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Peters WA, Liu PY, Barrett RJ, Stock RJ, Monk BJ, Berek JS, Souhami L, Grigsby P, Gordon W, Alberts DS. Concurrent Chemotherapy and Pelvic Radiation Therapy Compared With Pelvic Radiation Therapy Alone as Adjuvant Therapy After Radical Surgery in High-Risk Early-Stage Cancer of the Cervix. J Clin Oncol 2023; 41:4605-4612. [PMID: 37797409 DOI: 10.1200/jco.22.02769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
PURPOSE To determine whether the addition of cisplatin-based chemotherapy (CT) to pelvic radiation therapy (RT) will improve the survival of early-stage, high-risk patients with cervical carcinoma. PATIENTS AND METHODS Patients with clinical stage IA2, IB, and IIA carcinoma of the cervix, initially treated with radical hysterectomy and pelvic lymphadenectomy, and who had positive pelvic lymph nodes and/or positive margins and/or microscopic involvement of the parametrium were eligible for this study. Patients were randomized to receive RT or RT + CT. Patients in each group received 49.3 GY RT in 29 fractions to a standard pelvic field. Chemotherapy consisted of bolus cisplatin 70 mg/m2 and a 96-hour infusion of fluorouracil 1,000 mg/m2/d every 3 weeks for four cycles, with the first and second cycles given concurrent to RT. RESULTS Between 1991 and 1996, 268 patients were entered onto the study. Two hundred forty-three patients were assessable (127 RT + CT patients and 116 RT patients). Progression-free and overall survival are significantly improved in the patients receiving CT. The hazard ratios for progression-free survival and overall survival in the RT only arm versus the RT + CT arm are 2.01 (P = .003) and 1.96 (P = .007), respectively. The projected progression-free survivals at 4 years is 63% with RT and 80% with RT + CT. The projected overall survival rate at 4 years is 71% with RT and 81% with RT + CT. Grades 3 and 4 hematologic and gastrointestinal toxicity were more frequent in the RT + CT group. CONCLUSION The addition of concurrent cisplatin-based CT to RT significantly improves progression-free and overall survival for high-risk, early-stage patients who undergo radical hysterectomy and pelvic lymphadenectomy for carcinoma of the cervix.
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Affiliation(s)
- William A Peters
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - P Y Liu
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - Rolland J Barrett
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - Richard J Stock
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - Bradley J Monk
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - Jonathan S Berek
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - Luis Souhami
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - Perry Grigsby
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - William Gordon
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
| | - David S Alberts
- From the Puget Sound Oncology Consortium; and Southwest Oncology Group Statistical CenterSeattle, WA; Bowman Gray School of Medicine, Winston-Salem, NC; Walter Reed Army Medical Center, Washington, DC; University of California at Irvine, Irvine; University of California at Los Angeles, Los Angeles, CA; McGill University, Montreal, Quebec, Canada; Mallinckrodt Institute of Radiology, St Louis, MO; Clear Lake Regional Medical Center, Webster, TX; University of Arizona Cancer Center, Tucson, AZ
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Hsieh MK, Liu PY, Li YD, Wang CY, Hu CC, Tai CL, Lai PL. The role of counter-torque holders in tightening of pedicle screw-rod constructs: a biomechanical study in a porcine model. Spine J 2023; 23:315-324. [PMID: 36058516 DOI: 10.1016/j.spinee.2022.08.021] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/09/2022] [Accepted: 08/26/2022] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Pedicle screw-rod assembly procedures following pedicle screw insertion include contouring and placing rods into screw tulips, introducing set screws into the tulip along the screw thread, applying a counter-torque holder and tightening all the set screws clockwise. Even if an appropriate pedicle screw is implanted, screw dislodgement after tightening of the tulip and set screw is not uncommon. Pedicle wall violation resulting from excessive rotational force due to inadequate use of a counter-torque holder might be the reason. However, the strain change in the pedicle during tulip-set screw tightening and the role of counter-torque have never been investigated. PURPOSE This study determined differences in the strain change in the outer and inner pedicle walls during tulip-set screw tightening; additionally, the influence of counter-torque on pedicle wall violation was elucidated. STUDY DESIGN A controlled biomechanical study; the strain values of outer and inner pedicle walls in cadaveric porcine L4-L5 vertebrae during tulip-set screw tightening with or without a counter-torque holder were measured. METHODS Twelve L4-L5 fresh-frozen porcine lumbar vertebrae were implanted with screw-rod constructs; the set screw was randomly locked into the tulip in the right L5, right L4, left L5 and left L4 testing groups. The maximal values from eight strain gauges (P-R-O: outer cortex of right pedicle in proximal vertebra; P-R-I: inner cortex of right pedicle in proximal vertebra; D-R-O: outer cortex of right pedicle in distal vertebra; D-R-I: inner cortex of right pedicle in distal vertebra; P-L-O: outer cortex of left pedicle in proximal vertebra; P-L-I: inner cortex of left pedicle in proximal vertebra; D-L-O: outer cortex of left pedicle in distal vertebra; D-L-I: outer cortex of left pedicle in proximal vertebra) for each specimen during tightening to 12 Nm were measured. RESULTS The maximal strain values of the ipsilateral strain gauges in all testing groups were almost significantly higher when a counter-torque holder was not used than when one was used. The strain values in the adjacent pedicle of specimens without a counter-torque holder were significantly increased: P-R-O and P-R-I in the right L5 group; D-R-I in the right L4 group; P-L-I and P-L-O in the left L5 group; D-L-O and D-L-I in the left L4 group. CONCLUSIONS The constraint effect of counter-torque during tulip-set screw tightening is necessary. Clockwise rotational force with a fragile lateral pedicle wall suggests that caution is required when using a counter-torque holder to tighten the right L5 and left L4 constructs. CLINICAL SIGNIFICANCE A counter-torque holder is important during tulip-set screw tightening; improper use may lead to adjacent pedicle wall violation, sequentially resulting in pedicle screw loosening.
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Affiliation(s)
- Ming-Kai Hsieh
- Department of Orthopaedic Surgery, Spine Section, Chang Gung Memorial Hospital, Linkou, Taiwan, and College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Po-Yi Liu
- Department of Orthopaedic Surgery, Spine Section, Chang Gung Memorial Hospital, Linkou, Taiwan, and College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yun-Da Li
- Department of Orthopaedic Surgery, Spine Section, Chang Gung Memorial Hospital, Linkou, Taiwan, and College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Chi-Yun Wang
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; International Ph.D. Program in Innovative Technology of Biomedical Engineering and Medical Devices, Ming Chi University of Technology, No. 84, Gungjuan Rd., Taishan Dist., New Taipei City, 243303, Taiwan
| | - Chih-Chung Hu
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Mechanical Engineering, Ming Chi University of Technology, Taipei, Taiwan
| | - Ching-Lung Tai
- Department of Orthopaedic Surgery, Spine Section, Chang Gung Memorial Hospital, Linkou, Taiwan, and College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Po-Liang Lai
- Department of Orthopaedic Surgery, Spine Section, Chang Gung Memorial Hospital, Linkou, Taiwan, and College of Medicine, Chang Gung University, Taoyuan, Taiwan; Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.
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Zhang H, Lin KJ, Liu PY, Lu Y. Finite element analysis of coronoid prostheses with different fixation methods in the treatment of comminuted coronoid process fracture. J Orthop Traumatol 2022; 23:56. [PMID: 36469153 PMCID: PMC9723053 DOI: 10.1186/s10195-022-00675-2] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 11/19/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Comminuted fractures of the coronoid process significantly compromise the stability and function of the elbow joint. Reconstruction of the coronoid process with a prosthesis has been suggested as an alternative to restore the architecture. The purpose of this study was to investigate the strength and stability of various methods for the fixation of a coronoid prosthesis by finite element analysis. MATERIALS AND METHODS A coronoid prosthesis was designed based on the morphological information from computed tomography images acquired from 64 subjects in whom the top 40% of the coronoid process height was replaced. Four methods for the fixation of the prosthesis were suggested: (1) a double 2.0-mm fixation bolt, anterior to posterior; (2) a double 2.5-mm fixation bolt, anterior to posterior; (3) a single 4.0-mm fixation bolt, posterior to anterior; (4) a single 4.5-mm fixation bolt, posterior to anterior. The integrated prosthesis-bone constructs were analyzed via the finite element analysis of 10 simulated proximal ulna models with loading applied along the axis of the humerus and with three different elbow flexion angles (30°, 90°, and 130°). The maximum principal stress and the total deformation were quantified and compared. RESULTS A coronoid prosthesis was developed. The maximum principal stress of the fixation bolts occurred around the neck of the fixation bolt. For a comparison of the strengths of the four fixation methods, the maximum principal stress was the lowest for fixation using a single 4.5-mm fixation bolt. The value of the maximum principal stress significantly decreased with increased elbow flexion angle for all fixation methods. The maximum deformation of the fixation bolts occurred at the head of the fixation bolt. For a comparison of the maximum deformations in the four fixation methods, the maximum deformation was the lowest for fixation using a single 4.5-mm fixation bolt. The value of the maximum deformation significantly decreased with increased elbow flexion angle for all fixation methods. CONCLUSIONS The present study suggested that fixation of a coronoid prosthesis with a single 4.5-mm fixation bolt from posterior to anterior is an excellent option in terms of the strength and stability. Level of Evidence Experimental study.
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Affiliation(s)
- Hailong Zhang
- grid.414360.40000 0004 0605 7104Department of Sports Medicine, Beijing Jishuitan Hospital, No. 31 Xinjiekou East Street, Xicheng, Beijing, 100035 China
| | - Kun-Jhih Lin
- grid.411649.f0000 0004 0532 2121Department of Electrical Engineering & Translation Technology Center for Medical Device, Chung Yuan Christian University, Taoyuan, Taiwan China
| | - Po-Yi Liu
- grid.412019.f0000 0000 9476 5696Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan China
| | - Yi Lu
- grid.414360.40000 0004 0605 7104Department of Sports Medicine, Beijing Jishuitan Hospital, No. 31 Xinjiekou East Street, Xicheng, Beijing, 100035 China
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Duan YJ, Ma YF, Wu QD, Liu PY, Zhan JM, Liu ZQ. [Application status of CFD technology in occupational hazard control]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2022; 40:872-875. [PMID: 36510727 DOI: 10.3760/cma.j.cn121094-20210413-00217] [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: 12/15/2022]
Abstract
In the process of occupational hazard management, computational fluid dynamics technology can be used to reflect the distribution pattern of occupational hazards in the production process, so as to quickly and accurately guide the formulation of occupational disease prevention and control programs. This paper summarizes and analyzes the current research results on the prevention and control of occupational hazards in workplaces through computational fluid dynamics technology, and describes the application of these research results in the process of occupational disease prevention and control. On this basis, this paper presents the problems and application limitations of existing research and points out the future key research directions, which are of great reference value for guiding further systematic and in-depth research on simulation, experimentation and management of occupational hazards that can cause occupational diseases.
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Affiliation(s)
- Y J Duan
- Radiation Health Room of China Institute for Radiation Protection, Taiyuan 030006, China
| | - Y F Ma
- Radiation Health Room of China Institute for Radiation Protection, Taiyuan 030006, China
| | - Q D Wu
- Radiation Health Room of China Institute for Radiation Protection, Taiyuan 030006, China
| | - P Y Liu
- Radiation Health Room of China Institute for Radiation Protection, Taiyuan 030006, China
| | - J M Zhan
- Radiation Health Room of China Institute for Radiation Protection, Taiyuan 030006, China
| | - Z Q Liu
- Radiation Health Room of China Institute for Radiation Protection, Taiyuan 030006, China
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Wu QD, Duan YJ, Liu PY, Zhan JM. [Study on the diffusion of hydrogen fluoride in an electrolytic fluoride plant based on CFD numerical simulation method]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2022; 40:152-155. [PMID: 35255587 DOI: 10.3760/cma.j.cn121094-20200930-00553] [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: 06/14/2023]
Abstract
Objective: Using CFD technology to grasp the distribution and diffusion of hydrogen fluoride in an electrolytic fluorine plant, provide guidance and scientific basis for enterprises to carry out occupational health management in enterprises, install hazardous substance alarm devices, and protect workers' occupational health. Methods: In July 2019, the diffusion law of hydrogen fluoride gas produced in an electrolytic fluorine plant is selected as the research object. Through the establishment of models and grids, the Fluent numerical simulation method is finally used to simulate the diffusion and distribution of hydrogen fluoride gas under ventilation conditions. Results: The results showed that the average concentration of hydrogen fluoride was 0.045 mg/m(3) in the workplace, and the absorbed zone height (1.5 m) was 0.02 mg/m(3) in the inspection channel, which was in accordance with the national standard. However, there is eddy current above the electrolyzer near the inlet, may lead to the accumulation of hydrogen fluoride gas. Conclusion: The research of CFD numerical simulation method on the distribution and diffusion of hydrogen fluoride concentration in electrolytic fluorine plant can be applied to the prevention, control and management of occupational hazards in electrolytic fluorine plant.
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Affiliation(s)
- Q D Wu
- China Institute for Radiation Protection Department of Radiological Medicine and Environmental Medicine, Taiyuan 030006, China
| | - Y J Duan
- China Institute for Radiation Protection Department of Radiological Medicine and Environmental Medicine, Taiyuan 030006, China
| | - P Y Liu
- China Institute for Radiation Protection Department of Radiological Medicine and Environmental Medicine, Taiyuan 030006, China
| | - J M Zhan
- China Institute for Radiation Protection Department of Radiological Medicine and Environmental Medicine, Taiyuan 030006, China
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Huang M, Lin WC, Chen YD, Hsiao TA, Liu PY, Tsai WC. Explainable deep neural network for echocardiography view classification. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.012] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Technology, Taiwan
Background
Deep neural network may assist echocardiography interpretation in several tasks; however, the lack of expandability hindered its broader application since physicians couldn’t realize the rationale of interpretation clearly and comfortably.
Method
Retrospectively, we manually annotated 26,465 transthoracic echocardiography images into 29 classes for model development in 4:1 ratio as training and validation datasets. We added an autoencoder component into our model, adapted from capsule net, for view-classifying to deconvolute the feature maps of last layer as decoder for human interpretation. The performance of view classification was measured in accuracy and confusion matrix, and the interpretability of model were assessed by cardiologist.
Result
After appropriate model training, the accuracy of our model achieved averaged 98.2% for echocardiography view classification, ranged from lowest 80.0% in suprasternal view to 100% of several more common view in validation dataset. The successful deconvolution of feature map to reconstruct images showed essential independent components of echocardiography view and could be interpretated by cardiologist and clinical physicians.
Conclusion
With the use of autoencoder in model for echocardiography view classification showed maintainable good performance in accuracy and facilitated clinical interpretation to enhance its reliability. Abstract Figure. Model architecture and performance Abstract Figure. Example of explaniable deconvolution
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Affiliation(s)
- M Huang
- National Cheng Kung University Hospital, Cardiology department, Tainan, Taiwan
| | - WC Lin
- National Cheng Kung University Hospital, Cardiology department, Tainan, Taiwan
| | - YD Chen
- National Cheng Kung University Hospital, Cardiology department, Tainan, Taiwan
| | - TA Hsiao
- National Cheng Kung University Hospital, Cardiology department, Tainan, Taiwan
| | - PY Liu
- National Cheng Kung University Hospital, Cardiology department, Tainan, Taiwan
| | - WC Tsai
- National Cheng Kung University Hospital, Cardiology department, Tainan, Taiwan
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Bai JJ, Zhang WL, Wang L, Liu PY, Cai J. [Analysis of prescription and rationality of anti-hypertensive medication among community health centers in Beijing]. Zhonghua Xin Xue Guan Bing Za Zhi 2021; 49:993-999. [PMID: 34674437 DOI: 10.3760/cma.j.cn112148-20201231-01022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Explore the usage of anti-hypertension drugs and the rationality of hypertension prescription among the primary health centers in Dongcheng District, Beijing. Method: This cross-sectional and retrospective study was applied to analyze the hypertension prescriptions from the 8 community health centers in Dongcheng District. The anatomical, therapeutic and chemical classification (ATC) codes were used to determine the drug category. ATC information was used to filter data containing antihypertensive drugs, and group the number and proportion of ATC categories. The type of drug was judged by its generic name. According to the diagnosis information in the prescription, the prescription containing the Western medicine diagnosis of hypertension was screened out. The comorbidities of hypertension in the study included 7 types of diseases including diabetes, chronic kidney disease, coronary heart disease, heart failure, atrial fibrillation, stroke, and dyslipidemia. The analysis of prescription rationality included rationality of combination medication, rationality of drug dosage and rationality of drug price. The agreed daily dose (DDD) method was used to analyze the rationality of drug dosage. The drug utilization index (DUI) was used as a quantitative indicator to estimate the rationality of medication, and overdose was expressed by DUI>1. The reasonableness of the drug price was judged based on the price of the drug and whether it was a drug in the "4+7" plan. Results: A total of 658 140 prescriptions were extracted as the final data set, involving 7 categories and 60 commonly used anti-hypertensive drugs, and the corresponding cost of medication was ¥96.58 million. Drugs were prescribed according to comorbidities, and the choice followed the international guidelines. Calcium channel blockers (CCB) were the most prescribed drugs in the prescriptions of patients with comorbidities, and α-adrenergic receptor antagonists were the least prescribed drugs. The proportion of diuretics prescribed in hypertensive patients complicating with heart failure was 21.17% (505/2 385), which was much higher than that of patients complicating with other comorbidities (P<0.05). The proportion of diuretics prescribed in hypertension patients complicating with dyslipidemia was lower than that of patients with other comorbidities (2 639 (0.94%), P<0.05), and β-blockers (BB) or angiotensin Ⅱreceptor blockers (ARB) were more likely to be selected (BB: 59 348 (21.08%), ARB: 51 356 (18.24%))in these patients. The proportion of BB in prescriptions for hypertension patients with chronic kidney disease was lower than that of patients with other comorbidities (P<0.05). The proportion of BB in prescriptions for hypertension patients with coronary heart disease was higher than that of other comorbidities (P<0.05). Hypertension patients with atrial fibrillation or stroke accounted for a higher proportion of CCB prescriptions (P<0.05). Single antihypertensive drug prescriptions accounted for the highest proportion, 61.19% (402 745/658 140). Two-combination prescriptions accounted for the highest proportion of combination prescriptions, 72.19% (184 392/255 395). CCB based two-combination prescriptions accounted for the highest proportion, 122 350(66.36%). ARB-based tri-combination prescriptions accounted for the highest proportion, 48 915(89.50%),followed by CCB based tri-combination prescriptions (44 732(81.85%)).There were 2 174 (0.33%) prescriptions with unreasonable combination therapies and DUI>1 were found in 48 out of 60 commonly used drugs. In all possible antihypertensive drugs, only 40.92% (109 227/266 993)followed the "4+7" plan. Conclusions: The anti-hypertensive agents from these prescriptions in the primary health centers are diverse, and the choice is generally complied with the guidelines, but some unreasonable situations existed, especially on the combined anti-hypertensive medication, overdose, and"4+7"plan is not followed completely.
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Affiliation(s)
- J J Bai
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
| | - W L Zhang
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
| | - L Wang
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
| | - P Y Liu
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
| | - J Cai
- Hypertension Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
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Liu CF, Lyu TX, Liu ZR, Wan HB, Wang SH, Lin L, Zhang M, Zhao YH, Wang L, Su X, Yang YL, Zhu YH, Liu PY. [Investigation on two family clusters of COVID-19 in a county of Baotou city in Inner Mongolia Autonomous Region]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:1210-1213. [PMID: 32867426 DOI: 10.3760/cma.j.cn112338-20200305-00261] [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 investigate the epidemiological characteristics and transmission chain of COVID-19 in two families, and to provide scientific evidence for effective prevention and control measures. Methods: Field epidemiological investigation was conducted for the COVID-19 cases occurred in two families and the close contacts in a county of Baotou city in Inner Mongolia Autonomous Region. Descriptive statistical analysis on epidemiological data was conducted. Results: The infection source of the COVID-19 cases in the two families was a man who had living history in Wuhan. After his return, his parents were infected by him. A few days later, the members of a neighbor family were found to be infected, and relatives of this family were also infected after dining together repeatedly. Finally, ten confirmed cases and three suspected cases of COVID-19 were detected in the two families. Conclusions: Human-to-human transmission of COVID-19 can occur not only in a family but also in neighborhoods. The cases in two families had close relationship, indicating the necessity to strengthen the health education about COVID-19 prevention and control and the management of groups at high risk to reduce the incidence of COVID-19 in families and neighborhoods.
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Affiliation(s)
- C F Liu
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - T X Lyu
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - Z R Liu
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - H B Wan
- Baotou City Center for Disease Control and Prevention, Baotou 014020, China
| | - S H Wang
- Graduate School, Baotou Medical College, Baotou 014040, China
| | - L Lin
- Baotou City Center for Disease Control and Prevention, Baotou 014020, China
| | - M Zhang
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - Y H Zhao
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - L Wang
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - X Su
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - Y L Yang
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - Y H Zhu
- School of Public Health, Baotou Medical College, Baotou 014040, China
| | - P Y Liu
- School of Public Health, Baotou Medical College, Baotou 014040, China
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Kelly MR, O’Byrne N, Iranmanesh A, Martin JL, Liu PY. 0131 Decreased Habitual Sleep Efficiency is Associated with Increased Insulin Resistance in Healthy Adult Men. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Partial sleep deprivation is associated with increased insulin resistance (IR), a metabolic disease risk marker. Little is known about habitual sleep patterns and IR in the absence of acute sleep restriction. We anticipated greater change in habitual sleep over one month would be associated with increased IR.
Methods
24 males (age=33.6±6.4 years; BMI=25.7±2.5kg/m2) completed baseline (T1) and follow-up (T2; ≥4 weeks post-T1) study procedures: actigraphy (one week) followed by polysomnography (PSG; one 10h sleep opportunity) and a next morning oral glucose tolerance test (OGTT; homeostatic model assessment insulin resistance [HOMA-IR], β-cell function [HOMA-β], and Matsuda Index). Weekly average actigraphy total sleep time (aTST; 291-511min) and sleep efficiency (aSE; 72–93%) were computed at T1 and T2, as well as across the 1, 2, and 3 days prior to PSG/OGTT. Pearson and Spearman correlations assessed the change (T1-T2) in actigraphy (aSEΔ, aTSTΔ, PSGΔ) or PSG sleep (PSG-TSTΔ, PSG-SEΔ, sleep stages) versus change in metabolic risk (HOMA-IRΔ, HOMA-βΔ, MatsudaΔ).
Results
There were significant correlations between HOMA-IRΔ and aSEΔ [r(22)=-0.42, p=0.01; rs=-0.45, p=0.03], PSG TSTΔ [r(22)=0.50, p=0.012; rs=0.41, p=.045], and PSG-SEΔ [r(22)=0.49, p=0.015; rs=0.43, p=.037]. No significant associations emerged between change in metabolic risk versus aTSTΔ one week prior to PSG/OGTT, aSEΔ or aTSTΔ across 1–3 days prior to PSG/OGTT, or PSG sleep stages.
Conclusion
Within-subject T1-T2 decrease in habitual sleep quality, but not TST, was associated with increased IR. T1-T2 PSG TST and SE were associated with following day IR. At home sleep 1–3 days beforehand were not correlated with IR. Although preceding night sleep quality and TST are associated with IR, habitual sleep quality, rather than TST, may be a more important determinant of metabolic risk in community dwelling middle-aged men.
Support
This work was supported by NIH/NHLBI R01HL124211, NIH/NHLBI K24HL138632, NIH National Center for Advancing Translational Sciences (NCATS) UCLA CTSI Grant UL1TR001881 (PI: Liu); and NIH/NHLBI K24HL143055 (PI: Martin). Dr. Kelly is supported by the VA Office of Academic Affiliations through the Advanced Fellowship Programs in Geriatrics.
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Affiliation(s)
- M R Kelly
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - N O’Byrne
- Harbor UCLA Medical Center and Lundquist Institute, Torrance, CA
| | - A Iranmanesh
- Salem Veterans Affairs Medical Center, Salem, VA
| | - J L Martin
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - P Y Liu
- Harbor UCLA Medical Center and Lundquist Institute, Torrance, CA
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10
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Liu PY, Lai PL, Lin CL. A biomechanical investigation of the retentive force of pedicle screw structures for different screw tulip designs. Clin Biomech (Bristol, Avon) 2019; 70:23-30. [PMID: 31382200 DOI: 10.1016/j.clinbiomech.2019.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 05/28/2019] [Accepted: 06/04/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Pedicle screw based spinal fixation systems have been widely used for treating a variety of spinal diseases. The retentive force is an important factor that determines structural stability. The screw tulip design and the magnitude of nut tightening torque influence the retentive force. This study investigated the influences of varied tilt angles between the shaft-rod interface and varied nut tightening torques on the retentive force of the monoaxial, polyaxial, and uniplanar screws. METHODS Three types of tulip constructs were biomechanically tested. Two parameters that affect the retentive force include the tilt angle and the nut tightening torque. The retentive force was investigated by an axial gripping capacity test and axial torque gripping capacity test. FINDING Among all combinations of screw designs and tilt angles, the 12 Nm nut tightening torque offered a greater retentive force than the 8 Nm, except for monoaxial screws with a 0 degree tilt angle. For monoaxial screws, the retentive force was negatively correlated with increasing tilt angles. For polyaxial and uniplanar screws, the retentive forces remained constant with increasing tilt angles. INTERPRETATION In monoaxial screws, when the axis of the shaft isn't perpendicular to the axis of the rod, a gap is formed between the tulip-rod interface. This results in a decreased retentive force. In polyaxial and uniplanar screws, the contact surfaces were the same in different tilt angles, therefore, the retentive force remained constant, which was attributed to the adjustable tulips always being perpendicular to the axis of the rods.
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Affiliation(s)
- Po-Yi Liu
- Department of Biomedical Engineering, National Yang-Ming University, No.155, Sec. 2, Linong St., Beitou Dist., Taipei City 11221, Taiwan; Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33305, Taiwan
| | - Po-Liang Lai
- Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, No. 5, Fuxing St., Guishan Dist., Taoyuan City 33305, Taiwan.
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming University, No.155, Sec. 2, Linong St., Beitou Dist., Taipei City 11221, Taiwan.
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11
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Natale A, Mohanty S, Liu PY, Mittal S, Al-Ahmad A, De Lurgio DB, Horton R, Spear W, Bailey S, Bunch J, Musat D, O'Neill P, Compton S, Turakhia MP. Venous Vascular Closure System Versus Manual Compression Following Multiple Access Electrophysiology Procedures: The AMBULATE Trial. JACC Clin Electrophysiol 2019; 6:111-124. [PMID: 31971899 DOI: 10.1016/j.jacep.2019.08.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 03/13/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study compared the efficacy and safety of the VASCADE MVP Venous Vascular Closure System (VVCS) device (Cardiva Medical, Santa Clara, California) to manual compression (MC) for closing multiple access sites after catheter-based electrophysiology procedures. BACKGROUND The VASCADE MVP VVCS is designed to provide earlier ambulatory hemostasis than MC after catheter-based procedures. METHODS The AMBULATE (A Randomized, Multi-center Trial to Compare Cardiva Mid-Bore [VASCADE MVP] VVCS to Manual Compression in Closure of Multiple Femoral Venous Access Sites in 6 - 12 Fr Sheath Sizes) trial was a multicenter, randomized trial of device closure versus MC in patients who underwent ablation. Outcomes included time to ambulation (TTA), total post-procedure time (TPPT), time to discharge eligibility (TTDe), time to hemostasis (TTH), 30-day major and minor complications, pain medication usage, and patient-reported outcomes. RESULTS A total of 204 patients at 13 sites were randomized to the device arm (n = 100; 369 access sites) or the MC arm (n = 104; 382 access sites). Baseline characteristics were similar between groups. Mean TTA, TPPT, TTDe, and TTH were substantially lower in the device arm (respective decreases of 54%, 54%, 52%, and 55%; all p < 0.0001). Opioid use was reduced by 58% (p = 0.001). There were no major access site complications. Incidence of minor complications was 1.0% for the device arm and 2.4% for the MC arm (p = 0.45). Patient satisfaction scores with duration of and comfort during bedrest were 63% and 36% higher in device group (both p < 0.0001). Satisfaction with bedrest pain was 25% higher (p = 0.001) for the device overall, and 40% higher (p = 0.002) for patients with a previous ablation. CONCLUSIONS Use of the closure device for multiple access ablation procedures resulted in significant reductions in TTA, TPPT, TTH, TTDe, and opioid use, with increased patient satisfaction and no increase in complications. (A Randomized, Multi-center Trial to Compare Cardiva Mid-Bore VVCS to Manual Compression in Closure of Multiple Femoral Venous Access Sites in 6 - 12 Fr Sheath Sizes [AMBULATE]; NCT03193021).
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Affiliation(s)
- Andrea Natale
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA; Dell Medical School, University of Texas, Austin, Texas, USA; Case Western Reserve University, Cleveland, Ohio, USA; Interventional Electrophysiology, Scripps Clinic, San Diego, California, USA
| | - Sanghamitra Mohanty
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA; Dell Medical School, University of Texas, Austin, Texas, USA
| | - P Y Liu
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Suneet Mittal
- Valley Health System and the Snyder Center for Comprehensive Atrial Fibrillation, Ridgewood, New Jersey, USA
| | - Amin Al-Ahmad
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | | | - Rodney Horton
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - William Spear
- Advocate Christ Medical Center, Oak Lawn, Illinois, USA
| | - Shane Bailey
- Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA
| | - Jared Bunch
- Intermountain Medical Center, Salt Lake City, Utah, USA
| | - Dan Musat
- Valley Health System and the Snyder Center for Comprehensive Atrial Fibrillation, Ridgewood, New Jersey, USA
| | | | - Steven Compton
- Alaska Heart and Vascular Institute, Anchorage, Alaska, USA
| | - Mintu P Turakhia
- Stanford University, Stanford, California, USA; VA Palo Alto Health Care System, Palo Alto, California, USA.
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12
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Anawalt BD, Roth MY, Ceponis J, Surampudi V, Amory JK, Swerdloff RS, Liu PY, Dart C, Bremner WJ, Sitruk-Ware R, Kumar N, Blithe DL, Page ST, Wang C. Combined nestorone-testosterone gel suppresses serum gonadotropins to concentrations associated with effective hormonal contraception in men. Andrology 2019; 7:878-887. [PMID: 30969032 DOI: 10.1111/andr.12603] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Novel male-based contraceptives are needed to broaden family planning choices. A progestin, Nestorone® (Nes) gel, plus a testosterone (T) gel suppresses sperm concentrations to levels associated with effective contraception in normal men. However, administration of two gels on different parts of the body daily is impractical. OBJECTIVE Compare the effectiveness of daily application of a single, combined 8.3 mg Nes-62.5 mg T gel (Nes-T) vs. 62.7 mg T gel to suppress serum FSH and LH concentrations to ≤1.0 IU/L (a threshold associated with suppression of sperm concentrations to ≤1 million and effective contraception) and to compare the pharmacokinetics of serum Nes and T concentrations between the gel groups. DESIGN We conducted a 28-day, double-blind, controlled trial of 44 healthy men randomized to daily Nes-T or T gel with measurement of hormones at baseline, treatment, and recovery and during 24-h pharmacokinetic studies on days 1 and 28 of treatment. RESULTS Of the subjects who met pre-defined inclusion criteria, 84% of the Nes-T group suppressed serum gonadotropin concentrations to ≤1.0 IU/L at days 21-28 vs. 16.7% in the T group (p < 0.001). On day 1, Nes concentrations rose significantly above baseline by 2 h and continued to rise up to 24 h after Nes-T gel application. Nes concentrations were not detectable in the T group. Serum total T concentrations rose and were significantly higher in the T gel group compared to the Nes-T group at 24 h on day 1 and days 11, 14, and 21 (p < 0.01). There were no serious adverse events in either group. About 80% of the subjects reported satisfaction with both gels. CONCLUSION Daily Nes-T gel effectively and safely suppresses serum gonadotropins and is acceptable to most men. It should be studied further in efficacy trials of hormonal male contraception.
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Affiliation(s)
- B D Anawalt
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - M Y Roth
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - J Ceponis
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - V Surampudi
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - J K Amory
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R S Swerdloff
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - P Y Liu
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - C Dart
- Health Decisions, Durham, NC, USA
| | - W J Bremner
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R Sitruk-Ware
- Center for Biomedical Research, Population Council, New York, NY, USA
| | - N Kumar
- Center for Biomedical Research, Population Council, New York, NY, USA
| | - D L Blithe
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - S T Page
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - C Wang
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
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Yang YC, Chiou PC, Chen PC, Liu PY, Huang WC, Chao CC, Tang CH. Melatonin reduces lung cancer stemness through inhibiting of PLC, ERK, p38, β-catenin, and Twist pathways. Environ Toxicol 2019; 34:203-209. [PMID: 30421542 DOI: 10.1002/tox.22674] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 10/16/2018] [Accepted: 10/20/2018] [Indexed: 06/09/2023]
Abstract
Lung cancer is one of the most common cancer in cancer-related deaths worldwide, which is characterized by its strong metastatic potential. The melatonin hormone secreted by the pineal grand has an antioxidant effect and protects cells against carcinogenic substances. However, the effects of melatonin in lung cancer stemness are largely unknown. We found that melatonin reduces CD133 expression by ~50% in lung cancer cell lines, while results of a sphere formation assay showed that melatonin inhibits lung cancer stemness. These effects of melatonin were reversed when the cell lines were incubated with phospholipase C (PLC), ERK/p38, and a β-catenin activator. Transfection with Twist siRNA augmented the inhibitory effects of melatonin, indicating that melatonin suppresses lung cancer stemness by inhibiting the PLC, ERK/p38, β-catenin, and Twist signaling pathways. We also found CD133 expression is positively correlated with Twist expression in lung cancer specimens. Melatonin shows promise in the treatment of lung cancer stemness and deserves further study.
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Affiliation(s)
- Yi-Chen Yang
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Pei-Chen Chiou
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Po-Chun Chen
- Central Laboratory, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Po-Yi Liu
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan
- Department of Thoracic Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Wei-Chien Huang
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan
| | - Chia-Chia Chao
- Department of Respiratory Therapy, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chih-Hsin Tang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
- Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan
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14
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Yuen F, Wu S, Thirumalai A, Swerdloff RS, Page ST, Liu PY, Dart C, Wu H, Blithe DL, Sitruk-Ware R, Long J, Bai F, Hull L, Bremner WJ, Anawalt BD, Wang C. Preventing secondary exposure to women from men applying a novel nestorone/testosterone contraceptive gel. Andrology 2018; 7:235-243. [PMID: 30556332 DOI: 10.1111/andr.12577] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/07/2018] [Accepted: 11/27/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Testosterone (T)/Nestorone (NES) combination gel is a potential transdermal male contraceptive that suppresses gonadotropins and spermatogenesis. Transfer of transdermal T from men to women can be prevented by washing or covering application sites with clothing. OBJECTIVES We hypothesized that showering or wearing a shirt over gel application sites would prevent secondary exposure of T and NES to a woman after close skin contact. MATERIALS AND METHODS Twelve healthy male and 12 healthy female participants were recruited. Men applied T/NES 62 mg/8 mg gel to their shoulders and upper arms. Two hours after application, female partners rubbed the application site for 15 min. Exposure in the female partner was assessed under three conditions: a shirt covered the application site; the man showered prior to skin contact; or without intervention to reduce transfer. Serum T and NES concentrations were measured by LC-MS/MS in serial blood samples for 24 h after gel exposure. MAIN OUTCOMES Change in female serum T and NES levels as measured by average concentration over 24 h (Cavg ). RESULTS Median female serum T Cavg was 23.9 ng/dL (interquartile range, 19.3, 33.9) with the shirt barrier and 26.7 ng/dL (20.7, 33.9) after showering, which was higher than baseline 20.9 ng/dL (16.7, 25.0), both p < 0.03) but lower than without intervention (58.2 ng/dL [30.9, 89.1], both p < 0.01). Female serum NES Cavg and maximum concentration were below the lower limit of quantification with the shirt barrier and after showering, but increased without intervention in six of 12 women (maximum concentration <60 pg/mL). Men had lower average serum NES levels after showering (47 pg/ml [20, 94] compared to no intervention (153.3 pg/mL [51, 241], p < 0.02). CONCLUSION Secondary transfer of T and NES occurs after intensive skin contact with the gel application site. Secondary transfer is decreased by a shirt barrier or showering before contact.
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Affiliation(s)
- F Yuen
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - S Wu
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - A Thirumalai
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R S Swerdloff
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - S T Page
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - P Y Liu
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - C Dart
- Health Decisions, Durham, NC, USA
| | - H Wu
- Health Decisions, Durham, NC, USA
| | - D L Blithe
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - R Sitruk-Ware
- Center for Biomedical Research, Population Council, New York, NY, USA
| | - J Long
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - F Bai
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - L Hull
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - W J Bremner
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - B D Anawalt
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - C Wang
- Department of Medicine, Division of Endocrinology, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
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15
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Koppel S, Charlton JL, Hua P, Liu PY, Pham H, Stephan K, Logan D, St. Louis RM. ARE OLDER DRIVERS’ DRIVING PATTERNS DURING AN ON-ROAD DRIVING TASK REPRESENTATIVE OF THEIR REAL-WORLD DRIVING? Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2078] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Koppel
- Monash University Accident Research Centre, Melbourne, Victoria, Australia
| | - J L Charlton
- Monash University Accident Research Centre, Melbourne, Victoria, Australia
| | - P Hua
- BPsych(Hons), Monash University Accident Research Centre, Melbourne, Victoria, Australia
| | - P Y Liu
- Monash University Accident Research Centre, Melbourne, Victoria, Australia
| | - H Pham
- Monash University Accident Research Centre, Melbourne, Victoria, Australia
| | - K Stephan
- Monash University Accident Research Centre, Melbourne, Victoria, Australia
| | - D Logan
- Monash University Accident Research Centre, Melbourne, Victoria, Australia
| | - R M St. Louis
- Monash University Accident Research Centre, Melbourne, Victoria, Australia
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16
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Hsu LW, Liu PY. P3786The role of rho kinases in thrombin-stimulated platelets and monocyte platelet aggregates in atherothrombosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L W Hsu
- National Cheng Kung University, The institute of basic medical sciences, Tainan, Taiwan ROC
| | - P Y Liu
- National Cheng Kung University, The institute of clinical medicine, Tainan, Taiwan ROC
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17
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Liu XW, Liu PY, Jiang C, Gao YH. [Glucocorticoids and liver diseases]. Zhonghua Gan Zang Bing Za Zhi 2018; 26:557-560. [PMID: 30317784 DOI: 10.3760/cma.j.issn.1007-3418.2018.07.017] [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
Glucocorticoids is a type of steroid hormone secreted from zona fasciculata of adrenal cortex.As an immune and inflammatory inhibitor, glucocorticoids has been used to treat many kinds of diseases.T cell response plays a crucial role in the pathogenesis of liver diseases. However, the role of glucocorticoids in the mechanism and treatment of liver disease in current clinical practice is controversial. This paper summarizes the progress of glucocorticoid use for the treatment of liver diseases in recent years. References will be provided for how to grasp the indications,application timing and proper dosage of glucocorticoids in liver diseases.
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Affiliation(s)
- X W Liu
- Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, China
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18
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Liu PY, Zhou Q, Liu CY. [The controversy and challenge of anticoagulant therapy for hepatic cirrhosis with portal vein thrombosis]. Zhonghua Nei Ke Za Zhi 2018; 57:532-534. [PMID: 29996277 DOI: 10.3760/cma.j.issn.0578-1426.2018.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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19
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Koppel S, Charlton JL, Hua P, Liu PY, Pham H, Stephan K, Logan D, St Louis RM, Gao G, Griffiths D, Williams G, Witharanage T, Di Stefano M, Darzins P, Odell M, Porter MM, Mazer B, Gelinas I, Vrkljan B, Marshall S. Are older drivers' driving patterns during an on-road driving task representative of their real-world driving patterns? Traffic Inj Prev 2018; 19:S173-S175. [PMID: 30841798 DOI: 10.1080/15389588.2018.1532219] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The current study investigated whether older drivers' driving patterns during a customized on-road driving task were representative of their real-world driving patterns. METHODS Two hundred and eight participants (male: 68.80%; mean age = 81.52 years, SD = 3.37 years, range = 76.00-96.00 years) completed a customized on-road driving task that commenced from their home and was conducted in their own vehicle. Participants' real-world driving patterns for the preceding 4-month period were also collected via an in-car recording device (ICRD) that was installed in each participant's vehicle. RESULTS During the 4-month period prior to completing the on-road driving task, participants' median real-world driving trip distance was 2.66 km (interquartile range [IQR] = 1.14-5.79 km) and their median on-road driving task trip distance was 4.41 km (IQR = 2.83-6.35 km). Most participants' on-road driving task trip distances were classified as representative of their real-world driving trip distances (95.2%, n = 198). CONCLUSIONS These findings suggest that most older drivers were able to devise a driving route that was representative of their real-world driving trip distance. Future research will examine whether additional aspects of the on-road driving task (e.g., average speed, proportion of trips in different speed zones) are representative of participants' real-world driving patterns.
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Affiliation(s)
- S Koppel
- a Monash University Accident Research Centre , Victoria , Australia
| | - J L Charlton
- a Monash University Accident Research Centre , Victoria , Australia
| | - P Hua
- a Monash University Accident Research Centre , Victoria , Australia
| | - P Y Liu
- a Monash University Accident Research Centre , Victoria , Australia
| | - H Pham
- a Monash University Accident Research Centre , Victoria , Australia
| | - K Stephan
- a Monash University Accident Research Centre , Victoria , Australia
| | - D Logan
- a Monash University Accident Research Centre , Victoria , Australia
| | - R M St Louis
- a Monash University Accident Research Centre , Victoria , Australia
| | - G Gao
- a Monash University Accident Research Centre , Victoria , Australia
| | - D Griffiths
- a Monash University Accident Research Centre , Victoria , Australia
| | - G Williams
- a Monash University Accident Research Centre , Victoria , Australia
| | - T Witharanage
- a Monash University Accident Research Centre , Victoria , Australia
| | | | - P Darzins
- c Eastern Health , Victoria, Australia
| | - M Odell
- d Victorian Institute of Forensic Medicine , Victoria, Australia
| | - M M Porter
- e Faculty of Kinesiology and Recreation Management, and Centre on Aging , University of Manitoba , Canada
| | - B Mazer
- f McGill University , Winnipeg, Canada
| | - I Gelinas
- f McGill University , Winnipeg, Canada
| | - B Vrkljan
- g McMaster University , Hamilton, Canada
| | - S Marshall
- h Ottawa Hospital Research Institute , Ottawa, Canada
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Liu PY, Liu XW, Jiang C. [A noteworthy disease: non-alcoholic fatty pancreatic disease]. Zhonghua Yi Xue Za Zhi 2017; 97:3283-3285. [PMID: 29141370 DOI: 10.3760/cma.j.issn.0376-2491.2017.42.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Liu PY, Lai PL, Lin CL. A biomechanical investigation of different screw head designs for vertebral derotation in scoliosis surgery. Spine J 2017; 17:1171-1179. [PMID: 28414169 DOI: 10.1016/j.spinee.2017.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/29/2016] [Revised: 03/15/2017] [Accepted: 04/10/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The posterior pedicle screw-rod system, which is widely used to correct spinal deformities, achieves a good correction rate in the frontal and coronal planes but not in the axial plane. Direct vertebral derotation (DVD) was developed to correct axial plane deformities. However, the design of screw head and body connection, in terms of monoaxial, polyaxial, and uniplanar screw, may influence the efficiency of DVD. PURPOSE This study compared the efficiency of a newly designed uniplanar screw with that of monoaxial and polyaxial screws in the DVD maneuver. STUDY DESIGN A porcine spine model and monoaxial, polyaxial, and uniplanar screws were used to examine the biomechanics of the DVD maneuver. METHODS Six T7-T13 porcine thoracic spine segments were used as test specimens in this study. Pedicle screws were inserted in the left pedicles of the T9-T11 spinal segments and then connected with a rod. Three types of pedicle screws with different screw head designs (monoaxial, polyaxial, and uniplanar) were employed in this study. The material testing system (MTS) machine generated a rotational moment through the derotational tube on the T10 (apical body) pedicle screw, which simulated the motion applied during the surgical vertebral derotational procedure. The pedicle strain and the kinematics of the vertebral body and derotational tube were recorded to evaluate the derotational efficiency of different pedicle screw head designs. RESULTS The variances of the derotation for the monoaxial, polyaxial, and uniplanar screws were 2.22°±1.43°, 32.23°±2.26°, and 4.75°±1.60°, respectively; the derotation efficiency was 0.65, 0.51, and 0.12, respectively, when the torques of the spinal constructs reached 3 Nm. The rotational variance of the polyaxial screw was statistically greater than that of the monoaxial and uniplanar screws (p<.05). The maximum micro-strains of the pedicles for the monoaxial, polyaxial, and uniplanar screws were 1,067.45±550.35, 747.68±393.56, and 663.55±271.04, respectively, with no statistically significant differences (p>.05). CONCLUSIONS The screw head design played an important role in the efficiency and variance of the derotation during the DVD maneuver. The derotational efficiency of the newly designed uniplanar screw was closer to that of the monoaxial screw group than to that of the polyaxial screw group. The polyaxial screw was inferior to DVD owing to a derotational variance between the derotational tube and the apical body that was correlated with the range of motion of the screw head. In the present study, the pedicle strain was similar in all groups. However, the pedicle strain of the uniplanar screw group was lower than that of the monoaxial screw group and was similar to that of the polyaxial screw group when the angle of rotation of the apical body increased.
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Affiliation(s)
- Po-Yi Liu
- Department of Biomedical Engineering, National Yang-Ming University, No. 155, Sec. 2, Linong St, Taipei city 112, Taiwan; Bone and Joint Research Center, Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, No. 5 Fushing St Kweishan, Taoyuan city 333, Taiwan
| | - Po-Liang Lai
- Bone and Joint Research Center, Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, No. 5 Fushing St Kweishan, Taoyuan city 333, Taiwan.
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming University, No. 155, Sec. 2, Linong St, Taipei city 112, Taiwan.
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22
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Hu WW, Chen PC, Chen JM, Wu YM, Liu PY, Lu CH, Lin YF, Tang CH, Chao CC. Periostin promotes epithelial-mesenchymal transition via the MAPK/miR-381 axis in lung cancer. Oncotarget 2017; 8:62248-62260. [PMID: 28977942 PMCID: PMC5617502 DOI: 10.18632/oncotarget.19273] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 05/29/2017] [Indexed: 01/28/2023] Open
Abstract
Periostin (POSTN, PN, or osteoblast-specific factor OSF-2) is a multifunctional cytokine that signals between the cell and the extracellular matrix. Periostin plays an important role in tumor development and is involved in carcinoma cell epithelial-mesenchymal transition (EMT), whereby mature epithelial cells undergo phenotypic morphological changes and become invasive, motile cells. Here, we discuss the molecular mechanisms involved in periostin-induced promotion of EMT in lung cancer cells. Online TCGA datasets demonstrate the prognostic relevance of periostin in lung cancer; a higher periostin level correlates with poor overall survival. Similarly, our IHC results show that high periostin expression is positively correlated with the EMT markers Snail and Twist, as well as stage of lung cancer. We found that recombinant periostin induces the EMT phenotype in lung cancer cells through the p38/ERK pathway, while pretreatment with chemical inhibitors prevented periostin-induced EMT induction. Moreover, we found that periostin regulates EMT by repressing microRNA-381 (miR-381) expression, which targets both Snail and Twist. Using the miR-381 mimic, we dramatically reversed periostin-induced Snail and Twist expression. Furthermore, periostin knockdown dramatically affected EMT markers and cell migration potential. The role of periostin in lung cancer progression is elucidated by the in vivo mouse model. Our findings indicate that changes in periostin expression in lung cancer may serve as a therapeutic target for the treatment of lung cancer metastasis.
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Affiliation(s)
- Wei-Wei Hu
- Department of Thoracic Surgery, Dongyang People's Hospital, Dongyang, China
| | - Po-Chun Chen
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.,Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan
| | - Jun-Ming Chen
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Yue-Ming Wu
- Department of Thoracic Surgery, Dongyang People's Hospital, Dongyang, China
| | - Po-Yi Liu
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan.,Department of Thoracic Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Chih-Hao Lu
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Yu-Feng Lin
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan
| | - Chih-Hsin Tang
- Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan.,Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan.,Department of Pharmacology, School of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Chia Chao
- Department of Respiratory Therapy, Fu-Jen Catholic University, New Taipei, Taiwan
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23
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Jeng MD, Liu PY, Kuo JH, Lin CL. Load Fatigue Performance Evaluation on Two Internal Tapered Abutment–Implant Connection Implants Under Different Screw Tightening Torques. J ORAL IMPLANTOL 2017; 43:107-113. [DOI: 10.1563/aaid-joi-d-16-00129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study evaluates the load fatigue performance of different abutment–implant connection implant types—retaining-screw (RS) and taper integrated screwed-in (TIS) types under 3 applied torque levels based on the screw elastic limit. Three torque levels—the recommended torque (25 Ncm), 10% less, and 10% more than the ratio of recommended torque to screw elastic limits of different implants were applied to the implants to perform static and dynamic testing according to the ISO 14801 method. Removal torque loss was calculated for each group after the endurance limitation was reached (passed 5 × 106 cycles) in the fatigue test. The static fracture resistance results showed that the fracture resistance in the TIS-type implant significantly increased (P < .05) when the abutment screw was inserted tightly. The dynamic testing results showed that the endurance limitations for the RS-type implant were 229 N, 197 N, and 224 N and those for the TIS-type implant were 322 N, 364 N, and 376 N when the screw insertion torques were applied from low to high. The corresponding significant (P < .05) removal torque losses for the TIS-type implant were 13.2%, 5.3%, and 2.6% but no significant difference was found for the RS-type implant. This study concluded that the static fracture resistance and dynamic endurance limitation of the TIS-type implant (1-piece solid abutment) increased when torque was applied more tightly on the screw. Less torque loss was also found when increasing the screw insertion torque.
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Affiliation(s)
- Ming-Dih Jeng
- Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Po-Yi Liu
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Jia-Hum Kuo
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan
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24
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Mao WF, Wu YF, Yang QQ, Zhou YL, Wang XT, Liu PY, Tang JB. Modulation of digital flexor tendon healing by vascular endothelial growth factor gene transfection in a chicken model. Gene Ther 2017; 24:234-240. [DOI: 10.1038/gt.2017.12] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 01/30/2017] [Accepted: 02/07/2017] [Indexed: 12/19/2022]
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Hu W, Liu PY, Yang YC, Chen PC, Su CM, Chao CC, Tang CH. Association of HMGB1 Gene Polymorphisms with Lung Cancer Susceptibility and Clinical Aspects. Int J Med Sci 2017; 14:1197-1202. [PMID: 29104475 PMCID: PMC5666552 DOI: 10.7150/ijms.20933] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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: 05/09/2017] [Accepted: 08/07/2017] [Indexed: 12/27/2022] Open
Abstract
Lung cancer is one of the most frequently diagnosed malignancies and is associated with a poor survival rate in the Chinese Han population. Analysis of genetic variants could lead to improvements in prognosis following lung cancer therapy. High-mobility group box 1 protein (HMGB1) is a ubiquitous nuclear protein found in eukaryotic cells that participates in several biological functions including immune response, cell survival, apoptosis and cancer development. We investigated the effects of HMGB1 gene polymorphisms on the risk of lung cancer progression in a Chinese Han population. Our sample of 751 participants included 372 patients with lung cancer and 379 healthy controls. Four single-nucleotide polymorphisms (SNPs) of the HMGB1 gene were examined by real-time polymerase chain reaction (RT-PCR). We found that the CT or CC+CT heterozygotes of the HMGB1 rs1045411 polymorphism reduced the risks for lung cancer, while the G/T/C haplotypes of three HMGB1 SNPs (rs1360485, rs1045411 and rs2249825) also reduced the risk for lung cancer by almost half (0.486-fold). The current study is the first to examine the risk factors associated with HMGB1 SNPs in lung cancer development in the Chinese Han population.
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Affiliation(s)
- Weiwei Hu
- Department of Thoracic Surgery, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - Po-Yi Liu
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan.,Department of Thoracic Surgery, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Chen Yang
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Po-Chun Chen
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan.,Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan
| | - Chen-Ming Su
- Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China
| | - Chia-Chia Chao
- Department of Respiratory Therapy, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Chih-Hsin Tang
- Graduate Institute of Biomedical Science, China Medical University, Taichung, Taiwan.,Department of Biotechnology, College of Health Science, Asia University, Taichung, Taiwan.,School of Medicine, China Medical University, Taichung, Taiwan
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26
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Ayoub R, Page ST, Swerdloff RS, Liu PY, Amory JK, Leung A, Hull L, Blithe D, Christy A, Chao JH, Bremner WJ, Wang C. Comparison of the single dose pharmacokinetics, pharmacodynamics, and safety of two novel oral formulations of dimethandrolone undecanoate (DMAU): a potential oral, male contraceptive. Andrology 2016; 5:278-285. [PMID: 27907978 DOI: 10.1111/andr.12303] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/20/2016] [Accepted: 10/20/2016] [Indexed: 11/27/2022]
Abstract
Dimethandrolone (DMA, 7α,11β-dimethyl-19-nortestosterone) has both androgenic and progestational activities, ideal properties for a male hormonal contraceptive. In vivo, dimethandrolone undecanoate (DMAU) is hydrolyzed to DMA. We showed previously that single oral doses of DMAU powder in capsule taken with food are well tolerated and effective at suppressing both LH and testosterone (T), but absorption was low. We compared the pharmacokinetics and pharmacodynamics of two new formulations of DMAU, in castor oil and in self-emulsifying drug delivery systems (SEDDS), with the previously tested powder formulation. DMAU was dosed orally in healthy adult male volunteers at two academic medical centers. For each formulation tested in this double-blind, placebo-controlled study, 10 men received single, escalating, oral doses of DMAU (100, 200, and 400 mg) and two subjects received placebo. All doses were evaluated for both fasting and with a high fat meal. All three formulations were well tolerated without clinically significant changes in vital signs, blood counts, or serum chemistries. For all formulations, DMA and DMAU showed higher maximum (p < 0.007) and average concentrations (p < 0.002) at the 400 mg dose, compared with the 200 mg dose. The powder formulation resulted in a lower conversion of DMAU to DMA (p = 0.027) compared with both castor oil and SEDDS formulations. DMAU in SEDDS given fasting resulted in higher serum DMA and DMAU concentrations compared to the other two formulations. Serum LH and sex hormone concentrations were suppressed by all formulations of 200 and 400 mg DMAU when administered with food, but only the SEDDS formulation was effectively suppressed serum T when given fasting. We conclude that while all three formulations of oral DMAU are effective and well tolerated when administered with food, DMAU in oil and SEDDS increased conversion to DMA, and SEDDS may have some effectiveness when given fasting. These properties might be advantageous for the application of DMAU as a male contraceptive.
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Affiliation(s)
- R Ayoub
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - S T Page
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R S Swerdloff
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - P Y Liu
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - J K Amory
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - A Leung
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - L Hull
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - D Blithe
- Contraception Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - A Christy
- Contraception Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - J H Chao
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - W J Bremner
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - C Wang
- Department of Medicine, Division of Endocrinology, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
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27
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Ren YY, Zhou LC, Yang L, Liu PY, Zhao BW, Liu HX. Predicting the aquatic toxicity mode of action using logistic regression and linear discriminant analysis. SAR QSAR Environ Res 2016; 27:721-746. [PMID: 27653817 DOI: 10.1080/1062936x.2016.1229691] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 08/22/2016] [Indexed: 06/06/2023]
Abstract
The paper highlights the use of the logistic regression (LR) method in the construction of acceptable statistically significant, robust and predictive models for the classification of chemicals according to their aquatic toxic modes of action. Essentials accounting for a reliable model were all considered carefully. The model predictors were selected by stepwise forward discriminant analysis (LDA) from a combined pool of experimental data and chemical structure-based descriptors calculated by the CODESSA and DRAGON software packages. Model predictive ability was validated both internally and externally. The applicability domain was checked by the leverage approach to verify prediction reliability. The obtained models are simple and easy to interpret. In general, LR performs much better than LDA and seems to be more attractive for the prediction of the more toxic compounds, i.e. compounds that exhibit excess toxicity versus non-polar narcotic compounds and more reactive compounds versus less reactive compounds. In addition, model fit and regression diagnostics was done through the influence plot which reflects the hat-values, studentized residuals, and Cook's distance statistics of each sample. Overdispersion was also checked for the LR model. The relationships between the descriptors and the aquatic toxic behaviour of compounds are also discussed.
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Affiliation(s)
- Y Y Ren
- a School of Environmental and Municipal Engineering, Lanzhou Jiaotong University , Lanzhou , P.R. China
| | - L C Zhou
- b College of Chemistry and Chemical Engineering, Lanzhou University , Lanzhou , P.R. China
| | - L Yang
- a School of Environmental and Municipal Engineering, Lanzhou Jiaotong University , Lanzhou , P.R. China
| | - P Y Liu
- a School of Environmental and Municipal Engineering, Lanzhou Jiaotong University , Lanzhou , P.R. China
| | - B W Zhao
- a School of Environmental and Municipal Engineering, Lanzhou Jiaotong University , Lanzhou , P.R. China
| | - H X Liu
- c School of Pharmacy, Lanzhou University , Lanzhou , P.R. China
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28
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Liu PY, Zhang W. Short-term androgen therapy for men treated regularly with opioids for chronic noncancer pain: time will tell. Clin Endocrinol (Oxf) 2016; 85:170-1. [PMID: 27177598 DOI: 10.1111/cen.13102] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 05/10/2016] [Accepted: 05/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- P Y Liu
- Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute (LA BioMed), Torrance, CA, USA
| | - W Zhang
- Division of Endocrinology, Department of Medicine, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute (LA BioMed), Torrance, CA, USA
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29
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Liu PY, Chin LK, Ser W, Chen HF, Hsieh CM, Lee CH, Sung KB, Ayi TC, Yap PH, Liedberg B, Wang K, Bourouina T, Leprince-Wang Y. Cell refractive index for cell biology and disease diagnosis: past, present and future. Lab Chip 2016; 16:634-44. [PMID: 26732872 DOI: 10.1039/c5lc01445j] [Citation(s) in RCA: 210] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Cell refractive index is a key biophysical parameter, which has been extensively studied. It is correlated with other cell biophysical properties including mechanical, electrical and optical properties, and not only represents the intracellular mass and concentration of a cell, but also provides important insight for various biological models. Measurement techniques developed earlier only measure the effective refractive index of a cell or a cell suspension, providing only limited information on cell refractive index and hence hindering its in-depth analysis and correlation. Recently, the emergence of microfluidic, photonic and imaging technologies has enabled the manipulation of a single cell and the 3D refractive index of a single cell down to sub-micron resolution, providing powerful tools to study cells based on refractive index. In this review, we provide an overview of cell refractive index models and measurement techniques including microfluidic chip-based techniques for the last 50 years, present the applications and significance of cell refractive index in cell biology, hematology, and pathology, and discuss future research trends in the field, including 3D imaging methods, integration with microfluidics and potential applications in new and breakthrough research areas.
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Affiliation(s)
- P Y Liu
- Université Paris-Est, UPEM, F-77454 Marne-la-Vallée, France.
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Melehan KL, Hoyos CM, Yee BJ, Wong KK, Buchanan PR, Grunstein RR, Liu PY. Increased sexual desire with exogenous testosterone administration in men with obstructive sleep apnea: a randomized placebo-controlled study. Andrology 2015; 4:55-61. [PMID: 26610430 DOI: 10.1111/andr.12132] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 04/09/2015] [Revised: 09/27/2015] [Accepted: 10/18/2015] [Indexed: 12/21/2022]
Abstract
Testosterone (T) deficiency, sexual dysfunction, obesity and obstructive sleep apnea (OSA) are common and often coexist. T prescriptions have increased worldwide during the last decade, including to those with undiagnosed or untreated OSA. The effect of T administration on sexual function, neurocognitive performance and quality of life in these men is poorly defined. The aim of this study was to examine the impact of T administration on sexual function, quality of life and neurocognitive performance in obese men with OSA. We also secondarily examined whether baseline T might modify the effects of T treatment by dichotomizing on baseline T levels pre-specified at 8, 11 and 13 nmol/L. This was a randomized placebo-controlled study in which 67 obese men with OSA (mean age 49 ± 1.3 years) were randomized to receive intramuscular injections of either 1000 mg T undecanoate or placebo at baseline, week 6 and week 12. All participants were concurrently enrolled in a weight loss program. General and sleep-related quality of life, neurocognitive performance and subjective sexual function were assessed before and 6, 12 and 18 weeks after therapy. T compared to placebo increased sexual desire (p = 0.004) in all men, irrespective of baseline T levels. There were no differences in erectile function, frequency of sexual attempts, orgasmic ability, general or sleep-related quality of life or neurocognitive function (all p = NS). In those with baseline T levels below 8 nmol/L, T increased vitality (p = 0.004), and reduced reports of feeling down (p = 0.002) and nervousness (p = 0.03). Our findings show that 18 weeks of T therapy increased sexual desire in obese men with OSA independently of baseline T levels whereas improvements in quality of life were evident only in those with T levels below 8 nmol/L. These small improvements would need to be balanced against potentially more serious adverse effects of T therapy on breathing.
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Affiliation(s)
- K L Melehan
- NHMRC Centre for The Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - C M Hoyos
- NHMRC Centre for The Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - B J Yee
- NHMRC Centre for The Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - K K Wong
- NHMRC Centre for The Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - P R Buchanan
- NHMRC Centre for The Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Department of Respiratory Medicine, Liverpool Hospital, Sydney, NSW, Australia
| | - R R Grunstein
- NHMRC Centre for The Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - P Y Liu
- NHMRC Centre for The Integrated Research and Understanding of Sleep, Woolcock Institute of Medical Research, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Los Angeles, CA, USA
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31
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Wu YF, Mao WF, Zhou YL, Wang XT, Liu PY, Tang JB. Adeno-associated virus-2-mediated TGF-β1 microRNA transfection inhibits adhesion formation after digital flexor tendon injury. Gene Ther 2015; 23:167-75. [PMID: 26381218 DOI: 10.1038/gt.2015.97] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 09/08/2015] [Accepted: 09/11/2015] [Indexed: 01/12/2023]
Abstract
Adhesion formation after digital flexor tendon injury greatly affects gliding function of the tendon, which is a major clinical complication after hand surgery. Transforming growth factor beta 1 (TGF-β1) has a critical role in adhesion formation during tendon healing. Persistent regulation of TGF-β1 through application of microRNA (miRNA) specifically inhibiting the function of TGF-β1 (TGF-β1-miRNA) holds promise for treatment of such a complication. Adeno-associated virus (AAV) was used to transfer TGF-β1-miRNA to the chicken digital flexor tendons, which had been injured and surgically repaired. Four doses of AAV2-TGF-β1-miRNA (2 × 10¹¹, 2 × 10¹⁰, 2 × 10⁹ and 2 × 10⁸ vector genomes (vg)) were used to determine the transfection efficiency. At postoperative 3 weeks, we found a positive correlation between the administered AAV2-TGF-β1-miRNA doses and transfection efficiency. The transfection rate ranged from 10% to 77% as the doses increased. Production of TGF-β1 protein in the tendons decreased on increasing vector dosage. When 2 × 10¹¹ and 2 × 10¹⁰) vg were injected into the tendon, gliding excursion of the repaired tendon and work of flexion of chicken toes were significantly increased and adhesion score decreased 6 and 8 weeks later, indicating the improvement of tendon gliding and decreases in adhesion formations. However, the ultimate strength of the tendons transfected at the dose of 2 × 10¹⁰ vg was 12-24% lower than that of the control tendons. The results of this study demonstrate that application of TGF-β1-miRNA had a mixed impact on tendon healing: adhesion around the tendon is reduced but strength of the tendon healing is adversely affected. Future studies should aim at maintaining the beneficial effects of reducing tendon adhesions, while eliminating the adverse effects of decreasing the healing strength.
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Affiliation(s)
- Y F Wu
- Hand Surgery Research Center, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - W F Mao
- Department of Anatomy, Medical School of Nantong University, Nantong, Jiangsu, China
| | - Y L Zhou
- Hand Surgery Research Center, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - X T Wang
- Department of Plastic Surgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - P Y Liu
- Department of Plastic Surgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - J B Tang
- Hand Surgery Research Center, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Surampudi P, Chang I, Lue Y, Doumit T, Jia Y, Atienza V, Liu PY, Swerdloff RS, Wang C. Humanin protects against chemotherapy-induced stage-specific male germ cell apoptosis in rats. Andrology 2015; 3:582-589. [PMID: 25891800 DOI: 10.1111/andr.12036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [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: 10/30/2014] [Revised: 02/22/2015] [Accepted: 03/03/2015] [Indexed: 11/29/2022]
Abstract
Humanin (HN) has cytoprotective action on male germ cells after testicular stress induced by heat and hormonal deprivation. To examine whether HN has protective effects on chemotherapy-induced male germ cell apoptosis, we treated four groups of adult rats with (i) vehicle (control), (ii) HN, (iii) cyclophosphamide (CP); or (iv) HN+CP. To investigate whether the protective effects of HN on germ cells require the presence of Leydig cells, another four groups of rats were pre-treated with ethane dimethanesulfonate (EDS), a Leydig cell toxicant, to eliminate Leydig cells. After 3 days, when Leydig cells were depleted by EDS, we administered: (i) vehicle, (ii) HN, (iii) CP; or (iv) HN+CP to rats. All rats were killed 12 h after the injection of HN and/or CP. Germ cell apoptosis was detected by TUNEL assay and quantified by numerical count. Compared with control and HN (alone), CP significantly increased germ cell apoptosis; HN +CP significantly reduced CP-induced apoptosis at early (I-VI) and late stages (IX-XIV) but not at middle stages (VII-VIII) of the seminiferous epithelial cycle. Pre-treatment with EDS markedly suppressed serum and intratesticular testosterone (T) levels, and significantly increased germ cell apoptosis at the middle (VII-VIII) stages. CP did not further increase germ cell apoptosis in the EDS-pre-treated rats. HN significantly attenuated germ cell apoptosis at the middle stages in EDS pre-treated rats. To investigate whether HN has any direct effects on Leydig cell function, adult Leydig cells were isolated and treated with ketoconazole (KTZ) to block testosterone synthesis. HN was not effective in preventing the reduction of T production by KTZ in vitro. We conclude that HN decreases CP and/or EDS-induced germ cell apoptosis in a stage-specific fashion. HN acts directly on germ cells to protect against EDS-induced apoptosis in the absence of Leydig cells and intratesticular testosterone levels are very low.
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Affiliation(s)
- P Surampudi
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - I Chang
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Y Lue
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - T Doumit
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - Y Jia
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - V Atienza
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - P Y Liu
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - R S Swerdloff
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
| | - C Wang
- Division of Endocrinology, Department of Medicine, Harbor UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, CA, USA
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Liu PY, Chin LK, Ser W, Ayi TC, Yap PH, Bourouina T, Leprince-Wang Y. An optofluidic imaging system to measure the biophysical signature of single waterborne bacteria. Lab Chip 2014; 14:4237-4243. [PMID: 25205636 DOI: 10.1039/c4lc00783b] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this paper, for the first time, an on-chip optofluidic imaging system is innovated to measure the biophysical signatures of single waterborne bacteria, including both their refractive indices and morphologies (size and shape), based on immersion refractometry. The key features of the proposed optofluidic imaging platform include (1) multiple sites for single-bacterium trapping, which enable parallel measurements to achieve higher throughput, and (2) a chaotic micromixer, which enables efficient refractive index variation of the surrounding medium. In the experiments, the distinctive refractive index of Echerichia coli, Shigella flexneri and Vibrio cholera are measured with a high precision of 5 × 10(-3) RIU. The developed optofluidic imaging system has high potential not only for building up a database of biophysical signatures of waterborne bacteria, but also for developing single-bacterium detection in treated water that is in real-time, label-free and low cost.
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Affiliation(s)
- P Y Liu
- Université Paris-Est, UPEM, F-77454 Marne-la-Vallée, France
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Carrell DT, Rajpert-De Meyts E, Krausz C, Jannini EA, Liu PY, Gerton GL, La Salle S, Amaral A. The need of continuous focus on improved mentoring of trainees and young investigators in the field of andrology: highlights of current programs and opportunities for the future. Andrology 2014; 2:649-51. [PMID: 25124511 DOI: 10.1111/j.2047-2927.2014.00259.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D T Carrell
- Departments of Surgery (Urology), Human Genetics, and Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA
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Bowden LG, Maini PK, Moulton DE, Tang JB, Wang XT, Liu PY, Byrne HM. An ordinary differential equation model for full thickness wounds and the effects of diabetes. J Theor Biol 2014; 361:87-100. [PMID: 25017724 DOI: 10.1016/j.jtbi.2014.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 06/13/2014] [Accepted: 07/01/2014] [Indexed: 01/01/2023]
Abstract
Wound healing is a complex process in which a sequence of interrelated phases contributes to a reduction in wound size. For diabetic patients, many of these processes are compromised, so that wound healing slows down. In this paper we present a simple ordinary differential equation model for wound healing in which attention focusses on the dominant processes that contribute to closure of a full thickness wound. Asymptotic analysis of the resulting model reveals that normal healing occurs in stages: the initial and rapid elastic recoil of the wound is followed by a longer proliferative phase during which growth in the dermis dominates healing. At longer times, fibroblasts exert contractile forces on the dermal tissue, the resulting tension stimulating further dermal tissue growth and enhancing wound closure. By fitting the model to experimental data we find that the major difference between normal and diabetic healing is a marked reduction in the rate of dermal tissue growth for diabetic patients. The model is used to estimate the breakdown of dermal healing into two processes: tissue growth and contraction, the proportions of which provide information about the quality of the healed wound. We show further that increasing dermal tissue growth in the diabetic wound produces closure times similar to those associated with normal healing and we discuss the clinical implications of this hypothesised treatment.
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Affiliation(s)
- L G Bowden
- Wolfson Centre for Mathematical Biology, Mathematical Institute, University of Oxford, Andrew Wiles Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK.
| | - P K Maini
- Wolfson Centre for Mathematical Biology, Mathematical Institute, University of Oxford, Andrew Wiles Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - D E Moulton
- Wolfson Centre for Mathematical Biology, Mathematical Institute, University of Oxford, Andrew Wiles Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK
| | - J B Tang
- Department of Plastic Surgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - X T Wang
- Department of Plastic Surgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - P Y Liu
- Department of Plastic Surgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA
| | - H M Byrne
- Department of Computer Science, University of Oxford, Wolfson Building, Parks Road, Oxford OX1 3QD, UK
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Sun Y, Liu PY, Scarlett CJ, Malyukova A, Liu B, Marshall GM, MacKenzie KL, Biankin AV, Liu T. Histone deacetylase 5 blocks neuroblastoma cell differentiation by interacting with N-Myc. Oncogene 2014; 33:2987-94. [PMID: 23812427 DOI: 10.1038/onc.2013.253] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 05/10/2013] [Accepted: 05/31/2013] [Indexed: 12/18/2022]
Abstract
The N-Myc oncoprotein induces neuroblastoma, which arises from undifferentiated neuroblasts in the sympathetic nervous system, by modulating gene and protein expression and consequently causing cell differentiation block and cell proliferation. The class IIa histone deacetylase 5 (HDAC5) represses gene transcription, and blocks myoblast, osteoblast and leukemia cell differentiation. Here we showed that N-Myc upregulated HDAC5 expression in neuroblastoma cells. Conversely, HDAC5 repressed the ubiquitin-protein ligase NEDD4 gene expression, increased Aurora A gene expression and consequently upregulated N-Myc protein expression. Genome-wide gene expression analysis and protein co-immunoprecipitation assays revealed that HDAC5 and N-Myc repressed the expression of a common subset of genes by forming a protein complex, whereas HDAC5 and the class III HDAC SIRT2 independently repressed the expression of another common subset of genes without forming a protein complex. Moreover, HDAC5 blocked differentiation and induced proliferation in neuroblastoma cells. Taken together, our data identify HDAC5 as a novel co-factor in N-Myc oncogenesis, and provide the evidence for the potential application of HDAC5 inhibitors in the therapy of N-Myc-induced neuroblastoma and potentially other c-Myc-induced malignancies.
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Affiliation(s)
- Y Sun
- Children's Cancer Institute Australia for Medical Research, Randwick, New South Wales, Australia
| | - P Y Liu
- Children's Cancer Institute Australia for Medical Research, Randwick, New South Wales, Australia
| | - C J Scarlett
- 1] School of Environmental and Life Sciences, University of Newcastle, Ourimbah, New South Wales, Australia [2] Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - A Malyukova
- Children's Cancer Institute Australia for Medical Research, Randwick, New South Wales, Australia
| | - B Liu
- 1] Children's Cancer Institute Australia for Medical Research, Randwick, New South Wales, Australia [2] Kids Cancer Alliance, Randwick, New South Wales, Australia
| | - G M Marshall
- 1] Children's Cancer Institute Australia for Medical Research, Randwick, New South Wales, Australia [2] Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - K L MacKenzie
- Children's Cancer Institute Australia for Medical Research, Randwick, New South Wales, Australia
| | - A V Biankin
- 1] Cancer Research Program, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia [2] Department of Surgery, Bankstown Hospital, Bankstown, New South Wales, Australia [3] South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Liverpool, New South Wales, Australia
| | - T Liu
- 1] Children's Cancer Institute Australia for Medical Research, Randwick, New South Wales, Australia [2] School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Randwick, New South Wales, Australia
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Takahashi PY, Liu PY, Veldhuis JD. Distinct roles of age and abdominal visceral fat in reducing androgen receptor-dependent negative feedback on LH secretion in healthy men. Andrology 2014; 2:588-95. [PMID: 24782426 DOI: 10.1111/j.2047-2927.2014.00218.x] [Citation(s) in RCA: 7] [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: 02/04/2014] [Revised: 03/10/2014] [Accepted: 03/25/2014] [Indexed: 12/31/2022]
Abstract
Testosterone (T) impacts luteinizing hormone (LH) secretion through negative feedback via the androgen receptor (AR) in the hypothalamo-pituitary system. An untested postulate is that increasing body mass index (BMI), abdominal visceral fat (AVF) or total abdominal fat (TAF) with ageing decreases LH secretion by heightening T negative feedback via AR. This hypothesis was tested in a prospective, randomized double-blind cross-over study of 19 healthy men comparing the effects of flutamide, a selective non-steroidal AR antagonist and placebo administration on basal and pulsatile LH secretion as a function of age and obesity measures. To this end, serum levels of 2-hydroxyflutamide (2-OHF), a major active flutamide metabolite, were measured by mass spectrometry, and AVF/TAF quantified by abdominal computerized tomography. Statistical analysis showed that antiandrogen administration elevated 6-h mean LH concentrations to 5.4 ± 1.3 IU/L compared with 3.3 ± 1.2 IU/L for placebo (p < 10(-3) ), and total T by 35% (p < 10(-4) ). The LH-T concentration product doubled (p < 10(-8) ). According to deconvolution analysis, flutamide exposure increased total LH secretion (p < 10(-3) ) and pulsatile LH secretion (p = 0.0077), along with LH pulse frequency (p = 0.019). Despite feedback inhibition, the LH-T product declined as a linear function of AVF (p = 0.021) and TAF (p = 0.017). This was explained by the fact that higher BMI was associated with lower 2-OHF concentrations (R = -0.562, p = 0.012). In contrast, age was associated with less pulsatile LH secretion (R = -0.567, p = 0.011) even when LH responses were normalized to antiantrogen levels. In conclusion, increased AVF, TAF and BMI predict decreased LH and flutamide blood levels, whereas older age is marked by impaired stimulation of pulsatile LH secretion even when normalized for antiandrogen levels, suggesting different mechanisms of regulation by adiposity and age.
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Affiliation(s)
- P Y Takahashi
- Department of Internal Medicine, Endocrine Research Unit, Mayo Clinic College of Medicine, Center for Translational Science Activities, Mayo Clinic, Rochester, MN, USA
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Huang CL, Liu PY, Cheng CY, Wang BY. Concurrent dual-scopic management of diaphragm disease. Interact Cardiovasc Thorac Surg 2014; 19:315-7. [PMID: 24729312 DOI: 10.1093/icvts/ivu111] [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] [Indexed: 11/12/2022] Open
Abstract
With the increasing appliance of minimally invasive approaches in both thoracic and general surgery, more and more diaphragmatic conditions are being managed with laparoscopy or thoracoscopy. Which one is adopted depends on the disease, facility support and surgeon's preference. However, in difficult scenarios such as adhesions, uncertain tumour location or bulky herniated organs, addition of another approach could be beneficial. Here we describe 2 cases, one with metastatic tumours within the diaphragm and another with diaphragmatic hernia in which concurrent thoracoscopic and laparoscopic, so-called dual-scopic, management was performed.
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Affiliation(s)
- Chang-Lun Huang
- Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan, ROC
| | - Po-Yi Liu
- Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan, ROC
| | - Chin-Yuan Cheng
- Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan, ROC
| | - Bing-Yen Wang
- Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan, ROC Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Liu PY, Li B, Liu HD, Tian L. Photochemical behavior of fenpropathrin and λ-cyhalothrin in solution. Environ Sci Pollut Res Int 2014; 21:1993-2001. [PMID: 24019141 DOI: 10.1007/s11356-013-2119-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 08/29/2013] [Indexed: 06/02/2023]
Abstract
The photodegradation processes of fenpropathrin and λ-cyhalothrin were studied in hexane, methanol/water (1:1, v/v), and acetone in both ultraviolet light and simulated sunlight. Intermediates in the photodegradation process were identified using gas chromatography/mass spectrometry (GC/MS), and the analysis of intermediates was used to speculate on possible photodegradation pathways. The photodegradation processes of fenpropathrin and λ-cyhalothrin followed pseudo first-order kinetics. The photodegradation rates varied according to the solvent in decreasing order: hexane>methanol/water (1:1, v/v)>acetone. The effects of substances coexisting in the environment on the photodegradation of pyrethroids were also investigated in the research. Acetone, humic acid, and riboflavin increased photodegradation rates while L-ascorbic acid slowed the process. This study provides a theoretical basis for the removal of pyrethroid pollution from the natural environment.
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Affiliation(s)
- P Y Liu
- College of Chemistry and Environmental Science, Hebei University, Baoding, 071002, China.
| | - B Li
- College of Chemistry and Environmental Science, Hebei University, Baoding, 071002, China
| | - H D Liu
- College of Chemistry and Environmental Science, Hebei University, Baoding, 071002, China
| | - L Tian
- College of Chemistry and Environmental Science, Hebei University, Baoding, 071002, China
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Nikolaenko L, Jia Y, Wang C, Diaz-Arjonilla M, Yee JK, French SW, Liu PY, Laurel S, Chong C, Lee K, Lue Y, Lee WNP, Swerdloff RS. Testosterone replacement ameliorates nonalcoholic fatty liver disease in castrated male rats. Endocrinology 2014; 155:417-28. [PMID: 24280056 PMCID: PMC5393315 DOI: 10.1210/en.2013-1648] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Nonalcoholic fatty liver disease is common in developed countries and is associated with obesity, metabolic syndrome, and type 2 diabetes. T deficiency is a risk factor for developing these metabolic deficiencies, but its role in hepatic steatosis has not been well studied. We investigated the effects of T on the pathogenesis of hepatic steatosis in rats fed a high-fat diet (HFD). Adult male rats were randomly placed into four groups and treated for 15 weeks: intact rats on regular chow diet (RCD), intact rats on liquid HFD (I+HFD), castrated rats on HFD (C+HFD), and castrated rats with T replacement on HFD (C+HFD+T). Fat contributed 71% energy to the HFD but only 16% of energy to the RCD. Serum T level was undetectable in castrated rats, and T replacement led to 2-fold higher mean serum T levels than in intact rats. C+HFD rats gained less weight but had higher percentage body fat than C+HFD+T. Severe micro- and macrovesicular fat accumulated in hepatocytes with multiple inflammatory foci in the livers of C+HFD. I+HFD and C+HFD+T hepatocytes demonstrated only mild to moderate microvesicular steatosis. T replacement attenuated HFD-induced hepatocyte apoptosis in castrated rats. Serum glucose and insulin levels were not increased with HFD in any group. Immunoblots showed that insulin-regulated proteins were not changed in any group. This study demonstrates that T deficiency may contribute to the severity of hepatic steatosis and T may play a protective role in hepatic steatosis and nonalcoholic fatty liver disease development without insulin resistance.
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Affiliation(s)
- L Nikolaenko
- Divisions of Endocrinology, Departments of Medicine (L.N., Y.J., C.W., M.D.-A., P.Y.L., S.L., C.C., K.L., Y.L., R.S.S.) and Pediatrics (J.K.Y., W.N.P.L.), and Department of Pathology (S.W.F.) Harbor-UCLA Medical Center and Los Angeles Biomedical Research Institute, Torrance, California 90509
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Sosman JA, Moon J, Tuthill RJ, Warneke JA, Vetto JT, Redman BG, Liu PY, Unger JM, Flaherty LE, Sondak VK. A phase 2 trial of complete resection for stage IV melanoma: results of Southwest Oncology Group Clinical Trial S9430. Cancer 2011; 117:4740-06. [PMID: 21455999 DOI: 10.1002/cncr.26111] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 09/16/2010] [Accepted: 09/17/2010] [Indexed: 12/19/2022]
Abstract
BACKGROUND On the basis of retrospective experience at individual centers, it appears that patients with stage IV melanoma who undergo complete resection have a favorable outcome compared with patients with disseminated stage IV disease. The Southwest Oncology Group (SWOG) performed a prospective trial in patients with metastatic melanoma who were enrolled before complete resection of their metastatic disease and provided prospective outcomes in the cooperative group setting. METHODS Based on their physical examination and radiologic imaging studies, patients with a stage IV melanoma judged amenable to complete resection underwent surgery within 28 days of enrollment. All eligible patients were followed with scans (computed tomography or positron emission tomography) every 6 months until relapse and death. RESULTS Seventy-seven patients were enrolled from 18 different centers. Of those, 5 patients were ineligible; 2 had stage III disease alone; and 3 had no melanoma in their surgical specimen. In addition, 8 eligible patients had incompletely resected tumor. Therefore, the primary analysis included 64 completely resected patients. Twenty patients (31%) had visceral disease. With a median follow-up of 5 years, the median relapse-free survival was 5 months (95% CI, 3-7 months) whereas median overall survival was 21 months (95% CI, 16-34 months). Overall survivals at 3 and 4 years were 36% and 31%, respectively. CONCLUSIONS In a prospective multicenter setting, appropriately selected patients with stage IV melanoma achieved prolonged overall survival after complete surgical resection. Although median relapse-free survival was only 5 months, patients could still frequently undergo subsequent surgery for isolated recurrences. This patient population is appropriate for aggressive surgical therapy and for trials evaluating adjuvant therapy.
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Affiliation(s)
- Jeffrey A Sosman
- Vanderbilt University School of Medicine, Department of Medicine, Nashville, Tennessee, USA.
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Abstract
A fatal infection of irradiated white mice with the Breinl strain of European typhus has been established and passed serially for 22 passages by the intra-abdominal route. Rickettsiae were abundant and easily demonstrable in the moribund or dead mice. The mortality of irradiated mice infected with passage material (peritoneal washings or blood) was nearly 100 per cent as contrasted to no mortality in the control mice given the same dose of x-ray (450 R) and the same volume of fluid intra-abdominally. (The observation period of control mice was arbitrarily limited to 14 days.) After eighteen passages in irradiated mice no increase in virulence for non-irradiated adult mice was detected. After passage in guinea pigs, the rickettsial infection deriving from the mouse passage material was identical with the Breinl strain as judged by fever, cross immunity tests, and brain lesions in sections.
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Affiliation(s)
- P Y Liu
- Department of Bacteriology and Immunology, The Harvard Medical School, Boston
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Zhang LX, Zhao Y, Cheng G, Guo TL, Chin YE, Liu PY, Zhao TC. Targeted deletion of NF-kappaB p50 diminishes the cardioprotection of histone deacetylase inhibition. Am J Physiol Heart Circ Physiol 2010; 298:H2154-63. [PMID: 20382965 DOI: 10.1152/ajpheart.01015.2009] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [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] [Indexed: 01/24/2023]
Abstract
We have recently demonstrated that the inhibition of histone deacetylases (HDAC) protects the heart against ischemia-reperfusion (I/R) injury. The mechanism by which HDAC inhibition confers myocardial protection remains unknown. The purpose of this study is to investigate whether the disruption of NF-kappaB p50 would eliminate the protective effects of HDAC inhibition. Wild-type and NF-kappaB p50-deficient mice were treated with trichostatin A (TSA; 0.1 mg/kg ip), a potent inhibitor of HDACs. Twenty-four hours later, the hearts were perfused in Langendorff model and subjected to 30 min of ischemia and 30 min of reperfusion. Inhibition of HDACs by TSA in wild-type mice produced marked improvements in left ventricular end-diastolic pressure, left ventricular rate pressure product, and the reduction of infarct size compared with non-TSA-treated group. TSA-induced cardioprotection in wild-type animals was absent with genetic deletion of NF-kappaB p50 subunit. Notably, Western blot displayed a significant increase in nuclear NF-kappaB p50 and the immunoprecipitation demonstrated a remarkable acetylation of NF-kappaB p50 at lysine residues following HDAC inhibition. EMSA exhibited a subsequent increase in NF-kappaB DNA binding activity. Luciferase assay demonstrated an activation of NF-kappaB by HDAC inhibition. The pretreatment of H9c2 cardiomyoblasts with TSA (50 nmol/l) decreased cell necrosis and increased in cell viability in simulated ischemia. The resistance of H9c2 cardiomyoblasts to simulated ischemia by HDAC inhibition was eliminated by genetic knockdown of NF-kappaB p50 with transfection of NF-kappaB p50 short interfering RNA but not scrambled short interfering RNA. These results suggest that NF-kappaB p50 acetylation and activation play a pivotal role in HDAC inhibition-induced cardioprotection.
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Affiliation(s)
- L X Zhang
- Department of Medicine, Brown Medical School, Brown University, Providence, Rhode Island, USA
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Clark JI, Moon J, Hutchins LF, Sosman JA, Kast WM, Da Silva DM, Liu PY, Thompson JA, Flaherty LE, Sondak VK. Phase 2 trial of combination thalidomide plus temozolomide in patients with metastatic malignant melanoma: Southwest Oncology Group S0508. Cancer 2010; 116:424-31. [PMID: 19918923 PMCID: PMC2811758 DOI: 10.1002/cncr.24739] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In limited institution phase 2 studies, thalidomide and temozolomide has yielded response rates (RRs) up to 32% for advanced melanoma, leading to the use of this combination as "standard" by some. We conducted a multicenter phase 2 trial to better define the clinical efficacy of thalidomide and temozolomide and the immune modulatory effects of thalidomide, when combined with temozolomide, in patients with metastatic melanoma. METHODS Patients must have had stage IV cutaneous melanoma, no active brain metastases, Zubrod PS 0-1, up to 1 prior systemic therapy excluding thalidomide, temozolomide, or dacarbazine, adequate organ function, and given informed consent. The primary endpoint was 6-month progression-free survival (PFS). Secondary endpoints included overall survival (OS), RR, toxicities, and assessment of relationships between biomarkers and clinical outcomes. Patients received thalidomide (200 mg/d escalated to 400 mg/d for patients <70, or 100 mg/d escalated to 250 mg/d for patients > or =70) plus temozolomide (75 mg/m(2)/d x 6 weeks, and then 2 weeks rest). RESULTS Sixty-four patients were enrolled; 2 refused treatment. The 6-month PFS was 15% (95% confidence interval [CI], 6%-23%), the 1-year OS was 35% (95% CI, 24%-47%), and the RR was 13% (95% CI, 5%-25%), all partial. One treatment-related death occurred from myocardial infarction; 3 other grade 4 events occurred, including pulmonary embolism, neutropenia, and central nervous system (CNS) ischemia. There was no significant correlation between biomarkers and PFS or OS. CONCLUSIONS This combination of thalidomide and temozolomide does not appear to have a clinical benefit that exceeds dacarbazine alone. We would not recommend it further for phase 3 trials or for standard community use.
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Affiliation(s)
- Joseph I Clark
- Cardinal Bernardin Cancer Center, Loyola University Medical Center, Division of Hematology/Oncology, 2160 South First Avenue, Maywood, IL 60153, USA.
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Markman M, Liu PY, Moon J, Monk BJ, Copeland L, Wilczynski S, Alberts D. Impact on survival of 12 versus 3 monthly cycles of paclitaxel (175 mg/m2) administered to patients with advanced ovarian cancer who attained a complete response to primary platinum-paclitaxel: follow-up of a Southwest Oncology Group and Gynecologic Oncology Group phase 3 trial. Gynecol Oncol 2009; 114:195-8. [PMID: 19447479 PMCID: PMC2744303 DOI: 10.1016/j.ygyno.2009.04.012] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Revised: 04/06/2009] [Accepted: 04/13/2009] [Indexed: 11/21/2022]
Abstract
OBJECTIVES A SWOG/GOG phase 3 trial exploring the impact of 12-monthly cycles of paclitaxel given to patients with advanced ovarian cancer who achieved a complete response to primary chemotherapy was discontinued by the Data Safety and Monitoring Committee when a prospectively defined interim analysis revealed a highly statistically significant improvement in progression-free survival (PFS). At study closure, it was too early to assess the impact on overall survival. METHODS Patients (n=296) received either 3 or 12 monthly cycles of paclitaxel (175 mg/m(2) over 3 h). RESULTS Of the 146 patients on the 3-cycle arm, 9 (6%) received >3 cycles. Median (12 versus 3 cycles; intention-to-treat analysis) updated PFS (all pts) 22 versus 14 months, p=0.006; overall survival (all pts) 53 versus 48 months, p=0.34. CONCLUSION Twelve cycles of single agent maintenance paclitaxel significantly improves PFS. Explanations for the lack of a favorable influence on overall survival include: (a) treatment at relapse equalized outcome; (b) the sample size was insufficient to reveal a difference; (c) "crossover" of patients from 3 cycles to longer treatment masked a potential difference. An ongoing phase 3 trial will hopefully provide a definitive answer to the question of the impact of this maintenance strategy on overall survival.
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Affiliation(s)
- Maurie Markman
- University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77005, USA.
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Abstract
XXY mouse has been characterized as an experimental model for men with Klinefelter's syndrome (XXY male phenotype). To test whether donor XY germ cells could proliferate and differentiate in the XXY testicular environment, donor testicular cells from adult (2-3 months old) and immature (10 days old) XY green fluorescence protein (GFP) transgenic mice were transplanted into the seminiferous tubules of adult (4-7 months old) and young (6 weeks old) XXY recipient mice respectively. Twelve weeks after transplantation, GFP positive spermatogonia were found in 21.74% (five out of 23) of adult XXY recipients who received adult donor cells. The GFP positive segments of seminiferous tubules were observed in 44.44% (four out of nine) young XXY recipients who received donor cells from 10 days old GFP mice. We found using immunohistochemistry and cell morphology that donor-derived GFP positive germ cells were spermatogonia, spermatocytes, round spermatids and spermatozoa in some of the seminiferous tubules of young XXY recipient mice. The results demonstrated that the donor XY germ cells were able to qualitatively complete spermatogenesis in some of the seminiferous tubules of XXY mice.
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Affiliation(s)
- Y Lue
- Division of Endocrinology, Department of Medicine, David Geffen School of Medicine at UCLA, Harbor-UCLA Medical Center, Torrance, CA 90509, USA
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Smith HO, Moon J, Wilczynski SP, Tiersten AD, Hannigan EV, Robinson WR, Rivkin SE, Anderson GL, Liu PY, Markman M. Southwest Oncology Group Trial S9912: intraperitoneal cisplatin and paclitaxel plus intravenous paclitaxel and pegylated liposomal doxorubicin as primary chemotherapy of small-volume residual stage III ovarian cancer. Gynecol Oncol 2009; 114:206-9. [PMID: 19464730 DOI: 10.1016/j.ygyno.2009.04.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 04/13/2009] [Accepted: 04/19/2009] [Indexed: 11/18/2022]
Abstract
OBJECTIVE While primary cisplatin-based intraperitoneal chemotherapy has been shown to favorably impact survival in small-volume residual advanced ovarian cancer, there is a need to develop strategies that improve the effectiveness of this approach. METHODS A multi-center phase 2 trial was conducted that added intravenous pegylated liposomal doxorubicin (day 8; 30-40 mg/m(2)) to a regimen of intraperitoneal cisplatin (day 2; 75 mg/m(2)) and intravenous (day 1; 135 mg/m(2)) plus intraperitoneal (day 8; 60 mg/m(2)) paclitaxel. Treatment was initially delivered on an every 3-week schedule, but was modified to an every 4-week program due to excessive toxicity. Patients were to receive 6 cycles of this regimen. RESULTS Of 68 patients entering this trial, 63 patients were eligible and evaluable, of whom 39 (62%) completed 6 cycles. Overall, 32 (51%) experienced at least 1 grade 4 or worse toxicity (most commonly hematologic) including 5 treatment-related deaths. Median progression-free survival (PFS) was 25 months (2-year PFS: 52%) and median overall survival 51 months, an outcome similar to previous reports of cisplatin-based intraperitoneal chemotherapy in comparable patient populations. Seventeen patients (27% of all eligible patients) were without evidence of disease recurrence >4 years following entry into the trial. CONCLUSION Both the overall trial outcome, and specifically the excessively severe systemic toxicity of this regimen would prevent its future development in this exact form. The provocative PFS in a subset of individuals should encourage the development of alternative strategies designed to optimize the delivery of regional therapy in ovarian cancer management.
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Tiersten AD, Liu PY, Smith HO, Wilczynski SP, Robinson WR, Markman M, Alberts DS. Phase II evaluation of neoadjuvant chemotherapy and debulking followed by intraperitoneal chemotherapy in women with stage III and IV epithelial ovarian, fallopian tube or primary peritoneal cancer: Southwest Oncology Group Study S0009. Gynecol Oncol 2009; 112:444-9. [PMID: 19138791 PMCID: PMC3513943 DOI: 10.1016/j.ygyno.2008.10.028] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Revised: 10/30/2008] [Accepted: 10/31/2008] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Intraperitoneal (IP) chemotherapy prolongs survival in optimally reduced ovarian cancer patients. For patients in whom optimal debulking cannot be achieved, one could incorporate IP therapy post-operatively if the cancer was optimally debulked following neoadjuvant chemotherapy. We sought to evaluate overall survival (OS), progression-free survival (PFS), percent of patients optimally debulked and toxicity in patients treated with this strategy. METHODS Women with adenocarcinoma by biopsy or cytology with stage III/IV (pleural effusions only) epithelial ovarian, fallopian tube or primary peritoneal carcinoma that presented with bulky disease were treated with neoadjuvant intravenous (IV) paclitaxel 175 mg/m2 and carboplatin AUC 6 q 21 daysx3 cycles followed by surgery (if >/=50% decrease in CA125). If optimally debulked they received IV paclitaxel 175 mg/m2 and IP carboplatin AUC 5 (day 1) and IP paclitaxel 60 mg/m2 (day 8) q 28 daysx6 cycles. RESULTS Sixty-two patients were registered. Four were ineligible. Fifty-six were evaluated for neoadjuvant chemotherapy toxicities. One patient died of pneumonia. Five patients had grade 4 toxicity, including neutropenia (3), anemia, leukopenia, anorexia, fatigue, muscle weakness, respiratory infection, and cardiac ischemia. Thirty-six patients had debulking surgery. Two had grade 4 hemorrhage. Twenty-six patients received post-cytoreduction chemotherapy. Four had grade 4 neutropenia. At a median follow-up of 21 months, median PFS is 21 months and median OS is 32 months for all 58 patients. PFS and OS for the 26 patients who received IV/IP chemotherapy is 29 and 34 months respectively. CONCLUSIONS These results compare favorably with other studies of sub-optimally debulked patients.
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Affiliation(s)
- Amy D Tiersten
- New York University Cancer Center, 160 E. 34 St., New York, NY 10016, USA.
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