invasive surgery complement and promote each other. As two outstanding achievements of modern medicine, they are clinical treatments that provide sufficient theoretical basis for rapid recovery of patients and open a new chapter for the development of modern surgery.
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Affiliation(s)
- C C Chen
- Department of Colorectal Surgery, Gastrointestinal Surgery Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
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6
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Huang CW, Wang JY, Chen CP, Wei PL, Hu HM, Hsu WH, Shih HY, Huang MY, Chen CY, Kuo CH, Chen CC, Chiang TW, Chao JYC, Chiu YH, Tiong C, Lin PY, Lu LS, Kung CH, Yu WC, Wu YS. Phase 1b/ 2 study of a radio-enhancer, PEP503 (NBTXR3), in combination with concurrent chemo-radiation in locally advanced or unresectable rectal cancer. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.3603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3603 Background: PEP503 (aka NBTXR3) is a novel radio-enhancer composed of functionalized hafnium oxide nanoparticles that increases the energy deposition of radiotherapy. A phase 3 study in soft tissue sarcoma patients has significantly increased pCR and R0 when PEP503 was added to preop radiotherapy. This phase 1b/2 study was conducted with the aim to identify a recommended phase 2 dose (RP2D), and evaluate the efficacy of PEP503 intratumoral injection in combination with concurrent chemoradiation (CCRT) in patients with locally advanced rectal cancer (LARC). Methods: Patients with stage T3-T4 LARC (or with unresectable disease) suitable for neoadjuvant CCRT were enrolled. An intratumoral single administration of PEP503 (multiple punctures) was done 24 to 72 hours prior to IMRT of 50 Gy in 25 fractions of 2 Gy per fraction over 5-6 weeks with concurrent capecitabine or 5-FU. Traditional 3 + 3 design with 4 levels, 5%, 10%, 15%, and 22%, of the baseline GTV as measured by MRI, of PEP503 were assessed in Phase Ib. PEP503 nanoparticles intratumoral dispersion was analyzed by CT-scan. Surgery was performed 8 to 12 weeks after the completion of CCRT for patients with resectable tumors. Body kinetics was evaluated in Phase Ib. (ClinicalTrials.gov, NCT02465593) Results: Thirty-two (32) patients (male/female: 20/12; median age 62 years, range 38 to 76) were enrolled (1 dropped out before starting CCRT). In Phase 1b, 20 patients were treated and dose was escalated to 22%. RP2D was then determined as 22% with 6 patients treated at this dose level without DLT. Twelve (12) patients were included in the Phase 2. One (1) (3.2%) and 19 (61.3%) of evaluable patients (n = 31) had CR and PR, respectively, as the best tumor response across dose levels. No patient progressed as all evaluable patients (n = 31) achieved disease control for a DCR of 100%. Furthermore, twenty-five patients underwent surgery, of which 24 (96%) had microscopically clear resection margins and 5 of them (20%) had pathological complete response (pCR). The G3 AEs were diarrhea, ileus, thrombocytopenia, urosepsis, procedural haemorrhage, wound complication, hypokalaemia, and myalgia (all in 3.1%). No G4 AE were observed. The results of CT scans for nanoparticles dispersion demonstrated PEP503 remained within the tumor without leakage to the surrounding healthy tissues, before and after CCRT. In most patients, hafnium was not detected or below the Lower Limit of Quantification (LLOQ) in the circulation 60 minutes after PEP503 injection and was not found in urine. Conclusions: A single intratumoral injection of PEP503 in locally advanced or unresectable rectal adenocarcinoma undergoing capecitabine or 5-FU based CCRT is feasible and safe. The preliminary observed efficacy results may warrant further examination in larger clinical studies. Clinical trial information: NCT02465593.
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Affiliation(s)
- Ching-Wen Huang
- Division of Colorectal Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Jaw-Yuan Wang
- Division of Colorectal Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Chou-Pin Chen
- Division of Colorectal Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Li Wei
- Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Huang-Ming Hu
- Division of Gastroenterology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Wen-Hung Hsu
- Division of Gastroenterology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Hsiang-Yao Shih
- Division of Gastroenterology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Yii Huang
- Department of Radiation Oncology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Chiao-Yun Chen
- Department of Medical Imaging, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | | | - Chou-Chen Chen
- Division of Colorectal Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tzu-Wei Chiang
- Division of Colorectal Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | | | - You-Hsin Chiu
- Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cheng Tiong
- Department of Gastroenterology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Pao-Ying Lin
- Department of Gastroenterology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Long-Sheng Lu
- Department of Radiation Oncology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Ching-Huei Kung
- Department of Medical Imaging, Taipei Medical University Hospital, Taipei, Taiwan
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7
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Ma CJ, Hu WH, Huang MC, Chiang JM, Hsieh PS, Wang HS, Chiang CL, Hsieh HM, Chen CC, Wang JY. Taiwan Society of Colon and Rectum Surgeons (TSCRS) Consensus for Anti-Inflammatory Nutritional Intervention in Colorectal Cancer. Front Oncol 2022; 11:819742. [PMID: 35111685 PMCID: PMC8801427 DOI: 10.3389/fonc.2021.819742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/22/2021] [Indexed: 12/20/2022] Open
Abstract
Malnutrition and systemic inflammatory response (SIR) frequently occur in patients with colorectal cancer (CRC) and are associated with poor prognosis. Anti-inflammatory nutritional intervention is not only a way to restore the malnourished status but also modulate SIR. Nine experts, including colorectal surgeons, physicians and dieticians from 5 hospitals geographically distributed in Taiwan, attended the consensus meeting in Taiwan Society of Colon and Rectum Surgeons for a 3-round discussion and achieved the consensus based on a systematic literature review of clinical studies and published guidelines. The consensus recommends that assessment of nutritional risk and SIR should be performed before and after CRC treatment and appropriate nutritional and/or anti-inflammatory intervention should be adapted and provided accordingly.
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Affiliation(s)
- Cheng-Jen Ma
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Hsiang Hu
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung, Kaohsiung, Taiwan
| | - Meng-Chuan Huang
- Division of Nutrition and Dietetics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jy-Ming Chiang
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Pao-Shiu Hsieh
- Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Huann-Sheng Wang
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chien-Ling Chiang
- Division of Nutrition, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan
| | - Hui-Min Hsieh
- Division of Nutrition, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chou-Chen Chen
- Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Jaw-Yuan Wang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan.,Clinical Pharmacogenomics and Pharmacoproteinomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
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8
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Tsai CY, Chen CC, Chen CP, Yao PC. Clinical Treatment for Periostomy Bullous Pemphigoid with Generalized Progression. Eur J Surg Oncol 2022. [DOI: 10.1016/j.ejso.2021.12.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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9
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Chen HH, Ke TW, Huang CW, Jiang JK, Chen CC, Hsieh YY, Teng HW, Lin BW, Liang YH, Su YL, Hsu HC, Kuan FC, Chou YH, Lin J, Lin BR, Chang YY, Wang JY. Taiwan Society of Colon and Rectal Surgeons Consensus on mCRC Treatment. Front Oncol 2021; 11:764912. [PMID: 34868987 PMCID: PMC8634841 DOI: 10.3389/fonc.2021.764912] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/21/2021] [Indexed: 12/22/2022] Open
Abstract
Therapeutic options for metastatic CRC (mCRC) have changed significantly in recent years, greatly increasing the complexity of therapeutic decision-making. Although oncology guidelines have helped improve the care process, guidelines may also limit the flexibility to individualize in-clinic decision-making. This consensus paper addresses specific gaps in the current international guidelines to assist Taiwanese colon and rectal experts make specific therapeutic choices. Over 3 years and three meetings with selected experts on "real-world" Taiwanese practice patterns for mCRC, consensus was achieved. The experts also discussed specific questions during in-depth one-on-one consultation. Outcomes of the discussion were then correlated with published evidence by an independent medical writer. The final consensus includes clinically implementable recommendations to provide guidance in treating Taiwanese mCRC patients. The consensus includes criteria for defining fit and unfit intensive treatment patients, treatment goals, treatment considerations of molecular profiles, treatment consideration, and optimal treatment choices between different patient archetypes, including optimal treatment options based on RAS, BRAF, and microsatellite instability (MSI) status. This consensus paper is the second in the Taiwan Society of Colon and Rectal Surgeons (TSCRS) Consensus series to address unmet gaps in guideline recommendations in lieu of Taiwanese mCRC management. Meticulous discussions with experts, the multidisciplinary nature of the working group, and the final drafting of the consensus by independent medical professionals have contributed to the strong scientific value of this consensus.
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Affiliation(s)
- Hong-Hwa Chen
- Division of Colorectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tao-Wei Ke
- Department of Colorectal Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Ching-Wen Huang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Surgery, College of Medicine, Kaohsiung Medical University, Kaoshiung, Taiwan
| | - Jeng-Kae Jiang
- Division of Colon and Rectal Surgery, Department of Surgery, Veterans General Hospital, Taipei, Taiwan
| | - Chou-Chen Chen
- Department of Surgery, Veterans General Hospital, Taichung, Taiwan
| | - Yao-Yu Hsieh
- Division of Hematology and Oncology, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Hao-Wei Teng
- Division of Medical Oncology, Department of Oncology, Veterans General Hospital, Taipei, Taiwan
| | - Bo-Wen Lin
- Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Yi-Hsin Liang
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Li Su
- Division of Hematology Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Hung-Chih Hsu
- Division of Hematology Oncology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Feng-Che Kuan
- Department of Hematology and Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yenn-Hwei Chou
- Division of General Surgery, Department of Surgery, Shin-Kong Wu Ho Su Memorial Hospital, Taipei, Taiwan
| | - Johnson Lin
- Division of Hematology and Oncology, MacKey Memorial Hospital, Taipei, Taiwan
| | - Ben-Ren Lin
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Yao Chang
- Department of Colorectal Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Jaw-Yuan Wang
- Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Surgery, College of Medicine, Kaohsiung Medical University, Kaoshiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaoshiung, Taiwan
- Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
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10
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Hu HY, Cheng FS, Yen YF, Lin SY, Weng SH, Chou YC, Chu DC, Chen CC. Mask reuse during the COVID-19 pandemic: a national survey in Taiwan. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The use of masks is an effective measure to prevent severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection; however, mask reuse is not recommended. Studies examining the factors associated with mask reuse during the coronavirus disease (COVID-19) pandemic are limited. This nationwide survey aimed to determine the prevalence and factors associated with mask reuse among Taiwanese citizens during the pandemic.
Methods
From May 18 through May 31, 2020, a computer-assisted telephone interview system was used to randomly select Taiwanese citizens who were interviewed for COVID-19 preventive behaviors and knowledge on the usage of masks. Multivariate logistic regression was used to identify factors associated with mask reuse during the COVID-19 pandemic. Moreover, generalized estimating equations (GEE) were used to analyze the rate of mask reuse among participants before and during the pandemic.
Results
For a total of 1,075 participants, the overall mean age was 57.4 years, and 82.2% of participants reported mask reuse during the COVID-19 pandemic. After controlling for other covariates, participants who had a greater knowledge on mask usage or had a high supply of masks were less likely to reuse masks during the pandemic. GEE analysis showed that compared with the participants' mask wearing behaviors before the COVID-19 pandemic, they were more likely to reuse masks during the pandemic.
Conclusions
The rate of mask reuse among the general population during the pandemic was significantly higher than that before the pandemic. Individuals were less likely to reuse masks if they had adequate knowledge on mask usage or had a high supply of masks. Since mask reuse is associated with a higher risk of COVID-19 due to the possibility of wearing SAS-CoV-2-contaminated masks, it is imperative to educate people on the correct usage of masks. Further, the government should provide sufficient masks to the general population to decrease the reuse of masks.
Key messages
Mask reuse increased during the COVID-19 pandemic due to the shortage in supply. It is imperative to educate people about the correct usage of masks.
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Affiliation(s)
- HY Hu
- Taipei City Hospital, Taipei, Taiwan
- National Yang Ming Chiao Tung University, Taipei, Taiwan
- University of Taipei, Taipei, Taiwan
| | - FS Cheng
- Taipei City Hospital, Taipei, Taiwan
| | - YF Yen
- Taipei City Hospital, Taipei, Taiwan
- National Yang Ming Chiao Tung University, Taipei, Taiwan
- University of Taipei, Taipei, Taiwan
| | - SY Lin
- Taipei City Hospital, Taipei, Taiwan
| | - SH Weng
- Taipei City Hospital, Taipei, Taiwan
| | - YC Chou
- Taipei City Hospital, Taipei, Taiwan
| | - DC Chu
- Taipei City Hospital, Taipei, Taiwan
- National Yang Ming Chiao Tung University, Taipei, Taiwan
- University of Taipei, Taipei, Taiwan
| | - CC Chen
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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11
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Chen CC, Chen CP, Yao PC. Surgical resection for huge recurrent right colon carcinoma after cetuximab plus FOLFIRI. Asian J Surg 2021; 44:1310-1311. [PMID: 34330592 DOI: 10.1016/j.asjsur.2021.06.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- Chou-Chen Chen
- Department of Surgery, Division of Colorectal,Taichung Veterans General Hospital, Taichung City, 40705, Taiwan; Department of Environmental Engineering, Dayeh University, Changhua County, 51591, Taiwan.
| | - Chou-Pin Chen
- Department of Surgery, Division of Colorectal,Taichung Veterans General Hospital, Taichung City, 40705, Taiwan.
| | - Pin-Chuan Yao
- Department of Environmental Engineering, Dayeh University, Changhua County, 51591, Taiwan.
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12
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Guo JD, Hlavacek P, Poretta T, Wygant G, Lane D, Gorritz M, Wang X, Chen CC, Wade RL, Pan X, Rajpura J, Stwalley B, Rosenblatt L. Inpatient and outpatient treatment patterns of cancer-associated thrombosis in the United States. J Thromb Thrombolysis 2021; 50:386-394. [PMID: 31955338 PMCID: PMC7366581 DOI: 10.1007/s11239-019-02032-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Low molecular weight heparins (LMWHs) and direct oral anticoagulants (DOACs) are among the recommended treatment options for cancer-associated thrombosis (CAT) in the 2019 National Comprehensive Care Network guidelines. Little is known about the current utilization of DOACs in CAT patients, particularly on the inpatient to outpatient therapy transition. This study assessed real-world treatment patterns of CAT in hospital/ED in adult cancer patients (≥ 18 years) diagnosed with CAT during a hospital visit in IQVIA's Hospital Charge Data Master database between July 1, 2015 and April 30, 2018, and followed their outpatient medical and pharmacy claims to evaluate the initial inpatient/ED and outpatient anticoagulants received within 3 months post-discharge. Results showed that LMWH and unfractionated heparin (UFH) were the most common initial inpatient/ED CAT treatments (35.2% and 27.4%, respectively), followed by DOACs (9.6%); 20.8% of patients received no anticoagulants. Most DOAC patients remained on DOACs from inpatient/ED to outpatient settings (71.4%), while 24.1%, 43.5%, and 0.1% of patients treated with LMWH, warfarin, or UFH respectively, remained on the same therapy after discharge. In addition, DOACs were the most common initial post-discharge outpatient therapy. Outpatient treatment persistence and adherence appeared higher in patients using DOACs or warfarin versus LMWH or UFH. This study shows that DOACs are used as an inpatient/ED treatment option for CAT, and are associated with less post-discharge treatment switching and higher persistence and adherence. Further research generating real-world evidence on the role of DOACs to help inform the complex CAT clinical treatment decisions is warranted.
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Affiliation(s)
- J D Guo
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA.
| | | | - T Poretta
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - G Wygant
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - D Lane
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - M Gorritz
- IQVIA Inc, Plymouth Meeting, PA, USA
| | - X Wang
- IQVIA Inc, Plymouth Meeting, PA, USA
| | - C C Chen
- IQVIA Inc, Plymouth Meeting, PA, USA
| | - R L Wade
- IQVIA Inc, Plymouth Meeting, PA, USA
| | - X Pan
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - J Rajpura
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - B Stwalley
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
| | - L Rosenblatt
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrence Township, Lawrenceville, NJ, 08648, USA
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13
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Chen JB, Luo SC, Chen CC, Wu CC, Yen Y, Chang CH, Chen YA, P'eng FK. Colo-pancreaticoduodenectomy for locally advanced colon carcinoma-feasibility in patients presenting with acute abdomen. World J Emerg Surg 2021; 16:7. [PMID: 33639983 PMCID: PMC7913271 DOI: 10.1186/s13017-021-00351-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/11/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND En bloc right hemicolectomy plus pancreaticoduodenectomy (PD) is administered for locally advanced colon carcinoma that invades the duodenum and/or pancreatic head. This procedure may also be called colo-pancreaticoduodenectomy (cPD). Patients with such carcinomas may present with acute abdomen. Emergency PD often leads to high postoperative morbidity and mortality. Here, we aimed to evaluate the feasibility and outcomes of emergency cPD for patients with advanced colon carcinoma manifesting as acute abdomen. METHODS We retrospectively reviewed 4898 patients with colorectal cancer who underwent curative colectomy during the period from 1994 to 2018. Among them, 30 had locally advanced right colon cancer and had received cPD. Among them, surgery was performed in 11 patients in emergency conditions (bowel obstruction: 6, perforation: 3, tumor bleeding: 2). Selection criteria for emergency cPD were the following: (1) age ≤ 60 years, (2) body mass index < 35 kg/m2, (3) no poorly controlled comorbidities, and (4) perforation time ≤ 6 h. Three patients did not meet the above criteria and received non-emergency cPD after a life-saving diverting ileostomy, followed by cPD performed 3 months later. We analyzed these patients in terms of their clinicopathological characteristics, the early and long-term postoperative outcomes, and compared findings between emergency cPD group (e-group, n = 11) and non-emergency cPD group (non-e-group, n = 19). After cPD, staged pancreaticojejunostomy was performed in all e-group patients, and on 15 of 19 patients in the non-e-group. RESULTS The non-e-group was older and had a higher incidence of associated comorbidities, while other clinicopathological characteristics were similar between the two groups. None of the patients in the two groups succumbed from cPD. The postoperative complication rate was 63.6% in the e-group and 42.1% in the non-e-group (p = 0.449). The 5-year overall survival rate were 15.9% in the e-group and 52.6% in the non-e-group (p = 0.192). CONCLUSIONS Emergency cPD is feasible in highly selected patients if performed by experienced surgeons. The early and long-term positive outcomes of emergency cPD are similar to those after non-emergency cPD in patients with acute abdominal conditions.
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Affiliation(s)
- Joe-Bin Chen
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Environmental Engineering, Dayeh University, Changhwa, Taiwan
| | - Shao-Ciao Luo
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chou-Chen Chen
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Environmental Engineering, Dayeh University, Changhwa, Taiwan
| | - Cheng-Chung Wu
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
- Department of Surgery, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
- Cancer Translational Research Center, Taipei Medical University, Taipei, Taiwan.
- Department of Surgery, Cheng Hsin General Hospital, Taipei, Taiwan.
| | - Yun Yen
- Cancer Translational Research Center, Taipei Medical University, Taipei, Taiwan
| | - Chuan-Hsun Chang
- Department of Surgery, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Yun-An Chen
- Department of Pathology, Taichung Veterans General Hospital, Taiwan Boulevard Sec. 4, No. 1650, Taichung, 40705, Taiwan
| | - Fang-Ku P'eng
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Surgery, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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14
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Hung YC, Chang WS, Chou AK, Pei JS, Yang MD, Yang HR, Yang TM, Wang YC, Hsiau YC, Chen CP, Chen CC, Yu CC, Tsai CW, Bau DAT. Association of Adiponectin Genotypes With Colorectal Cancer Susceptibility in Taiwan. Anticancer Res 2020; 40:1297-1306. [PMID: 32132026 DOI: 10.21873/anticanres.14071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 01/28/2020] [Accepted: 02/03/2020] [Indexed: 11/10/2022]
Abstract
AIM To investigate the association between adiponectin (ADIPOQ) genotypes and colorectal cancer (CRC) risk among Taiwanese. MATERIALS AND METHODS Polymerase chain reaction-restriction fragment length polymorphism was adopted to identify ADIPOQ rs266729, rs2241766 and rs1501299 genotypes among 362 CRC patients and 362 healthy controls. RESULTS ADIPOQ rs266729 GG genotype (p=0.0075) and G allele (p=0.0061) are associated with a significantly increased CRC risk. There is no differential distribution of rs2241766 and rs1501299 genotypes. As for the gene-lifestyle interaction, there are obvious joint effects of rs266729 genotype on the CRC risk among non-smoker, non-alcohol drinker, while not on smoker or non-drinker subgroups. No significant correlation was observed between rs266729 genotypic distributions and age, gender, tumor size, location or metastasis status. Interestingly, a correlation of rs266729 genotype and larger BMI on CRC risk was found. CONCLUSION G allele at ADIPOQ rs266729 may serve as a determiner for CRC risk, especially for those with BMI ≥24.
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Affiliation(s)
- Yi-Chih Hung
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C.,Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Wen-Shin Chang
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C.,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - An-Kuo Chou
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Anesthesiology, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Jen-Sheng Pei
- Department of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan, R.O.C
| | - Mei-Due Yang
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Horng-Ren Yang
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Ta-Ming Yang
- Department of Surgery, Tainan Municipal Hospital, Tainan, Taiwan, R.O.C
| | - Yun-Chi Wang
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C.,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Yu-Chen Hsiau
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chou-Pin Chen
- Department of Surgery, Division of Colorectal, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Chou-Chen Chen
- Department of Surgery, Division of Colorectal, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C
| | - Chien-Chih Yu
- School of Pharmacy, China Medical University, Taichung, Taiwan, R.O.C.
| | - Chia-Wen Tsai
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C. .,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - DA-Tian Bau
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, R.O.C. .,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, R.O.C.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan, R.O.C
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15
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Jiang LL, Chen CC, Yang K. Lessons learned from an unusual condition of incidental synchronous multiple hernias of indirect inguinal hernia, femoral hernia, and incarcerated obturator hernia. Niger J Clin Pract 2019; 22:281-284. [PMID: 30729956 DOI: 10.4103/njcp.njcp_200_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hernias are one of the most common diseases. The frequency of multiple hernias is much higher than the frequency reported during herniorrhaphy. Multiple hernias may account for some of the so-called recurrences, in which the small hernia may be veiled by the bigger one and omitted. In this study, we present a case of an 83-year-old female who suffered from multiple hernias namely a left-sided indirect inguinal hernia, a right-sided femoral hernia, and a right-sided incarcerated obturator hernia. Additionally, the characteristics and treatment of obturator hernia were discussed. Ultrasound and computed tomography (CT) are capable of accurately diagnosing groin hernia. Preoperative bilateral ultrasound of examinations or abdominopelvic CT should be recommended to perform routinely for patients with suspected hernias to avoid ignoring the concurrent hernias. A careful exploration of the operative field in the operation is mandatory. The CT is also helpful for early diagnosis of obturator hernia. In addition, the intra-abdominal approach through a low midline incision might be a preference for the treatment of obturator hernia.
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Affiliation(s)
- L L Jiang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - C C Chen
- Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China
| | - K Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China
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16
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Chen Q, Chen CC, Bai J. Pathological Changes of Petechial Hemorrhage after High Temperature Treatment. Fa Yi Xue Za Zhi 2019; 34:631-634. [PMID: 30896101 DOI: 10.12116/j.issn.1004-5619.2018.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the main features of mechanical asphyxia--the pathological characteristics of petechial hemorrhage after high temperature effect (roasted, boiled) and its changing rules. METHODS Rabbit model of mechanical asphyxia death with choking neck and death from anteposition hanging was established. The experimental rabbits were randomly divided into roasted group and boiled group (n=4, in each group). The laryngeal ventricles and cardiopulmonary tissues in the roasted group were roasted for 3, 6 and 10 min, and the positions of petechial hemorrhage were observed and photographed. The same organs and tissues in the boiled group were heated in boiling water (100 ℃), and were observed and photographed at 30 and 60 s. Then histopathological examination was performed on all the laryngeal ventricles and cardiopulmonary tissues. RESULTS The petechial hemorrhage originating from laryngeal ventricle, trachea and lung did not disappear after high temperature treatment in the eight rabbits. The deepened color was visible to naked eyes and distinct from the surrounding normal tissues, with bleeding under the microscope. CONCLUSIONS Petechial hemorrhage caused by mechanical asphyxia would not disappear under high temperature, which might be related to the manner of death, the intensity and time of action, and the individual differences.
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Affiliation(s)
- Q Chen
- Forensic Judicial Appraisal Center of Beijing Public Security Bureau, Beijing 100192, China
| | - C C Chen
- Forensic Judicial Appraisal Center of Beijing Public Security Bureau, Beijing 100192, China
| | - J Bai
- Forensic Judicial Appraisal Center of Beijing Public Security Bureau, Beijing 100192, China
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17
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Gorham PW, Rotter B, Allison P, Banerjee O, Batten L, Beatty JJ, Bechtol K, Belov K, Besson DZ, Binns WR, Bugaev V, Cao P, Chen CC, Chen CH, Chen P, Clem JM, Connolly A, Cremonesi L, Dailey B, Deaconu C, Dowkontt PF, Fox BD, Gordon JWH, Hast C, Hill B, Hughes K, Huang JJ, Hupe R, Israel MH, Javaid A, Lam J, Liewer KM, Lin SY, Liu TC, Ludwig A, Macchiarulo L, Matsuno S, Miki C, Mulrey K, Nam J, Naudet CJ, Nichol RJ, Novikov A, Oberla E, Olmedo M, Prechelt R, Prohira S, Rauch BF, Roberts JM, Romero-Wolf A, Russell JW, Saltzberg D, Seckel D, Schoorlemmer H, Shiao J, Stafford S, Stockham J, Stockham M, Strutt B, Varner GS, Vieregg AG, Wang SH, Wissel SA. Observation of an Unusual Upward-Going Cosmic-Ray-like Event in the Third Flight of ANITA. Phys Rev Lett 2018; 121:161102. [PMID: 30387639 DOI: 10.1103/physrevlett.121.161102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/14/2018] [Indexed: 06/08/2023]
Abstract
We report on an upward traveling, radio-detected cosmic-ray-like impulsive event with characteristics closely matching an extensive air shower. This event, observed in the third flight of the Antarctic Impulsive Transient Antenna (ANITA), a NASA-sponsored long-duration balloon payload, is consistent with a similar event reported in a previous flight. These events could be produced by the atmospheric decay of an upward-propagating τ lepton produced by a ν_{τ} interaction, although their relatively steep arrival angles create tension with the standard model neutrino cross section. Each of the two events have a posteriori background estimates of ≲10^{-2} events. If these are generated by τ-lepton decay, then either the charged-current ν_{τ} cross section is suppressed at EeV energies, or the events arise at moments when the peak flux of a transient neutrino source was much larger than the typical expected cosmogenic background neutrinos.
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Affiliation(s)
- P W Gorham
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - B Rotter
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - P Allison
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - O Banerjee
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - L Batten
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - J J Beatty
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - K Bechtol
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - K Belov
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - D Z Besson
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
- National Research Nuclear University, MEPhI (Moscow Engineering Physics Institute), Kashirskoe shosse 31, Moscow 115409, Russian Federation
| | - W R Binns
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - V Bugaev
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - P Cao
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - C C Chen
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - C H Chen
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - P Chen
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - J M Clem
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - A Connolly
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - L Cremonesi
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - B Dailey
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - C Deaconu
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - P F Dowkontt
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - B D Fox
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - J W H Gordon
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - C Hast
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - B Hill
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - K Hughes
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - J J Huang
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - R Hupe
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - M H Israel
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - A Javaid
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - J Lam
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - K M Liewer
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - S Y Lin
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - T C Liu
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - A Ludwig
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - L Macchiarulo
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - S Matsuno
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - C Miki
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - K Mulrey
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - J Nam
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - C J Naudet
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - R J Nichol
- Department of Physics and Astronomy, University College London, London WC1E 6BT, United Kingdom
| | - A Novikov
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
- National Research Nuclear University, MEPhI (Moscow Engineering Physics Institute), Kashirskoe shosse 31, Moscow 115409, Russian Federation
| | - E Oberla
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - M Olmedo
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - R Prechelt
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - S Prohira
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - B F Rauch
- Department of Physics & McDonnell Center for the Space Sciences, Washington University in St. Louis, Missouri 63130, USA
| | - J M Roberts
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - A Romero-Wolf
- Jet Propulsion Laboratory, Pasadena, California 91109, USA
| | - J W Russell
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - D Saltzberg
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - D Seckel
- Department of Physics, University of Delaware, Newark, Delaware 19716, USA
| | - H Schoorlemmer
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - J Shiao
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - S Stafford
- Department of Physics, Center for Cosmology and AstroParticle Physics, Ohio State University, Columbus, Ohio 43210, USA
| | - J Stockham
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - M Stockham
- Department of Physics and Astronomy, University of Kansas, Lawrence, Kansas 66045, USA
| | - B Strutt
- Department of Physics and Astronomy, University of California, Los Angeles, Los Angeles, California 90095, USA
| | - G S Varner
- Department of Physics and Astronomy, University of Hawaii, Manoa, Hawaii 96822, USA
| | - A G Vieregg
- Department of Physics, Enrico Fermi Institute, Kavli Institute for Cosmological Physics, University of Chicago, Chicago, Illinois 60637, USA
| | - S H Wang
- Department of Physics, Graduate Institute. of Astrophysics, & Leung Center for Cosmology and Particle Astrophysics, National Taiwan University, Taipei 10617, Taiwan
| | - S A Wissel
- Physics Department, California Polytechnic State University, San Luis Obispo, California 93407, USA
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Wu VC, Chen SW, Wu M, Liu CH, Chang CW, Chen CC, Wu KP, Chang SH, Lin MS, Lee TH, Hsieh IC, Chu PH, Lin YS. P5138Resuming anticoagulation in patients with atrial fibrillation experiencing hemorrhage stroke or nontraumatic intracranial hemorrhage. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- V C Wu
- Chang Gung Memorial Hospital, Division of Cardiology, Taoyuan City, Taiwan ROC
| | - S W Chen
- Chang Gung Memorial Hospital, Department of Cardiothoracic and Vascular Surgery, Taoyuan City, Taiwan ROC
| | - M Wu
- Brown University, Division of Cardiovascular Medicine, Providence, United States of America
| | - C H Liu
- Chang Gung Memorial Hospital, Department of Neurology, Taoyuan City, Taiwan ROC
| | - C W Chang
- Chang Gung Memorial Hospital, Department of Neurology, Taoyuan City, Taiwan ROC
| | - C C Chen
- Chang Gung Memorial Hospital, Department of Neurosurgery, Taoyuan City, Taiwan ROC
| | - K P Wu
- Chang Gung Memorial Hospital, Department of Physical Medicine and Rehabilitation, Taoyuan City, Taiwan ROC
| | - S H Chang
- Chang Gung Memorial Hospital, Division of Cardiology, Taoyuan City, Taiwan ROC
| | - M S Lin
- Chang Gung Memorial Hospital, Department of Cardiology, Chiayi, Taiwan ROC
| | - T H Lee
- Chang Gung Memorial Hospital, Department of Neurology, Taoyuan City, Taiwan ROC
| | - I C Hsieh
- Chang Gung Memorial Hospital, Division of Cardiology, Taoyuan City, Taiwan ROC
| | - P H Chu
- Chang Gung Memorial Hospital, Division of Cardiology, Taoyuan City, Taiwan ROC
| | - Y S Lin
- Chang Gung Memorial Hospital, Department of Cardiology, Chiayi, Taiwan ROC
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19
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Bao C, Wang XC, Hu XL, Hou DN, Chen CC, Song YL, Yang D. [Clinical manifestations analysis of patients diagnosed with primary pulmonary mucosa-associated lymphoid tissue lymphoma]. Zhonghua Yi Xue Za Zhi 2018; 98:1419-1423. [PMID: 29804405 DOI: 10.3760/cma.j.issn.0376-2491.2018.18.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical features of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma. Methods: A total of 14 cases diagnosed with primary pulmonary MALT lymphoma were collected from May 2007 to May 2017 in Zhongshan Hospital, Fudan University. The clinical features, pathological characteristics, diagnosis, treatment and prognosis were retrospectively analyzed. Results: All 14 cases were pathologically diagnosed with primary pulmonary MALT lymphoma. The biopsy tissues were obtained through the Video-assisted Thoracoscopic Surgery (VATS) (4 cases), percutaneous puncture (2 cases), and bronchoscopy (8 cases). Cell types of these tumors were centrocyte-like cells (10 cases), lymphocytoid cells (2 cases), and monocytoid B cells (2 cases). The B cell clonality was detected by IgH cloning test in 4 cases and 3 of them were demonstrated with monoclonal strips. MALT1 breakup gene was positive in 3 out of 6 examined cases using fluorescence in situ hybridization (FISH). As for the treatment, 8 patients underwent chemotherapy, 5 patients underwent surgical resection and 1 patient abandoned treatment. Twelve patients were followed up to 9 years. The tumor recurrence occurred in 2 patients and resulted their death. Conclusions: The clinical manifestations of primary pulmonary MALT lymphoma are lack of specificity. The pathology, immunohistochemistry, IgH cloning test and MALT1 breakup gene tested by FISH are the criteria for diagnosis.
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Affiliation(s)
- C Bao
- Respiratory Department, Zhongshan Hospital, Fudan University, Shanghai 200032, China
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20
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Lin Q, Ge XM, Mo JC, Li SS, Chen CC, Chen SY. [An investigation of psychological state at different stages of occupational AIDS exposure and related influencing factors in Nanning, China]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2018; 34:762-764. [PMID: 28043249 DOI: 10.3760/cma.j.issn.1001-9391.2016.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the changes in psychological state after occupational exposure in the AIDS occupational exposure population and related influencing factors, and to provide baseline data and a basis for related departments to conduct mental health prevention and intervention for personnel with occupational AIDS exposure. Methods: AIDS risk assessment was performed for all personnel with occupational AIDS exposure in 2014 in Nanning, China, and the Symptom Checklist-90 (SCL-90) psychological scale was used for psychological state evaluation at 24 hours, 1 week, and 3 months after occupational exposure in all persons who met the research criteria. Results: Most of the persons with occupational AIDS exposure came from secondary and tertiary hospitals (85%) , and nurses accounted for the highest percentage (78.3% ). The age ranged from 21 to 50 years, and the mean age was 31.02 ± 7.92 years. The persons with occupational AIDS exposure aged 20~29 years accounted for the highest percentage (51.6%) , and most persons (76.7%) graduated from junior colleges. Compared with the adult norm, there was significant increases in the total psychological score and the number of positive items after occupational exposure (P<0.05). The scores of all items at 24 hours were significantly higher than those at the other time points, and the scores of all items gradually decreased over time (F=227.24, 267.57, and 287.46, P<0.05). Compared with the adult norm, there were significant increases in the factor points at 24 hours and significant reductions in the factor points at 3 months (P<0.05). Compared with those at 24 hours, the factor scores at 3 months decreased significantly (P<0.05). Conclusion: Occupational AIDS exposure affects the mental status of related personnel, and the mental status at 24 hours after exposure is poor. Related departments should provide corresponding psychological counseling for the occupational exposure population at different exposure times.
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Affiliation(s)
- Q Lin
- Nanning Center for Disease Control and Prevention, Nanning 530023, China
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21
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Berglund JA, Gafni RI, Wodajo F, Cowen EW, El-Maouche D, Chang R, Chen CC, Guthrie LC, Molinolo AA, Collins MT. Tumor-induced osteomalacia in association with PTEN-negative Cowden syndrome. Osteoporos Int 2018; 29:993-997. [PMID: 29380000 PMCID: PMC7983154 DOI: 10.1007/s00198-017-4372-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 12/26/2017] [Indexed: 12/30/2022]
Abstract
Tumor-induced osteomalacia (TIO) is a rare paraneoplastic condition in which phosphaturic mesenchymal tumors (PMTs) secrete high levels of fibroblast growth factor 23 (FGF23) into the circulation. This results in renal phosphate wasting, hypophosphatemia, muscle weakness, bone pain, and pathological fractures. Recent studies suggest that fibronectin-fibroblast growth factor receptor 1 (FN1-FGFR1) translocations may be a driver of tumorigenesis. We present a patient with TIO who also exhibited clinical findings suggestive of Cowden syndrome (CS), a rare autosomal dominant disorder characterized by numerous benign hamartomas, as well as an increased risk for multiple malignancies, such as thyroid cancer. While CS is a clinical diagnosis, most, but not all, harbor a mutation in the tumor suppressor gene PTEN. Genetic testing revealed a somatic FN1-FGFR1 translocation in the FGF23-producing tumor causing TIO; however, a germline PTEN mutation was not identified. To our knowledge, this is the first reported case of concurrent TIO and CS.
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Affiliation(s)
- J A Berglund
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - R I Gafni
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - F Wodajo
- Musculoskeletal Tumor Surgery, Virginia Cancer Specialists, Fairfax, VA, USA
| | - E W Cowen
- Dermatology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - D El-Maouche
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - R Chang
- Nuclear Medicine, Radiology and Imaging Sciences, Hatfield Clinical Research Center, National Institutes of Health, Bethesda, MD, USA
| | - C C Chen
- Nuclear Medicine, Radiology and Imaging Sciences, Hatfield Clinical Research Center, National Institutes of Health, Bethesda, MD, USA
| | - L C Guthrie
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - A A Molinolo
- Department of Pathology, University of California San Diego, San Diego, CA, USA
| | - M T Collins
- Section on Skeletal Disorders and Mineral Homeostasis, Craniofacial and Skeletal Diseases Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.
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Fanchiang YT, Chen KHM, Tseng CC, Chen CC, Cheng CK, Yang SR, Wu CN, Lee SF, Hong M, Kwo J. Strongly exchange-coupled and surface-state-modulated magnetization dynamics in Bi 2Se 3/yttrium iron garnet heterostructures. Nat Commun 2018; 9:223. [PMID: 29335558 PMCID: PMC5768741 DOI: 10.1038/s41467-017-02743-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 12/20/2017] [Indexed: 12/03/2022] Open
Abstract
Harnessing the spin–momentum locking of topological surface states in conjunction with magnetic materials is the first step to realize novel topological insulator-based devices. Here, we report strong interfacial coupling in Bi2Se3/yttrium iron garnet (YIG) bilayers manifested as large interfacial in-plane magnetic anisotropy (IMA) and enhancement of damping probed by ferromagnetic resonance. The interfacial IMA and damping enhancement reaches a maximum when the Bi2Se3 film approaches its two-dimensional limit, indicating that topological surface states play an important role in the magnetization dynamics of YIG. Temperature-dependent ferromagnetic resonance of Bi2Se3/YIG reveals signatures of the magnetic proximity effect of TC as high as 180 K, an emerging low-temperature perpendicular magnetic anisotropy competing the high-temperature IMA, and an increasing exchange effective field of YIG steadily increasing toward low temperature. Our study sheds light on the effects of topological insulators on magnetization dynamics, essential for the development of topological insulator-based spintronic devices. Understanding the effects of topological insulators on magnetization dynamics of adjacent magnetic materials is essential for novel spintronic devices. Here, Fanchiang et al. report thickness dependence of interfacial in-plane magnetic anisotropy and damping enhancement in Bi2Se3/yttrium iron garnet (YIG) bilayers, indicating an important role of topological surface states in the magnetization dynamics of YIG.
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Affiliation(s)
- Y T Fanchiang
- Department of Physics, National Taiwan University, Taipei, 10617, Taiwan
| | - K H M Chen
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - C C Tseng
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - C C Chen
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - C K Cheng
- Department of Physics, National Taiwan University, Taipei, 10617, Taiwan
| | - S R Yang
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - C N Wu
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan
| | - S F Lee
- Institute of Physics, Academia Sinica, Taipei, 11529, Taiwan.
| | - M Hong
- Department of Physics, National Taiwan University, Taipei, 10617, Taiwan.
| | - J Kwo
- Department of Physics, National Tsing Hua University, Hsinchu, 30013, Taiwan.
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Lin CY, Lin TH, Chen CC, Chen MC, Chen CP. Combination chemotherapy with Regorafenib in metastatic colorectal cancer treatment: A single center, retrospective study. PLoS One 2018; 13:e0190497. [PMID: 29304109 PMCID: PMC5755875 DOI: 10.1371/journal.pone.0190497] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/15/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Regorafenib has been demonstrated as effective in refractory metastatic colorectal cancer. Combination use with chemotherapy has not been reported. We examined the efficacy and safety of adding chemotherapy to Regorafenib for the treatment of metastatic colorectal cancer(mCRC) patients. METHODS We recruited mCRC patients at our institute who received either regorafenib monotherapy or regorafenib in combination with other chemotherapies. All patients had received chemo and target therapies and presented with disease progression before regorafenib treatment. The primary end point was overall survival. FINDINGS Between September1, 2015 and May 31, 2017, 100 mCRC patients at our institute received regorafenib treatment. 39 patients were excluded due to poor performance, lack of timely treatment, or inadequate clinical data. A total of 34 patients received regorafenib combined with other chemotherapies, and 27 patients received regorafenib alone. Median follow up time was 10.4 and 6.1 months, respectively. The primary end point of median OS was higher in the combination group than in the single use group (20.9m vs 10.3m, p = 0.015). The most frequent adverse events were hand-foot skin reactions(16[47.1%]vs 12[44.4%]), fatigue(6[17.6%] vs 7[25.9%]), gastrointestinal discomfort (7[20.6%] vs 6[22.2%]), neutropenia (4[11.8%] vs 1[3.7%]), diarrhea(4[11.8%] vs 1[3.7%]), and mucositis(5[14.7%] vs 1[3.7%]). CONCLUSION The present study showed the efficacy and side effects of regorafenib combination treatment. Superiority in median OS and median PFS was noted in the combination group. The sampling difference between the study and observation groups effects justifies the comparison. Further clinical evidence of combination therapy efficacy is pending future studies.
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Affiliation(s)
- Chun-Yu Lin
- Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan
| | - Tseng-Hsi Lin
- Division of Hematology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chou-Chen Chen
- Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan
| | - Ming-Cheng Chen
- Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan
| | - Chou-Pin Chen
- Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taichung, Taiwan
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Hung YC, Lin CC, Chen HJ, Chang MP, Huang KC, Chen YH, Chen CC. Severe hypoglycemia and hip fracture in patients with type 2 diabetes: a nationwide population-based cohort study. Osteoporos Int 2017; 28:2053-2060. [PMID: 28374044 DOI: 10.1007/s00198-017-4021-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 03/27/2017] [Indexed: 02/01/2023]
Abstract
UNLABELLED Hypoglycemia is a major concern in glycemic control. Using the Taiwan National Health Insurance Research Database, we found that the risk of hip fracture was associated with emergency or hospitalization visits of severe hypoglycemia in patients with type 2 diabetes; greater visits were associated with higher incidence of hip fracture. INTRODUCTION The objective of the study was to assess the risk of hip fracture among patients with type 2 diabetes mellitus (T2DM) and severe hypoglycemia. METHODS Using the National Health Insurance Research database in Taiwan, we identified 2588 patients with T2DM who had developed severe hypoglycemia from 2001 to 2009. A comparison cohort who had never developed severe hypoglycemia was frequency matched at a ratio of approximately 1:2. Multivariate Cox proportional hazard regression analysis was used to evaluate the risk of hip fracture. RESULTS During a median follow-up period of 3.9 years, there were 219 hip fracture events in 5173 comparison cohorts and 148 hip fracture events in 2588 hypoglycemia cohorts. The incidence of hip fracture was higher in patients with severe hypoglycemia than without severe hypoglycemia (17.19 vs. 8.83 per 1000 person-years; adjusted HR 1.71, 95% CI = 1.35-2.16). Approximately half of the individuals developed hip fracture within 2 years from the first occurrence of severe hypoglycemia. There was a significant associated trend towards increased hip fracture risk with increasing average visit of severe hypoglycemia per year (p for trend <0.001). Medication analysis showed that patients taking sulfonylurea alone, insulin alone, and insulin secretagogues combined with insulin had a higher associated risk to develop hip fracture. CONCLUSIONS Severe hypoglycemia was associated with a higher risk to develop hip fracture. The more the visits of severe hypoglycemia per year indicated the higher associated risk in patients with T2DM. Fall is likely an important reason for severe hypoglycemia in relation to increased risk of hip fracture.
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Affiliation(s)
- Y C Hung
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan
- Department of Medicine, China Medical University, Taichung, 40402, Taiwan
| | - C C Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan
- Veterans General Hospital, Taichung, Taiwan
| | - H J Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan
| | - M P Chang
- Department of Nursing, School of Health, National Taichung University of Science and Technology, Taichung, 40343, Taiwan
| | - K C Huang
- Department of Integration of Traditional Chinese and Western Medicine, China Medical University Hospital, Taichung, 40447, Taiwan
- School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan
| | - Y H Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan
- Department of Medicine, China Medical University, Taichung, 40402, Taiwan
| | - C C Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung, 40447, Taiwan.
- School of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan.
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Chen CC, Chen YW, Zheng JW. [Clinical observation of partial resection and drainage of abscess around tonsils on the upper pole of the tonsils]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:879-880. [PMID: 29775007 DOI: 10.13201/j.issn.1001-1781.2017.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Indexed: 11/12/2022]
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Wang F, Fan XL, Chen CC. [The occupational disease hazards prevention and control status survey of tertiary hospitals in Shandong province]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2017; 35:154-156. [PMID: 28355712 DOI: 10.3760/cma.j.issn.1001-9391.2017.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Chen CC, Granger CV, Peimer CA, Moy OJ, Wald S. Manual Ability Measure (MAM-16): A Preliminary Report on a New Patient-Centred and Task-Oriented Outcome Measure of Hand Function. ACTA ACUST UNITED AC 2016; 30:207-16. [PMID: 15757777 DOI: 10.1016/j.jhsb.2004.12.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2004] [Accepted: 12/06/2004] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to develop an easy-to-use and psychometrically sound outcome instrument that is task-oriented and patient-centred. One hundred fifteen patients with a variety of hand impairments completed a rating scale of perceived manual ability (i.e., the Manual Ability Measure). The first 70 patients also completed two other questionnaires about physical health and psychological well-being. Rasch Analyses were conducted to transform the ordinal ratings into linear measures; Rasch statistics were used to evaluate its measurement properties at both scale and item levels. Eighty-three original items were reduced to 16 common tasks; Rasch reliabilities were good; the easy-to-difficult item hierarchy makes sense clinically. Moderate correlations were found between manual ability, physical function and general sense of well-being. The results of this preliminary study suggest that the MAM is a promising outcome measure that has adequate psychometric properties and can be used to complement other objective clinical measurements.
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Affiliation(s)
- C C Chen
- Department of Occupational Therapy, New York University, USA.
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Chen CC, Chen YW, He YS. [Report and analysis of 2 cases of nerve paralysis with aspiration pneumonia after infection of herpes zoster virus]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2016; 30:1249-1250. [PMID: 29798342 DOI: 10.13201/j.issn.1001-1781.2016.15.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Indexed: 06/08/2023]
Abstract
Two cases of patients were hospitalized for sore throat with Dysphagia.Check:Wall of the pharynx,tongue and epiglottis scattered the ulcer.The patients were loss of pharynx reflex.Oropharynx and piriform fossa has a lot of saliva retention.Posterior pharyngeal wall was drooping like waterfull.CT scan showed may be the aspiration pneumonia in right lower lung.The admission diagnosiswere pharyngeal herpes zoster virus infection,pharyngeal side muscle paralysis,and inhalation pneumonia.The patients' clinical data were retrospectively analyzed,and the report is as follows.
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Lai G, Mahadevan A, Hackney D, Warnke PC, Nigim F, Kasper E, Wong ET, Carter BS, Chen CC. Diagnostic Accuracy of PET, SPECT, and Arterial Spin-Labeling in Differentiating Tumor Recurrence from Necrosis in Cerebral Metastasis after Stereotactic Radiosurgery. AJNR Am J Neuroradiol 2015; 36:2250-5. [PMID: 26427832 DOI: 10.3174/ajnr.a4475] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 05/03/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND PURPOSE Radiographic assessment of cerebral metastasis after stereotactic radiosurgery remains a major challenge in neuro-oncology. It is often difficult to distinguish tumor progression from radiation necrosis in this setting using conventional MR imaging. The objective of this study was to compare the diagnostic sensitivity and specificity of different functional imaging modalities for detecting tumor recurrence after stereotactic radiosurgery. MATERIALS AND METHODS We retrospectively reviewed patients treated between 2007 and 2010 and identified 14 patients with cerebral metastasis who had clinical or radiographic progression following stereotactic radiosurgery and were imaged with arterial spin-labeling, FDG-PET, and thallium SPECT before stereotactic biopsy. Diagnostic accuracy, specificity, sensitivity, positive predictive value, and negative predictive value were calculated for each imaging technique by using the pathologic diagnosis as the criterion standard. RESULTS Six patients (42%) had tumor progression, while 8 (58%) developed radiation necrosis. FDG-PET and arterial spin-labeling were equally sensitive in detecting tumor progression (83%). However, the specificity of arterial spin-labeling was superior to that of the other modalities (100%, 75%, and 50%, respectively). A combination of modalities did not augment the sensitivity, specificity, positive predictive value, or negative predictive value of arterial spin-labeling. CONCLUSIONS In our series, arterial spin-labeling positivity was closely associated with the pathologic diagnosis of tumor progression after stereotactic radiosurgery. Validation of this finding in a large series is warranted.
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Affiliation(s)
- G Lai
- From the School of Medicine (G.L., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | | | | | - P C Warnke
- Division of Neurosurgery (P.C.W.), University of Chicago, Chicago, Illinois
| | - F Nigim
- Division of Neurosurgery (F.N., E.K.)
| | - E Kasper
- Division of Neurosurgery (F.N., E.K.)
| | - E T Wong
- Department of Neurology (E.T.W.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - B S Carter
- From the School of Medicine (G.L., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - C C Chen
- From the School of Medicine (G.L., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
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Abstract
Chronic pain, when not effectively treated, is a leading health and socioeconomic problem and has a harmful effect on all aspects of health-related quality of life. Therefore, understanding the molecular mechanism of how pain transitions from the acute to chronic phase is essential for developing effective novel analgesics. Accumulated evidence has shown that the transition from acute to chronic pain is determined by a cellular signaling switch called hyperalgesic priming, which occurs in primary nociceptive afferents. The hyperalgesic priming is triggered by inflammatory mediators and is involved in a signal switch from protein kinase A (PKA) to protein kinase Cε (PKCε) located in both isolectin B4 (IB4)-positive (nonpeptidergic) and IB4-negative (peptidergic) nociceptors. Acidosis may be the decisive factor regulating the PKA-to-PKCε signal switch in a proton-sensing G-protein-coupled receptor-dependent manner. Protons can also induce the hyperalgesic priming in IB4-negative muscle nociceptors in a PKCε-independent manner. Acid-sensing ion channel 3 (ASIC3) and transient receptor potential/vanilloid receptor subtype 1 (TRPV1) are 2 major acid sensors involved in the proton-induced hyperalgesic priming. The proton-induced hyperalgesic priming in muscle afferents can be prevented by a substance P-mediated signaling pathway. In this review, we summarize the factors that modulate hyperalgesic priming in both IB4-positive and IB4-negative nociceptors and discuss the role of acid signaling in inflammatory and noninflammatory pain as well as orofacial muscle pain.
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Affiliation(s)
- W H Sun
- Department of Life Sciences, National Central University, Jhongli, Taiwan
| | - C C Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan Taiwan Mouse Clinic-National Comprehensive Mouse Phenotyping and Drug Testing Center, Academia Sinica, Taipei, Taiwan
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Chen CC, Cheng KW, Chang SS. Impact on population alcohol use of policy changes following WTO membership in Taiwan. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Liu YW, Fu TY, Peng WS, Chen YH, Cao YM, Chen CC, Hung WL, Tsai YC. Evaluation of the potential anti-allergic effects of heat-inactivated Lactobacillus paracasei V0151 in vitro, ex vivo, and in vivo. Benef Microbes 2015; 6:697-705. [PMID: 26192907 DOI: 10.3920/bm2014.0159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The efficacy of Lactobacillus paracasei V0151 (V0151), isolated from the faeces of a child, to modulate immune responses was investigated. In RAW 264.7 cells expressing an inducible nitric oxide synthase (iNOS)-directed luciferase gene, heat-inactivated V0151 stimulated iNOS expression followed by nitric oxide production. V0151 significantly elevated interferon gamma, interleukin (IL)-10, tumour necrosis factor alpha, and IL-1β production in human peripheral blood mononuclear cells. In splenocytes isolated from ovalbumin (OVA)-sensitised BALB/c mice treated with OVA and V0151 at different bacterium-to-cell ratios (1:1, 10:1, and 20:1) for 96 h, IL-2, IL-4, IL-5, and IL-13 production was dose-dependently downregulated, whereas IL-12 was dose-dependently upregulated. Collectively, our findings indicate that V0151 might regulate pro-inflammatory factors in macrophages and splenocytes. Furthermore, the T helper 1/T helper 2 (Th1/Th2) balance was also skewed toward Th1 dominance through the elevation of Th1 cytokine production.
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Affiliation(s)
- Y W Liu
- 1 Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Li-Nong St., Sec. 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C
| | - T Y Fu
- 1 Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Li-Nong St., Sec. 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C.,2 Probiotics Research Center, National Yang-Ming University, No. 155, Li-Nong St., Section 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C
| | - W S Peng
- 1 Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Li-Nong St., Sec. 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C.,2 Probiotics Research Center, National Yang-Ming University, No. 155, Li-Nong St., Section 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C
| | - Y H Chen
- 1 Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Li-Nong St., Sec. 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C.,2 Probiotics Research Center, National Yang-Ming University, No. 155, Li-Nong St., Section 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C
| | - Y M Cao
- 3 Want Want China Holdings Ltd., No.1088, East Hond Song Rd., Shanghai 201103, China P.R
| | - C C Chen
- 3 Want Want China Holdings Ltd., No.1088, East Hond Song Rd., Shanghai 201103, China P.R
| | - W L Hung
- 3 Want Want China Holdings Ltd., No.1088, East Hond Song Rd., Shanghai 201103, China P.R
| | - Y C Tsai
- 1 Institute of Biochemistry and Molecular Biology, National Yang-Ming University, No. 155, Li-Nong St., Sec. 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C.,2 Probiotics Research Center, National Yang-Ming University, No. 155, Li-Nong St., Section 2, BeiTou Dist., Taipei 11221, Taiwan, R.O.C
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Sheu YT, Chen SC, Chien CC, Chen CC, Kao CM. Application of a long-lasting colloidal substrate with pH and hydrogen sulfide control capabilities to remediate TCE-contaminated groundwater. J Hazard Mater 2015; 284:222-232. [PMID: 25463237 DOI: 10.1016/j.jhazmat.2014.11.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Revised: 11/15/2014] [Accepted: 11/19/2014] [Indexed: 06/04/2023]
Abstract
A long-lasting emulsified colloidal substrate (LECS) was developed for continuous carbon and nanoscale zero-valent iron (nZVI) release to remediate trichloroethylene (TCE)-contaminated groundwater under reductive dechlorinating conditions. The developed LECS contained nZVI, vegetable oil, surfactants (Simple Green™ and lecithin), molasses, lactate, and minerals. An emulsification study was performed to evaluate the globule droplet size and stability of LECS. The results show that a stable oil-in-water emulsion with uniformly small droplets (0.7 μm) was produced, which could continuously release the primary substrates. The emulsified solution could serve as the dispensing agent, and nZVI particles (with diameter 100-200 nm) were distributed in the emulsion evenly without aggregation. Microcosm results showed that the LECS caused a rapid increase in the total organic carbon concentration (up to 488 mg/L), and reductive dechlorination of TCE was significantly enhanced. Up to 99% of TCE (with initial concentration of 7.4 mg/L) was removed after 130 days of operation. Acidification was prevented by the production of hydroxide ion by the oxidation of nZVI. The formation of iron sulfide reduced the odor from produced hydrogen sulfide. Microbial analyses reveal that dechlorinating bacteria existed in soils, which might contribute to TCE dechlorination.
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Affiliation(s)
- Y T Sheu
- Institute of Environmental Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - S C Chen
- Department of Life Sciences, National Central University, Chung-Li, Taiwan
| | - C C Chien
- Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Chung-Li, Taiwan
| | - C C Chen
- Department of Biotechnology, National Kaohsiung Normal University, Kaohsiung, Taiwan
| | - C M Kao
- Institute of Environmental Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan.
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Chen CM, Huang KC, Chen CC, Huang SU, Huang CE, Chen YY, Hsu SL. The impact of joint range of motion limitations on health-related quality of life in patients with haemophilia A: a prospective study. Haemophilia 2015; 21:e176-e184. [PMID: 25684270 DOI: 10.1111/hae.12644] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2015] [Indexed: 11/29/2022]
Abstract
In patients with haemophilia A, repeated occurrences of haemarthrosis and synovitis lead to limitations in range of motion (ROM) of major joints. However, the effect of limitations in joint ROM on health-related quality of life (HRQOL) in these patients has not been studied previously. The aim of this study was to assess the impact of ROM limitations of 10 major joints (bilateral shoulders, elbows, hips, knees and ankles), combined with other possibly influential factors, on HRQOL in patients with haemophilia A. The ROM limitations in 13 movements and pain intensity of the 10 major joints were measured. The socio-demographic and clinical data were recorded. Short-Form 36 was used as the HRQOL measurement. Eighteen patients (mean age: 36.9 years) were included. Hip ROM limitations, knee ROM limitations and hip pain intensity predicted physical functioning scale (P < 0.001; adjusted R2 = 0.553). Shoulder ROM limitations and age predicted role limitation were due to emotional problems scale (P < 0.001; adjusted R2 = 0.373). Elbow ROM limitations and haemophilia severity predicted mental health scale (P = 0.001; adjusted R2 = 0.320). Hip ROM limitations predicted social functioning scale (P = 0.041; adjusted R2 = 0.091). Educational level and elbow ROM limitations predicted vitality scale (P < 0.001; adjusted R2 = 0.416). The ROM limitations of hip, knee, shoulder and elbow could be predictors for HRQOL in patients with haemophilia A. Improving ROM of major joints could be an appropriate treatment strategy to enhance HRQOL in these patients.
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Affiliation(s)
- C M Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Haemophilia and Thrombosis Treatment Center, Chang Gung Memorial Hospital, Chiayi, Taiwan
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Cheng YH, Deng TC, Chen CC, Chiang CH, Chang CA. First Report of Euphorbia leaf curl virus and Papaya leaf curl Guangdong virus on Passion Fruit in Taiwan. Plant Dis 2014; 98:1746. [PMID: 30703901 DOI: 10.1094/pdis-05-13-0554-pdn] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Passion fruit (Passiflora edulis × Passiflora edulis f. flavicarpa) 'Tainung No. 1' is the main variety cultivated in Taiwan, which is a hybrid and propagated only by grafting. In the spring of 2011, plants with systemic mottle and malformation on leaves were found in some orchards located in Puli and Nantou in central Taiwan. Interestingly, after 3 months of growth, most of these diseased plants became symptomless when the weather became warmer. Nevertheless, some striped concaves were observed on immature fruit surfaces of diseased plants. In March of 2011, two leaf samples exhibiting mosaic and three samples showing malformation were collected and tested by DAS-ELISA; none positively reacted with antibodies against the Cucumber mosaic virus (CMV), East Asian passiflora virus (EAPV), Passion fruit mottle virus (PaMV), or Passion fruit crinkle virus (PCV) that have previously occurred in Taiwan. Rolling-circle amplification (RCA) with hexamer primers were adopted to analyze potential begomoviruses that were prevalent on the other crops in Taiwan (3). The RCA amplified products were digested with BamHI and separated on 1.2% agarose by gel electrophoresis. A fragment, about 3 kb, was purified from each gel and cloned into the respective site of pBluescript SK(-) individually. Clones were screened by EcoRI digestion and two types of restriction fragment length patterns were found among them. One type of a clone containing 2,745 nucleotides (Accession No. KC161185) with 98.5% identity to Euphorbia leaf curl virus (EuLCV) (1) and the other type of a clone containing 2,732 nucleotides (KC161184) with 91.7% identity to Papaya leaf curl Guangdong virus (PaLCuGDV) (2) were revealed by nucleotide comparisons of their DNA-A in GenBank. Accordingly, we confirmed the existence of passiflora isolates of EuLCV and PaLCuGDV. PCR primers CPup/Edw/Pdw (5'TGTGAAGG(A/C/G/T)CC(A/G/T)TGTAA(A/G)GT3'/5'CGCAGTTT CTGGAGGATATTAAG3'/5'TCGCATGCCACTTCCTCAGT3') were designed to differentiate these viruses by amplifying a 235 bp DNA fragment for EuLCV and 345 bp for PaLCuGDV. In a brief survey, all 26 passion fruit leaf samples collected from seven orchards were double infected with EuLCV and PaLCuGDV; only six samples collected from a specific orchard were found to harbor the PaLCuGDV infection. Thirty-seven seedlings from passion fruit (P. edulis f. flavicarpa) seeds were indexed and all were free from both viruses. Five virus-free plantlets of P. edulis f. flavicarpa, one EuLCV and PalCuGDV double infected P. edulis × P. edulis f. flavicarpa, and 20 whiteflies were put into one net tent for 2 months, and then the five plantlets were tested by PCR. The two EuLCV and PalCuGDV specific fragments were amplified from all five plantlets. The two begomoviruses cause mild symptoms on passion fruit plant but the appearance of the fruit was affected. To our knowledge, this is the first report of begomoviruses infecting passion fruit in Taiwan and in Asia. References: (1) X. Ma et al. J. Phytopathol. 152:215. (2) X. Wang et al. Virus Genes 29:303. (3) C. Wu et al. J. Virol. Methods 147:355.
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Affiliation(s)
- Y H Cheng
- Division of Plant Pathology, Agricultural Research Institute, Taichung, Taiwan
| | - T C Deng
- Division of Plant Pathology, Agricultural Research Institute, Taichung, Taiwan
| | - C C Chen
- Division of Plant Pathology, Agricultural Research Institute, Taichung, Taiwan
| | - C H Chiang
- Department of Molecular Biotechnology, Da-Yeh University, Chunghua, Taiwan
| | - C A Chang
- Graduate Institute of Biochemical Science and Technology, Chaoyang University of Technology, Taichung, Taiwan
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Steed TC, Treiber JM, Patel KS, Taich Z, White NS, Treiber ML, Farid N, Carter BS, Dale AM, Chen CC. Iterative probabilistic voxel labeling: automated segmentation for analysis of The Cancer Imaging Archive glioblastoma images. AJNR Am J Neuroradiol 2014; 36:678-85. [PMID: 25414001 DOI: 10.3174/ajnr.a4171] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/30/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Robust, automated segmentation algorithms are required for quantitative analysis of large imaging datasets. We developed an automated method that identifies and labels brain tumor-associated pathology by using an iterative probabilistic voxel labeling using k-nearest neighbor and Gaussian mixture model classification. Our purpose was to develop a segmentation method which could be applied to a variety of imaging from The Cancer Imaging Archive. MATERIALS AND METHODS Images from 2 sets of 15 randomly selected subjects with glioblastoma from The Cancer Imaging Archive were processed by using the automated algorithm. The algorithm-defined tumor volumes were compared with those segmented by trained operators by using the Dice similarity coefficient. RESULTS Compared with operator volumes, algorithm-generated segmentations yielded mean Dice similarities of 0.92 ± 0.03 for contrast-enhancing volumes and 0.84 ± 0.09 for FLAIR hyperintensity volumes. These values compared favorably with the means of Dice similarity coefficients between the operator-defined segmentations: 0.92 ± 0.03 for contrast-enhancing volumes and 0.92 ± 0.05 for FLAIR hyperintensity volumes. Robust segmentations can be achieved when only postcontrast T1WI and FLAIR images are available. CONCLUSIONS Iterative probabilistic voxel labeling defined tumor volumes that were highly consistent with operator-defined volumes. Application of this algorithm could facilitate quantitative assessment of neuroimaging from patients with glioblastoma for both research and clinical indications.
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Affiliation(s)
- T C Steed
- From the Neurosciences Graduate Program (T.C.S.) School of Medicine (T.C.S., J.M.T.) Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - J M Treiber
- School of Medicine (T.C.S., J.M.T.) Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - K S Patel
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California Weill-Cornell Medical College (K.S.P.), New York Presbyterian Hospital, New York, New York
| | - Z Taich
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - N S White
- Multimodal Imaging Laboratory (N.S.W., N.F., A.M.D.)
| | - M L Treiber
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - N Farid
- Multimodal Imaging Laboratory (N.S.W., N.F., A.M.D.) Department of Radiology (N.F., A.M.D.)
| | - B S Carter
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
| | - A M Dale
- Multimodal Imaging Laboratory (N.S.W., N.F., A.M.D.) Department of Radiology (N.F., A.M.D.)
| | - C C Chen
- Center for Theoretical and Applied Neuro-Oncology, Division of Neurosurgery, Moores Cancer Center (T.C.S., J.M.T., K.S.P., Z.T., M.L.T., B.S.C., C.C.C.), University of California, San Diego, La Jolla, California
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Chen CC, Chang MW, Chang CP, Chan SC, Chang WY, Yang CL, Lin MT. A forced running wheel system with a microcontroller that provides high-intensity exercise training in an animal ischemic stroke model. ACTA ACUST UNITED AC 2014; 47:858-68. [PMID: 25140816 PMCID: PMC4181221 DOI: 10.1590/1414-431x20143754] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 05/12/2014] [Indexed: 12/19/2022]
Abstract
We developed a forced non-electric-shock running wheel (FNESRW) system that provides rats with high-intensity exercise training using automatic exercise training patterns that are controlled by a microcontroller. The proposed system successfully makes a breakthrough in the traditional motorized running wheel to allow rats to perform high-intensity training and to enable comparisons with the treadmill at the same exercise intensity without any electric shock. A polyvinyl chloride runway with a rough rubber surface was coated on the periphery of the wheel so as to permit automatic acceleration training, and which allowed the rats to run consistently at high speeds (30 m/min for 1 h). An animal ischemic stroke model was used to validate the proposed system. FNESRW, treadmill, control, and sham groups were studied. The FNESRW and treadmill groups underwent 3 weeks of endurance running training. After 3 weeks, the experiments of middle cerebral artery occlusion, the modified neurological severity score (mNSS), an inclined plane test, and triphenyltetrazolium chloride were performed to evaluate the effectiveness of the proposed platform. The proposed platform showed that enhancement of motor function, mNSS, and infarct volumes was significantly stronger in the FNESRW group than the control group (P<0.05) and similar to the treadmill group. The experimental data demonstrated that the proposed platform can be applied to test the benefit of exercise-preconditioning-induced neuroprotection using the animal stroke model. Additional advantages of the FNESRW system include stand-alone capability, independence of subjective human adjustment, and ease of use.
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Affiliation(s)
- C C Chen
- Department of Electrical Engineering, National Cheng-Kung University, Tainan, Taiwan
| | - M W Chang
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - C P Chang
- Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - S C Chan
- Department of Electrical Engineering, National Cheng-Kung University, Tainan, Taiwan
| | - W Y Chang
- Department of Electrical Engineering, National Cheng-Kung University, Tainan, Taiwan
| | - C L Yang
- Department of Electrical Engineering, National Cheng-Kung University, Tainan, Taiwan
| | - M T Lin
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
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Tain YL, Sheen JM, Chen CC, Yu HR, Tiao MM, Kuo HC, Huang LT. Maternal citrulline supplementation prevents prenatal dexamethasone-induced programmed hypertension. Free Radic Res 2014; 48:580-6. [PMID: 24555785 DOI: 10.3109/10715762.2014.895341] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Glucocorticoids are administered to premature infants to accelerate pulmonary maturation. In experimental model, prenatal dexamethasone (DEX) results in reduced nephron number and adulthood hypertension. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase (NOS), can cause oxidative stress and is involved in the development of hypertension. L-citrulline can be converted to l-arginine (the substrate for NOS) in the body. Thus we intended to determine if maternal L-citrulline therapy can prevent prenatal DEX-induced programmed hypertension by restoration ADMA/nitric oxide (NO) balance, alterations of renin-angiotensin system (RAS) and sodium transporters, and epigenetic regulation by histone deacetylases (HDACs). Male offspring were assigned to four groups: control, pregnancy rats received intraperitoneal DEX (0.2 mg/kg body weight) daily on gestational days 15 and 16 (DEX), pregnancy rats received 0.25% L-citrulline in drinking water during the entire pregnancy and lactation period (CIT), and DEX + CIT. We found DEX group developed hypertension at 16 weeks of age, which was prevented by maternal L-citrulline therapy. Prenatal DEX exposure increased plasma ADMA concentrations and reduced renal NO production. However, L-citrulline reduced plasma ADMA level and increased renal level of NO in DEX + CIT group. Next, prenatal DEX-induced programmed hypertension is related to increased mRNA expression of angiotensin and angiotensin II type 1 receptor, and class I HDACs in the kidney. Prenatal DEX exposure increased renal protein abundance of Na(+)/Cl(-) cotransporter (NCC), which was prevented by L-citrulline therapy. The beneficial effects of L-citrulline therapy include restoration of ADMA/NO balance and alteration of NCC, to prevent the prenatal DEX-induced programmed hypertension.
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Affiliation(s)
- Y L Tain
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine , Kaohsiung , Taiwan
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Lin PL, Huang PY, Huang PW, Hsu HC, Chen CC. Teeth segmentation of dental periapical radiographs based on local singularity analysis. Comput Methods Programs Biomed 2014; 113:433-445. [PMID: 24252317 DOI: 10.1016/j.cmpb.2013.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 09/12/2013] [Accepted: 10/22/2013] [Indexed: 06/02/2023]
Abstract
Teeth segmentation for periapical raidographs is one of the most critical tasks for effective periapical lesion or periodontitis detection, as both types of anomalies usually occur around tooth boundaries and dental radiographs are often subject to noise, low contrast, and uneven illumination. In this paper, we propose an effective scheme to segment each tooth in periapical radiographs. The method consists of four stages: image enhancement using adaptive power law transformation, local singularity analysis using Hölder exponent, tooth recognition using Otsu's thresholding and connected component analysis, and tooth delineation using snake boundary tracking and morphological operations. Experimental results of 28 periapical radiographs containing 106 teeth in total and 75 useful for dental examination demonstrate that 105 teeth are successfully isolated and segmented, and the overall mean segmentation accuracy of all 75 useful teeth in terms of (TP, FP) is (0.8959, 0.0093) with standard deviation (0.0737, 0.0096), respectively.
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Affiliation(s)
- P L Lin
- Department of Computer Science and Information Engineering, Providence University, Shalu, Taichung 43301, Taiwan.
| | - P Y Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - P W Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - H C Hsu
- College of Oral Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - C C Chen
- College of Oral Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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Abstract
Neonatal lupus is a rare and acquired autoimmune disease. Central nervous system abnormalities are potential manifestations in neonatal lupus. Through a systematic literature review, we analyzed the clinical features of previously reported neonatal lupus cases where central nervous system abnormalities had been identified. Most reported neonatal lupus patients with central nervous system involvement were neuroimaging-determined and asymptomatic. Only seven neonatal lupus cases were identified as having a symptomatic central nervous system abnormality which caused physical disability or required neurosurgery. A high percentage of these neurosymptomatic neonatal lupus patients had experienced a transient cutaneous skin rash and had no maternal history of autoimmune disease before pregnancy.
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Affiliation(s)
- C C Chen
- 1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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McDonald CR, White NS, Farid N, Lai G, Kuperman JM, Bartsch H, Hagler DJ, Kesari S, Carter BS, Chen CC, Dale AM. Recovery of white matter tracts in regions of peritumoral FLAIR hyperintensity with use of restriction spectrum imaging. AJNR Am J Neuroradiol 2013; 34:1157-63. [PMID: 23275591 DOI: 10.3174/ajnr.a3372] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE DTI is being increasingly used to visualize critical white matter tracts adjacent to brain tumors before neurosurgical resection. However, brain tumors, particularly high-grade gliomas, are typically surrounded by regions of FLAIR hyperintensity that include edema, which increase isotropic diffusion, degrading the ability of standard DTI to uncover orientation estimates within these regions. We introduce a new technique, RSI, which overcomes this limitation by removing the spherical, fast diffusion component introduced by edema, providing better analysis of white matter architecture. MATERIALS AND METHODS A total of 10 patients with high-grade gliomas surrounded by FLAIR-HI that at least partially resolved on follow-up imaging were included. All patients underwent RSI and DTI at baseline (FLAIR-HI present) and at follow-up (FLAIR-HI partially resolved). FA values obtained with RSI and DTI were compared within regions of FLAIR-HI and NAWM at both time points. RESULTS RSI showed higher FA in regions of FLAIR-HI and NAWM relative to DTI, reflecting the ability of RSI to specifically measure the slow, restricted volume fraction in regions of edema and NAWM. Furthermore, a method by time interaction revealed that FA estimates increased when the FLAIR-HI resolved by use of standard DTI but remained stable with RSI. Tractography performed within the region of FLAIR-HI revealed the superior ability of RSI to track fibers through severe edema relative to standard DTI. CONCLUSIONS RSI improves the quantification and visualization of white matter tracts in regions of peritumoral FLAIR-HI associated with edema relative to standard DTI and may provide a valuable tool for neurosurgical planning.
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Affiliation(s)
- C R McDonald
- Departments of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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Abstract
Neonatal lupus is a passively acquired autoimmune syndrome resulting from the transplacental passage of maternal anti-Ro/SSA and/or anti-La/SSB antibodies to the fetus. Few past studies have reported central nervous system involvement in neonatal lupus, and most cases had a good neurological outcome. We report here a preterm case of neonatal lupus with thrombocytopenia and comorbid hemorrhagic stroke. In the follow-up, the infant developed spastic quadriplegia and showed delayed milestones. We believe that this is the first reported case of neonatal lupus accompanied by perinatal hemorrhagic stroke. We present this case to remind clinicians to conduct regular central nervous system surveys in cases of neonatal lupus.
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Affiliation(s)
- C C Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Wu CC, Hus LC, Chiang PN, Liu JC, Kuan WH, Chen CC, Tzou YM, Wang MK, Hwang CE. Oxidative removal of arsenite by Fe(II)- and polyoxometalate (POM)-amended zero-valent aluminum (ZVAl) under oxic conditions. Water Res 2013; 47:2583-2591. [PMID: 23497977 DOI: 10.1016/j.watres.2013.02.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 02/11/2013] [Accepted: 02/16/2013] [Indexed: 06/01/2023]
Abstract
Abiotic transformation of As(III) to As(V) is possible which would decrease As toxicity. This study investigated the potential applications of zero-valent Al (ZVAl) or Al wastes, such as Al beverage cans, for converting As(III) to As(V) in an acidic solution under aerobic conditions. Results showed that As(III) could not be oxidized by ZVAl within 150 min reaction at pH 1 because of the presence of an oxide layer on ZVAl. However, 85 μM As(III) could be completely oxidized with the addition of Fe(II) or POM due to the generation of a Fenton reaction or the enhancement of H2O2 production, respectively, on the ZVAl surfaces. Because Fe(II) or polyoxometalate (POM) exhibited more stable at low pH and scavenged rapidly the H2O2 produced on the aerated ZVAl surfaces, OH radical productions were more efficient and As(III) was rapidly oxidized in the ZVAl/O2 system with theses two catalysts. The catalytic oxidation kinetics of As(III) in the presence of Fe(II) or POM were best described by zero-order reaction, and the rate constants increased with a decrease of pH from 2 to 1. Following the oxidative conversion of As(III) to As(V) in the ZVAl/Fe/O2 system, As(V) was removed by the newly formed hydrous Al/Fe precipitates by increasing the solution pH to 6. Nonetheless, the As(V) removal was incomplete in the ZVAl/POM/O2 system because the hydrolyzed products of POM, e.g., PO4(3-), inhibited As(V) removal due to the competitive adsorption of the oxyanion on Al precipitates. Discarded Al-based beverage cans exhibit a higher efficiency for As(III) oxidation and final As removal compared with that of ZVAl, and thus, the potential application of Al beverage cans to scavenge As in solutions is feasible.
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Affiliation(s)
- C C Wu
- Department of Soil & Environmental Sciences, National Chung Hsing University, 250 Kuo-Kuang Rd., Taichung 40227, Taiwan, ROC
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Chang KW, Lin MC, Lee SY, Chen HY, Chen CC, Fu YK. Effects of [123I]ADAM, a serotonin transporter radiopharmaceutical, on pregnant Sprague-Dawley rats. Appl Radiat Isot 2012; 70:2646-51. [PMID: 22960183 DOI: 10.1016/j.apradiso.2012.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 06/20/2012] [Accepted: 06/21/2012] [Indexed: 11/26/2022]
Abstract
Serotonin transport abnormalities are implicated in neuropsychiatric disorders. [(123)I]ADAM ([(123)I]-2-([2-({dimethylamino}methyl)phenyl]thio)-5-iodophenylamine) is a novel radiotracer that targets serotonin transporters. We assessed the toxicity of [(123)I]ADAM (18.5 MBq) administered in early- and late-phases (8 and 14 day postfertilization, respectively) of pregnancy. The mortality, clinical status, and gross necropsy were measured in pregnant rats, and the fertility index was measured in rat offspring (weight, clinical observations). We found no dosing-related clinical signs. In conclusion, [(123)I]ADAM was not toxic in an animal pregnancy model.
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Affiliation(s)
- K W Chang
- Institute of Nuclear Energy Research, Division of Isotope Application, Taoyuan County, Taiwan
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Chen CC, Williams CL. Interactions between epinephrine, ascending vagal fibers, and central noradrenergic systems in modulating memory for emotionally arousing events. Front Behav Neurosci 2012; 6:35. [PMID: 22754515 PMCID: PMC3384987 DOI: 10.3389/fnbeh.2012.00035] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 06/12/2012] [Indexed: 02/06/2023] Open
Abstract
It is well-established that exposure to emotionally laden events initiates secretion of the arousal-related hormone epinephrine in the periphery. These neuroendocrine changes and the subsequent increase in peripheral physiological output play an integral role in modulating brain systems involved in memory formation. The impermeability of the blood brain barrier to epinephrine represents an important obstacle in understanding how peripheral hormones initiate neurochemical changes in the brain that lead to effective memory formation. This obstacle necessitated the identity of a putative pathway capable of conveying physiological changes produced by epinephrine to limbic structures that incorporate arousal and affect related information into memory. A major theme of the proposed studies is that ascending fibers of the vagus nerve may represent such a mechanism. This hypothesis was tested by evaluating the contribution of ascending vagal fibers in modulating memory for responses learned under behavioral conditions that produce emotional arousal by manipulating appetitive stimuli. A combination of electrophysiological recording of vagal afferent fibers and in vivo microdialysis was employed in a second study to simultaneously assess how elevations in peripheral levels of epinephrine affect vagal nerve discharge and the subsequent potentiation of norepinephrine release in the basolateral amygdala. The final study used double immunohistochemistry labeling of c-fos and dopamine beta hydroxylase (DBH), the enzyme for norepinephrine synthesis to determine if epinephrine administration alone or stimulation of the vagus nerve at an intensity identical to that which improved memory in Experiment 1 produces similar patterns of neuronal activity in brain areas involved in processing memory for emotional events. Findings emerging from this collection of studies establish the importance of ascending fibers of the vagus nerve as an essential pathway for conveying the peripheral consequences of physiological arousal on brain systems that encode new information into memory storage.
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Affiliation(s)
- C C Chen
- Department of Psychology, The University of Virginia, Charlottesville VA, USA
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Huang SW, Chiang PN, Liu JC, Hung JT, Kuan WH, Tzou YM, Wang SL, Huang JH, Chen CC, Wang MK, Loeppert RH. Chromate reduction on humic acid derived from a peat soil--exploration of the activated sites on HAs for chromate removal. Chemosphere 2012; 87:587-94. [PMID: 22309710 DOI: 10.1016/j.chemosphere.2012.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 01/06/2012] [Accepted: 01/07/2012] [Indexed: 05/25/2023]
Abstract
Humic substances are a major component of soil organic matter that influence the behavior and fate of heavy metals such as Cr(VI), a toxic and carcinogenic element. In the study, a repetitive extraction technique was used to fractionate humic acids (HAs) from a peat soil into three fractions (denoted as F1, F2, and F3), and the relative importance of O-containing aromatic and aliphatic domains in humic substances for scavenging Cr(VI) was addressed at pH 1. Spectroscopic analyses indicated that the concentrations of aromatic C and O-containing functional groups decreased with a progressive extraction as follows: F1>F2>F3. Cr(VI) removal by HA proceeded slowly, but it was enhanced when light was applied due to the production of efficient reductants, such as superoxide radical and H(2)O(2), for Cr(VI). Higher aromatic- and O-containing F1 fraction exhibited a greater efficiency for Cr(VI) reduction (with a removal rate of ca. 2.89 mmol g(-1) HA under illumination for 3 h). (13)C NMR and FTIR spectra further demonstrated that the carboxyl groups were primarily responsible for Cr(VI) reduction. This study implied the mobility and fate of Cr(VI) would be greatly inhibited in the environments containing such organic groups.
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Affiliation(s)
- S W Huang
- Department of Soil & Environmental Sciences, National Chung Hsing University, Taichung, TW 40227, Taiwan, ROC
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Becker BF, Fischer J, Hartmann H, Chen CC, Sommerhoff CP, Tschoep J, Conzen PC, Annecke T. Inosine, not adenosine, initiates endothelial glycocalyx degradation in cardiac ischemia and hypoxia. Nucleosides Nucleotides Nucleic Acids 2012; 30:1161-7. [PMID: 22132971 DOI: 10.1080/15257770.2011.605089] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Ischemia/reperfusion and hypoxia/reoxygenation of the heart both induce shedding of the coronary endothelial glycocalyx. The processes leading from an oxygen deficit to shedding are unknown. An involvement of resident perivascular cardiac mast cells has been proposed. We hypothesized that either adenosine or inosine or both, generated by nucleotide catabolism, attain the concentrations in the interstitial space sufficient to stimulate A3 receptors of mast cells during both myocardial ischemia/reperfusion and hypoxia/reoxygenation. Isolated hearts of guinea pigs were subjected to either normoxic perfusion (hemoglobin-free Krebs-Henseleit buffer equilibrated with 95% oxygen), 20 minutes hypoxic perfusion (buffer equilibrated with 21% oxygen) followed by 20 minutes reoxygenation, or 20 minutes stopped-flow ischemia followed by 20 minutes normoxic reperfusion (n = 7 each). Coronary venous effluent was collected separately from so-called transudate, a mixture of interstitial fluid and lymphatic fluid appearing on the epicardial surface. Adenosine and inosine were determined in both fluid compartments using high-performance liquid chromatography. Damage to the glycocalyx was evident after ischemia/reperfusion and hypoxia/reoxygenation. Adenosine concentrations rose to a level of 1 μM in coronary effluent during hypoxic perfusion, but remained one order of magnitude lower in the interstitial fluid. There was only a small rise in the level during postischemic perfusion. In contrast, inosine peaked at over 10 μM in interstitial fluid during hypoxia and also during reperfusion, while effluent levels remained relatively unchanged at lower levels. We conclude that only inosine attains levels in the interstitial fluid of hypoxic and postischemic hearts that are sufficient to explain the activation of mast cells via stimulation of A3-type receptors.
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Affiliation(s)
- B F Becker
- Walter-Brendel-Centre of Experimental Medicine, Ludwig-Maximilians-University, Munich, Germany.
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Chen KY, Liu JC, Chiang PN, Wang SL, Kuan WH, Tzou YM, Deng Y, Tseng KJ, Chen CC, Wang MK. Chromate removal as influenced by the structural changes of soil components upon carbonization at different temperatures. Environ Pollut 2012; 162:151-158. [PMID: 22243860 DOI: 10.1016/j.envpol.2011.10.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 10/19/2011] [Accepted: 10/29/2011] [Indexed: 05/31/2023]
Abstract
Surface fire could induce heat transferring into the soil, creating a carbonized environment, which may alter the chemical compositions of soil organic matters (SOM). In the study, a surface soil was carbonized at up to 600 °C with limited air to simulate soils experiencing a surface fire, and Cr(VI) removal on the carbonized soils was investigated. NMR and FTIR analyses demonstrated a remarkable change of SOM structures at 300-400 °C. TGA-MS spectra indicated that (e.g. C(2)H(4), CH(3)OH and C(3)H(8)) were the major components in the evolved gases from the pyrolyzed soil. A maximum amount of Cr(VI) removal (ca. 4 mg g(-1) soil) occurred for the 200 °C-carbonized soils, attributed mainly to a significant increase of Cr(VI) reduction by 0.1 M KCl extractable organic carbon (EOC) with abundant carboxylic groups. Nonetheless, the formation of aromatic C upon carbonization of the soil at >400 °C may be responsible for Cr(VI) reduction.
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Affiliation(s)
- K Y Chen
- Department of Soil & Environmental Sciences, National Chung Hsing University, Taichung, Taiwan, ROC
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Chen SY, Huang SW, Chiang PN, Liu JC, Kuan WH, Huang JH, Hung JT, Tzou YM, Chen CC, Wang MK. Influence of chemical compositions and molecular weights of humic acids on Cr(VI) photo-reduction. J Hazard Mater 2011; 197:337-344. [PMID: 22001571 DOI: 10.1016/j.jhazmat.2011.09.091] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 09/26/2011] [Accepted: 09/26/2011] [Indexed: 05/31/2023]
Abstract
Humic acids (HA) strongly affect the fate of trace metals in soils and aquatic environments. One of the remarkable properties of HA is its ability to reduce Cr(VI), an extremely toxic anion. However, it is unclear which HA components are involved in Cr(VI) reduction and possess the photo-induced properties. In this study, an ultrafiltration technique was used to fractionate HAs into four fractions of different nominal molecular weights (M(w)): >100, 50-100, 10-50 and <10 kDa. Each HA fraction was characterized by spectroscopic analyses followed by examining Cr(VI) removal on each fraction of HA at pH 1-5. Spectroscopic results indicated that low-M(w) HA was enriched with polar and aromatic domains. These polar, including polar C in aliphatic region, and aromatic groups were the major sites for Cr(VI) reduction because they disappeared rapidly upon interaction with Cr(VI). As a result, low M(w) of HA exhibited greater efficiency of Cr(VI) reduction. Light induced the rapid transfer of electrons between chromate-phenol/carboxyl ester, or the formation of peroxide radicals or H(2)O(2) through the ready decay of peroxy radicals associated with polar substituents, explained the rapid scavenging of Cr(VI) on polar and aromatic groups of HAs under illumination.
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Affiliation(s)
- S Y Chen
- Department of Soil & Environmental Sciences, National Chung Hsing University, Taichung, Taiwan, ROC
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Ko CH, Yen JY, Yen CF, Chen CS, Chen CC. The association between Internet addiction and psychiatric disorder: a review of the literature. Eur Psychiatry 2011; 27:1-8. [PMID: 22153731 DOI: 10.1016/j.eurpsy.2010.04.011] [Citation(s) in RCA: 419] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Revised: 04/24/2010] [Accepted: 04/25/2010] [Indexed: 12/17/2022] Open
Abstract
Internet addiction is a newly emergent disorder. It has been found to be associated with a variety of psychiatric disorders. Information about such coexisting psychiatric disorders is essential to understand the mechanism of Internet addiction. In this review, we have recruited articles mentioning coexisting psychiatric disorders of Internet addiction from the PubMed database as at November 3, 2009. We describe the updated results for such disorders of Internet addiction, which include substance use disorder, attention-deficit hyperactivity disorder, depression, hostility, and social anxiety disorder. We also provide discussion for possible mechanisms accounting for the coexistence of psychiatric disorders and Internet addiction. The review might suggest that combined psychiatric disorders mentioned above should be evaluated and treated to prevent their deteriorating effect on the prognosis of Internet addiction. On the other hand, Internet addiction should be paid more attention to when treating people with these coexisting psychiatric disorders of Internet addiction. Additionally, we also suggest future necessary research directions that could provide further important information for the understanding of this issue.
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Affiliation(s)
- C H Ko
- Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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