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Xu HT, Zimmerman J, Bertoch T, Chen L, Chen PJ, Onel E. CPL-01, an investigational long-acting ropivacaine, demonstrates safety and efficacy in open inguinal hernia repair. Hernia 2024:10.1007/s10029-024-03047-3. [PMID: 38713429 DOI: 10.1007/s10029-024-03047-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/13/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND There is an unmet medical need for effective nonopioid analgesics that can decrease pain while reducing systemic opioid use. CPL-01, an extended-release injectable formulation of ropivacaine, is designed to safely provide analgesia and reduce or eliminate opioid use in the postoperative period. METHODS Subjects undergoing open inguinal hernia with mesh were prospectively randomized to 1 of 3 doses of CPL-01 (10, 20, or 30 ml of 2% CPL-01, n = 14, 12, and 14, respectively), Naropin (150 mg, n = 40), or saline placebo (n = 13) infiltrated into the surgical site prior to closure. Pain and rescue medication usage was assessed, and Numeric Rating Scale (NRS) pain scores were adjusted for opioid usage using windowed worst observation carried forward (wWOCF) imputation. The primary efficacy endpoint was the mean area under the curve (AUC) of the NRS pain intensity scores with activity. RESULTS Ninety-three subjects were treated, and 91 subjects completed 72 h of post-operative monitoring. Subjects who received the highest dose of CPL-01 in Cohort 3 showed a clinically meaningful reduction in postoperative pain intensity scores, which was the lowest value for any treatment in all cohorts, showing a trend towards statistical significance as compared to the pooled placebo group (p = 0.08), and numerically better than the 40 subjects who received Naropin. Opioid use through 72 h in subjects who received CPL-01 in Cohort 3 was approximately half of that shown in the placebo and Naropin groups; approximately 2/3 of the CPL-01 subjects (9/14) required no opioids at all through the first 72 h after the operation. More CPL-01 subjects avoided severe pain and were ready for discharge earlier than other groups. CPL-01 was safe and well-tolerated, with no clinically meaningful safety signals, and showed predictable and consistent extended-release pharmacokinetics. CONCLUSION Results suggest that CPL-01 may be the first long-acting ropivacaine to address postoperative pain while reducing the need for opioids.
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Affiliation(s)
- H T Xu
- Cali (SZ) Biosciences Co., Ltd. Shanghai Branch, Building 7, 690 Bibo Road, Shanghai, R715S, China.
| | - J Zimmerman
- Trovare Clinical Research, 3838 San Dimas St Ste A280, Bakersfield, CA, 93301, USA
| | - T Bertoch
- CeneExel JBR, 650 East 4500 South, Suite 100, Salt Lake City, UT, 84107, USA
| | - L Chen
- Cali Biosciences US, LLC, 9675 Businesspark Avenue, San Diego, CA, 92131, USA
| | - P J Chen
- Cali (SZ) Biosciences Co., Ltd. Shanghai Branch, Building 7, 690 Bibo Road, Shanghai, R715S, China
- Cali Biosciences US, LLC, 9675 Businesspark Avenue, San Diego, CA, 92131, USA
| | - E Onel
- Cali Biosciences US, LLC, 9675 Businesspark Avenue, San Diego, CA, 92131, USA
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Zisook S, Moutier CY, Rush AJ, Johnson GR, Tal I, Chen PJ, Davis LL, Hicks PB, Wilcox J, Planeta B, Lauro KW, Scrymgeour AA, Kasckow J, Mohamed S. Effect of next-step antidepressant treatment on suicidal ideation: findings from the VAST-D trial. Psychol Med 2024; 54:1172-1183. [PMID: 37859623 DOI: 10.1017/s0033291723003008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) contributes to suicide risk. Treating MDD effectively is considered a key suicide prevention intervention. Yet many patients with MDD do not respond to their initial medication and require a 'next-step'. The relationship between next-step treatments and suicidal thoughts and behaviors is uncharted. METHOD The VA Augmentation and Switching Treatments for Depression trial randomized 1522 participants to one of three next-step treatments: Switching to Bupropion, combining with Bupropion, and augmenting with Aripiprazole. In this secondary analysis, features associated with lifetime suicidal ideation (SI) and attempts (SA) at baseline and current SI during treatment were explored. RESULTS Compared to those with SI only, those with lifetime SI + SA were more likely to be female, divorced, or separated, unemployed; and to have experienced more childhood adversity. They had a more severe depressive episode and were more likely to respond to 'next-step' treatment. The prevalence of SI decreased from 46.5% (694/1492) at baseline to 21.1% (315/1492) at end-of-treatment. SI during treatment was associated with baseline SI; low positive mental health, more anxiety, greater severity and longer duration of current MDD episode; being male and White; and treatment with S-BUP or C-BUP as compared to A-ARI. CONCLUSION SI declines for most patients during next-step medication treatments. But about 1 in 5 experienced emergent or worsening SI during treatment, so vigilance for suicide risk through the entire 12-week acute treatment period is necessary. Treatment selection may affect the risk of SI.
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Affiliation(s)
- Sidney Zisook
- University of California San Diego, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | | | - A John Rush
- Duke Medical School, Durham, NC, USA
- Duke-National University of Singapore, Singapore
| | - Gary R Johnson
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ilanit Tal
- VA San Diego Healthcare System, San Diego, CA, USA
| | - P J Chen
- Department of Psychiatry, VA Northeast Ohio Healthcare System, and Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Lori L Davis
- Tuscaloosa VA Medical Center, Tuscaloosa, AL, USA
| | - Paul B Hicks
- Department of Psychiatry, Texas A&M College of Medicine, Temple, TX, USA
| | - James Wilcox
- Department of Veterans Affairs, Phoenix, AZ, USA
| | - Beata Planeta
- Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Alexandra A Scrymgeour
- Cooperative Studies Program Clinical Research Pharmacy Coordinating Center, Albuquerque, NM, USA
| | - John Kasckow
- University of Pittsburgh Physicians, Pittsburgh, PA, USA
| | - Somaia Mohamed
- Veterans Affairs (VA) New England Mental Illness Research, Education, and Clinical Center, VA Connecticut Healthcare System, West Haven, CT, USA
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Yang EH, Chen WY, Chiang HC, Li CH, Wu IH, Chen PJ, Wu CT, Tsai YC, Cheng WC, Huang CJ, Sheu BS, Cheng HC. 10-Day versus 14-day bismuth quadruple therapy for first-line eradication of Helicobacter pylori infection: a randomised, open-label, non-inferiority trial. EClinicalMedicine 2024; 70:102529. [PMID: 38500841 PMCID: PMC10945111 DOI: 10.1016/j.eclinm.2024.102529] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/04/2024] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
Background Bismuth quadruple therapy is currently consensus recommendation for first-line Helicobacter pylori (H. pylori) treatment; however, the optimal duration is unknown. We compared the efficacy of 10-day bismuth quadruple therapy with that of 14-day bismuth quadruple therapy for first-line eradication. Methods For our multicentre, parallel randomised, open-label, and non-inferiority study, we recruited H. pylori treatment-naïve patients from one medical centre and one teaching hospital in Taiwan. Patients were randomly assigned (1:1) to receive 10-day (PBMT-10) or 14-day (PBMT-14) bismuth quadruple therapy. The primary outcome was the eradication rate as determined by intention-to-treat (ITT) and per-protocol (PP) analyses. The eradication rates between the two groups were compared using a one-sided α value of 0.025 and a non-inferiority margin of 7%. The secondary outcomes were the rate of adverse effects. The trial is registered with ClincialTrials.gov (NCT04527055). Findings From August 3, 2020 to April 28, 2023, 313 H. pylori treatment-naïve patients (PBMT-10 = 157; PBMT-14 = 156) were enrolled. 35 patients were excluded from PP analyses. The eradication rates (95% CI) for PBMT-10 and PBMT-14 were respectively 92.4% (88.2%-96.5%) and 92.9% (88.9%-97.0%) by ITT analyses, and 97.9% (95.5%-100.0%) and 99.3% (97.8%-100.0%) by PP analyses. The eradication rates for PBMT-10 were non-inferior to those for PBMT-14 (absolute difference [lower boundary of the one-sided 97.5% CI] -0.6% [-6.7%], PNI = 0.020 in ITT analyses, -1.4% [-5.8%], PNI = 0.007 in PP analyses). The rates of overall adverse effects (54.1% versus 57.1%, P = 0.604) were similar between the two groups; nevertheless, the rates of dizziness (18.5% versus 34.0%, P = 0.003) and vomiting (4.5% versus 12.8%, P = 0.008) were lower in PBMT-10 than in PBMT-14. Interpretation The 10-day bismuth quadruple therapy was non-inferior to the 14-day therapy as a first-line treatment for eradicating H. pylori infection and had no different rates of overall adverse effects, but less serious adverse events in terms of dizziness and vomiting. Funding The National Science and Technology Council and Ministry of Health and Welfare, Taiwan.
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Affiliation(s)
- Er-Hsiang Yang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ying Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsueh-Chien Chiang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Hao Li
- Department of Family Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - I-Hsuan Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Health Management Centre, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Tai Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ching Tsai
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Gastroenterology and Hepatology, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Wei-Chun Cheng
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Gastroenterology and Hepatology, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Chien-Jui Huang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bor-Shyang Sheu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsiu-Chi Cheng
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Liu T, Lin CH, Chen YL, Yeh CC, Chiou YY, Wang JY, Lee CT, Lee KT, Shiau AL, Wu CL, Chen CC, Kang JW, Chen PJ, Kuo HY, Yang EH, Chuang CH. Relationship Between Rectal Swab and Tissue Samples in Mucosa-associated Microbiota in Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2024; 30:447-458. [PMID: 37651099 DOI: 10.1093/ibd/izad179] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Gut mucosa-associated microbiota is more closely correlated with disease phenotypes than fecal microbiota; however sampling via tissue biopsy is more invasive and uncomfortable. Rectal swab may be a suitable substitute for tissue biopsy, but its effectiveness is controversial. This study aimed to evaluate differences in the microbiota at these sites in patients with inflammatory bowel disease (IBD). METHODS Inflammatory bowel disease patients and a control group were enrolled when surveillance colonoscopy was scheduled. Samples of colon biopsy tissues, rectal swabs during colonoscopy, and feces before bowel preparation were collected to analyze microbial composition. To explore the short-term effects of bowel preparation on swab microbiota, prepreparation swab samples were also collected from 27 IBD patients. RESULTS A total of 33 Crohn's disease, 54 ulcerative colitis, and 21 non-IBD patients were enrolled. In beta diversity analysis, fecal microbiota clearly differed from swab and tissue microbiota in the 3 disease groups. The swab microbiota was closer to, but still different from, the tissue microbiota. Consistently, we identified that swab samples differed more in abundant genera from feces than from tissue. Beta diversity analysis did not reveal a difference in swab microbiota before and after bowel preparation, but the genus composition of most individuals varied markedly. CONCLUSIONS Swab microbiota more closely resembled tissue microbiota relative to fecal microbiota, but there were still differences. Bowel preparation did not alter the overall swab microbiota in the short term but markedly changed the microbial composition in most patients.
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Affiliation(s)
- Tsunglin Liu
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Cheng-Han Lin
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Lin Chen
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Cheng Yeh
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yuan-Yow Chiou
- National Laboratory Animal Center, National Applied Research Laboratories, Taipei, Taiwan
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jiu-Yao Wang
- Research Center of Allergy, Immunology, and Microbiome, China Medical University Children's Hospital, Taichung, Taiwan
| | - Chung-Ta Lee
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kuo-Ting Lee
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University Tainan, Taiwan
| | - Ai-Li Shiau
- Department of Microbiology and Immunology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Chao-Liang Wu
- Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chien-Chin Chen
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, Taiwan
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Jui-Wen Kang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsin-Yu Kuo
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Er-Hsiang Yang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chiao-Hsiung Chuang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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5
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Chiang HC, Chen PJ, Lin XZ, Chuang CH. Response. Gastrointest Endosc 2023; 98:1037-1038. [PMID: 37977663 DOI: 10.1016/j.gie.2023.07.021] [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] [Received: 07/07/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 11/19/2023]
Affiliation(s)
- Hsueh-Chien Chiang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Xi-Zhang Lin
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Chiao-Hsiung Chuang
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
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Chiang HC, Chen PJ, Yang EH, Hsieh MT, Shih IC, Cheng HC, Chang WL, Chen WY, Chiu HC, Kuo HY, Tsai WC, Lo YN, Yang KC, Chiang CM, Chen WC, Huang KK, Tseng HH, Chen CY, Lin XZ, Chuang CH. Precise application of topical tranexamic acid to enhance endoscopic hemostasis for peptic ulcer bleeding: a randomized controlled study (with video). Gastrointest Endosc 2023; 98:755-764. [PMID: 37356632 DOI: 10.1016/j.gie.2023.06.013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/04/2023] [Accepted: 06/14/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND AND AIMS Peptic ulcer recurrent bleeding occurs in 20% to 30% of patients after standard endoscopic hemostasis, particularly within 4 days after the procedure. The application of additional tranexamic acid (TXA) to the ulcer may enhance hemostasis. This study investigated the effectiveness of TXA powder application on bleeding ulcers during endoscopic hemostasis. METHODS This study enrolled patients who had peptic ulcer bleeding between March 2022 and February 2023. After undergoing standard endoscopic therapy, the patients were randomly assigned to either the TXA group or the standard group. In the TXA group, an additional 1.25 g of TXA powder was sprayed endoscopically on the ulcer. Both groups then received 3 days of high-dose (8 mg/h) continuous infusion proton pump inhibitor therapy. Second-look endoscopy was conducted on days 3 to 4. The primary end point of early treatment failure was defined as ulcer recurrent bleeding within 4 days or major stigmata of recent hemorrhage on the second-look endoscopy. RESULTS Sixty patients (30 in each group) with peptic ulcer bleeding and balanced baseline characteristics were randomly assigned to a treatment group. The early treatment failure rate was lower in the TXA group (6.7%) than in the standard group (30%) (P = .042). The freedom from treatment failure periods for 4 and 28 days was significantly longer in the TXA group than in the standard group (P = .023). No adverse events from TXA were recorded. CONCLUSIONS The precise delivery of topical TXA alongside standard endoscopic hemostasis reduced the early treatment failure rate in patients with bleeding peptic ulcers. (Clinical trial registration number: NCT05248321.).
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Affiliation(s)
- Hsueh-Chien Chiang
- Department of Internal Medicine, National Cheng Kung University Hospital; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Er-Hsiang Yang
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Ming-Tsung Hsieh
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - I-Cheng Shih
- Department of Internal Medicine, National Cheng Kung University Hospital; Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Hsiu-Chi Cheng
- Department of Internal Medicine, National Cheng Kung University Hospital; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Wei-Lun Chang
- Department of Internal Medicine, National Cheng Kung University Hospital; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ying Chen
- Department of Internal Medicine, National Cheng Kung University Hospital; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hung-Chih Chiu
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Hsin-Yu Kuo
- Department of Internal Medicine, National Cheng Kung University Hospital; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Chu Tsai
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Yi-Ning Lo
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Kai-Chun Yang
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Chien-Ming Chiang
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Wei-Chih Chen
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Kuan-Kai Huang
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Hsu-Huan Tseng
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Chiung-Yu Chen
- Department of Internal Medicine, National Cheng Kung University Hospital
| | - Xi-Zhang Lin
- Department of Internal Medicine, National Cheng Kung University Hospital
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Wu JS, Hong TC, Wu HT, Lin YJ, Chang TT, Wang CT, Liu WC, Hsieh MT, Wu IC, Chen PJ, Chen CY, Lin SH, Chuang CH, Han MZ, Chen HP, Tsai HM, Kuo HY. Hepatic arterial infusion chemotherapy and immune checkpoint inhibitors, alone or in combination, in advanced hepatocellular carcinoma with macrovascular invasion: a single-centre experience in Taiwan. J Gastrointest Oncol 2023; 14:849-862. [PMID: 37201085 PMCID: PMC10186549 DOI: 10.21037/jgo-22-858] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Received: 09/15/2022] [Accepted: 04/04/2023] [Indexed: 05/20/2023] Open
Abstract
Background The presence of vascular invasion is associated with poor survival in advanced hepatocellular carcinoma (HCC). We compared the effectiveness of hepatic arterial infusion chemotherapy (HAIC) and immune checkpoint inhibitors (ICIs), alone or in combination, in patients with advanced HCC. Methods We retrospectively reviewed medical records of adult patients with unresectable HCC and macrovascular invasion (MVI) who were treated with HAIC or ICIs alone or in combination at a single centre in Taiwan. Overall tumour response, vascular thrombi response, overall survival (OS) and progression-free survival (PFS) in 130 patients were analysed. Results The treatment group showed no significant effect on the overall tumour response [objective response rate (ORR), 22.86% for HAIC, 26.09% for ICI, 50.00% for HAIC+ICI; P=0.111], but showed a significant effect on vessel response (objective response rate of tumour thrombi (ORRT), 38.57% for HAIC, 45.65% for ICI, 78.57% for HAIC+ICI; P=0.023). Post-hoc comparisons followed by Bonferroni correction revealed that vessel ORRT was significantly different between the HAIC+ICI and HAIC groups (P=0.014). A significant effect of treatment group on portal vein tumour thrombus (PVTT) was also detected (ORRT, 40.00% for HAIC, 50.00% for ICI, 90.00% for HAIC; P=0.013), with significant difference between the HAIC+ICI and HAIC groups (P=0.005). Patients treated with HAIC, ICI, and HAIC+ICI respectively had 12-month OS rates of 44.9%, 31.4%, and 67.5% (P=0.127) and 12-month PFS rates of 21.2%, 24.6%, and 33.2% (P=0.091). In multivariate analysis of PFS, HAIC+ICI was associated with reduced risk of progression or death compared with HAIC alone (adjusted hazard ratio: 0.46; 95% confidence interval: 0.23-0.94; P=0.032). Conclusions HAIC combined with ICIs had a superior response of PVTT compared to HAIC alone, and was associated with reduced risk of progression or death. Future studies are needed to address the survival benefit of the combination therapy in advanced HCC with MVI.
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Affiliation(s)
- Juei-Seng Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Tzu-Chun Hong
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Hung-Tsung Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Yih-Jyh Lin
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Ting-Tsung Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Chung-Teng Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Wen-Chun Liu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Ming-Tsung Hsieh
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - I-Chin Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Po-Jun Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Chiung-Yu Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Chiao-Hsiung Chuang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Meng-Zhi Han
- Department of Internal Medicine, An Nan Hospital, China Medical University, Tainan
| | - Huang-Pin Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Hong-Ming Tsai
- Department of Diagnostic Radiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Hsin-Yu Kuo
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan
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Kuo HY, Han MZ, Liao CH, Lin YJ, Wang CT, Chen SH, Chang TT, Chen PJ, Lin SH, Chen CY, Chuang CH, Wu IC, Wu JS, Hong TC, Hsieh MT, Lee YC, Wu HT, Tsai HM. Real-World Comparative Effectiveness of Nivolumab versus Pembrolizumab in Patients with Unresectable Hepatocellular Carcinoma. Pharmaceutics 2022; 14:2263. [PMID: 36365082 PMCID: PMC9697961 DOI: 10.3390/pharmaceutics14112263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 09/06/2022] [Revised: 09/23/2022] [Accepted: 10/19/2022] [Indexed: 08/31/2023] Open
Abstract
PURPOSE Immune checkpoint inhibitors are effective therapies for advanced hepatocellular carcinoma (HCC); however, comparisons of the clinical efficacy and safety profile for these drugs are still scarce. Thus, the aims of this study were to investigate the differences in efficacy and safety between nivolumab and pembrolizumab in unresectable HCC patients in a real-world setting. PATIENTS AND METHODS A total of 115 patients who received treatment with nivolumab (n = 73) or pembrolizumab (n = 42) in combination with or without tyrosine kinase inhibitors was enrolled. Therapeutic response, survival outcomes, and safety profiles were compared among these groups. Multivariate analysis of survival response was performed using Cox proportional hazards regression. RESULTS Patients treated with pembrolizumab demonstrated a significantly higher objective response rate than those with nivolumab (38.1% vs. 15.1%; odds ratio 4.18, p = 0.005) regardless of the combination strategies. In addition, pembrolizumab performed a better overall survival (OS) than nivolumab, (34.9 vs. 9.5 months; hazard ratio (HR) = 0.39, p = 0.004). In subgroup analysis, pembrolizumab exhibited favorable OS than nivolumab for monotherapy (HR = 0.16, p = 0.001) or combination therapy (HR = 0.33, p = 0.006) as second-line or later-line (HR = 0.19, p = 0.001) therapy and those with (HR = 0.31, p = 0.006) or without (HR = 0.15, p = 0.004) well-compensated liver disease. The incidence of adverse events was comparable for both treatments. CONCLUSION Both pembrolizumab and nivolumab had significant effects for HCC therapy, and pembrolizumab had a significant survival benefit as compared with nivolumab.
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Affiliation(s)
- Hsin-Yu Kuo
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Meng-Zhi Han
- Department of Internal Medicine, An Nan Hospital, China Medical University, Tainan 70965, Taiwan
| | - Chih-Hsiang Liao
- Department of Environmental Resources Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
| | - Yih-Jyh Lin
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chung-Teng Wang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Shang-Hung Chen
- Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70456, Taiwan
- National Institute of Cancer Research, National Health Research Institutes, Tainan 70456, Taiwan
| | - Ting-Tsung Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Sheng-Hsiang Lin
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chiung-Yu Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chiao-Hsiung Chuang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - I-Chin Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Juei-Seng Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Tzu-Chun Hong
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Ming-Tsung Hsieh
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Yang-Cheng Lee
- Department of Internal Medicine, Tainan Municipal Hospital, Tainan 70103, Taiwan
| | - Hung-Tsung Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Hong-Ming Tsai
- Department of Diagnostic Radiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
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Ho JT, Liang CC, Chen PJ. First Report of Root-Knot Nematode Meloidogyne enterolobii on Cockscomb ( Celosia argentea var. cristata) in Taiwan. Plant Dis 2022; 106:PDIS10212126PDN. [PMID: 34854766 DOI: 10.1094/pdis-10-21-2126-pdn] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- J-T Ho
- Department of Plant Pathology, National Chung Hsing University, Taichung 40223, Taiwan
| | - C-C Liang
- Department of Plant Pathology, National Chung Hsing University, Taichung 40223, Taiwan
| | - P J Chen
- Department of Plant Pathology, National Chung Hsing University, Taichung 40223, Taiwan
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10
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Liang CC, Chen PJ. First Report of Root-Knot Nematode Meloidogyne enterolobii on Poinsettia 'Luv U Pink' in Taiwan. Plant Dis 2022; 106:PDIS09211899PDN. [PMID: 34818910 DOI: 10.1094/pdis-09-21-1899-pdn] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- C-C Liang
- Department of Plant Pathology, National Chung Hsing University, Taichung 40223, Taiwan
| | - P J Chen
- Department of Plant Pathology, National Chung Hsing University, Taichung 40223, Taiwan
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11
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Liang CC, Chiu CW, Chen PJ. First Report of a Sheathoid Nematode ( Hemicriconemoides litchi) on Longan in Taiwan. Plant Dis 2021; 105:2256. [PMID: 33565889 DOI: 10.1094/pdis-07-20-1453-pdn] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- C-C Liang
- Department of Plant Pathology, National Chung Hsing University, Taichung 40223, Taiwan
| | - C-W Chiu
- Department of Plant Pathology, National Chung Hsing University, Taichung 40223, Taiwan
| | - P J Chen
- Department of Plant Pathology, National Chung Hsing University, Taichung 40223, Taiwan
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12
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Tsai HM, Han MZ, Lin YJ, Chang TT, Chen CY, Cheng PN, Chuang CH, Wu IC, Chen PJ, Kang JW, Chiu YC, Chiu HC, Chien SC, Kuo HY. Real-world outcome of immune checkpoint inhibitors for advanced hepatocellular carcinoma with macrovascular tumor thrombosis. Cancer Immunol Immunother 2021; 70:1929-1937. [PMID: 33409737 PMCID: PMC8195886 DOI: 10.1007/s00262-020-02845-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/28/2020] [Indexed: 02/08/2023]
Abstract
Programmed cell death protein-1 (PD-1) inhibitors have shown promising results for treating advanced hepatocellular carcinoma (HCC). However, the clinical utility of such inhibitors in HCC patients with vascular tumor thrombosis remains unclear. This study investigated PD-1 inhibitor efficacy in advanced HCC with macrovascular invasion in a clinical setting. Among the 110 patients with unresectable HCC treated with PD-1 inhibitors, 34 patients with vascular metastases in the portal vein and inferior vena cava were retrospectively compared with 34 patients without tumor thrombi. The vascular response and its effect on survival were assessed. Predictors of survival were identified using multivariate analysis. Among patients achieving objective response, those with and without thrombi exhibited similar response to immunotherapy and comparable survival. Among the 34 patients with tumor thrombi, including 13 receiving PD-1 inhibitors alone and 21 receiving it in combination with tyrosine kinase inhibitors, the median overall survival was 8.9 months (95% confidence interval 3.2-12.6). The objective response rate of vascular metastasis was 52.9%, and vascular responders had a significantly longer survival than did non-responders (11.1 vs 3.9 months). Failure to obtain a vascular response correlated significantly with increased post-treatment Child-Pugh score or class. Multivariate analysis showed that vascular response was a significant positive factor for longer overall survival. Treatment-related grade 3/4 adverse events occurred in 3 (8.8%) of the patients with tumor thrombi. Immunotherapy with PD-1 inhibitors may be a feasible treatment option for HCC with tumor thrombi owing to the high response rate of tumor thrombi and favorable survival outcomes.
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Affiliation(s)
- Hong-Ming Tsai
- Department of Diagnostic Radiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Zhi Han
- Department of Internal Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yih-Jyh Lin
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ting-Tsung Chang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Chiung-Yu Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Pin-Nan Cheng
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Chiao-Hsiung Chuang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - I-Chin Wu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Jui-Wen Kang
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Yen-Cheng Chiu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Hung-Chih Chiu
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Shih-Chieh Chien
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan
| | - Hsin-Yu Kuo
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, Taiwan.
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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13
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Cheng WC, Chen PJ, Kang JW, Chen WY, Sheu BS. Age, male sex, smoking and metabolic syndrome as risk factors of advanced colorectal neoplasia for fecal immunochemical test negative patients. J Formos Med Assoc 2021; 121:402-408. [PMID: 34127350 DOI: 10.1016/j.jfma.2021.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/12/2020] [Revised: 05/02/2021] [Accepted: 05/23/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Fecal immunochemical test (FIT) is worldwide strategy for colorectal cancer screening. The subjects with negative FIT still have the risk of an advanced colorectal neoplasia (AN), including adenoma with villous histology, high grade dysplasia or larger than 1 cm in size, or adenocarcinoma. The study determined the risk factors associated with AN in FIT-negative subjects. METHODS The study included asymptomatic subjects who received health checkup colonoscopy and have provided FIT study within 6 months prior to colonoscopy. The risk factors to have AN in cases with negative FIT were analyzed. The numbers of colonoscopies needed to detect one AN were calculated for the subjects with different risk factors. RESULTS There were 1411 cases, 85 with positive FIT and 1326 with negative FIT within 6 months before colonoscopy. In FIT positive and FIT negative cases, 45.9% and 34.6% were found to have colorectal adenoma, while 20.2% and 4.6% had AN, respectively. The univariate and multivariate logistic regression analyses showed that age more than 50 years old, male sex, smoking history and metabolic syndrome were the significant risk factors to have AN in the FIT negative cases. For cases with negative FIT to have these risk factors, the number of colonoscopies needed to detect one AN was 3.7, lower than 4.5 of the cases with positive FIT. CONCLUSION For the cases with negative FIT, colonoscopy screening should be considered for those male patients over 50 years old, with a history of smoking and metabolic syndrome to detect AN.
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Affiliation(s)
- Wei-Chun Cheng
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Gastroenterology Department, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Po-Jun Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jui-Wen Kang
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ying Chen
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bor-Shyang Sheu
- Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Li X, Zheng C, Nowak ER, Haughey K, Shull RD, Chen PJ, Pong PWT. Tunable magnetic low-frequency noise in magnetic tunnel junctions: effect of shape anisotropy. J Phys Condens Matter 2020; 32:495805. [PMID: 32955020 DOI: 10.1088/1361-648x/abb443] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The intrinsic magnetic low-frequency noise (LFN) is of fundamental scientific interest to the study of magnetic tunnel junctions (MTJs). To gain insight into its mechanism, the fluctuation-dissipation theorem, which describes the linear relation between magnetic LFN and magnetic sensitivity product, has been utilized. However, deviation from the linear correlation has been reported in some studies. To understand and effectively control the magnetic LFN, a more elaborate analytical description and further experimental validation are required. In this work, the magnetic LFN contributed from the magnetization fluctuation in the pinned layer of MTJs with various shape anisotropies was investigated. The MTJs with different shape anisotropies, achieved by altering their aspect ratios, possessed distinct demagnetizing factors. Large magnetic noise was correlated with the increase of magnetic phase loss of ferromagnetic layers during magnetization reversal at which magnetization fluctuation was enhanced. Upon increasing the shape anisotropy, a notable reduction of the magnetic phase loss in the antiparallel (AP) state was observed while it exhibited a slight decrease in the parallel (P) state, revealing that the increase of the shape anisotropy caused a more pronounced suppression of the equilibrium magnetization fluctuation in the AP state. These phenomena were computationally validated by constructing a macrospin model to describe the thermally-induced magnetization fluctuation in the pinned layer. This work reveals the physical relation between MTJ shape anisotropy and magnetic LFN. The effect of the shape anisotropy on the magnetic LFN can be extended to other types of in-plane uniaxial anisotropies.
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Affiliation(s)
- Xu Li
- Fujian Provincial Key Laboratory of Semiconductors and Applications, Collaborative Innovation Center for Optoelectronic Semiconductors and Efficient Devices, Department of Physics, Xiamen University, Xiamen 361005, People's Republic of China. These authors contributed equally to this work
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15
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Wang L, Zhao YM, Sun TT, Xu YL, Li SJ, Zhang XY, Cai Y, Li YH, Li ZW, Chen PJ, Peng YF, Wang WH, Wu AW. [Total neoadjuvant therapy followed by watch and wait approach or organ preservation for MRI stratified low-risk rectal cancer: early result from a prospective, single arm trial]. Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23:258-265. [PMID: 32192305 DOI: 10.3760/cma.j.cn.441530-20200222-00070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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 explore the safety and efficacy of watch and wait strategy and organ preservation surgery after total neoadjuvant treatment for MRI stratified low-risk rectal cancer. Methods: A prospective single arm phase Ⅱ trial developed at Department of Gastrointestinal Cancer, Peking University Cancer Hospital & Institute was preliminarily analyzed. Subjects were enrolled from August 2016 to January 2019. Low-risk rectal cancer with following MRI features were recruited: mid-low tumor, mrT2-3b, MRF (-), EMVI (-), CRM (-), differentiation grade 1-3. Patients received intensity-modulated radiotherapy (IMRT) 50.6 Gy/22f with concurrent capecitabine and 4 cycles of consolidation CAPEOX. Patients with cCR/near-cCR confirmed by physical examination, rectal MRI, endoscopy, and serum CEA were recommended for watch & wait approach or local excision (LE). The main study outcomes were 2-year organ preservation rate (OPR) and sphincter preservation rate (SPR). Results: Thirty-eight patients were eligible for analysis, including 24 males and 14 females with median age of 56 years; 9 cases of mrT2 (23.7%), 14 cases of mrT3a (36.8%) and 15 cases of mrT3b (39.5%); 5 cases of well differentiated adenocarcinoma (13.2%), 32 cases of moderately differentiated adenocarcinoma (84.2%) and 1 case of mucinous adenocarcinoma (2.6%). Carcinoemobryonic antigen (CEA) was elevated before treatment in 1 case. One case (2.6%) of grade 3 radiation dermatitis occurred during IMRT; 18 cases (47.4%) occurred grade 3 to 4 adverse events during consolidation chemotherapy. After total neoadjuvant treatment, the cCR and near-cCR rates were 42.1% (16/38) and 23.7% (9/38), respectively, while non-cCR rate was 34.2% (13/38). Twenty patients (20/38, 52.6%) of cCR or near-cCR underwent watch & wait approach, with a local regrowth rate of 20% (4/20). Four patients received LE, including one salvage LE. Thirteen patients (4 were ypCR) received radical resection, including 10 cases of initial low anterior resections (LAR), 1 cases of initial abdominal perineal resection (APR) and 2 cases of salvage LAR, four patients refused operation. The median follow-up time was 23.5 (8.5-38.3) months. At the last interview of follow-up, the OPR and SPR were 52.6% (20/38) and 84.2% (32/38), respectively. Only one patient developed lung metastasis and no local recurrence occurred after radical resection or LE. Conclusion: Total neoadjuvant treatment for low-risk rectal cancer achieves high cCR/near-cCR rate, with increased probability of receiving watch and wait approach and organ preservation in this subgroup.
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Affiliation(s)
- L Wang
- Department of Gastrointestinal Cancer, Unit III, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - Y M Zhao
- Department of Gastrointestinal Cancer, Unit III, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - T T Sun
- Department of Gastrointestinal Cancer, Unit III, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - Y L Xu
- Department of Gastrointestinal Cancer, Unit III, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - S J Li
- Endoscopy Center, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - X Y Zhang
- Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - Y Cai
- Department of Radiology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - Y H Li
- Department of Radiology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - Z W Li
- Department of Pathology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - P J Chen
- Department of Gastrointestinal Cancer, Unit III, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - Y F Peng
- Department of Gastrointestinal Cancer, Unit III, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - W H Wang
- Department of Radiology, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
| | - A W Wu
- Department of Gastrointestinal Cancer, Unit III, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Bejing 100142, China
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16
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Chen PJ, Wang L, Chen N, Lu XY, Wang HS, He X, Wang Z, Wu AW. [Short-term outcomes and prognosis of palliative surgery for malignant bowel obstruction caused by peritoneal metastasis of colorectal cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2019; 22:1051-1057. [PMID: 31770836 DOI: 10.3760/cma.j.issn.1671-0274.2019.11.008] [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 explore the short-term efficacy and prognosis of palliative surgical treatment for malignant bowel obstruction (MBO) caused by peritoneal metastasis of colorectal cancer (mCRC). Methods: A retrospective cohort study was conducted. The inclusion criteria for patients were as follows: (1) primary colorectal cancer; (2) massive peritoneal metastasis; (3)obstructive site located below Treitz ligament by imaging; (4) obstruction refractory to conservative treatment; (5) estimated rese survival time more than 2 months; (6) patients and their families had strong willingness for operation; (7) surgical treatment included stoma/bypass and debulking surgery. In accordance with the above criteria, clinicopathological data of 46 patients undergoing palliative surgery at Peking University Gastrointestinal Cancer Center, Unit III from January 2016 to October 2018 were retrospectively collected. Postoperative symptomatic relief rate, morbidity of complication within 30 days, complication classification (Clavien-Dindo classification), mortality and survival after operation were analyzed. Kaplan-Meier method was used to evaluate survival and Cox regression analysis was used to identify prognostic factors. Results: Among 46 patients, 30 were male and 16 were female with median age of 63 (19-87) years; 23 patients received stoma/bypass surgery (stoma/bypass group), and 23 cases received tumor debulking surgery (debulking group). The overall symptom relief rate was 76.1% (35/46), while symptom relief rate in the debulking group was 91.3% (21/23), which was significantly higher than 60.9% (14/23) in the stoma/bypass group (χ(2)=4.301, P=0.038). Postoperative complications occurred in 25 patients. The complication rate was 52.2% (12/23) in the debulking group and 56.5% (13/23) in the stoma/bypass group, without statistically significant difference (χ(2)=0.088, P=0.767). Morbidity of complication beyond grade III was 8.7% (2/23) and 13.0% (3/23) in the debulking group and stoma/bypass group respectively, without statistically significant difference (χ(2)=0.224, P=0.636). Four patients died within 30 days after operation, 2 (8.7%) in each group. Twenty-four patients underwent 1-8 cycles of chemotherapy ± targeting therapy (regimens: CapeOX ± Bevacizumab, FOLFOX/FOLFIRI ± Bevacizumab/Cetuximab), including 10 cases in the stoma/bypass group and 14 cases in the debulking group. Two patients of debulking group received postoperative radiotherapy and chemotherapy (50.6 Gy/22 f, with concurrent oral capecitabine). Till the last follow up of April 2019, 34 patients died (34/46, 73.9%) with a median overall survival time of 6.4 months, and the 6-month and 1-year survival rate was 54.5% and 29.2% respectively. The median survival time in the debulking group was significantly longer than that in the stoma/bypass group (11.5 months vs. 5.2 months, χ(2)=5.117, P=0.024). The median survival time of the 35 patients with symptomatic relief after operation was significant longer than that of 11 patients without relief (7.1 months vs 5.1 months, χ(2)=3.844, P=0.050). Multivariate analysis showed stoma/bypass surgery (HR=2.917, 95%CI:1.357-6.269, P=0.006) and greater omental metastasis (HR=4.060, 95%CI:1.419-11.617, P=0.009) were independent risk factors associated with prognosis of patients with MBO caused by peritoneal mCRC. Conclusions: For patients of MBO caused by peritoneal mCRC, tumor debulking surgery may achieve higher symptom relief rate and prolong survival. Greater omental metastasis indicates poor prognosis.
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Affiliation(s)
- P J Chen
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Cancer Center, Unit III, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - L Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Cancer Center, Unit III, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - N Chen
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Cancer Center, Unit III, Peking University Cancer Hospital & Institute, Beijing 100142, China
| | - X Y Lu
- Department of Gastrointestinal Cancer Surgery, Unit III, Beijing Nanjiao Cancer Hospital, Beijing 100076, China
| | - H S Wang
- Department of Gastrointestinal Cancer Surgery, Unit III, Beijing Nanjiao Cancer Hospital, Beijing 100076, China
| | - X He
- Department of Gastrointestinal Cancer Surgery, Unit III, Beijing Nanjiao Cancer Hospital, Beijing 100076, China
| | - Z Wang
- Department of Gastrointestinal Cancer Surgery, Unit III, Beijing Nanjiao Cancer Hospital, Beijing 100076, China
| | - A W Wu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Gastrointestinal Cancer Center, Unit III, Peking University Cancer Hospital & Institute, Beijing 100142, China
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Sun TT, Wang L, Yao YF, Peng YF, Zhao J, Zhan TC, Leng JH, Wang HY, Chen N, Chen PJ, Li YJ, Zhang X, Liu XZ, Zhang Y, Wu AW. ["Watch and wait" strategy after neoadjuvant therapy for rectal cancer: status survey of perceptions, attitudes and treatment selection in Chinese surgeons]. Zhonghua Wei Chang Wai Ke Za Zhi 2019; 22:550-559. [PMID: 31238634 DOI: 10.3760/cma.j.issn.1671-0274.2019.06.008] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To understand the perceptions, attitudes and treatment selection of Chinese surgeons on the "watch and wait" strategy for rectal cancer patients after achieving a clinical complete response (cCR) following neoadjuvant chemoradiotherapy (nCRT). Methods: A cross-sectional survey was used in this study. Selection of subjects: (1) Domestic public grade III A (provincial and prefecture-level) oncology hospitals or general hospitals possessing the radiotherapy department and the diagnosis and treatment qualifications for colorectal cancer. (2) Surgeons of deputy chief physician or above. Using the "Questionnaire Star" online survey platform to create a questionnaire about cognition, attitude and treatment choice of the "watch and wait" strategy after cCR following nCRT for rectal cancer. The questionnaire contained 32 questions, such as the basic information of doctor, the current status of rectal cancer surgery, the management of pathological complete remission (ypCR) after nCRT for rectal cancer, the selection of examination items for diagnosis of cCR, the selection of suitable people undergoing "watch and wait" approach, the nCRT mode for promotion of cCR, the choice of evaluation time point, the willingness to perform "watch and wait" approach and the treatment choice, and the risk and monitoring of "watch and wait" approach. A total of 116 questionnaires were sent to the respondents via WeChat between January 31 and February 19, 2019. Statistical analysis was performed using Fisher's exact test for categorical variables. Results: Forty-eight hospitals including 116 surgeons meeting criteria were enrolled, of whom 77 surgeons filled the questionnaire with a response rate of 66.4%. "Watch and wait" strategy was carried out in 76.6% (59/77) of surgeons. Seventy surgeons (90.9%) were aware of the ypCR rate of rectal cancer after preoperative nCRT and 49 surgeons (63.6%) knew the 3-year disease-free survival of patients with ypCR in their own hospitals. Fifty-five surgeons (71.4%) believed that patients with ypCR undergoing radical surgery met the treatment criteria and were not over-treated. Three most necessary examinations in diagnosing cCR were colonoscopy (96.1%, 74/77), digital rectal examination (DRE) (90.9%,70/77) and DWI-MRI (83.1%, 64/77). Responders preferred to consider a "watch and wait" strategy for patients with baseline characteristics as mrN0 (77.9%, 60/77), mrT2 (68.8%, 53/77) and well-differentiated adenocarcinoma (68.8%, 53/77). Sixty-six surgeons (85.7%) believed that long-term chemoradiotherapy (LCRT) with combination or without combination of induction and/or consolidation of the CapeOX regimen (capecitabine + oxaliplatin) should be the first choice as a neoadjuvant therapy to achieve cCR. Forty-one surgeons (53.2%) believed that a reasonable interval of judging cCR after nCRT should be ≥ 8 weeks. Forty-four surgeons (57.1%) routinely, or in most cases, informed patient the possibility of cCR and proposed to "watch and wait" strategy in the initial diagnosis of patients with non-metastatic rectal cancer. Thirteen surgeons (16.9%) would take the "watch and wait" strategy as the first choice after the patient having cCR. Fifty-two surgeons (67.5%) would be affected by the surgical method, that was to say, "watch and wait" approach would only be recommended to those patients who would achieve cCR and could not preserve the anus or underwent difficult anus-preservation surgery. Sixteen surgeons (20.8%) demonstrated that "watch and wait" strategy would not be recommended to patients with cCR regardless of whether the surgical procedure involved anal sphincter. Eleven surgeons (14.3%) believed that the main risk of "watch and wait" approach came from distant metastasis rather than local recurrence or regrowth. Twenty-nine of surgeons (37.7%) did not understand the difference between "local recurrence" and "local regrowth" during the period of "watch and wait". Twenty-six surgeons (33.8%) thought that the monitoring interval for the first 3 years of "watch and wait" strategy was 3 months, and the follow-up monitoring interval could be 6 months to 5 years. Surgeons from cancer specialist hospitals had higher approval rate, notification rate, and referral rate of "watch and wait" strategy than those from general hospitals. Thirty-one surgeons (42.5%) considered that the difficulty and concern of carrying out "watch and wait" approach in the future was the disease progress leading to medical disputes. Twenty-six surgeons (35.6%) demonstrated that their concern was lack of uniform evaluation standard for cCR. Conclusions: Chinese surgeons seem to have inadequate knowledge of non-operative management for rectal cancer patients achieving cCR after nCRT and show relatively conservative attitudes toward the strategy. Chinese consensus needs to be formed to guide the non-operative management in selected patients. Chinese Watch & Wait Database (CWWD) is also needed to establish and provide more evidence for the use of alternative procedure after a cCR following nCRT.
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Affiliation(s)
- T T Sun
- Ward III of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100142, China
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18
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Affiliation(s)
- Sheng-Yao Cheng
- 1 Department of Otolaryngology - Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, China
| | - Po-Jun Chen
- 1 Department of Otolaryngology - Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, China
| | - Yueng-Hsiang Chu
- 1 Department of Otolaryngology - Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, China
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19
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Maaroufi A, Vince A, Himatt SM, Mohamed R, Fung J, Opare-Sem O, Workneh A, Njouom R, Al Ghazzawi I, Abdulla M, Kaliaskarova KS, Owusu-Ofori S, Abdelmageed MK, Adda D, Akin O, Al Baqali A, Al Dweik N, Al Ejji K, Al Kaabi S, Al Naamani K, Al Qamish J, Al Sadadi M, Al Salman J, AlBadri M, Al-Busafi SA, Al-Romaihi HE, Ampofo W, Antonov K, Anyaike C, Arome F, Bane A, Blach S, Borodo MM, Brandon SM, Bright B, Butt MT, Cardenas I, Chan HLY, Chen CJ, Chen DS, Chen PJ, Chien RN, Chuang WL, Cuellar D, Derbala M, Elbardiny AA, Estes C, Farag E, Gamkrelidze I, Garcia V, Genov J, Ghandour Z, Ghuloom M, Gomez B, Gunter J, Habeeb J, Hajelssedig O, Hamoudi W, Hrstic I, Hu CC, Huang CF, Hui YT, Jahis R, Jelev D, John AK, Kamel Y, Kao JH, Khamis J, Khattabi H, Khoudri I, Konysbekova A, Kotzev I, Lai MS, Lao WC, Layden J, Lee MH, Lesi O, Li M, Lo A, Loo CK, Lukšić B, Malu AO, Mateva L, Mitova R, Morović M, Murphy K, Mustapha B, Nde H, Nersesov A, Ngige E, Njoya O, Nonković D, Obekpa S, Oguche S, Okolo EE, Omede O, Omuemu C, Ondoa P, Phillips RO, Prokopenko YN, Razavi H, Razavi-Shearer D, Redae B, Reic T, Rinke de Wit T, Rios C, Robbins S, Roberts LR, Sanad SJ, Schmelzer JD, Sharma M, Simonova M, Su TH, Sultan K, Tan SS, Tchernev K, Tsang OTY, Tsang S, Tzeuton C, Ugoeze S, Uzochukwu B, Vi R, Wani HU, Wong VWS, Yacoub R, Yesmembetov KI, Youbi M, Yuen MF, Razavi-Shearer K. Historical epidemiology of hepatitis C virus in select countries-volume 4. J Viral Hepat 2017; 24 Suppl 2:8-24. [PMID: 29105285 DOI: 10.1111/jvh.12762] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/03/2017] [Indexed: 12/11/2022]
Abstract
Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.
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Affiliation(s)
- A Maaroufi
- National Institute of Health Administration, Rabat, Morocco
| | - A Vince
- Medical School University of Zagreb, University Hospital of Infectious Diseases Zagreb, Zagreb, Croatia
| | - S M Himatt
- Ministry of Public Health Qatar, Doha, Qatar
| | - R Mohamed
- University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - J Fung
- Department of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - O Opare-Sem
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - A Workneh
- Non-Communicable Diseases Programme, World Health Organization, Addis Ababa, Ethiopia.,Federal Ministry of Health, Addis Ababa, Ethiopia
| | - R Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - I Al Ghazzawi
- GI and Hepatology Department, Jordan Royal Medical Services, Amman, Jordan
| | - M Abdulla
- Salmaniya Medical Complex, Manama, Bahrain
| | - K S Kaliaskarova
- Ministry of Healthcare and Social Development of the Republic of Kazakhstan, Astana, Kazakhstan.,Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan
| | | | | | - D Adda
- Civil Society Network on Hepatitis, Abuja, Nigeria.,Chagro-Care Trust (CCT), Jalingo, Nigeria
| | - O Akin
- Federal Ministry of Health, Abuja, Nigeria
| | - A Al Baqali
- Al Kindi Specialised Hospital, Manama, Bahrain
| | - N Al Dweik
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K Al Ejji
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - S Al Kaabi
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K Al Naamani
- Division of Gastroenterology and Hepatology, Department of Medicine, Armed Forces Hospital, Muscat, Oman
| | - J Al Qamish
- Gastroenterolgy Clinic, IBN Al-Nafees Hospital, Manama, Bahrain
| | | | | | - M AlBadri
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - S A Al-Busafi
- Division of Gastroenterology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - W Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - K Antonov
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - C Anyaike
- Federal Ministry of Health, Abuja, Nigeria
| | - F Arome
- Advocacy for the Prevention of Hepatitis in Nigeria, Jos, Nigeria
| | - A Bane
- Gastroenterology and Hepatology, Addis Ababa University Medical School, Addis Ababa, Ethiopia.,Ethiopian Gastroenterological Association, Addis Ababa, Ethiopia
| | - S Blach
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - M M Borodo
- Aminu Kano Teaching Hospital, Kano, Nigeria.,Bayero University, Kano, Nigeria
| | - S M Brandon
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - B Bright
- LiveWell Initiative (LWI), Lagos, Nigeria
| | - M T Butt
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - I Cardenas
- Communicable Diseases Division, Ministry of Health and Social Protection, Bogota, Colombia
| | - H L Y Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | | | - D S Chen
- Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
| | - P J Chen
- National Taiwan University, Taipei, Taiwan
| | - R N Chien
- Liver Research Unit, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - W L Chuang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - D Cuellar
- Department of Epidemiology and Demography, Ministry of Health and Social Protection, Bogota, Colombia
| | - M Derbala
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - C Estes
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - E Farag
- Ministry of Public Health Qatar, Doha, Qatar
| | - I Gamkrelidze
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - V Garcia
- Ministry of Public Health, Santo Domingo, Dominican Republic
| | - J Genov
- University Hospital "Queen Joanna", Sofia, Bulgaria
| | - Z Ghandour
- BDF Hospital, Royal Medical Services, Riffa, Bahrain
| | - M Ghuloom
- Salmaniya Medical Complex, Manama, Bahrain
| | - B Gomez
- Pan American Health Organization, Washington, DC, USA
| | - J Gunter
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - J Habeeb
- Salmaniya Medical Complex, Manama, Bahrain
| | - O Hajelssedig
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - W Hamoudi
- Department of Gastroenterology & Hepatology, Al Bashir Hospital, Amman, Jordan.,Jordan Ministry of Health, Amman, Jordan
| | - I Hrstic
- General Hospital Pula, Pula, Croatia
| | - C C Hu
- Liver Research Unit, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - C F Huang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Y T Hui
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, SAR, China
| | - R Jahis
- Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - D Jelev
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - A K John
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Y Kamel
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Miniya University, Minya, Egypt
| | - J H Kao
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - J Khamis
- Salmaniya Medical Complex, Manama, Bahrain
| | - H Khattabi
- Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - I Khoudri
- National Institute of Health Administration, Rabat, Morocco
| | - A Konysbekova
- Republican Diagnostic Center, Astana, Kazakhstan.,University Medical Center, Astana, Kazakhstan
| | - I Kotzev
- University Hospital "St. Marina", Varna, Bulgaria
| | - M S Lai
- Department of Medicine, North District Hospital, Hong Kong, SAR, China
| | - W C Lao
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, SAR, China
| | - J Layden
- Department of Public Health Sciences, Loyola University Chicago, Chicago, IL, USA
| | - M H Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - O Lesi
- University of Lagos, Lagos, Nigeria.,Lagos University Teaching Hospital, Lagos, Nigeria
| | - M Li
- Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, SAR, China
| | - A Lo
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - C K Loo
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, SAR, China
| | - B Lukšić
- Clinical Department of Infectious Diseases, Split University Hospital and Split University Medical School, Split, Croatia
| | - A O Malu
- Benue State University Teaching Hospital, Makurdi, Nigeria
| | - L Mateva
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - R Mitova
- University Hospital "Queen Joanna", Sofia, Bulgaria
| | - M Morović
- Department of Infectious Diseases, Zadar General Hospital, Zadar, Croatia
| | - K Murphy
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | | | - H Nde
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - A Nersesov
- National Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - E Ngige
- Federal Ministry of Health, Abuja, Nigeria
| | - O Njoya
- Research Laboratory on Viral Hepatitis & Health Communication, Faculty of Medicine, University of Yaoundé, Yaoundé, Cameroon
| | - D Nonković
- Department of Epidemiology, Institute of Public Health, County of Dalmatia, Split, Croatia
| | - S Obekpa
- Advocacy for the Prevention of Hepatitis in Nigeria, Jos, Nigeria.,Benue State University Teaching Hospital, Makurdi, Nigeria
| | - S Oguche
- Department of Pediatrics, University of Jos, Jos, Nigeria.,Department of Medicine, University of Jos, Jos, Nigeria.,Jos University Teaching Hospital, Jos, Nigeria
| | - E E Okolo
- Beacon Youth Initiative, Lafia, Nigeria
| | - O Omede
- Federal Ministry of Health, Abuja, Nigeria
| | - C Omuemu
- University of Benin, Benin City, Nigeria
| | - P Ondoa
- Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands.,African Society of Laboratory Medicine, Addis Ababa, Ethiopia
| | - R O Phillips
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Y N Prokopenko
- Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan
| | - H Razavi
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | | | - B Redae
- Ethiopian Gastroenterological Association, Addis Ababa, Ethiopia.,St. Paul's Hospital Millennium College, Addis Ababa, Ethiopia
| | - T Reic
- European Liver Patients Association, Sint-Truiden, Belgium
| | - T Rinke de Wit
- PharmAccess Foundation, Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - C Rios
- Department of Health Promotion and Disease Prevention, Ministry of Health and Social Protection, Bogota, Colombia
| | - S Robbins
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - L R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S J Sanad
- BDF Hospital, Royal Medical Services, Riffa, Bahrain
| | - J D Schmelzer
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - M Sharma
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - M Simonova
- Clinic of Gastroenterology, Military Medical Academy, Sofia, Bulgaria
| | - T H Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - K Sultan
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - S S Tan
- Department of Hepatology, Selayang Hospital, Selangor, Malaysia
| | | | - O T Y Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital Authority, Hong Kong, SAR, China
| | - S Tsang
- Department of Medicine, Tseung Kwan O Hospital, Hong Kong, SAR, China
| | - C Tzeuton
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - S Ugoeze
- Federal Medical Centre, Jalingo, Nigeria
| | - B Uzochukwu
- Institute of Public Health, University of Nigeria, Nsukka, Nigeria
| | - R Vi
- Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan.,International HepatoTransplant Group, Astana, Kazakhstan
| | - H U Wani
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - V W S Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - R Yacoub
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K I Yesmembetov
- National Scientific Center of Oncology and Transplantology, Astana, Kazakhstan
| | - M Youbi
- National Institute of Health Administration, Rabat, Morocco
| | - M F Yuen
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR, China
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20
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Chan HLY, Chen CJ, Omede O, Al Qamish J, Al Naamani K, Bane A, Tan SS, Simonova M, Cardenas I, Derbala M, Akin O, Phillips RO, Abdelmageed MK, Abdulla M, Adda D, Al Baqali A, Al Dweik N, Al Ejji K, Al Ghazzawi I, Al Kaabi S, Al Sadadi M, Al Salman J, AlBadri M, Al-Busafi SA, Al-Romaihi HE, Ampofo W, Antonov K, Anyaike C, Arome F, Blach S, Borodo MM, Brandon SM, Bright B, Butt MT, Chen DS, Chen PJ, Chien RN, Chuang WL, Cuellar D, Elbardiny AA, Estes C, Farag E, Fung J, Gamkrelidze I, Garcia V, Genov J, Ghandour Z, Ghuloom M, Gomez B, Gunter J, Habeeb J, Hajelssedig O, Hamoudi W, Himatt SM, Hrstic I, Hu CC, Huang CF, Hui YT, Jahis R, Jelev D, John AK, Kaliaskarova KS, Kamel Y, Kao JH, Khamis J, Khattabi H, Khoudri I, Konysbekova A, Kotzev I, Lai MS, Lao WC, Layden J, Lee MH, Lesi O, Li M, Lo A, Loo CK, Lukšić B, Maaroufi A, Malu AO, Mateva L, Mitova R, Mohamed R, Morović M, Murphy K, Mustapha B, Nersesov A, Ngige E, Njouom R, Njoya O, Nonković D, Obekpa S, Oguche S, Okolo EE, Omuemu C, Ondoa P, Opare-Sem O, Owusu-Ofori S, Prokopenko YN, Razavi H, Razavi-Shearer D, Razavi-Shearer K, Redae B, Reic T, Rinke de Wit T, Rios C, Robbins S, Roberts LR, Sanad SJ, Schmelzer JD, Sharma M, Su TH, Sultan K, Tchernev K, Tsang OTY, Tsang S, Tzeuton C, Ugoeze S, Uzochukwu B, Vi R, Vince A, Wani HU, Wong VWS, Workneh A, Yacoub R, Yesmembetov KI, Youbi M, Yuen MF, Nde H. The present and future disease burden of hepatitis C virus infections with today's treatment paradigm: Volume 4. J Viral Hepat 2017; 24 Suppl 2:25-43. [PMID: 29105283 DOI: 10.1111/jvh.12760] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/03/2017] [Indexed: 12/13/2022]
Abstract
Factors influencing the morbidity and mortality associated with viremic hepatitis C virus (HCV) infection change over time and place, making it difficult to compare reported estimates. Models were developed for 17 countries (Bahrain, Bulgaria, Cameroon, Colombia, Croatia, Dominican Republic, Ethiopia, Ghana, Hong Kong, Jordan, Kazakhstan, Malaysia, Morocco, Nigeria, Qatar and Taiwan) to quantify and characterize the viremic population as well as forecast the changes in the infected population and the corresponding disease burden from 2015 to 2030. Model inputs were agreed upon through expert consensus, and a standardized methodology was followed to allow for comparison across countries. The viremic prevalence is expected to remain constant or decline in all but four countries (Ethiopia, Ghana, Jordan and Oman); however, HCV-related morbidity and mortality will increase in all countries except Qatar and Taiwan. In Qatar, the high-treatment rate will contribute to a reduction in total cases and HCV-related morbidity by 2030. In the remaining countries, however, the current treatment paradigm will be insufficient to achieve large reductions in HCV-related morbidity and mortality.
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Affiliation(s)
- H L Y Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | | | - O Omede
- Federal Ministry of Health, Abuja, Nigeria
| | - J Al Qamish
- Gastroenterolgy Clinic, IBN Al-Nafees Hospital, Manama, Bahsrain
| | - K Al Naamani
- Division of Gastroenterology and Hepatology, Department of Medicine, Armed Forces Hospital, Muscat, Oman
| | - A Bane
- Gastroenterology and Hepatology, Addis Ababa University Medical School, Addis Ababa, Ethiopia.,Ethiopian Gastroenterological Association, Addis Ababa, Ethiopia
| | - S S Tan
- Department of Hepatology, Selayang Hospital, Selangor, Malaysia
| | - M Simonova
- Clinic of Gastroenterology, Military Medical Academy, Sofia, Bulgaria
| | - I Cardenas
- Communicable Diseases Division, Ministry of Health and Social Protection, Bogota, Colombia
| | - M Derbala
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - O Akin
- Federal Ministry of Health, Abuja, Nigeria
| | - R O Phillips
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - M Abdulla
- Salmaniya Medical Complex, Manama, Bahrain
| | - D Adda
- Civil Society Network on Hepatitis, Abuja, Nigeria.,Chagro-Care Trust (CCT), Jalingo, Nigeria
| | - A Al Baqali
- Al Kindi Specialised Hospital, Manama, Bahrain
| | - N Al Dweik
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K Al Ejji
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - I Al Ghazzawi
- GI and Hepatology Department, Jordan Royal Medical Services, Amman, Jordan
| | - S Al Kaabi
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | | | - M AlBadri
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - S A Al-Busafi
- Division of Gastroenterology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - W Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - K Antonov
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - C Anyaike
- Federal Ministry of Health, Abuja, Nigeria
| | - F Arome
- Advocacy for the Prevention of Hepatitis in Nigeria, Jos, Nigeria
| | - S Blach
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - M M Borodo
- Aminu Kano Teaching Hospital, Kano, Nigeria.,Bayero University, Kano, Nigeria
| | - S M Brandon
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - B Bright
- LiveWell Initiative (LWI), Lagos, Nigeria
| | - M T Butt
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - D S Chen
- Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
| | - P J Chen
- National Taiwan University, Taipei, Taiwan
| | - R N Chien
- Liver Research Unit, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - W L Chuang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - D Cuellar
- Department of Epidemiology and Demography, Ministry of Health and Social Protection, Bogota, Colombia
| | | | - C Estes
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - E Farag
- Ministry of Public Health Qatar, Doha, Qatar
| | - J Fung
- Department of Medicine, The University of Hong Kong, Hong Kong, SAR, China
| | - I Gamkrelidze
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - V Garcia
- Ministry of Public Health, Santo Domingo, Dominican Republic
| | - J Genov
- University Hospital "Queen Joanna", Sofia, Bulgaria
| | - Z Ghandour
- BDF Hospital, Royal Medical Services, Riffa, Bahrain
| | - M Ghuloom
- Salmaniya Medical Complex, Manama, Bahrain
| | - B Gomez
- Pan American Health Organization, Washington, DC, USA
| | - J Gunter
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - J Habeeb
- Salmaniya Medical Complex, Manama, Bahrain
| | - O Hajelssedig
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - W Hamoudi
- Department of Gastroenterology & Hepatology, Al Bashir Hospital, Amman, Jordan.,Jordan Ministry of Health, Amman, Jordan
| | - S M Himatt
- Ministry of Public Health Qatar, Doha, Qatar
| | - I Hrstic
- General Hospital Pula, Pula, Croatia
| | - C C Hu
- Liver Research Unit, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - C F Huang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Y T Hui
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, SAR, China
| | - R Jahis
- Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - D Jelev
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - A K John
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K S Kaliaskarova
- Ministry of Healthcare and Social Development of the Republic of Kazakhstan, Astana, Kazakhstan.,Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan
| | - Y Kamel
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Miniya University, Minya, Egypt
| | - J H Kao
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - J Khamis
- Salmaniya Medical Complex, Manama, Bahrain
| | - H Khattabi
- Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - I Khoudri
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - A Konysbekova
- Republican Diagnostic Center, Astana, Kazakhstan.,University Medical Center, Astana, Kazakhstan
| | - I Kotzev
- University Hospital "St. Marina", Varna, Bulgaria
| | - M S Lai
- Department of Medicine, North District Hospital, Hong Kong, SAR, China
| | - W C Lao
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, SAR, China
| | - J Layden
- Department of Public Health Sciences, Loyola University Chicago, Chicago, IL, USA
| | - M H Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - O Lesi
- University of Lagos, Lagos, Nigeria.,Lagos University Teaching Hospital, Lagos, Nigeria
| | - M Li
- Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, SAR, China
| | - A Lo
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - C K Loo
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, SAR, China
| | - B Lukšić
- Clinical Department of Infectious Diseases, Split University Hospital and Split University Medical School, Split, Croatia
| | - A Maaroufi
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - A O Malu
- Benue State University Teaching Hospital, Makurdi, Nigeria
| | - L Mateva
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - R Mitova
- University Hospital "Queen Joanna", Sofia, Bulgaria
| | - R Mohamed
- University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - M Morović
- Department of Infectious Diseases, Zadar General Hospital, Zadar, Croatia
| | - K Murphy
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | | | - A Nersesov
- National Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - E Ngige
- Federal Ministry of Health, Abuja, Nigeria
| | - R Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - O Njoya
- Research Laboratory on Viral Hepatitis & Health Communication, Faculty of Medicine, University of Yaoundé, Yaoundé, Cameroon
| | - D Nonković
- Department of Epidemiology, Institute of Public Health, County of Dalmatia, Split, Croatia
| | - S Obekpa
- Advocacy for the Prevention of Hepatitis in Nigeria, Jos, Nigeria.,Benue State University Teaching Hospital, Makurdi, Nigeria
| | - S Oguche
- Department of Pediatrics, University of Jos, Jos, Nigeria.,Department of Medicine, University of Jos, Jos, Nigeria.,Jos University Teaching Hospital, Jos, Nigeria
| | - E E Okolo
- Beacon Youth Initiative, Lafia, Nigeria
| | - C Omuemu
- University of Benin, Benin City, Nigeria
| | - P Ondoa
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.,African Society of Laboratory Medicine, Addis Ababa, Ethiopia
| | - O Opare-Sem
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Y N Prokopenko
- Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan
| | - H Razavi
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | | | | | - B Redae
- Ethiopian Gastroenterological Association, Addis Ababa, Ethiopia.,St. Paul's Hospital Millennium College, Addis Ababa, Ethiopia
| | - T Reic
- European Liver Patients Association, Sint-Truiden, Belgium
| | - T Rinke de Wit
- PharmAccess Foundation, Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - C Rios
- Department of Health Promotion and Disease Prevention, Ministry of Health and Social Protection, Bogota, Colombia
| | - S Robbins
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - L R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S J Sanad
- BDF Hospital, Royal Medical Services, Riffa, Bahrain
| | - J D Schmelzer
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - M Sharma
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - T H Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - K Sultan
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - O T Y Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital Authority, Hong Kong, SAR, China
| | - S Tsang
- Department of Medicine, Tseung Kwan O Hospital, Hong Kong, SAR, China
| | - C Tzeuton
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - S Ugoeze
- Federal Medical Centre, Jalingo, Nigeria
| | - B Uzochukwu
- Institute of Public Health, University of Nigeria, Nsukka, Nigeria
| | - R Vi
- Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan.,International HepatoTransplant Group, Astana, Kazakhstan
| | - A Vince
- Medical School University of Zagreb, University Hospital of Infectious Diseases Zagreb, Zagreb, Croatia
| | - H U Wani
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - V W S Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - A Workneh
- Non-Communicable Diseases Programme, World Health Organization, Addis Ababa, Ethiopia.,Federal Ministry of Health, Addis Ababa, Ethiopia
| | - R Yacoub
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K I Yesmembetov
- National Scientific Center of Oncology and Transplantology, Astana, Kazakhstan
| | - M Youbi
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - M F Yuen
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR, China
| | - H Nde
- Center for Disease Analysis (CDA), Lafayette, CO, USA
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21
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Chen DS, Hamoudi W, Mustapha B, Layden J, Nersesov A, Reic T, Garcia V, Rios C, Mateva L, Njoya O, Al-Busafi SA, Abdelmageed MK, Abdulla M, Adda D, Akin O, Al Baqali A, Al Dweik N, Al Ejji K, Al Ghazzawi I, Al Kaabi S, Al Naamani K, Al Qamish J, Al Sadadi M, Al Salman J, AlBadri M, Al-Romaihi HE, Ampofo W, Antonov K, Anyaike C, Arome F, Bane A, Blach S, Borodo MM, Brandon SM, Bright B, Butt MT, Cardenas I, Chan HLY, Chen CJ, Chen PJ, Chien RN, Chuang WL, Cuellar D, Derbala M, Elbardiny AA, Estes C, Farag E, Fung J, Gamkrelidze I, Genov J, Ghandour Z, Ghuloom M, Gomez B, Gunter J, Habeeb J, Hajelssedig O, Himatt SM, Hrstic I, Hu CC, Huang CF, Hui YT, Jahis R, Jelev D, John AK, Kaliaskarova KS, Kamel Y, Kao JH, Khamis J, Khattabi H, Khoudri I, Konysbekova A, Kotzev I, Lai MS, Lao WC, Lee MH, Lesi O, Li M, Lo A, Loo CK, Lukšić B, Maaroufi A, Malu AO, Mitova R, Mohamed R, Morović M, Murphy K, Nde H, Ngige E, Njouom R, Nonković D, Obekpa S, Oguche S, Okolo EE, Omede O, Omuemu C, Ondoa P, Opare-Sem O, Owusu-Ofori S, Phillips RO, Prokopenko YN, Razavi H, Razavi-Shearer D, Razavi-Shearer K, Redae B, Rinke de Wit T, Robbins S, Roberts LR, Sanad SJ, Sharma M, Simonova M, Su TH, Sultan K, Tan SS, Tchernev K, Tsang OTY, Tsang S, Tzeuton C, Ugoeze S, Uzochukwu B, Vi R, Vince A, Wani HU, Wong VWS, Workneh A, Yacoub R, Yesmembetov KI, Youbi M, Yuen MF, Schmelzer JD. Strategies to manage hepatitis C virus infection disease burden-Volume 4. J Viral Hepat 2017; 24 Suppl 2:44-63. [PMID: 29105286 DOI: 10.1111/jvh.12759] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/03/2017] [Indexed: 01/03/2023]
Abstract
The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 17 countries in Africa, Asia, Europe, Latin America and the Middle East, and interventions for achieving the Global Health Sector Strategy on viral hepatitis targets-"WHO Targets" (65% reduction in HCV-related deaths, 90% reduction in new infections and 90% of infections diagnosed by 2030) were considered. Scaling up treatment and diagnosis rates over time would be required to achieve these targets in all but one country, even with the introduction of high SVR therapies. The scenarios developed to achieve the WHO Targets in all countries studied assumed the implementation of national policies to prevent new infections and to diagnose current infections through screening.
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Affiliation(s)
- D S Chen
- Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
| | - W Hamoudi
- Department of Gastroenterology & Hepatology, Al Bashir Hospital, Amman, Jordan.,Jordan Ministry of Health, Amman, Jordan
| | | | - J Layden
- Department of Public Health Sciences, Loyola University Chicago, Chicago, IL, USA
| | - A Nersesov
- National Research Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
| | - T Reic
- European Liver Patients Association, Sint-Truiden, Belgium
| | - V Garcia
- Ministry of Public Health, Santo Domingo, Dominican Republic
| | - C Rios
- Department of Health Promotion and Disease Prevention, Ministry of Health and Social Protection, Bogota, Colombia
| | - L Mateva
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - O Njoya
- Research Laboratory on Viral Hepatitis & Health Communication, Faculty of Medicine, University of Yaoundé, Yaoundé, Cameroon
| | - S A Al-Busafi
- Division of Gastroenterology, Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - M Abdulla
- Salmaniya Medical Complex, Manama, Bahrain
| | - D Adda
- Civil Society Network on Hepatitis, Abuja, Nigeria.,Chagro-Care Trust (CCT), Jalingo, Nigeria
| | - O Akin
- Federal Ministry of Health, Abuja, Nigeria
| | - A Al Baqali
- Al Kindi Specialised Hospital, Manama, Bahrain
| | - N Al Dweik
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K Al Ejji
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - I Al Ghazzawi
- GI and Hepatology Department, Jordan Royal Medical Services, Amman, Jordan
| | - S Al Kaabi
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K Al Naamani
- Division of Gastroenterology and Hepatology, Department of Medicine, Armed Forces Hospital, Muscat, Oman
| | - J Al Qamish
- Gastroenterolgy Clinic, IBN Al-Nafees Hospital, Manama, Bahrain
| | | | | | - M AlBadri
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - W Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - K Antonov
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - C Anyaike
- Federal Ministry of Health, Abuja, Nigeria
| | - F Arome
- Advocacy for the Prevention of Hepatitis in Nigeria, Jos, Nigeria
| | - A Bane
- Gastroenterology and Hepatology, Addis Ababa University Medical School, Addis Ababa, Ethiopia.,Ethiopian Gastroenterological Association, Addis Ababa, Ethiopia
| | - S Blach
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - M M Borodo
- Aminu Kano Teaching Hospital, Kano, Nigeria.,Bayero University, Kano, Nigeria
| | - S M Brandon
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - B Bright
- LiveWell Initiative (LWI), Lagos, Nigeria
| | - M T Butt
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - I Cardenas
- Communicable Diseases Division, Ministry of Health and Social Protection, Bogota, Colombia
| | - H L Y Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | | | - P J Chen
- National Taiwan University, Taipei, Taiwan
| | - R N Chien
- Liver Research Unit, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - W L Chuang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - D Cuellar
- Department of Epidemiology and Demography, Ministry of Health and Social Protection, Bogota, Colombia
| | - M Derbala
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - C Estes
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - E Farag
- Ministry of Public Health Qatar, Doha, Qatar
| | - J Fung
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - I Gamkrelidze
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - J Genov
- University Hospital "Queen Joanna", Sofia, Bulgaria
| | - Z Ghandour
- BDF Hospital, Royal Medical Services, Riffa, Bahrain
| | - M Ghuloom
- Salmaniya Medical Complex, Manama, Bahrain
| | - B Gomez
- Pan American Health Organization, Washington, DC, USA
| | - J Gunter
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - J Habeeb
- Salmaniya Medical Complex, Manama, Bahrain
| | - O Hajelssedig
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - S M Himatt
- Ministry of Public Health Qatar, Doha, Qatar
| | - I Hrstic
- General Hospital Pula, Pula, Croatia
| | - C C Hu
- Liver Research Unit, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - C F Huang
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
| | - Y T Hui
- Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China
| | - R Jahis
- Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | - D Jelev
- University Hospital "St. Ivan Rilski", Sofia, Bulgaria
| | - A K John
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K S Kaliaskarova
- Ministry of Healthcare and Social Development of the Republic of Kazakhstan, Astana, Kazakhstan.,Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan
| | - Y Kamel
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Miniya University, Minya, Egypt
| | - J H Kao
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - J Khamis
- Salmaniya Medical Complex, Manama, Bahrain
| | - H Khattabi
- Eastern Mediterranean Regional Office, World Health Organization, Cairo, Egypt
| | - I Khoudri
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - A Konysbekova
- Republican Diagnostic Center, Astana, Kazakhstan.,University Medical Center, Astana, Kazakhstan
| | - I Kotzev
- University Hospital "St. Marina", Varna, Bulgaria
| | - M S Lai
- Department of Medicine, North District Hospital, Hong Kong, China
| | - W C Lao
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China
| | - M H Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - O Lesi
- University of Lagos, Lagos, Nigeria.,Lagos University Teaching Hospital, Lagos, Nigeria
| | - M Li
- Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Hong Kong, China
| | - A Lo
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - C K Loo
- Department of Medicine and Geriatrics, Kwong Wah Hospital, Hong Kong, China
| | - B Lukšić
- Clinical Department of Infectious Diseases, Split University Hospital and Split University Medical School, Split, Croatia
| | - A Maaroufi
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - A O Malu
- Benue State University Teaching Hospital, Makurdi, Nigeria
| | - R Mitova
- University Hospital "Queen Joanna", Sofia, Bulgaria
| | - R Mohamed
- University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - M Morović
- Department of Infectious Diseases, Zadar General Hospital, Zadar, Croatia
| | - K Murphy
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - H Nde
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - E Ngige
- Federal Ministry of Health, Abuja, Nigeria
| | - R Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - D Nonković
- Department of Epidemiology, Institute of Public Health, Split, Croatia
| | - S Obekpa
- Advocacy for the Prevention of Hepatitis in Nigeria, Jos, Nigeria.,Benue State University Teaching Hospital, Makurdi, Nigeria
| | - S Oguche
- Department of Pediatrics, University of Jos, Jos, Nigeria.,Department of Medicine, University of Jos, Jos, Nigeria.,Jos University Teaching Hospital, Jos, Nigeria
| | - E E Okolo
- Beacon Youth Initiative, Lafia, Nigeria
| | - O Omede
- Federal Ministry of Health, Abuja, Nigeria
| | - C Omuemu
- University of Benin, Benin City, Nigeria
| | - P Ondoa
- Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands.,African Society of Laboratory Medicine, Addis Ababa, Ethiopia
| | - O Opare-Sem
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - R O Phillips
- Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Y N Prokopenko
- Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan
| | - H Razavi
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | | | | | - B Redae
- Ethiopian Gastroenterological Association, Addis Ababa, Ethiopia.,St. Paul's Hospital Millennium College, Addis Ababa, Ethiopia
| | - T Rinke de Wit
- PharmAccess Foundation, Department of Global Health, University of Amsterdam, Amsterdam, The Netherlands
| | - S Robbins
- Center for Disease Analysis (CDA), Lafayette, CO, USA
| | - L R Roberts
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S J Sanad
- BDF Hospital, Royal Medical Services, Riffa, Bahrain
| | - M Sharma
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - M Simonova
- Clinic of Gastroenterology, Military Medical Academy, Sofia, Bulgaria
| | - T H Su
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - K Sultan
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - S S Tan
- Department of Hepatology, Selayang Hospital, Selangor, Malaysia
| | | | - O T Y Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital Authority, Hong Kong, SAR China
| | - S Tsang
- Department of Medicine, Tseung Kwan O Hospital, Hong Kong, China
| | - C Tzeuton
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
| | - S Ugoeze
- Federal Medical Centre, Jalingo, Nigeria
| | - B Uzochukwu
- Institute of Public Health, University of Nigeria, Nsukka, Nigeria
| | - R Vi
- Republican Coordination Center for Hepatology and Gastroenterology, Astana, Kazakhstan.,International HepatoTransplant Group, Astana, Kazakhstan
| | - A Vince
- Medical School University of Zagreb, University Hospital of Infectious Diseases Zagreb, Zagreb, Croatia
| | - H U Wani
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - V W S Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - A Workneh
- Non-Communicable Diseases Programme, World Health Organization, Addis Ababa, Ethiopia.,Federal Ministry of Health, Addis Ababa, Ethiopia
| | - R Yacoub
- Division of Gastroenterology, Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - K I Yesmembetov
- National Scientific Center of Oncology and Transplantation, Astana, Kazakhstan
| | - M Youbi
- Department of Epidemiology and Disease Control, Ministry of Health, Rabat, Morocco
| | - M F Yuen
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - J D Schmelzer
- Center for Disease Analysis (CDA), Lafayette, CO, USA
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22
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Cheng HC, Yang EH, Wu CT, Wang WL, Chen PJ, Lin MY, Sheu BS. Hypoalbuminemia is a predictor of mortality and rebleeding in peptic ulcer bleeding under proton pump inhibitor use. J Formos Med Assoc 2017; 117:316-325. [PMID: 28751088 DOI: 10.1016/j.jfma.2017.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 04/29/2017] [Revised: 06/08/2017] [Accepted: 07/07/2017] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND/PURPOSE Peptic ulcer bleeding remains a deadly disease, and a simple indicator of long-term outcomes is crucial. This study validated whether hypoalbuminemia and its related factors in patients with peptic ulcer bleeding can indicate long-term mortality and rebleeding under proton pump inhibitor use. METHODS The prospective cohort study enrolled 426 patients with peptic ulcer bleeding who had high risk stigmata at endoscopy and had received endoscopic hemostasis. They were divided into 79 patients in the hypoalbuminemia group (Hypo-AG, serum albumin <28 g/L), 135 in the marginal hypoalbuminemia group (Margin-AG, serum albumin 28-34.9 g/L), and 212 in the normal albuminemia group (Normal-AG, serum albumin ≥35 g/L). Each subject received 72-h of intravenous infusion and then the oral form of proton pump inhibitors and were monitored for 84 days to assess all-cause mortality and recurrent bleeding. RESULTS The primary outcome of all-cause mortality rates were increased in a stepwise fashion in a trend from Normal-AG, Margin-AG, to Hypo-AG (0-28th day: 1.9%, 2.2%, 12.8%, p < 0.001; 29th-84th day: 2.5%, 8.0%, 10.6%, p < 0.01). The secondary outcome of recurrent bleeding rates were also increased in the same fashion (0-28th day: 6.4%, 15.4%, 24.6%, p < 0.001; 29th-84th day: 0%, 3.0%, 4.2%, p = 0.01). Abnormal albuminemia was <30 g/L related to hemoglobin levels <70 g/L, nosocomial bleeding, cirrhosis, age ≥70 years, shock, and ulcer size ≥1.0 cm independently (p < 0.05). CONCLUSION Hypoalbuminemia in patients with peptic ulcer bleeding can be an alarm indicator of all-cause mortality and recurrent bleeding in a long-term follow-up situation under proton pump inhibitor use (NCT01591083).
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Affiliation(s)
- Hsiu-Chi Cheng
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan.
| | - Er-Hsiang Yang
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan.
| | - Chung-Tai Wu
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan.
| | - Wen-Lun Wang
- Department of Internal Medicine, E-Da Hospital, I-Shou University, 1 Yida Road, Yanchao District, Kaohsiung, 82445, Taiwan.
| | - Po-Jun Chen
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan.
| | - Meng-Ying Lin
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan.
| | - Bor-Shyang Sheu
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, Tainan, 70403, Taiwan; Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Executive Yuan, Tainan, Taiwan.
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23
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Chen XH, Chen PJ, Long Y, Huang QP. [Determination and significance of serum MPO and amylin in adult patients with OSAHS after short-range noninvasive positive pressure ventilation]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:873-876. [PMID: 29775005 DOI: 10.13201/j.issn.1001-1781.2017.11.013] [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: 03/17/2017] [Indexed: 11/12/2022]
Abstract
Objective:The aim of this study to investigate the determination and significance of serum MPO and amylin in adult patients with OSAHS after short-range noninvasive positive pressure ventilation. Method:Eighty-seven OSAHS patients were divided into severe group (30 cases), moderate group (30 cases) and mild group (27 cases) according to the AHI range. Twenty-seven outpatient health persons were selected as the control group. Serum amylin and myeloperoxidase were measured by ELISA; Amyloid and myeloperoxidase were reassessed in 30 patients with severe OSAHS after 6 months of combined therapy, and the relationship between amylin, myeloperoxidase and PSG was analyzed. Result:①With the severity of OSAHS patients increased, the serum amylin and myeloperoxidase levels gradually increased (F=22.486, 19.755;P<0.01); There was no significant difference in MPO and amylin concentration between the mild group and the control group (P>0.05), and the other groups were significantly different from each other (P<0.01). ②There was no correlation among serum amylin and myeloperoxidase level and BMI and age in OSAHS patients (P>0.05); and a negative correlation with SaO₂, and AHI was positively correlated (P<0.01). ③After 3 months of CPAP treatment, LSaO₂ increased which the AHI and peripheral blood MPO, amylin levels lower than before in 30 patients (P<0.05); The amylin and myeloperoxidase concentrations of blood after 6 months of treatment were significantly lower than those of 3 months after treatment (P<0.05), which still increased compared with the control group. Conclusion:The determination of serum amylin and MPO in patients with OSAHS has a certain reference value in predicting the condition and curative effect of diabetes mellitus and insulin resistance. CPAP treatment can significantly reduce the degree of hypoxiapatients and cardiovascular damage in OSAHS patients, which was significantly correlated with the treatment time.
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Affiliation(s)
- X H Chen
- Department of Otorhinolaryngology Head and Neck Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - P J Chen
- Clinical Laboratory, Shenzhen Seventh People's Hospital
| | - Y Long
- Department of Otorhinolaryngology Head and Neck Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
| | - Q P Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, 518033, China
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Chen PJ, Zhu M, Tibus S, Dyer T, Piccirillo J, Ocker B, Shull RD. Annealing Stability Study of Co 20Fe 60B 20\MgO\ Co 20Fe 60B 20 Perpendicular Magnetic Tunnel Junctions. J Phys D Appl Phys 2017; 50:025006. [PMID: 28210007 PMCID: PMC5304246 DOI: 10.1088/1361-6463/50/2/025006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A full Co20Fe60B20\MgO\ Co20Fe60B20 perpendicular magnetic tunnel junction (pMTJ) with (Co\Pt) multilayers as pinning layers and different functional multilayers stacks were made and annealed at different temperatures. The tunneling magnetoresistance ratio (TMR) and MgO barrier resistance-area product (RA) were measured and analyzed as a function of annealing temperature. The TMR of pMTJs dramatically declines with increasing annealing temperatures from 320 °C to 400 °C while the RA increases with temperature from 375 °C to 450 °C. The pMTJs and partial stacks were also measured in a vibrating sample magnetometer (VSM). We found that the (Co\Pt) multilayers are very stable and maintain a magnetization direction perpendicular to the film plane up to 450 °C. However, the magnetization direction of the CoFeB above and below the MgO barrier rotates from perpendicular to in-plane with increasing annealing temperature. Furthermore, the CoFeB layer influences the adjacent (Co\Pt) layers to rotate at the same time. The pMTJs' elemental depth profiles in the as deposited and annealed states were determined by Secondary Ion Mass Spectrometry (SIMS). We found that Boron and Tantalum migrate towards the top of the stack. The other elements (Platinum, Cobalt, Ruthenium, and Magnesium) are very stable and do not interdiffuse during annealing up to 450°C.
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Affiliation(s)
- P J Chen
- National Institute of Standards and Technology, Gaithersburg, MD 20899-8552; Theiss Research, 7411 Eads Ave.La Jolla, CA 92037
| | - M Zhu
- Colleges of Nanoscale Science & Engineering, SUNY Polytechnic Institute, Albany, NY 12203
| | - S Tibus
- Singulus Technologies AG, 63796 Kahl am Main, Germany
| | - T Dyer
- SEMATECH Inc., 257 Fuller Rd., Albany, NY 12203
| | - J Piccirillo
- Colleges of Nanoscale Science & Engineering, SUNY Polytechnic Institute, Albany, NY 12203
| | - B Ocker
- Singulus Technologies AG, 63796 Kahl am Main, Germany
| | - R D Shull
- National Institute of Standards and Technology, Gaithersburg, MD 20899-8552
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Hsu HP, Loh ZJ, Lee KT, Chung WP, Chen WC, Kuo HL, Chen PJ, Lu HH. Invasive lobular carcinoma of breast with synchronous colon metastasis. Formos J Surg 2017. [DOI: 10.4103/fjs.fjs_22_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Chen PJ, Chen HC. An unusual cause of tinnitus. Ear Nose Throat J 2016; 95:368. [PMID: 27657313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Affiliation(s)
- Po-Jun Chen
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Abstract
Perpendicular Magnetic Tunneling Junctions (pMTJs) with Ta\CoFeB\MgO have been extensively studied in recent years. However, the effects of the underlayer on the formation of the CoFeB perpendicular magnetic anisotropy (PMA) are still not well understood. Here we report the results of our systematic use of a wide range of elements (Ti, V, Cr, Zr, Nb, Mo, Ru, Rh, Pd, Ag, Hf, Ta, W, Re, Os, Ir, Pt and Au) encompassed by columns IVA, VA, VIA, VIIA and VIIIA of the periodic table as the underlayer in a underlayer\Co20Fe60B20\MgO stack. Our goals were to survey more elements which could conceivably create a PMA in CoFeB and thereby to explore the mechanisms enabling these underlayers to enhance or create the PMA. We found underlayer elements having both an outer shell of 4d electrons (Zr, Nb Mo, and Pd) and 5d electrons (Hf, Ta, W, Re, Ir, and Pt) resulted in the development of a PMA in the MgO-capped Co20Fe60B20. Hybridization between the 3d electrons of the Fe or Co (in the Co20Fe60B20) at the interface with the 4d or 5d electrons of the underlayer is thought to be the cause of the PMA development.
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Affiliation(s)
- P J Chen
- National Institute of Standards of Technology, Gaithersburg, MD, 20899, USA
| | - Y L Iunin
- National Institute of Standards of Technology, Gaithersburg, MD, 20899, USA; Institute of Solid State Physics, RAS, Chernogolovka, Moscow distr., 142432 Russia
| | - S F Cheng
- Naval Research Laboratory, Washington, DC 20375, USA
| | - R D Shull
- National Institute of Standards of Technology, Gaithersburg, MD, 20899, USA
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Cheng HC, Wu CT, Chen WY, Yang EH, Chen PJ, Sheu BS. Risk factors determining the need for second-look endoscopy for peptic ulcer bleeding after endoscopic hemostasis and proton pump inhibitor infusion. Endosc Int Open 2016; 4:E255-62. [PMID: 27004241 PMCID: PMC4798837 DOI: 10.1055/s-0041-111499] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 12/14/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND STUDY AIMS The need for routine second-look endoscopy in cases of peptic ulcer bleeding remains uncertain. We investigated risk factors related to the need for second-look endoscopy after endoscopic hemostasis and proton pump inhibitor (PPI) infusion. PATIENTS AND METHODS We prospectively enrolled 316 patients with peptic ulcer bleeding after endoscopic hemostasis. Second-look endoscopy was scheduled after 72-hour PPI infusion (Day-3 subgroup) or one day early (Day-2 subgroup). If early rebleeding developed within 3 days, emergent second-look endoscopy was conducted. Risk factors for early rebleeding (use of E2(nd) score to predict the need for early second-look endoscopy) and persistent major stigmata in the Day-3 subgroup (use of R2(nd) score to predict the need for routine second-look endoscopy) were analyzed using univariable and multivariable regression. RESULTS Excluding 10 of 316 patients with early rebleeding, the rate of persistent major stigmata was lower in the Day-3 subgroup than in the Day-2 subgroup (4.8 % vs. 15.4 %, P = 0.002). Endoscopic epinephrine-injection monotherapy and hypoalbuminemia < 3.0 g/dL were two independent risk factors for early rebleeding (P ≤ 0.05). The Forrest Ia-Ib type and hypoalbuminemia < 3.5 g/dL were two independent risk factors for persistent major stigmata on the day-3 second-look endoscopy (P < 0.05). The E2(nd) score was highly accurate for prediction of early rebleeding (AUROC 0.86; 95 % CI, 0.73~0.99), and the R2(nd) score could predict persistent major stigmata at second-look endoscopy (AUROC 0.84; 95 % CI, 0.69~0.99). CONCLUSIONS For patients with peptic ulcer bleeding, E2(nd) and R2(nd) scores can indicate the need for early and routine second-look endoscopy, respectively (Trial registration identifier: NCT02197039).
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Affiliation(s)
- Hsiu-Chi Cheng
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung Univeristy, Tainan, Taiwan,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Tai Wu
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung Univeristy, Tainan, Taiwan,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Ying Chen
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung Univeristy, Tainan, Taiwan,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Er-Hsiang Yang
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung Univeristy, Tainan, Taiwan,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Jun Chen
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung Univeristy, Tainan, Taiwan,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Bor-Shyang Sheu
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung Univeristy, Tainan, Taiwan,Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Sarin SK, Kumar M, Lau GK, Abbas Z, Chan HLY, Chen CJ, Chen DS, Chen HL, Chen PJ, Chien RN, Dokmeci AK, Gane E, Hou JL, Jafri W, Jia J, Kim JH, Lai CL, Lee HC, Lim SG, Liu CJ, Locarnini S, Al Mahtab M, Mohamed R, Omata M, Park J, Piratvisuth T, Sharma BC, Sollano J, Wang FS, Wei L, Yuen MF, Zheng SS, Kao JH. Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int 2016; 10:1-98. [PMID: 26563120 PMCID: PMC4722087 DOI: 10.1007/s12072-015-9675-4] [Citation(s) in RCA: 1661] [Impact Index Per Article: 207.6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/14/2015] [Indexed: 02/06/2023]
Abstract
Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.
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Affiliation(s)
- S K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
| | - M Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - G K Lau
- Division of Gastroenterology and Hepatology, Humanity and Health Medical Centre, Hong Kong SAR, China
- The Institute of Translational Hepatology, Beijing, China
| | - Z Abbas
- Department of Hepatogastroenterlogy, Sindh Institute of Urology and Transplantation, Karachi, Pakistan
| | - H L Y Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - C J Chen
- Genomics Research Center, Academia Sinica, National Taiwan University, Taipei, Taiwan
| | - D S Chen
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - H L Chen
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - P J Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - R N Chien
- Liver Research Unit, Chang Gung Memorial Hospital and University, Chilung, Taiwan
| | - A K Dokmeci
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey
| | - Ed Gane
- New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand
| | - J L Hou
- Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Guangzhou, China
| | - W Jafri
- Department of Medicine, Aga Khan University, Karachi, Pakistan
| | - J Jia
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | | | - C L Lai
- Department of Medicine, University of Hong Kong, Hong Kong, China
| | - H C Lee
- Internal Medicine Asan Medical Center, Seoul, Korea
| | - S G Lim
- Division of Gastroenterology and Hepatology, National University Health System, Singapore, Singapore
| | - C J Liu
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - S Locarnini
- Research and Molecular Development, Victorian Infectious Diseases Reference Laboratory, Melbourne, Australia
| | - M Al Mahtab
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - R Mohamed
- Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - M Omata
- Yamanashi Hospitals (Central and Kita) Organization, 1-1-1 Fujimi, Kofu-shi, Yamanashi, 400-8506, Japan
| | - J Park
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - T Piratvisuth
- NKC Institute of Gastroenterology and Hepatology, Prince of Songkla University, Songkhla, Thailand
| | - B C Sharma
- Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India
| | - J Sollano
- Department of Medicine, University of Santo Tomas, Manila, Philippines
| | - F S Wang
- Treatment and Research Center for Infectious Diseases, Beijing 302 Hospital, Beijing, China
| | - L Wei
- Peking University Hepatology Institute, Beijing, China
| | - M F Yuen
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Pofulam, Hong Kong
| | - S S Zheng
- Department of Hepatobiliary and Pancreatic Surgery, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang Province, China
| | - J H Kao
- Graduate Institute of Clinical Medicine and Hepatitis Research Center, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Wang H, Du Q, Chen PJ, Li JA, He XH. Quantitative ultrasound measurements of bone strength in female adolescent idiopathic scoliosis patients. Scoliosis 2013. [PMCID: PMC3675426 DOI: 10.1186/1748-7161-8-s1-o7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
Neutrophil to lymphocyte ratio and levels of pro-inflammatory cytokines were evaluated in overweight, male Chinese adolescents upon completing a 4-week diet and physical exercise intervention. 43 recruited, non-randomized adolescents (body mass index >25 kg/m2) completed the controlled study. Anthropometric and biologic parameters were measured pre- and post-intervention. After the 4-week intervention, participants exhibited a significant decrease in body mass, body mass index, percentage body fat, basal heart rate, diastolic blood pressure, and all body shape indices tested. A significant decrease in serum lipids (except high-density lipoprotein cholesterol) and insulin levels was observed post-intervention. The neutrophil to lymphocyte ratio was significantly lower post-intervention. Bivariate correlation analyses showed that decrement in Δneutrophil to lymphocyte ratio significantly correlated with decrement in Δinterleukin-6 and Δwhite blood cell count. Thus, a 4-week diet and physical exercise intervention significantly reduces the neutrophil to lymphocyte ratio in a population of overweight, male adolescents. Weight loss caused by the intervention was associated with a significant decrease of pro-inflammatory cytokine levels.
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Affiliation(s)
- R Wang
- Shanghai University of Sport, Department of Sports Medicine, Shanghai, China
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Huang TY, Chen PJ, Liu YC, Jin JS. Inflammatory myofibroblastic tumor of the terminal ileum. Endoscopy 2011; 43 Suppl 2 UCTN:E14-5. [PMID: 21271518 DOI: 10.1055/s-0030-1255823] [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: 12/10/2022]
Affiliation(s)
- T Y Huang
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, Taiwan, Republic of China.
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Chen PJ, Tsai MY, Chi CC, Perng TP. On the formation and photoluminescence of Si(1-x)Ge(x) nanoparticles. J Nanosci Nanotechnol 2007; 7:3340-3343. [PMID: 18019172 DOI: 10.1166/jnn.2007.916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Si(1-x)Ge(x) nanoparticles were prepared from two annealed alloy ingots at the compositions of Si:Ge = 9.5:0.5 and 9:1 using a vapor condensation technique under Ar atmosphere. These nanoparticles are all spherical, and increasing the working pressure leads to an increased particle size and size dispersion. Comparing to the alloy ingots, the nanoparticles have a higher average content of Ge. In addition, increasing the working pressure also causes the Si(1-x)Ge(x) nanoparticles to become more Ge-rich. This can be ascribed to the lower melting point and higher kinetic energy of Ge than Si during the evaporation process. The photoluminescence of Si(1-x)Ge(x) nanoparticles ranges from visible light to infrared region, and the luminescence peak exhibits a red shift as the Ge content in the nanoparticles increases. This indicates that the incorporation of Ge into Si has a dominant effect in the radiative recombination process, in comparison with the constant luminescence peak position in the case of pure Si nanoparticles with similar size distribution.
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Affiliation(s)
- P J Chen
- Department of Materials Science and Engineering, National Tsing Hua University, Hsinchu 300, Taiwan
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Abstract
The hepatitis delta virus (HDV) genome has only one open reading frame, which encodes the viral small delta antigen. After RNA editing, the same open reading frame is extended 19 amino acids at the carboxyl terminus and encodes the large delta antigen. These two viral proteins escort the HDV genome through different cellular compartments for the complicated phases of replication, transcription and, eventually, the formation of progeny virions. To orchestrate these events, the delta antigens have to take distinct cues to traffic to the right compartments and make correct molecular contacts. In eukaryotes, post-translational modification (PTM) is a major mechanism of dictating the multiple functions of a single protein. Multiple PTMs, including phosphorylation, isoprenylation, acetylation, and methylation, have been identified on hepatitis delta antigens. In this chapter we review these PTMs and discuss their functions in regulating and coordinating the life cycle of HDV.
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Affiliation(s)
- W H Huang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, and Hepatitis Research Center, National Taiwan University Hospital, Taipei
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Abstract
Subtypes of hepatitis B virus (HBV) have specific geographic distributions and can serve as epidemiological markers. The relationship of HBV serotypes and genotypes in Taiwan and their correlation with the domiciles of origin in 122 patients with chronic HBV infection were investigated. The serotype of HBV was determined by comparing the surface gene encoding amino acids 22-148 of the major surface protein with published sequences. Genotyping of HBV was performed by polymerase chain reaction-restriction fragment length polymorphism. Serotype adw accounted for 70% (85/122) of all HBVs, with the remaining belonging to serotype adr. All adr HBVs were genotype C, regardless of the patient's domicile. Of the 85 adw HBVs, 69 (81%) were genotype B, 10 (12%) were genotype C, 5 (6%) were genotype F and only 1 (1%) was genotype A. In the 31 patients originating from mainland China, the prevalence of adr/genotype C was higher than in the 91 Taiwanese patients (15/31 vs. 22/91; p < 0.05). The distribution of the HBV serotypes and genotypes was not significantly different between 17 patients born in Taiwan (6 adw/genotype B, 2 adw/genotype C, 1 adw/genotype F and 8 adr/genotype C) and 14 patients born in mainland China (5 adw/genotype B, 2 adw/genotype C and 7 adr/genotype C). Our results indicate that in Taiwan, most HBVs of serotype adw are genotype B, and all HBVs of serotype adr are genotype C. Patients with origins in mainland China have a higher proportion of serotype adr/genotype C infection.
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Affiliation(s)
- C J Liu
- Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan, ROC
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Yu BKJ, Kuo BIT, Yen MS, Twu NF, Lai CR, Chen PJ, Chien PS, Chao KC, Yuan CC. Improved early detection of cervical intraepithelial lesions by combination of conventional Pap smear and speculoscopy. EUR J GYNAECOL ONCOL 2003; 24:495-9. [PMID: 14658588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
PURPOSE To evaluate the efficacy of the addition of speculoscopy to a Pap smear in cervical cancer screening. METHODS All women were screened using the Pap smear plus speculoscopy (PapSure) and colposcopy in the multicenter trial. The final diagnosis of each patient was based on a histological evaluation of the colposcopic target biopsy. Results were analyzed using a proportional compare test, sensitivity, specificity and predictive value with significant value determined at less than 0.05. RESULTS Of 1,717 eligible cases, 26 cases had LGSIL and 16 cases had HGSIL. Of the Pap smears, five cases had LSIL and 14 cases had HGSIL. Of the combination of the PapSure, 23 cases had LGSIL and 16 cases had HGSIL. The sensitivity of the Pap smear to that of PapSure was calculated at 45.2% and 92.9%, respectively (p < 0.001). The estimated cost to detect a cervical lesion using PapSure is less than that of the Pap smear. CONCLUSION The addition of speculoscopy along with a Pap smear screening results in early detection of cervical lesions in comparison to the Pap smear alone. This screening combination is also more cost-effective and requires fewer visits to the clinic in comparison to a Pap smear screening alone.
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Affiliation(s)
- B K J Yu
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taiwan, ROC
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37
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Abstract
Subtypes of hepatitis B virus (HBV) have specific geographic distributions and can serve as epidemiological markers. The relationship of HBV serotypes and genotypes in Taiwan and their correlation with the domiciles of origin in 122 patients with chronic HBV infection were investigated. The serotype of HBV was determined by comparing the surface gene encoding amino acids 22-148 of the major surface protein with published sequences. Genotyping of HBV was performed by polymerase chain reaction-restriction fragment length polymorphism. Serotype adw accounted for 70% (85/122) of all HBVs, with the remaining belonging to serotype adr. All adr HBVs were genotype C, regardless of the patient's domicile. Of the 85 adw HBVs, 69 (81%) were genotype B, 10 (12%) were genotype C, 5 (6%) were genotype F and only 1 (1%) was genotype A. In the 31 patients originating from mainland China, the prevalence of adr/genotype C was higher than in the 91 Taiwanese patients (15/31 vs. 22/91; p < 0.05). The distribution of the HBV serotypes and genotypes was not significantly different between 17 patients born in Taiwan (6 adw/genotype B, 2 adw/genotype C, 1 adw/genotype F and 8 adr/genotype C) and 14 patients born in mainland China (5 adw/genotype B, 2 adw/genotype C and 7 adr/genotype C). Our results indicate that in Taiwan, most HBVs of serotype adw are genotype B, and all HBVs of serotype adr are genotype C. Patients with origins in mainland China have a higher proportion of serotype adr/genotype C infection.
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Affiliation(s)
- C J Liu
- Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan, ROC
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Kao JH, Lai MY, Chen PJ, Chen DS. Probable reinfection with hepatitis C virus in a chronic hepatitis C patient with a sustained response to combination therapy. J Formos Med Assoc 2001; 100:824-8. [PMID: 11802523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Superinfection with hepatitis C virus (HCV) in already chronically infected subjects has been documented. Whether a complete response to antiviral therapy is associated with protective immunity against reinfection with HCV remains unknown. We describe a patient who had a sustained biochemical and virologic response with loss of intrahepatic HCV RNA after a course of combination therapy using interferon plus ribavirin. Histopathologically, the chronic hepatitis was in remission on follow-up biopsy 6 months post-therapy. Unfortunately, 34 weeks post-therapy, a flare of hepatitis with reappearance of hepatitis C viremia was noted 2 months after he received injections from a non-licensed medical provider. Analysis of the core gene sequences showed a 95% homology between the HCV strains isolated before antiviral treatment and during the hepatitis flare. The data indicated that the hepatitis flare after a period of sustained response to combination therapy in this patient could have been caused by reinfection with homotypic HCV. Our observation indicates the lack of protective immunity against reinfection with HCV in patients with chronic hepatitis C, even after successful clearance of the virus. Therefore, reinforcing the education of these subjects to avoid HCV reinfection should be stressed.
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Affiliation(s)
- J H Kao
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Wu HL, Chen PJ, Lin HK, Lee RS, Lin HL, Liu CJ, Lee PJ, Lee JJ, Chen DS. Molecular cloning and expression of woodchuck granulocyte-macrophage colony stimulating factor. J Med Virol 2001; 65:567-75. [PMID: 11596095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Granulocyte-macrophage colony stimulating factor (GM-CSF) has immunoregulatory and antiviral effects, and may thus be promising for the treatment of chronic hepatitis B. Using woodchuck hepatitis virus (WHV)-infected woodchuck as an animal model to test the efficacy and safety of GM-CSF on the therapy of chronic hepatitis B, woodchuck GM-CSF will be required due to the apparent species-specific activity of GM-CSF. The cDNA of woodchuck GM-CSF was cloned using reverse transcription-polymerase chain reaction (RT-PCR) with primers deriving from highly conserved regions of GM-CSF genes from other species. The deduced amino acids, including the signal peptide, is 138 in length and its identities to human, murine, canine and bovine GM-CSFs are 63, 49, 63, and 63% respectively. The genomic DNA of woodchuck GM-CSF was also cloned by PCR. Its organization is highly homologous to that of human and murine GM-CSF genes, consisting of four exons and three introns. Cloned woodchuck GM-CSF was expressed transiently in 293T cells. The recombinant protein expressed was found to stimulate the growth and differentiation of woodchuck bone marrow cells, indicating the protein expressed by the cloned gene is functional. These results pave the way for future studies on the potential role of GM-CSF for the treatment of chronic hepatitis B by using this animal model.
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Affiliation(s)
- H L Wu
- Hepatitis Research Center, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan
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Fang SH, Lai MY, Hwang LH, Yang PM, Chen PJ, Chiang BL, Chen DS. Ribavirin enhances interferon-gamma levels in patients with chronic hepatitis C treated with interferon-alpha. J Biomed Sci 2001; 8:484-91. [PMID: 11702012 DOI: 10.1007/bf02256611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Some patients with chronic hepatitis C respond to interferon (IFN)-alpha treatment, and the efficiency can be improved by combining it with ribavirin. The mechanism of this improvement is unknown. To investigate the effects of these two regimens on the immune responses in 51 patients with chronic hepatitis C, we examined the hepatitis C core antigen-specific proliferative response and cytokine production profiles, natural killer (NK) cell cytotoxicity and cytotoxic T cell function during treatment. The results are as follows: (1) both viral clearance and biochemical normalization occurred more frequently in patients receiving combination therapy; (2) the function of NK cells increased after treatment in the responders of both groups (p < 0.05); (3) the level of IFN-gamma produced by hepatitis C core antigen-stimulated peripheral blood mononuclear cells was higher in patients receiving combination therapy, especially in responders; (4) the core antigen-specific proliferative response decreased after treatment, and (5) in addition, the core-specific cytotoxic T cell activities of five responder patients also increased significantly after therapy. In conclusion, enhancement of immune responses, especially those related to type-1 T helper cell activity, may contribute to better efficacy in combining ribavirin with IFN-alpha for treatment of chronic hepatitis C.
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Affiliation(s)
- S H Fang
- Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
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Abstract
There are 7 genotypes of hepatitis B virus (HBV). Whether superinfection of HBV carriers with different HBV genotypes occurs remains unknown. We therefore determined the HBV genotype and association between superinfection and acute exacerbation of disease in a cohort of 244 patients with chronic HBV infection who had elevated serum aminotransferase levels for at least 1 year. Within this group, 103 patients experienced acute exacerbation with an annual incidence of 13%, and 20 of the 103 patients had IgM antibody to hepatitis B core antigen (IgM anti-HBc). These 20 patients had a higher prevalence of genotype C infection (65%) than the remaining 83 anti-core IgM-negative patients (40%) who also had acute exacerbations (P <.05). Detailed analysis of HBV genotypes and sequences of the variable pre-S gene were determined in serial samples from 20 patients with IgM anti-HBc-positive acute exacerbations (group A), 20 patients with IgM anti-HBc-negative acute exacerbations (group B), and 20 patients without exacerbations (group C). Two (10%) of the group A patients had virologic evidence of HBV superinfection during acute exacerbation, one superinfected with heterotypic virus and the other with homotypic virus. The newly introduced virus disappeared after the exacerbation and the original virus resumed thereafter. The calculated prevalence of HBV superinfection in the hepatitis B carriers and those with acute exacerbations was 0.8% (2 of 244) and 1.9% (2 of 103), respectively. In conclusion, superinfection of HBV on hepatitis B carriers indeed occurs and may cause acute exacerbations, albeit at a low frequency even in hyperendemic areas of HBV infection.
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Affiliation(s)
- J H Kao
- Graduate Institute of Clinical Medicine, Department of Internal Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
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Mu JJ, Chen DS, Chen PJ. The conserved serine 177 in the delta antigen of hepatitis delta virus is one putative phosphorylation site and is required for efficient viral RNA replication. J Virol 2001; 75:9087-95. [PMID: 11533172 PMCID: PMC114477 DOI: 10.1128/jvi.75.19.9087-9095.2001] [Citation(s) in RCA: 31] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hepatitis delta virus (HDV) small delta antigen (S-HDAg) plays a critical role in virus replication. We previously demonstrated that the S-HDAg phosphorylation occurs on both serine and threonine residues. However, their biological significance and the exact phosphorylation sites of S-HDAg are still unknown. In this study, phosphorylated S-HDAg was detected only in the intracellular compartment, not in viral particles. In addition, the number of phosphorylated isoforms of S-HDAg significantly increased with the extent of viral replication in transfection system. Site-directed mutagenesis showed that alanine replacement of serine 177, which is conserved among all the known HDV strains, resulted in reduced phosphorylation of S-HDAg, while the mutation of the other two conserved serine residues (2 and 123) had little effect. The S177A mutant dramatically decreased its capability in assisting HDV RNA replication, with a preferential and profound impairment of the antigenomic RNA replication. Furthermore, the viral RNA editing, a step relying upon antigenomic RNA replication, was also abolished by this mutation. These results suggested that phosphorylation of S-HDAg, with serine 177 as a presumable site, plays a critical role in viral RNA replication, especially in augmenting the replication of antigenomic RNA.
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Affiliation(s)
- J J Mu
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Kao JH, Lai MY, Chen PJ, Cheng YM, Chen DS. Prolonged interferon treatment after combination interferon and ribavirin therapy in patients with chronic hepatitis C: a clinical trial of interferon relapsers and non-responders. J Formos Med Assoc 2001; 100:662-7. [PMID: 11760371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND AND PURPOSE For the retreatment of chronic hepatitis C patients relapsing after, or non-responsive to, previous interferon therapy, the efficacy of combination therapy with interferon alfa plus ribavirin is superior to interferon alone. The aim of this study was to determine whether prolonged interferon alfa treatment after 24-week combination therapy can further increase the efficacy of combination therapy. METHODS Nineteen interferon relapsers and 17 interferon non-responders were randomly assigned to receive either interferon alfa 5 million units (MU) thrice weekly plus oral ribavirin 1,200 mg daily for 24 weeks (regimen A) or interferon alfa 5 MU thrice weekly plus oral ribavirin 1,200 mg daily for 24 weeks followed by interferon alfa 3 MU thrice weekly for another 24 weeks (regimen B). Efficacy was assessed by normalization of serum aminotransferase concentrations and disappearance of serum hepatitis C virus (HCV) RNA at the end of treatment and at 24 weeks after stopping treatment. RESULTS Overall, 67% of relapsers receiving regimen A and 80% of those receiving regimen B had sustained virologic responses 24 weeks after stopping treatment. In contrast, 45% of non-responders receiving regimen A and 63% of those receiving regimen B had sustained responses. The sustained response was more common in relapsers with non-1b HCV genotypes. The sustained response rate to combination therapy was 50% or more in patients with genotype 1b infection. CONCLUSIONS Prolonged interferon treatment after combination therapy has a comparable efficacy to combination therapy alone for the retreatment of chronic hepatitis C patients relapsing after, or non-responsive to, previous interferon therapy.
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Affiliation(s)
- J H Kao
- Graduate Institute of Clinical Medicine, Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei
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Chow SN, Chen M, Chen PJ, Chen RJ, Chien CH. Cell cycle analysis and detection of proliferative cell nuclear antigen of the endometrium after hormone replacement therapy. Maturitas 2001; 39:227-37. [PMID: 11574182 DOI: 10.1016/s0378-5122(01)00215-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND To understand the effect of sequential combined hormone replacement therapy (HRT) on the postmenopausal endometrium. METHODS Sonographic endometrial thickness, endometrial histopathology, flow cytometric cell cycle analysis and the level of proliferative cell nuclear antigen (PCNA) were studied. RESULTS One hundred and thirty-eight postmenopausal women were enrolled in this study. Among which, 97 women had their endometrium being adequately obtained; the most frequent type of histopathology was normal endometrium (91.8%). Endometrial hyperplasia was found in seven patients (7.2%), including typical simple hyperplasia (n=1, 1%), focal simple hyperplasia (n=5, 5.2%) and complex hyperplasia without atypia (n=1, 1%). The proliferative fractions (PF; S plus G2-M phase) of cells from normal and hyperplastic endometrium of menopausal women after HRT were 8.18 and 8.95%, respectively, which were lower than those from 29 premenopausal women without HRT. The level of PCNA of normal and hyperplastic endometrium in postmenopausal women after HRT was about 80 and 84%, respectively, of that from premenopausal endometrium. CONCLUSIONS Our study showed the PF of the cell cycle and the level of PCNA were not increased in the menopausal endometrium under HRT as compared to the premenopausal controls.
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Affiliation(s)
- S N Chow
- Department of Obstetrics and Gynaecology, National Taiwan University Hospital and College of Medicine, National Taiwan University, 7, Chung-Shan South Road, 100, Taipei, Taiwan, ROC.
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Abstract
BACKGROUND & AIMS Cirrhotic nodules have long been assumed to be the precancerous lesions of hepatocellular carcinoma (HCC). We thus investigated the allelic imbalance (AI) in cirrhotic nodules to define the genetic aberrations in early hepatocarcinogenesis. METHODS One hundred eighty cirrhotic nodules from 7 female patients with HCC were collected by microdissection. Their clonality nature was assessed by examining the X chromosome methylation pattern. AI in monoclonal cirrhotic nodules and the corresponding HCCs were analyzed with microsatellite polymorphic markers. RESULTS One hundred one out of 180 nodules (56.1%) were monoclonal and the average fractional AI (FAI) was 21%, lower than the 40% in HCC. Their overall AI patterns differed significantly from that in HCC (P < 0.001) with FAI on 2q, 4q, 8p, and Xq higher than the mean value. Comparison of FAI in nodules (stratified by increasing total AI events) further revealed a progressive increase of FAI on 4q, 8p, and Xq. In contrast, FAI on 1p, 13q, 16q, and 17p were low in nodules but rose above the mean only in HCC. CONCLUSIONS About half of the cirrhotic nodules are monoclonal and already have chromosome aberrations. AI on 4q, 8p, and Xq may be the earlier mutations, whereas AI on 1p, 13q, 16q, and 17p occurs late in hepatocarcinogenesis.
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Affiliation(s)
- S H Yeh
- Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
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Liu CJ, Lai MY, Lee PH, Chou NK, Chu SH, Chen PJ, Kao JH, Jen YM, Chen DS. Lamivudine treatment for hepatitis B reactivation in HBsAg carriers after organ transplantation: a 4-year experience. J Gastroenterol Hepatol 2001; 16:1001-8. [PMID: 11595064 DOI: 10.1046/j.1440-1746.2001.02532.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Reactivation of hepatitis B after organ transplantation in hepatitis B surface antigen (HBsAg) carriers may be fatal. In this study, we reported our experience of lamivudine treatment in HBsAg carriers who had post-transplant reactivation of hepatitis B. METHODS The patients were 15 men and one woman. Nine received kidney transplants, six received heart transplants, and one received a lung transplant. They developed a reactivation of hepatitis B 1-101 months (median, 14 months) after transplantation. They received lamivudine 100 mg daily on a compassionate-use basis, and had regular follow ups. The median pretreatment total serum bilirubin level was 3.0 mg/dL, and the alanine aminotransferase level was 357 U/L. Four of the 16 patients were positive for HBeAg. The serum hepatitis B virus (HBV) DNA levels were > 3000 pg/mL in 13 (81%) patients. Three were coinfected with hepatitis C virus. RESULTS The overall survival rate was 75%. All four fatal cases had a pretreatment total serum bilirubin level of > or = 3 mg/dL. Serum HBV-DNA soon became undetectable in 12 survivors. Of the 12 survivors, after a median treatment period of 101 weeks, a lamivudine-resistant strain with variation in the YMDD motif of the HBV polymerase gene developed in three (25%). None had significant adverse reactions to lamivudine treatment. CONCLUSIONS These results indicated that lamivudine is effective in the treatment of post-transplant hepatitis B reactivation, including patients with dual chronic hepatitis B and C. Early recognition of HBV reactivation and prompt lamivudine treatment are important to prevent mortality.
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Affiliation(s)
- C J Liu
- Department of Internal Medicine, National Taiwan University College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Liu CJ, Chen PJ, Lai MY, Kao JH, Chen DS. Hepatitis B virus variants in patients receiving lamivudine treatment with breakthrough hepatitis evaluated by serial viral loads and full-length viral sequences. Hepatology 2001; 34:583-9. [PMID: 11526546 DOI: 10.1053/jhep.2001.27220] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Both viral loads and genome variations have been implicated in the pathogenesis of acute exacerbation of chronic hepatitis B. Hepatitis B exacerbation in patients receiving lamivudine treatment represented a unique setting to clarify their importance. Three organ recipients with posttransplantation hepatitis B exacerbation and 3 patients with chronic hepatitis B were studied. All received lamivudine treatment and their alanine aminotransferase (ALT) levels and hepatitis B virus (HBV) loads were regularly followed. Full-length genomic sequences before and during lamivudine treatment were determined in patients who had breakthrough of serum HBV DNA or elevation of serum ALT. Breakthrough of serum HBV DNA occurred after 6 to 15 months of lamivudine treatment in all. A rapid increase of viral load accompanying the emergence of tyrosine-methionine-aspartate-aspartate (YMDD) variant was followed by hepatitis B exacerbation in each patient. The mean number of nucleotide and amino acid substitutions per genome pair was equivalent in immunosuppressed or immunocompetent patients (6.3 vs. 6.3 for nucleotide, P >.05; 6.0 vs. 6.7 for amino acid, P >.05). Changes of nucleotide and amino acid beyond the YMDD motif were distributed along the whole HBV genome but none occurred within the known B-cell epitopes and human leukocyte antigen class I- or II-restricted T-cell epitopes. Our results suggest that a resurgence of viral load rather than changes of the known immunogenic viral epitopes is more closely associated with the development of hepatitis B exacerbation after the emergence of YMDD variants in patients receiving lamivudine treatment.
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Affiliation(s)
- C J Liu
- Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
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Abstract
Rapid changes in sexual traits are ubiquitous in evolution. To analyze this phenomenon, we are studying species of the genus Caenorhabditis. These animals use one of two different mating systems-male/hermaphroditic, like the model organism Caenorhabditis elegans, or male/female, like C. remanei. Since hermaphrodites are essentially females that produce sperm for self-fertilization, elucidating the control of cell fate in the germ line in each species could provide the key to understanding how these mating systems evolved. In C. elegans, FOG-3 is required to specify that germ cells become sperm. Thus, we cloned its homologs from both C. remanei and C. briggsae. Each species produces a single homolog of FOG-3, and RNA-mediated interference indicates that FOG-3 functions in each species to specify that germ cells develop as sperm rather than as oocytes. What factors account for the different mating systems? Northern analyses and RT-PCR data reveal that the expression of fog-3 is always correlated with spermatogenesis. Since the promoters for all three fog-3 genes contain binding sites for the transcription factor TRA-1A and are capable of driving expression of fog-3 in C. elegans hermaphrodites, we propose that alterations in the upstream sex-determination pathway, perhaps acting through TRA-1A, allow spermatogenesis in C. elegans and C. briggsae XX larvae but not in C. remanei.
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Affiliation(s)
- P J Chen
- Department of Biology, University of Michigan, Ann Arbor, Michigan 48109, USA
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Abstract
Invasive amebiasis rarely occurs in homosexual men and human immunodeficiency virus (HIV)-infected individuals and has not been regarded as a beacon for concomitant HIV infection. We encountered a bisexual man with a protracted course of amebic liver abscess and amebic colitis. In the presence of fever, generalized lymphadenopathy, and elevated serum aminotransferase levels, HIV infection was suspected and then confirmed by a de novo seroconversion of HIV antibody. Subsequently, we noted two consecutive patients with amebic liver abscess, also later found to be infected with HIV. The ameba obtained from these three cases was identified as Entamoeba histolytica by amplification of 16S ribosomal RNA by polymerase chain reaction and direct sequencing. This observation suggests that amebic liver abscess and colitis can be presentations for HIV infection in the Far East. Thus, the local patients with invasive amebiasis, especially those with a protracted course or with risk factors of HIV infection, should be tested for HIV.
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Affiliation(s)
- C J Liu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Tseng LH, Chen PJ, Lin MT, Shau WY, Chaung SM, Martin PJ, Hansen JA. Single nucleotide polymorphisms in intron 2 of the human interleukin-1 receptor antagonist (IL-1Ra) gene: further definition of the IL-1 beta and IL-1Ra polymorphisms in North American Caucasians and Taiwanese Chinese. Tissue Antigens 2001; 57:318-24. [PMID: 11380940 DOI: 10.1034/j.1399-0039.2001.057004318.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Previous studies have suggested that a variable number tandem repeat (VNTR) polymorphism in the second intron of the interleukin-1 receptor antagonist (IL-1Ra) gene and the single nucleotide polymorphisms at positions -511 and +3954 of the IL-1beta gene might be associated with increased risks of chronic inflammatory diseases, autoimmune diseases and gastric cancer. In the present study, IL-1beta and IL-1Ra genotypes were analyzed among Asians in Taiwan and Caucasians in North America. We identified a novel polymorphism with 3 nucleotide substitutions in the IL-1Ra VNTR 2-repeat allele. One of the substitutions corresponds with the fourth 3' end nucleotide of the reverse primer that is often used for analysis of the IL-1Ra-associated VNTR locus. Mismatching between this primer and the 2-repeat allele can cause misleading amplification results when stringent conditions are used for annealing. The estimated haplotype frequencies of the variant IL-1 genes were significantly different between Taiwanese and Caucasians. The frequency of the pro-inflammatory IL-1Ra 2-repeat allele was significantly lower in Taiwanese than in Caucasians. In contrast, the frequencies of the pro-inflammatory IL-1beta -511T allele and +3954C allele were significantly higher among Taiwanese compared with Caucasians.
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Affiliation(s)
- L H Tseng
- Department of Medical Genetics, Pathology and Oncology, National Taiwan University Hospital, and Graduate Institutes of Clinical Medicine and Cancer Research Center, National Taiwan University, Taipei, Taiwan
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