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Hsu FM, Huang TC, Guo JC, Hsu CH, Lee JM, Huang PM, Chang YL, Cheng JCH. A Prospective Study of Bevacizumab and Neoadjuvant Concurrent Chemoradiation in Locally Advanced Esophageal Squamous Cell Carcinoma: Paradoxical Increase in Circulating Vascular Endothelial Growth Factor-A and Effect on Outcome. Int J Radiat Oncol Biol Phys 2023; 117:e302-e303. [PMID: 37785104 DOI: 10.1016/j.ijrobp.2023.06.2320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In the prior prospective biomarker study, high serum vascular endothelial growth factor-A (VEGF-A) was associated with a poor prognosis. We conducted a prospective phase II trial of adding Bevacizumab, an anti-VEGF-A monoclonal antibody, to neoadjuvant concurrent chemoradiation (neoCCRT) for patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC). This prospective biomarker study aims to evaluate the expressions of angiogenesis-associated circulating biomarkers before and after neoCCRT and compare clinical outcomes for patients receiving platinum/5-fluorouracil (PF) with or without Bevacizumab. MATERIALS/METHODS Patients with biopsy-proven resectable non-T4 LA-ESCC were enrolled for the prospective phase II trial investigating PF-neoCCRT plus Bevacizumab (BPF group). A parallel patient cohort enrolled in a prospective biomarker study receiving PF-neoCCRT was included in the present analysis as the control group (PF group). Radiotherapy was delivered with 40 Gy in 20 fractions. All patients had restaging workups after enoCCRT and underwent radical esophagectomy if the disease remained resectable. Serums were collected before and after neoCCRT. The serum concentrations of angiogenesis-associated biomarkers were determined by the multiplex enzyme-linked immunosorbent assay. Survival analyses were performed by the Kaplan-Meier method. The t-test and log-rank test were used to compare differences in biomarker expression and survival between groups. RESULTS From 2016 to 2019, 43 patients (BPF/PF group: 21/22) were enrolled in the study. Twenty patients in each group had serum samples available for biomarker analysis. 15 out of 21 patients in the BPF group and 20 out of 22 patients in the PF group underwent radical esophagectomy. Six patients in the BPF group and nine patients in the PF group achieved pathological complete responses. The median overall survival for the BPF and PF group was 20.8 months and not-reached, respectively (hazard ratio = 1.33, long rank p = 0.58). In the BPF group, the serum VEGF-A level was significantly increased from an average value of 446 pg/mL to 723 pg/mL after neoCCRT (p = 0.037), while its level was decreased from 815 ng/mL to 380 pg/mL in the PF group (p = 0.104). In addition, the expression value of circulating Angiopoietin-1 was not changed in the BPF group (before neoCCRT, mean value = 828 pg/mL; after neoCCRT, mean value 762 pg/mL, p = 0.67). In contrast, serum Angiopoietin-1 level was reduced from an average value of 659 pg/mL before neoCCRT to 271 pg/mL after neoCCRT (p = 0.002) in the PF group. CONCLUSION The addition of Bevacizumab to PF-neoCCRT did not improve pathological or survival outcomes in patients with resectable LA-ESCC. Adding a single dose of Bevacizumab paradoxically increases circulating VEGF-A while maintaining the Angiopoietin-1 serum level after neoCCRT. Further investigation by using additional VEGF-A inhibition may be required to achieve sustained angiogenesis blocked for tumor control.
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Affiliation(s)
- F M Hsu
- Department of Radiation Oncology, National Taiwan University Cancer Center, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - T C Huang
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - J C Guo
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - C H Hsu
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - J M Lee
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - P M Huang
- Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Y L Chang
- Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan
| | - J C H Cheng
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan; Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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Harhash AA, Kluge MA, Muthukrishnan A, Noc M, Radsel P, Jentzer JC, Seder DB, Lee K, Lotun K, Stub D, Hsu CH, Kern KB. Coronary angiographic findings for out-of-hospital cardiac arrest survivors presenting with nonshockable rhythms and no ST elevation post resuscitation. Resuscitation 2022; 178:63-68. [PMID: 35870556 DOI: 10.1016/j.resuscitation.2022.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/27/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Recent guidelines suggest that coronary angiography (CAG) should be considered for out-of-hospital cardiac arrest (OHCA) survivors, including those without ST elevation (STE) and without shockable rhythms. However, there is no prospective data to support CAG for survivors with nonshockable rhythms and no STE post resuscitation. METHODS This was a re-analysis of the PEARL study (randomized OHCA survivors without STE to early CAG versus not). Patients were subdivided by initial rhythm as nonshockable (Nsh) vs shockable (Sh). The primary outcome was coronary angiographic evidence of acute culprit lesion, with secondary outcomes being survival to hospital discharge and neurological recovery. RESULTS The PEARL study included 99 patients with OHCA from a presumed cardiac etiology, 24 with nonshockable and 75 with shockable rhythms. There was no difference in the frequency of CAG between the two groups [71% (Nsh) and 75% (Sh); p = 0.79], presence of CAD [81% (Nsh) and 68% (sh); p = 0.37, or culprit lesions identified in each group [50% (Nsh) and 45% (Sh); p = 0.78. Nonshockable patients had worse discharge survival [33% (Nsh) vs 57% (Sh); p = 0.04] and those survived, had worse neurological recovery [30% (Nsh) vs 54% (Sh); p = 0.02] compared to shockable patients. CONCLUSIONS OHCA survivors presenting with nonshockable rhythms and no STE post resuscitation had similar prevalence of culprit coronary lesions to those with shockable rhythms. CAG may be considered in patients with OHCA without STE regardless of initial presenting rhythm. There was no benefit of emergent CAG both in shockable and non-shockable rhythms.
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Affiliation(s)
- A A Harhash
- University of Vermont Medical Center, Burlington, VT, United States
| | - M A Kluge
- University of Vermont Medical Center, Burlington, VT, United States
| | - A Muthukrishnan
- University of Vermont Medical Center, Burlington, VT, United States
| | - M Noc
- Center for Intensive Medicine, University Medical Center Ljubljana, Slovenia
| | - P Radsel
- Center for Intensive Medicine, University Medical Center Ljubljana, Slovenia
| | - J C Jentzer
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States
| | - D B Seder
- Department of Critical Care Services, Maine Medical Center, ME, United States
| | - K Lee
- University of Arizona Sarver Heart Center, Tucson, AZ, United States
| | - K Lotun
- University of Arizona Sarver Heart Center, Tucson, AZ, United States
| | - D Stub
- Alfred Hospital & Monash University, Melbourne, Australia
| | - C-H Hsu
- University of Arizona Sarver Heart Center, Tucson, AZ, United States
| | - K B Kern
- University of Arizona Sarver Heart Center, Tucson, AZ, United States.
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Cao Y, Qin S, Luo S, Li Z, Cheng Y, Fan Y, Sun Y, Yin X, Yuan X, Li W, Liu T, Hsu CH, Lin X, Kim SB, Kojima T, Zhang J, Lee SH, Bai Y, Muro K, Doi T, Bai C, Gu K, Pan HM, Bai L, Yang JW, Cui Y, Lu W, Chen J. Pembrolizumab versus chemotherapy for patients with esophageal squamous cell carcinoma enrolled in the randomized KEYNOTE-181 trial in Asia. ESMO Open 2021; 7:100341. [PMID: 34973513 DOI: 10.1016/j.esmoop.2021.100341] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 08/25/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND In the randomized phase III KEYNOTE-181 study, pembrolizumab prolonged overall survival (OS) compared with chemotherapy as second-line therapy in patients with advanced esophageal cancer and programmed death-ligand 1 (PD-L1) combined positive score (CPS) ≥10. We report a post hoc subgroup analysis of patients with esophageal squamous cell carcinoma (ESCC) enrolled in KEYNOTE-181 in Asia, including patients from the KEYNOTE-181 China extension study. PATIENTS AND METHODS Three hundred and forty Asian patients with advanced/metastatic ESCC were enrolled in KEYNOTE-181, including the China cohort. Patients were randomly assigned 1 : 1 to receive pembrolizumab 200 mg every 3 weeks for ≤2 years or investigator's choice of paclitaxel, docetaxel, or irinotecan. OS, progression-free survival, response, and safety were analyzed without formal comparisons. OS was evaluated based on PD-L1 CPS expression level. RESULTS In Asian patients with ESCC, median OS was 10.0 months with pembrolizumab and 6.5 months with chemotherapy [hazard ratio (HR), 0.63; 95% CI 0.50-0.80; nominal P < 0.0001]. Median progression-free survival was 2.3 months with pembrolizumab and 3.1 months with chemotherapy (HR, 0.79; 95% CI 0.63-0.99; nominal P = 0.020). Objective response rate was 17.1% with pembrolizumab and 7.1% with chemotherapy; median duration of response was 10.5 months and 7.7 months, respectively. In patients with PD-L1 CPS <1 tumors (pembrolizumab versus chemotherapy), the HR was 0.99 (95% CI 0.56-1.72); the HR (95% CI) for death was better for patients with PD-L1 CPS cut-offs >1 [CPS ≥1, 0.57 (0.44-0.75); CPS ≥5, 0.56 (0.41-0.76); CPS ≥10, 0.53 (0.37-0.75)]. Treatment-related adverse events were reported in 71.8% of patients in the pembrolizumab group and 89.8% in the chemotherapy group; grade 3-5 events were reported in 20.0% and 44.6%, respectively. CONCLUSIONS Pembrolizumab monotherapy demonstrated promising efficacy in Asian patients with ESCC, with fewer treatment-related adverse events than chemotherapy. PD-L1 CPS ≥1 is an appropriate cut-off and a predictive marker of pembrolizumab efficacy in Asian patients with ESCC.
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Affiliation(s)
- Y Cao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing, China.
| | - S Qin
- PLA Cancer Centre of Nanjing Bayi Hospital, Nanjing, China
| | - S Luo
- The Affiliated Tumor Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Z Li
- Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Y Cheng
- Jilin Cancer Hospital, Jilin, China
| | - Y Fan
- Cancer Hospital of University of Chinese Academy of Sciences, Institute of Cancer and Basic Medicine of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Y Sun
- The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, and The Affiliated Hospital of Anhui Medical University, Hefei, China
| | - X Yin
- Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - X Yuan
- Tongji Hospital, Wuhan, China
| | - W Li
- Hubei Cancer Hospital, Wuhan, China
| | - T Liu
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - C-H Hsu
- National Taiwan University Hospital, Taipei, Taiwan
| | - X Lin
- Fujian Medical University Union Hospital, Fuzhou, China
| | - S-B Kim
- Asan Medical Center, Seoul, South Korea
| | - T Kojima
- National Cancer Center Hospital East, Kashiwa, Japan
| | - J Zhang
- Ruijin Hospital, Shanghai, China
| | - S-H Lee
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y Bai
- Harbin Medical University Cancer Hospital, Harbin, China
| | - K Muro
- Aichi Cancer Center Hospital, Nagoya, Japan
| | - T Doi
- National Cancer Center Hospital East, Kashiwa, Japan
| | - C Bai
- Peking Union Medical College Hospital, Beijing, China
| | - K Gu
- The First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China
| | - H-M Pan
- Sir Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - L Bai
- Chinese PLA General Hospital, Beijing, China
| | - J-W Yang
- Fujian Province Cancer Hospital, Fuzhou, China
| | - Y Cui
- MSD China, Shanghai, China
| | - W Lu
- MSD China, Shanghai, China
| | - J Chen
- Jiangsu Cancer Hospital, Nanjing, China
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Hsu CH, Chen YL, Hsieh CH, Liang YJ, Liu SH, Pei D. Hemogram-based decision tree for predicting the metabolic syndrome and cardiovascular diseases in the elderly. QJM 2021; 114:363-373. [PMID: 32573729 DOI: 10.1093/qjmed/hcaa205] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/17/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aimed to build a hemogram-based decision tree to evaluate the association between current probability of metabolic syndrome (MetS) and prediction of future hypertension, type 2 diabetes and cardiovascular diseases (CVD) risk. METHODS A total of 40 395 elder participants (≥60 years) were enrolled in a standard health examination program in Taiwan from January 1999 to December 2014. A decision tree classification of the presence or absence of MetS at baseline, using age, sex and hemogram (white blood cell, hemoglobin and platelet) as independent variables, was conducted for the randomly assigned training (70%) and validation (30%) groups. Participants without MetS at baseline (n = 25 643) were followed up to observe whether they developed MetS, hypertension, type 2 diabetes or CVD in the future. RESULTS Modest accuracy of the decision tree in the training and validation groups with area under the curves of 0.653 and 0.652, respectively, indicated an acceptable generalizability of results. The predicted probability of baseline MetS was obtained from decision tree analysis. Participants without MetS at baseline were categorized into three equally sized groups according to the predicted probability. Participants in the third tertile had significantly higher risks of future MetS (hazard ratio 1.40, 95% confidence interval 1.25-1.58); type 2 diabetes (1.46, 1.17-1.83); hypertension (1.14, 1.01-1.28); and CVD (1.21, 1.01-1.44), compared with those in the first tertile. CONCLUSIONS Execution of hemogram-based decision tree analysis can assist in early identification and prompt management of elderly patients at a high risk of future hypertension, type 2 diabetes and CVD.
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Affiliation(s)
- C-H Hsu
- From the Department of Family Medicine
- Department of Geriatric Medicine, Center for Geriatrics and Gerontology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wenchang Rd., Shilin Dist., Taipei City 111, Taiwan
- Department of Family Medicine, Cardinal Tien Hospital, No.362, Zhongzheng Rd., Xindian Dist., New Taipei City 231, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, 510 Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242, Taiwan
| | - Y-L Chen
- School of Medicine, College of Medicine, Fu Jen Catholic University, 510 Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242, Taiwan
- Department of Pathology, Cardinal Tien Hospital, No.362, Zhongzheng Rd., Xindian Dist., New Taipei City 231, Taiwan
| | - C-H Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Neihu Dist., Taipei City 114, Taiwan
| | - Y-J Liang
- Department of Life Science, Graduate Institute of Applied Science and Engineering, College of Science and Engineering, Fu Jen Catholic University, 510 Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242, Taiwan
| | - S-H Liu
- School of Nursing, College of Nursing, National Taipei University of Nursing and Health Science, No. 365, Mingde Rd., Beitou Dist., Taipei City 112, Taiwan
| | - D Pei
- School of Medicine, College of Medicine, Fu Jen Catholic University, 510 Zhongzheng Rd., Xinzhuang Dist., New Taipei City 242, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Fu Jen Catholic University Hospital, No. 69, Guizi Rd., Taishan Dist., New Taipei City 243, Taiwan
- Department of Internal Medicine, Cardinal Tien Hospital, No.362, Zhongzheng Rd., Xindian Dist., New Taipei City 231, Taiwan
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Taylor-Piliae R, Morrison H, Hsu CH, Grandner M. Changes in symptoms, sleep, oxidative stress, and inflammatory markers among community-dwelling stroke survivors after a tai chi exercise intervention. Eur J Cardiovasc Nurs 2021. [DOI: 10.1093/eurjcn/zvab060.075] [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: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Laurence B. Emmons Research Award
Background
Depression is prevalent among one-third to two-thirds of stroke survivors. Despite the availability of pharmacotherapies and/or psychotherapies, depression persists, even 5-10 years post-stroke, reflecting limited treatment responses and/or adherence to this conventional care. Mind-body interventions are commonly used among adults to ameliorate depressive symptoms, thus we investigated the feasibility of Tai Chi, alongside conventional care, to manage post-stroke depression.
Purpose
Describe changes in symptoms of depression, anxiety and stress, sleep, oxidative stress, and inflammatory markers post-intervention among community-dwelling stroke survivors with depressive symptoms.
Methods
In this feasibility study, a single-group pre-post intervention design was used. Due to COVID-19, participants attended a 1-hour Tai Chi exercise class three times per week for 8 weeks, instead of the planned 12-weeks. Symptoms of depression, anxiety and stress were assessed using standardized questionnaires (Center for Epidemiological Studies Depression scale, CESD; Generalized Anxiety Disorder Assessment; Perceived Stress Scale), objective sleep was assessed via a research-grade triaxial accelerometer (ActiGraph GT9X), and blood samples were taken to assess oxidative stress (plasma superoxide dismutase, SOD) and inflammatory markers (serum tumor necrosis factor-alpha, interleukin-6, interleukin-10). Pre-post intervention changes were assessed using paired t-tests.
Results
Community-dwelling stroke survivors (N = 11) on average 69.7 ± 9.3 years old, mainly retired (73%, n = 8), married men (55%, n = 6) with >13 years education (91%, n = 10), reporting depression symptoms (CESD = 17.3 ± 11.4) and 55% taking anti-depressant medications, enrolled. The majority of participants reported having an ischemic stroke (82%, n = 9) with hemiparesis (55%, n = 6), but were able to walk 15 feet without assistance (91%, n = 10). After the Tai Chi intervention, we observed significant reductions in symptoms of depression (-5.3 ± 5.9, p = 0.01), anxiety (-2.2 ± 2.4, p = 0.01) and stress (-4.6 ± 4.8, p = 0.01); along with better sleep efficiency (+1.8 ± 1.8, p = 0.01), less wakefulness after sleep onset (-9.3 ± 11.6, p = 0.04), and less time awake (-9.3 ± 11.6, p = 0.04). In addition, there was a 36% decrease in SOD activity (p = 0.02) indicative of a decreased oxidative environment post-intervention; though no significant changes in any of the inflammatory markers were found (all p-values >0.05).
Conclusion
Symptoms of depression, anxiety and stress were observed in these community-dwelling stroke survivors along with sub-optimal sleep. Among community-dwelling stroke survivors, Tai Chi exercise is a feasible intervention that can be used alongside conventional care to manage post-stroke depression and may also aid in reducing symptoms of anxiety and stress, and improve sleep. Further research is needed with rigorous study designs and larger samples, before widespread recommendations can be made.
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Affiliation(s)
| | - H Morrison
- University of Arizona, Tucson, United States of America
| | - C-H Hsu
- University of Arizona, Tucson, United States of America
| | - M Grandner
- University of Arizona, Tucson, United States of America
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Algotar AM, Kumar R, Babiker HM, Dougherty ST, Hsu CH, Chow HH, Smith TE, Marrero DG, Courneya KS, Abraham I, Ligibel JA, Thomson CA. Protocol for a feasibility and early efficacy study of the Comprehensive Lifestyle Improvement Program for Prostate Cancer-2 (CLIPP2). Contemp Clin Trials Commun 2021; 21:100701. [PMID: 33511299 PMCID: PMC7815988 DOI: 10.1016/j.conctc.2021.100701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/18/2020] [Accepted: 01/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background Although androgen deprivation therapy (ADT) for prostate cancer demonstrates improved overall and disease-free survival, it is associated with adverse effects such as obesity and metabolic syndrome that increase risk of cardiometabolic disease and diabetes type 2. ADT also leads to fatigue, depression and erectile dysfunction, which reduce quality of life (QoL). Lifestyle modification has shown promise in reducing obesity, metabolic syndrome and diabetes type 2 in other disease types. However, there is a paucity of data regarding the utility of lifestyle modification in men receiving ADT for prostate cancer. Methods The primary aim of the Comprehensive Lifestyle Improvement Program for Prostate Cancer-2 (CLIPP2) is to test the feasibility of conducting a 24-week lifestyle modification intervention in men on ADT for prostate cancer. Additionally, it will also determine the effect of this intervention on weight loss, cardiometabolic markers (secondary aim and markers of interest: serum glucose, insulin resistance, hemoglobin A1C and lipid panel), and QoL (tertiary aim). The intervention will be delivered weekly via telephone for the first 10 weeks and bi-weekly for the remaining 14 weeks. Questionnaires and serum samples will be collected at baseline, week 12, and week 24. Anthropometric measurements will be collected at baseline, week 6, week 12, week 18 and week 24. Results We hypothesize that the CLIPP2 intervention will produce a 7% weight loss that will result in improved markers associated with cardiometabolic disease and type 2 diabetes in the study population. Conclusion Results will provide insight into the role of lifestyle modification in addressing ADT adverse effects as well as provide preliminary data to inform the development of future lifestyle interventions in this area. Trial registration NCT04228055 Clinicaltrials. gov.
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Affiliation(s)
- A M Algotar
- Department of Family and Community Medicine, University of Arizona, USA.,The University of Arizona Cancer Center, USA
| | - R Kumar
- Radiation Oncology, Banner MD Anderson Cancer Center, USA
| | - H M Babiker
- The University of Arizona Cancer Center, USA.,Department of Hematology-Oncology, University of Arizona, USA
| | - S T Dougherty
- The University of Arizona Cancer Center, USA.,Department of Radiation Oncology, University of Arizona, USA
| | - C H Hsu
- The University of Arizona Cancer Center, USA.,Department of Epidemiology and Biostatistics, Mel and Enid College of Public Health, University of Arizona, USA
| | - H-H Chow
- The University of Arizona Cancer Center, USA
| | - T E Smith
- Department of Family and Community Medicine, University of Arizona, USA
| | - D G Marrero
- Department of Health Promotion Science, Mel and Enid College of Public Health, University of Arizona, USA
| | - K S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Canada
| | - I Abraham
- Department of Family and Community Medicine, University of Arizona, USA.,College of Pharmacy, University of Arizona, USA
| | - J A Ligibel
- Dana Farber Cancer Institute, Harvard Medical School, USA
| | - C A Thomson
- The University of Arizona Cancer Center, USA.,Department of Health Promotion Science, Mel and Enid College of Public Health, University of Arizona, USA
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Wu CC, Hsu CH, Hsu CW. Endoscopic submucosal dissection strategy for laterally spreading tumour involving appendiceal orifice - a video vignette. Colorectal Dis 2020; 22:1760-1761. [PMID: 32396684 DOI: 10.1111/codi.15119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/12/2020] [Indexed: 02/08/2023]
Affiliation(s)
- C-C Wu
- Division of Colorectal Surgery, Kaohsiung Veteran General Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - C-H Hsu
- Division of Colorectal Surgery, Kaohsiung Veteran General Hospital, Kaohsiung, Taiwan
| | - C-W Hsu
- Division of Colorectal Surgery, Kaohsiung Veteran General Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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Lee MS, Ryoo BY, Hsu CH, Numata K, Stein S, Verret W, Hack SP, Spahn J, Liu B, Abdullah H, Wang Y, He AR, Lee KH, Bang YJ, Bendell J, Chao Y, Chen JS, Chung HC, Davis SL, Dev A, Gane E, George B, He AR, Hochster H, Hsu CH, Ikeda M, Lee J, Lee M, Mahipal A, Manji G, Morimoto M, Numata K, Pishvaian M, Qin S, Ryan D, Ryoo BY, Sasahira N, Stein S, Strickler J, Tebbutt N. Atezolizumab with or without bevacizumab in unresectable hepatocellular carcinoma (GO30140): an open-label, multicentre, phase 1b study. Lancet Oncol 2020. [DOI: 10.1016/s1470-2045(20)30156-x 10.1016/s1470-2045(20)30156-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Chen LT, Martinelli E, Cheng AL, Pentheroudakis G, Qin S, Bhattacharyya GS, Ikeda M, Lim HY, Ho GF, Choo SP, Ren Z, Malhotra H, Ueno M, Ryoo BY, Kiang TC, Tai D, Vogel A, Cervantes A, Lu SN, Yen CJ, Huang YH, Chen SC, Hsu C, Shen YC, Tabernero J, Yen Y, Hsu CH, Yoshino T, Douillard JY. Pan-Asian adapted ESMO Clinical Practice Guidelines for the management of patients with intermediate and advanced/relapsed hepatocellular carcinoma: a TOS-ESMO initiative endorsed by CSCO, ISMPO, JSMO, KSMO, MOS and SSO. Ann Oncol 2020; 31:334-351. [PMID: 32067677 DOI: 10.1016/j.annonc.2019.12.001] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [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: 08/07/2019] [Revised: 11/18/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of hepatocellular carcinoma (HCC) was published in 2018, and covered the diagnosis, management, treatment and follow-up of early, intermediate and advanced disease. At the ESMO Asia Meeting in November 2018 it was decided by both the ESMO and the Taiwan Oncology Society (TOS) to convene a special guidelines meeting immediately after the Taiwan Joint Cancer Conference (TJCC) in May 2019 in Taipei. The aim was to adapt the ESMO 2018 guidelines to take into account both the ethnic and the geographic differences in practice associated with the treatment of HCC in Asian patients. These guidelines represent the consensus opinions reached by experts in the treatment of patients with intermediate and advanced/relapsed HCC representing the oncology societies of Taiwan (TOS), China (CSCO), India (ISMPO) Japan (JSMO), Korea (KSMO), Malaysia (MOS) and Singapore (SSO). The voting was based on scientific evidence, and was independent of the current treatment practices, the drug availability and reimbursement situations in the individual participating Asian countries.
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Affiliation(s)
- L-T Chen
- National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan; Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - E Martinelli
- Department of Clinical and Experimental Medicine 'F Magrassi' - Medical Oncology, Università degli Studi della Campania L Vanvitelli, Naples, Italy
| | - A-L Cheng
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan; Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - G Pentheroudakis
- Department of Medical Oncology, University of Ioannina, Ioannina, Greece
| | - S Qin
- Chinese PLA Cancer Center, Jinling Hospital, Nanjing, China
| | | | - M Ikeda
- Department of Hepatobiliary & Pancreatic Oncology, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Japan
| | - H-Y Lim
- Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - G F Ho
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - S P Choo
- Curie Oncology, Singapore; National Cancer Centre Singapore, Singapore, Singapore
| | - Z Ren
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - H Malhotra
- Department of Medical Oncology, Sri Ram Cancer Center, Mahatma Gandhi Medical College Hospital, Jaipur, India
| | - M Ueno
- Department of Gastroenterology, Hepatobiliary and Pancreatic Medical Oncology Division, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - B-Y Ryoo
- Department of Oncology, Asan Medical Center University of Ulsan College of Medicine, Seoul, South Korea
| | - T C Kiang
- Hospital Umum Sarawak, Kuching, Sarawak, Malaysia
| | - D Tai
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - A Vogel
- Department of Gastroenterology, Hepatology and Endocrinology, Medical School Hannover, Hannover, Germany
| | - A Cervantes
- CIBERONC, Department of Medical Oncology, Institute of Health Research, INCLIVIA, University of Valencia, Valencia, Spain
| | - S-N Lu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - C-J Yen
- Department of Internal Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Y-H Huang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - S-C Chen
- Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - C Hsu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Y-C Shen
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - J Tabernero
- Medical Oncology Department, Vall d' Hebron University Hospital and Institute of Oncology (VHIO), UVic, IOB-Quiron, Barcelona, Spain
| | - Y Yen
- Taipei Medical University, Taipei, Taiwan
| | - C-H Hsu
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - T Yoshino
- Department of Hepatobiliary & Pancreatic Oncology, National Cancer Center Hospital East, Kashiwanoha, Kashiwa, Japan
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10
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Liu IL, Tsai CH, Hsu CH, Hu JM, Chen YC, Tian YF, You SL, Chen CY, Hsiao CW, Lin CY, Chou YC, Sun CA. Helicobacter pylori infection and the risk of colorectal cancer: a nationwide population-based cohort study. QJM 2019; 112:787-792. [PMID: 31250012 DOI: 10.1093/qjmed/hcz157] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 05/30/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The role of Helicobacter pylori (H. pylori) infection in the development of colorectal neoplasia has been a matter of scientific debate with controversial findings. AIMS This study examined the association between H. pylori infection and colorectal cancer (CRC) in a nationwide population-based Chinese cohort study. METHODS A total of approximately 3936 individuals with newly diagnosed H. pylori infection (the H. pylori-infected cohort) and 15 744 age- and sex-matched patients with diagnoses absence of H. pylori infection (the comparison cohort) from 2000 to 2005 were identified from Taiwan's National Health Insurance Research Database. The Kaplan-Meier method was used for measuring the cumulative incidence of CRC in each cohort. Cox proportional hazards models were used to compute hazard ratios (HRs) and accompanying 95% confidence intervals (CIs) for the estimation of the association between H. pylori infection and CRC. RESULTS The cumulative incidence of CRC was higher in H. pylori-infected cohort than that in the comparison cohort (log-rank test, P < 0.001). After adjustment for potential confounders, H. pylori infection was associated with a significantly increased risk of CRC (adjusted HR 1.87; 95% CI 1.37-2.57). In addition, the HR of CRC appeared to increase with increasing frequency of clinical visits for H. pylori infection. CONCLUSIONS Our study demonstrated that H. pylori infection was associated with an increased risk of CRC, which warrants confirmation and exploration of the underlying biologic mechanisms by future studies.
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Affiliation(s)
- I-L Liu
- Graduate Institute of Life Sciences, National Defense Medical Center
| | - C-H Tsai
- School of Public Health, National Defense Medical Center
| | - C-H Hsu
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 161, Section 6, Minquan East Road, Neihu District, Taipei City 114, Taiwan, Republic of China
- Teaching Office, Tri-Service General Hospital, National Defense Medical Center
| | - J-M Hu
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 161, Section 6, Minquan East Road, Neihu District, Taipei City 114, Taiwan, Republic of China
- Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Chenggong Road, Neihu District, Taipei City 114, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, No. 161, Section 6, Minquan East Road, Neihu District, Taipei City 114, Taiwan, Republic of China
| | - Y-C Chen
- Department of Medicine, College of Medicine, Fu-Jen Catholic University
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City, Taiwan, Republic of China
| | - Y-F Tian
- Division of General Surgery, Department of Surgery, Chi-Mei Hospital, No. 901, Zhonghua Road, Yongkang District, Tainan, Taiwan, Republic of China
| | - S-L You
- Department of Medicine, College of Medicine, Fu-Jen Catholic University
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City, Taiwan, Republic of China
| | - C-Y Chen
- Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Chenggong Road, Neihu District, Taipei City 114, Taiwan, Republic of China
- School of Medicine, National Defense Medical Center, No. 161, Section 6, Minquan East Road, Neihu District, Taipei City 114, Taiwan, Republic of China
| | - C-W Hsiao
- Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Chenggong Road, Neihu District, Taipei City 114, Taiwan, Republic of China
| | - C-Y Lin
- Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Taichung, Taiwan, Republic of China
| | - Y-C Chou
- Graduate Institute of Life Sciences, National Defense Medical Center
- School of Public Health, National Defense Medical Center
| | - C-A Sun
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City, Taiwan, Republic of China
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, No. 510, Zhongzheng Road, Xinzhuang District, New Taipei City, Taiwan, Republic of China
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11
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Ho TH, Yang FC, Lin JC, Hsu CH, Lee JT. Sturge-Weber syndrome. QJM 2019; 112:299. [PMID: 30357409 DOI: 10.1093/qjmed/hcy246] [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] [Indexed: 11/14/2022] Open
Affiliation(s)
- T-H Ho
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - F-C Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - J-C Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - C-H Hsu
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - J-T Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China
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12
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Huff AJ, Gomez J, Calhoun E, Hsu CH, Chalasani P, Fitzpatrick K, Borders M, Lang L, Prado Y. Abstract P5-13-19: Addressing non-adherence for breast cancer screening across ethnicity in southern Arizona. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-13-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background In Arizona, female breast cancer has the highest incidence rate and the second highest death rate compared to all other cancers. This ongoing single arm intervention study investigates non-adherence with recommended annual mammography or follow-up breast imaging. Data collected for this study is both retrospective, using the university Electronic Health Record (EHR) system (January 1, 2014 to September 30, 2017), and prospective, implementing a questionnaire during the intervention phase. Potential study participants were identified using EHR and categorized by BI-RADS (Breast Imaging-Reporting and Data System) 0 to 5. With IRB approval from University of Arizona, we designed a questionnaire to measure barriers to adherence and we navigate participants to schedule and attend follow-up appointments. This study's overall specific aims are to increase first time mammography screening by 25% among women in Southern Arizona; increase adherence or repeat screening rate by 20% among women lost to follow-up; establish the framework for a community- academic partnership in ethnically diverse areas. Women, age 40 and older who are not compliant with recommended annual mammograms or recommended follow-up screenings after a suspicious finding are eligible to participate in this study. Men and children, as well as women for whom breast imaging is not recommended are excluded from participating in this study. Results Patient's age was summarized by mean ± standard deviation for continuous variables and frequency and the associated percentage for categorical variables. BI-RADS scores were classified into Negative, Benign, Possible Malignancy and Proven Malignancy and compared between ethnic and racial groups using Fisher's exact test. Of 8823 non-compliant woman over nearly 4 years of data, 0.2% are BI-RADS 4 and 5, 2.2% are BI-RADS 3, 96% are BI-RADS 1 and 2, and 0.3% are BI-RADS 0. The mean age is 61.59 years, with 25% reporting as Hispanic, 66% reporting as non-Hispanic women (NHW), and 10% preferring to receive care in Spanish. Initial data shows only .24% with proven malignancies. Further, the data reveals that Hispanics have a slightly higher rate of possible malignancy (.36%) than NHW (.18%); however, NHW show a slightly higher rate of proven malignancy (.27% compared to .18%, respectively). Discussion These data provide valuable information for the direction of this study; in particular, understanding the disparity between Hispanic and NHW malignancies and developing culturally competent interventions and education materials to increase compliance with breast cancer screening recommendations. Further, these data indicate our focus should be on screening compliance for BI-RADS 1 and 2. These data also point to a possible high non-compliance issue. Comparing non-compliance data from other regional clinics will continue to shape this study's direction. The target sample size for this study is 300 participants. We accept a 95% confidence level and a 5% margin of error. Out of 420 recruitment letters mailed, the navigators have reached 152 potential participants by phone and have a 26% study recruitment rate (n=40).
Citation Format: Huff AJ, Gomez J, Calhoun E, Hsu C-H, Chalasani P, Fitzpatrick K, Borders M, Lang L, Prado Y. Addressing non-adherence for breast cancer screening across ethnicity in southern Arizona [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-13-19.
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Affiliation(s)
- AJ Huff
- University of Arizona, Tucson, AZ
| | - J Gomez
- University of Arizona, Tucson, AZ
| | | | - C-H Hsu
- University of Arizona, Tucson, AZ
| | | | | | | | - L Lang
- University of Arizona, Tucson, AZ
| | - Y Prado
- University of Arizona, Tucson, AZ
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13
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Komenaka IK, Cocco D, Huliyar R, Hsu CH, Martinez ME, Gago M, Nodora J, Mehta D, Caruso DM. Abstract P5-13-08: Association of tumor infiltrating lymphocytes and chemotherapy regimen in response to preoperative chemotherapy in underserved patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-13-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Preoperative chemotherapy can demonstrate an individual's response to the chemotherapeutic regimen by comparing the amount of cancer at presentation to the amount remaining after treatment. Multiple previous studies have demonstrated that the amount of residual cancer, or final pathologic stage, is a better indicator of prognosis than the initial stage at presentation.
Tumor infiltrating lymphocytes have been recognized in breast cancer, and when found concentrated in breast cancer specimens, have been associated with a good prognosis. Breast cancer is not only a heterogeneous disease, but also displays varied presentation and behavior in patients of different race/ethnicities.
This study was performed to evaluate factors which predict response to chemotherapy. The effectiveness of different chemotherapeutic regimens, the effect of breast cancer subtype, and tumor infiltrating lymphocytes (TILs) were evaluated in our racial/ethnic minority population.
Methods
All patients at the safety net institution in Phoenix, AZ who underwent preoperative chemotherapy from 2002 to 2017 and had tissue available for evaluation were included in the study. Response to chemotherapy regimen was recorded. Pathologic complete response (pCR) was defined as no invasive cancer in the breast and lymph nodes in the final pathologic specimen. Breast cancer subtypes were divided based on IHC and FISH testing. Luminal subtypes were classified based on Ki67 (>15%) and/or PR (<20%) for Luminal B. Her2 subtype was defined as Her2 IHC 3+ or Her2 FISH amplified. Triple negative breast cancer (TNBC) was defined as ER and PR (<5%) and Her2 negative. TILs concentration was determined from fixed formalin paraffin embedded (FFPE) core needle biopsy specimens.
Results
A total of 259 patients were included in the study. The mean age was 45 years. 80% of the population were racial/ethnic minorities. The vast majority (94%) were underinsured or uninsured, with 75% uninsured. The mean clinical tumor size at presentation was 6cm. 52% presented at clinical stage 2 while 48% presented at clinical stage 3. The overall pCR rate was 32%. pCR rate was impacted by breast cancer subtype with TNBC 52% and Her2 38% showing a better response to chemotherapy, while Luminal B was 16% and Luminal A 2% (p < 0.05). In TNBC, chemotherapy regimens with anthracycline and docetaxel may have improved efficacy with pCR of 56% (p = 0.05). In the subgroup available for TIL evaluation, breast cancer subtype appeared to show similar importance with pathologic complete response rates of TNBC 50%, Her2 44%, Luminal B 12%, and Luminal A 0%. TIL appeared to affect the likelihood of pCR. When TIL were less than 5% the pCR rate was 16% compared to when there were TIL of at least 5% or more the pCR rate was 41% (p < 0.05).
Conclusions
In our racial/ethnic minority population, breast cancer subtype and chemotherapy regimen did affect likelihood of pathologic complete response. Tumor infiltrating lymphocyte concentration as low as 5% may indicate a higher likelihood of pathologic complete response and could be used as an additional factor in the evaluation of patients for preoperative therapy.
Citation Format: Komenaka IK, Cocco D, Huliyar R, Hsu C-H, Martinez ME, Gago M, Nodora J, Mehta D, Caruso DM. Association of tumor infiltrating lymphocytes and chemotherapy regimen in response to preoperative chemotherapy in underserved patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-13-08.
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Affiliation(s)
- IK Komenaka
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
| | - D Cocco
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
| | - R Huliyar
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
| | - C-H Hsu
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
| | - ME Martinez
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
| | - M Gago
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
| | - J Nodora
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
| | - D Mehta
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
| | - DM Caruso
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson; UC - San Diego, San Diego; University of Southern California, Los Angeles
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14
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Shao YY, Chen BB, Ou DL, Lin ZZ, Hsu CH, Wang MJ, Cheng AL, Hsu C. Lenalidomide as second-line therapy for advanced hepatocellular carcinoma: exploration of biomarkers for treatment efficacy. Aliment Pharmacol Ther 2017; 46:722-730. [PMID: 28815645 DOI: 10.1111/apt.14270] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/05/2017] [Accepted: 07/26/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Lenalidomide has immunomodulatory and anti-angiogenic effects and showed moderate anti-tumour efficacy in patients with. advanced hepatocellular carcinoma (HCC) AIM: To explore potential biomarkers of lenalidomide efficacy as second-line therapy for HCC. METHODS Eligible patients were diagnosed with advanced HCC, documented progression on sorafenib, and Child-Pugh class A liver function. Patients received 25 mg/day lenalidomide orally on days 1-21 every 4 weeks. The primary endpoint was 6 month progression-free survival rate. Early α-fetoprotein response was defined as a > 20% decline of α-fetoprotein levels from baseline within the first 4 weeks of treatment. Vascular response, evaluated using dynamic contrast-enhanced magnetic resonance imaging, was defined as a > 40% decline in Ktrans after 2 weeks of treatment. The percentage of peripheral blood lymphocyte subsets were also analysed. RESULTS Fifty-five patients were enrolled. The response rate was 13%, and the disease-control rate was 53%. The 6 month progression-free survival rate was 9.1%. The median progression-free and overall survival was 1.8 months and 8.9 months respectively. Early α-fetoprotein response was significantly associated with higher disease-control rate (76% vs 22%, P = .001) and longer progression-free survival (P = .020). Vascular response was not associated with any treatment outcomes. Patients with a high pre-treatment B cell percentage were more likely to have disease control (70% vs 36%, P = .010) and exhibited longer progression-free survival (P < .001) and overall survival (P = .042). CONCLUSIONS Lenalidomide exhibited moderate activity as second-line therapy for advanced HCC. Its immunomodulatory effects should be further explored (www.clinicaltrials.gov NCT01545804).
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Affiliation(s)
- Y-Y Shao
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.,National Taiwan University Cancer Center, Taipei, Taiwan.,Departments of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - B-B Chen
- Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
| | - D-L Ou
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.,National Taiwan University Cancer Center, Taipei, Taiwan
| | - Z-Z Lin
- Departments of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - C-H Hsu
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.,National Taiwan University Cancer Center, Taipei, Taiwan.,Departments of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - M-J Wang
- Departments of Oncology, National Taiwan University Hospital, Taipei, Taiwan
| | - A-L Cheng
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.,National Taiwan University Cancer Center, Taipei, Taiwan.,Departments of Oncology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - C Hsu
- Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan.,National Taiwan University Cancer Center, Taipei, Taiwan.,Departments of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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15
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Bea JW, Hsu CH, Blew RM, Irving AP, Caan BJ, Kwan ML, Abraham I, Going SB. Use of iDXA spine scans to evaluate total and visceral abdominal fat. Am J Hum Biol 2017; 30. [PMID: 28884861 DOI: 10.1002/ajhb.23057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 06/30/2017] [Accepted: 08/24/2017] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Abdominal fat may be a better predictor than body mass index (BMI) for risk of metabolically-related diseases, such as diabetes, cardiovascular disease, and some cancers. We sought to validate the percent fat reported on dual energy X-ray absorptiometry (DXA) regional spine scans (spine fat fraction, SFF) against abdominal fat obtained from total body scans using the iDXA machine (General Electric, Madison, WI), as previously done on the Prodigy model. METHODS Total body scans and regional spine scans were completed on the same day (N = 50). In alignment with the Prodigy-based study, the following regions of interest (ROI) were assessed from total body scans and compared to the SFF from regional spine scans: total abdominal fat at (1) lumbar vertebrae L2-L4 and (2) L2-Iliac Crest (L2-IC); (3) total trunk fat; and (4) visceral fat in the android region. Separate linear regression models were used to predict each total body scan ROI from SFF; models were validated by bootstrapping. RESULTS The sample was 84% female, a mean age of 38.5 ± 17.4 years, and mean BMI of 23.0 ± 3.8 kg/m2 . The SFF, adjusted for BMI, predicted L2-L4 and L2-IC total abdominal fat (%; Adj. R2 : 0.90) and total trunk fat (%; Adj. R2 : 0.88) well; visceral fat (%) adjusted R2 was 0.83. Linear regression models adjusted for additional participant characteristics resulted in similar adjusted R2 values. CONCLUSIONS This replication of the strong correlation between SFF and abdominal fat measures on the iDXA in a new population confirms the previous Prodigy model findings and improves generalizability.
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Affiliation(s)
- J W Bea
- University of Arizona Cancer Center, Tucson, Arizona 85724-5024.,Department of Medicine, College of Medicine, University of Arizona, Tucson, Arizona 85724-5024.,Department of Nutritional Sciences, University of Arizona, Tucson, Arizona 85721.,The Collaboratory for Metabolic Disease Prevention and Treatment, University of Arizona, Tucson, Arizona 85714
| | - C-H Hsu
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724
| | - R M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona 85721.,The Collaboratory for Metabolic Disease Prevention and Treatment, University of Arizona, Tucson, Arizona 85714
| | - A P Irving
- University of Arizona Cancer Center, Tucson, Arizona 85724-5024.,Department of Nutritional Sciences, University of Arizona, Tucson, Arizona 85721
| | - B J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California 94612
| | - M L Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland, California 94612
| | - I Abraham
- University of Arizona Cancer Center, Tucson, Arizona 85724-5024.,Center for Health Outcomes and PharmacoEconomic Research, University of Arizona, Tucson, Arizona 85721
| | - S B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona 85721.,The Collaboratory for Metabolic Disease Prevention and Treatment, University of Arizona, Tucson, Arizona 85714
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16
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Liao SY, Chiang CW, Hsu CH, Chen YT, Jen J, Juan HF, Lai WW, Wang YC. CK1δ/GSK3β/FBXW7α axis promotes degradation of the ZNF322A oncoprotein to suppress lung cancer progression. Oncogene 2017; 36:5722-5733. [PMID: 28581525 DOI: 10.1038/onc.2017.168] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/30/2017] [Accepted: 04/10/2017] [Indexed: 12/11/2022]
Abstract
Overexpression of Cys2His2 zinc-finger 322A (ZNF322A) oncogenic transcription factor is associated with lung tumorigenesis. However, the mechanism of ZNF322A overexpression remains poorly understood. Here, we discover that protein stability of ZNF322A is regulated by coordinated phosphorylation and ubiquitination through the CK1δ/GSK3β/FBXW7α axis. CK1δ and GSK3β kinases sequentially phosphorylate ZNF322A at serine-396 and then serine-391. Moreover, the doubly phosphorylated ZNF322A protein creates a destruction motif for the ubiquitin ligase FBXW7α leading to ZNF322A protein destruction. Overexpression of FBXW7α induces ZNF322A protein degradation, thereby blocks ZNF322A transcription activity and suppresses ZNF322A-induced tumor growth and metastasis in vitro and in vivo. Clinically, overexpression of ZNF322A correlates with low FBXW7α or defective CK1δ/GSK3β-mediated phosphorylation in lung cancer patients. Multivariate Cox regression analysis indicates that patients with ZNF322A high/FBXW7 low expression profile can be used as an independent factor to predict the clinical outcome in lung cancer patients. Our results reveal a new mechanism of ZNF322A oncoprotein destruction regulated by the CK1δ/GSK3β/FBXW7α axis. Deregulation of this signaling axis results in ZNF322A overexpression and promotes cancer progression.
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Affiliation(s)
- S-Y Liao
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - C-W Chiang
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - C-H Hsu
- Department of Agricultural Chemistry, National Taiwan University, Taipei, Taiwan
| | - Y-T Chen
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - J Jen
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - H-F Juan
- Department of Life Science, Institute of Molecular and Cellular Biology, Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - W-W Lai
- Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Y-C Wang
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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17
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Komenaka IK, Djenic B, Hsu CH, Nodora J, Winton L, Bouton M, Martinez ME. Abstract P3-13-18: Technical skill of surgical residents may affect margin status of breast conserving operations. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-13-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Quality of patient care and surgical outcomes have come under increased scrutiny. Numerous other studies have examined outcomes at teaching hospitals compared to non-teaching hospitals. The most important factor to determine early success of breast conservation is the attainment of pathologically negative margins. Few studies, however, have examined the effect of teaching residents on margin status. The current study was performed to evaluate the effect teaching residents on margin status after lumpectomy.
Methods: Retrospective review of all patients from July 2006-June 2015 was evaluated. A resident was usually considered the primary surgeon. If the resident was unavailable or unprepared to operate, the attending surgeon was the primary surgeon. As part of the routine evaluation of surgical residents, technical ability was classified as satisfactory or unsatisfactory for level of training. All evaluations of the technical ability of the residents were completed prior to the collection of the current data. The effect of surgical residents' participation and their technical ability to perform lumpectomy was evaluated to determine if there was an effect on margin status. Logistic regression analysis was performed to adjust for clinical variables known to affect margin status.
Results: Of 292 patients, 15% of patients had positive margins. The attending surgeon has positive margin rate of 10.7% vs 16% for Residents (p = 0.32).When technical skill evaluation was included, Residents with unsatisfactory technical skills had positive margin rate of 27% compared to 10.2% for residents with satisfactory skills (p = 0.002). In multivariate logistic regression analysis, operating surgeon remained significantly associated with positive margins. Operations done by residents with satisfactory technical skills or attending surgeon were less likely to have positive margins than those done by residents with unsatisfactory technical skills (OR 0.39, 95% CI 0.22-0.86; p = 0.03). Patients who underwent preoperative chemotherapy were also less like to have positive margins (OR 0.40, 95% CI 0.18-0.91); p = 0.04). In patients with at least 2 years of followup (mean follow up of 48 months) breast cancer specific survival was 94% and 2% had local recurrences as a first event.
Conclusions: Technically ability of residents may affect margin status after lumpectomy. With the increased use of surgical outcomes to measure quality of care in medicine, the importance of teaching surgical residents needs to be considered in future quality of care evaluation.
Citation Format: Komenaka IK, Djenic B, Hsu C-H, Nodora J, Winton L, Bouton M, Martinez ME. Technical skill of surgical residents may affect margin status of breast conserving operations [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-13-18.
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Affiliation(s)
- IK Komenaka
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - B Djenic
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - C-H Hsu
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - J Nodora
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - L Winton
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - M Bouton
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - ME Martinez
- Marciopa Medical Center; University of Arizona; University of California San Diego
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Komenaka IK, VanderVelde J, Hsu CH, Nodora J, Winton L, Bouton M, Martinez ME. Abstract P5-13-02: Weight gain after breast cancer diagnosis and patients' opinion on weight loss strategies. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-13-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The rate of obesity is increasing in many countries worldwide. Most populations are not aware of steady weight gain with age. In addition, obesity is increasingly being recognized as a risk factor for breast cancer. Some studies have also demonstrated that weight gain after diagnosis is associated with increased risk for recurrence. The current study was performed to evaluate weight gain in a population of patients seen at a safety net institution. Additionally, patients also gave their opinion on weight loss strategies.
Methods: A retrospective review of all breast cancer patients seen at the county, safety net institution from July 2001 to June 2014 who had at least 2 years of follow up were evaluated for change in weight. For the question on weight loss strategies, all patients from May 2014 to May 2015 were included. Sociodemographic, clinical, and treatment variables were evaluated.
Results: From July 2001 to June 2014, 225 breast cancer patients had follow up prior to January 2013. Of these patients 59% gained weight after their diagnosis of breast cancer. Overall these patients gained an average of 2 kg after their diagnosis.
Starting in January 2013, patients were given a simple message, “avoiding gaining weight” after their diagnosis. For 115 patients with follow up after January 2013, only 35% gained weight and on average, this group of patient lost 4 kg from diagnosis. Patients who initially gained weight were provided with basic weight loss strategies.
From May 2014 to May 2015, 1198 consecutive patients were seen. The average age was 45 years. 12% were non-Hispanic White. Only 30% of patients stated that their primary care provider discussed weight maintenance or weight loss as part of their routine health care. 40% of patients did feel that a permanent change was necessary to facilitate weight loss. However, fewer than half (44%) the patients felt that exercise was necessary. Dietary beliefs were varied, with the most commonly held belief was that vegetarian/vegan diet was necessary (28%). Patients rarely cited commonly recommended weight loss strategies: lower caloric intake (9%), eat frequently (0.3%), adequate fiber (0.1%), adequate protein (0.6%), enough sleep (0.1%), don't eat late (0.1%), no fast food (2%), avoid soda (1%), drink more water (1%). 6% of patients felt a low/no carbohydrate diet was important. By contrast, older strategies or popular ideas: low fat (8%), no flour/wheat/gluten (4%) were also felt to be important. 7.3% stated they did not know any strategy. 5% patients recommended stopping eating altogether to lose weight.
Conclusions: Similar to population wide data, breast cancer patients treated at a safety net institution tend to gain weight with follow up. Also similar to most populations, the population was not aware of recommended weight loss strategies and most do not feel that exercise is an important component of weight maintenance. As with the rest of the US population significant effort will be necessary to help patients avoid weight gain after diagnosis. Making patients aware of their weight may help patients avoid gaining weight.
Citation Format: Komenaka IK, VanderVelde J, Hsu C-H, Nodora J, Winton L, Bouton M, Martinez ME. Weight gain after breast cancer diagnosis and patients' opinion on weight loss strategies [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-13-02.
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Affiliation(s)
- IK Komenaka
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - J VanderVelde
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - C-H Hsu
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - J Nodora
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - L Winton
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - M Bouton
- Marciopa Medical Center; University of Arizona; University of California San Diego
| | - ME Martinez
- Marciopa Medical Center; University of Arizona; University of California San Diego
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Hsu CH, Wu MY, Liu YC, Wong CS. An unusual case of focal segmental glomerulosclerosis presenting with retropharyngeal edema. Eur Ann Otorhinolaryngol Head Neck Dis 2016; 133:355-356. [PMID: 27133291 DOI: 10.1016/j.anorl.2015.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/03/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Acute neck swelling with pharyngeal signs often triggers emergency consultation. Treatment and diagnosis are usually multidisciplinary. Failing to find a possible etiology may lead to misdiagnosis. CASE PRESENTATION A young man presented to the emergency room with a 4-day history of cough, neck swelling and sore throat. Laboratory testing showed a leukocyte count of 9200 without left shift. Mild elevated CRP with 1.7 was noted and computed tomography (CT) showed fluid accumulation in the retropharyngeal space and neck edema down to thyroid region. Antibiotic was prescribed and admitted to infection ward under the impression of deep neck infection. During hospitalization, needle aspiration was performed where water fluid was collected without pus. Investigations showed massive proteinuria, hypoalbuminemia and hypercholesterolemia. The early focal segmental glomerulosclerosis was found by renal biopsy. After prednisolone 60mg daily and albumin supplement, the neck swelling, swallowing pain and general edema had completely resolved. DISCUSSION The purpose of this case is to raise awareness of nephrotic syndrome as an unusual but possibly cause of retropharyngeal edema. We highlight the diagnostic features that will allow the physicians to make the correct diagnosis, avoid unnecessary incision and drainage, and commence effective treatment early in the disease course.
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Affiliation(s)
- C-H Hsu
- Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - M-Y Wu
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Y-C Liu
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Division of Infection Disease, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - C-S Wong
- Department of Emergency Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Department of emergency medicine, school of medicine, Taipei Medical University, Taipei, Taiwan.
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Bea JW, Blew RM, Going SB, Hsu CH, Lee MC, Lee VR, Caan BJ, Kwan ML, Lohman TG. Dual energy X-ray absorptiometry spine scans to determine abdominal fat in postmenopausal women. Am J Hum Biol 2016; 28:918-926. [PMID: 27416964 DOI: 10.1002/ajhb.22892] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/06/2016] [Accepted: 06/18/2016] [Indexed: 11/09/2022] Open
Abstract
Body composition may be a better predictor of chronic disease risk than body mass index (BMI) in older populations. OBJECTIVES We sought to validate spine fat fraction (%) from dual energy X-ray absorptiometry (DXA) spine scans as a proxy for total abdominal fat. METHODS Total body DXA scan abdominal fat regions of interest (ROI) that have been previously validated by magnetic resonance imaging were assessed among healthy, postmenopausal women who also had antero-posterior spine scans (n = 103). ROIs were (1) lumbar vertebrae L2-L4 and (2) L2-Iliac Crest (L2-IC), manually selected by two independent raters, and (3) trunk, auto-selected by DXA software. Intra-class correlation coefficients evaluated intra and inter-rater reliability on a random subset (N = 25). Linear regression models, validated by bootstrapping, assessed the relationship between spine fat fraction (%) and total abdominal fat (%) ROIs. RESULTS Mean age, BMI, and total body fat were 66.1 ± 4.8 y, 25.8 ± 3.8 kg/m2 and 40.0 ± 6.6%, respectively. There were no significant differences within or between raters. Linear regression models adjusted for several participant and scan characteristics were equivalent to using only BMI and spine fat fraction. The model predicted L2-L4 (Adj. R2 : 0.83) and L2-IC (Adj. R2 : 0.84) abdominal fat (%) well; the adjusted R2 for trunk fat (%) was 0.78. Model validation demonstrated minimal over-fitting (Adj. R2 : 0.82, 0.83, and 0.77 for L2-L4, L2-IC, and trunk fat, respectively). CONCLUSIONS The strong correlation between spine fat fraction and DXA abdominal fat measures make it suitable for further development in postmenopausal chronic disease risk prediction models. Am. J. Hum. Biol. 28:918-926, 2016. © 2016Wiley Periodicals, Inc.
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Affiliation(s)
- J W Bea
- Department of Medicine, University of Arizona Cancer Center, Tucson, Arizona, 85724-5024.,Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721
| | - R M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721
| | - S B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721
| | - C-H Hsu
- University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, 85724
| | - M C Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721
| | - V R Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721
| | - B J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California, 94612
| | - M L Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland, California, 94612
| | - T G Lohman
- Department of Physiology, University of Arizona, Tucson, Arizona, 85721
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Hsu CH, Brown CM, Murphy JM, Haskell MG, Williams C, Feldman K, Mitchell K, Blanton JD, Petersen BW, Wallace RM. Perceptions and Practices of Mass Bat Exposure Events in the Setting of Rabies Among U.S. Public Health Agencies. Zoonoses Public Health 2016; 64:127-136. [PMID: 27389926 PMCID: PMC5525325 DOI: 10.1111/zph.12289] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Indexed: 12/25/2022]
Abstract
Current guidelines in the setting of exposures to potentially rabid bats established by the Advisory Committee on Immunization Practices (ACIP) address post-exposure prophylaxis (PEP) administration in situations where a person may not be aware that a bite or direct contact has occurred and the bat is not available for diagnostic testing. These include instances when a bat is discovered in a room where a person awakens from sleep, is a child without an adult witness, has a mental disability or is intoxicated. The current ACIP guidelines, however, do not address PEP in the setting of multiple persons exposed to a bat or a bat colony, otherwise known as mass bat exposure (MBE) events. Due to a dearth of recommendations for response to these events, the reported reactions by public health agencies have varied widely. To address this perceived limitation, a survey of 45 state public health agencies was conducted to characterize prior experiences with MBE and practices to mitigate the public health risks. In general, most states (69% of the respondents) felt current ACIP guidelines were unclear in MBE scenarios. Thirty-three of the 45 states reported prior experience with MBE, receiving an average of 16.9 MBE calls per year and an investment of 106.7 person-hours annually on MBE investigations. PEP criteria, investigation methods and the experts recruited in MBE investigations varied between states. These dissimilarities could reflect differences in experience, scenario and resources. The lack of consistency in state responses to potential mass exposures to a highly fatal disease along with the large contingent of states dissatisfied with current ACIP guidance warrants the development of national guidelines in MBE settings.
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Affiliation(s)
- C H Hsu
- Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA, USA.,Epidemic Intelligence Service, Atlanta, GA, USA
| | - C M Brown
- Massachusetts Department of Public Health State Laboratory Institute, Jamaica Plain, MA, USA
| | - J M Murphy
- Virginia Department of Health, Office of Epidemiology, Richmond, VA, USA
| | - M G Haskell
- Division of Public Health, Communicable Disease Branch, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - C Williams
- Division of Public Health, Communicable Disease Branch, North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - K Feldman
- Center for Zoonotic and Vector-borne Diseases, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA
| | - K Mitchell
- Center for Zoonotic and Vector-borne Diseases, Maryland Department of Health and Mental Hygiene, Baltimore, MD, USA
| | - J D Blanton
- Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA, USA
| | - B W Petersen
- Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA, USA
| | - R M Wallace
- Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA, USA
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Abstract
A cross-sectional cohort study was conducted to investigate whether ghrelin level in obese women predicts the quality of life (QOL). A total of 307 subjects fulfilled the criteria: (1) age between 20 and 65 years old, (2) body mass index ≥27 kg/m2 (3) waist circumference ≥80 cm were enrolled in the study. All subjects were assigned to one of the plasma ghrelin level categories according to the quartiles. The median of age and BMI of the 307 obese women were 45 ± 18 years and 29.9 ± 4.1 kg/m2, respectively. The main outcome evaluated is the associations of plasma ghrelin level and QOL, which were evaluated using multiple linear regression analysis. Results of linear trend test show significant statistical difference in plasma lipoproteins (triglyceride, cholesterol, HDL-cholestero and LDL-cholesterol = and levels of obesity-related hormone peptides, including leptin, adiponectin, insulin among quartiles of ghrelin. Multiple liner regression analysis of serum obesity-related hormone peptide level and QOL using stepwise method shows ghrelin concentration was the only predictor of QOL, including PCS-12 level (β = -0.18, p = 0.001), MCS-12 level (β = -0.14, p = 0.009), WHOQOL-BREF scores: physical (β = -0.13, p = 0.03), psychological (β = -0.16, p = 0.007), social (β = -0.21, p = < 0.001), and environmental (β = -0.22, p = <0.001), after adjusting other factors for obese female subjects. This study demonstrated that ghrelin concentration is strongly associated with QOL level among obese women. Hence, ghrelin concentration might be a valuable marker to be monitored in obese women.
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Affiliation(s)
- P H Lu
- a School of Medicine, Institute of Traditional Medicine , National Yang-Ming University , Taipei , Taiwan.,b Department of Dermatology , Far Eastern Memorial Hospital , New Taipei City , Taiwan
| | - Y L Song
- a School of Medicine, Institute of Traditional Medicine , National Yang-Ming University , Taipei , Taiwan
| | - C H Hsu
- a School of Medicine, Institute of Traditional Medicine , National Yang-Ming University , Taipei , Taiwan.,c Branch of Linsen and Chinese Medicine , Taipei City Hospital , Taipei , Taiwan
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Algotar AM, Behnejad R, Singh P, Thompson PA, Hsu CH, Stratton SP. EFFECT OF SELENIUM SUPPLEMENTATION ON PROTEOMIC SERUM BIOMARKERS IN ELDERLY MEN. J Frailty Aging 2016; 4:107-10. [PMID: 26366377 DOI: 10.14283/jfa.2015.48] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES To determine the effect of selenium supplementation on the human proteomic profile. DESIGN Serum samples were collected in this pilot study from a randomized placebo controlled Phase 2 clinical trial (Watchful Waiting (WW)). SETTING Subjects were followed every three months for up to five years at the University of Arizona Prostate Cancer Prevention Program. PARTICIPANTS One hundred and forty men (age < 85 years) had biopsy-proven prostate cancer, a Gleason sum score less than eight, no metastatic cancer, and no prior treatment for prostate cancer. INTERVENTION As part of the WW trial, men were randomized to placebo, selenium 200 μg/day or selenium 800 μg/day. For the purpose of the current study, 40 subjects enrolled in the WW study (20 from the placebo group and 20 from Se 800 μg/day group) were selected. MEASUREMENTS Baseline serum samples were collected at each follow-up visit and stored at -80 degrees Celsius. A multiplexed proteomic panel investigated changes in 120 proteins markers simultaneously. RESULTS Thirteen proteins (Apolipoprotein J, IL-10, IL-1 alpha, MMP-3, IL-12p70, IL-2 receptor alpha, cathepsin B, eotaxin, EGFR, FGF-basic, myeloperoxidase, RANTES, TGF-beta) were determined to be either statistically (p-value < 0.05) or marginally significantly (0.05 < p-value <0.1) changed in the selenium supplemented group as compared to placebo. CONCLUSION Although independent validation of these results is needed, this study is the first of its kind to utilize high throughput fluorescence based protein multiplex panel in analyzing changes in the proteomic profile due to selenium supplementation. Results from this study provide insight into the ability of selenium to modulate numerous protein markers and thus impact various biological processes in humans.
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Affiliation(s)
- A M Algotar
- Department of Preventive Medicine, Loma Linda University Medical Center, Loma Linda, CA ; University of Arizona Cancer Center, Tucson, AZ
| | - R Behnejad
- University of Arizona Cancer Center, Tucson, AZ
| | - P Singh
- Department of Hematology-Oncology, University of Arizona, Tucson, AZ
| | - P A Thompson
- Department of Cellular and Molecular Medicine, University of Arizona, Tucson, AZ
| | - C H Hsu
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
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Lu PH, Hsu CH. Does supplementation with green tea extract improve acne in post-adolescent women? A randomized, double-blind, and placebo-controlled clinical trial. Complement Ther Med 2016; 25:159-63. [PMID: 27062963 DOI: 10.1016/j.ctim.2016.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 04/06/2015] [Revised: 03/04/2016] [Accepted: 03/04/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Green tea is believed to have beneficial effects in the prevention and treatment of acne. OBJECTIVE To examine the effects of a decaffeinated green tea extract (GTE), providing a daily dose of 856 mg of epigallocatechin gallate (EGCG) upon women with post-adolescent acne. METHODS A randomized, double-blind, placebo-controlled clinical trial was conducted from May 2012 through October 2013. A final group of 80 subjects were randomly assigned to receive either 1500 mg of decaffeinated GTE or placebo (cellulose) daily for 4 weeks. Inflammatory lesion counts were used as the major outcome measurement. At baseline and after 4 weeks of treatment, anthropometric measurements, fasting glucose levels and a lipid profile were measured from both groups. RESULTS Sixty-four of 80 women, from 25 to 45 years of age with moderate-to-severe acne completed the study. Statistically significant differences were noted in inflammatory lesion counts distributed on the nose, periorally and on the chin between the two groups. However, there were no significant differences between groups for total lesion counts. Within-group comparison revealed that the GTE group had significant reductions in inflammatory lesions distributed on the forehead and cheek, and significant reductions in total lesion counts. GTE resulted in significant reductions in total cholesterol levels within the GTE group. CONCLUSIONS GTE resulted in significant reductions in lesions located on the nose, perioral area and chin. More research is required to determine whether a decaffeinated GTE standardized for EGCG content will provide clinical benefits in women with post-adolescent acne.
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Affiliation(s)
- P H Lu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taiwan; Department of Dermatology, Far Eastern Memorial Hospital, Taiwan
| | - C H Hsu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taiwan; Branch of Linsen and Chinese Medicine, Taipei City Hospital, Taiwan.
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Mehta D, Winton L, Walters J, Hsu CH, Nodora J, Martinez ME, Bouton M, Komenaka IK. Abstract P6-12-06: Preoperative chemotherapy regimens and breast cancer subtype in an underinsured Hispanic population. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-12-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Although the Hispanic population is among the fastest growing in the United States, however, less is known about them then other populations. Breast cancer in different racial/ethnic populations display different behaviors. The current study was performed to examine response to preoperative chemotherapy regimen and by breast cancer subtype in a Hispanic safety net population.
Methods: A retrospective review of Hispanic breast cancer patients who underwent preoperative chemotherapy from July 2001 to February May 2015 at a safety net hospital. Sociodemographic, clinical, and treatment variables were evaluated. Response to chemotherapy regimen was recorded. Breast cancer subtypes were divided based on IHC and FISH testing. Luminal B subtype was classified based on Ki67 (>15%) and PR (<20%).
Results: The average age of the 133 patients was 45 years. 93% of the patients were insured with Medicaid or uninsured (70%). The average size of the cancers at presentation was 5cm. Overall 86% of patients had a clinical response to preoperative chemotherapy and 35% had pathologic complete response (pCR). AC and TC regimens had the lowest rate of pCR at 16%. AC/T (every 3 week and weekly) had similar rates of pCR 23% and 29%, while dose dense regimens showed pCR 40%. Herceptin containing regimens had pCR 57%. 7 patients received TAC and 71% had pCR.
By subtype, Luminal A and B patients had low rates of pCR 9% and 14% respectively. Luminal B patients did benefit from preoperative chemotherapy as 86% of patients who were not candidates for breast conservation at presentation were able to undergo lumpectomy after preoperative chemotherapy. Her2 subtype patients who got Herceptin had pCR 57%. Triple negative patients had pCR 54%.
Conclusions: In this underinsured, Hispanic population who presented at advanced stages, differences in response to preoperative chemotherapy were seen based on breast cancer subtype. Differences were also seen based on chemotherapy regimen. TAC maybe a particularly effective regimen in triple negative Hispanic women.
Citation Format: Mehta D, Winton L, Walters J, Hsu C-H, Nodora J, Martinez ME, Bouton M, Komenaka IK. Preoperative chemotherapy regimens and breast cancer subtype in an underinsured Hispanic population. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-12-06.
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Affiliation(s)
- D Mehta
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfironia, San Diego, San Diego, CA
| | - L Winton
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfironia, San Diego, San Diego, CA
| | - J Walters
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfironia, San Diego, San Diego, CA
| | - C-H Hsu
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfironia, San Diego, San Diego, CA
| | - J Nodora
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfironia, San Diego, San Diego, CA
| | - ME Martinez
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfironia, San Diego, San Diego, CA
| | - M Bouton
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfironia, San Diego, San Diego, CA
| | - IK Komenaka
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfironia, San Diego, San Diego, CA
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Komenaka IK, Djenic B, Walters J, Hsu CH, Nodora JN, Martinez ME, Bouton M, Mehta D. Abstract P6-12-07: The benefit of preoperative chemotherapy in an underinsured Hispanic population with poor use of screening mammography. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-12-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Despite prospective clinical trials demonstrating the safety and effectiveness of preoperative chemotherapy for nearly 2 decades, it may still be underutilized in underserved, uninsured populations most likely to present with advanced cancers. The current study was performed to evaluate the effect of preoperative chemotherapy (PC) in a Hispanic safety net population.
Methods: A retrospective review of Hispanic breast cancer patients who presented at clinical stage 2 or higher and were treated from July 2001 to February May 2015 at a safety net hospital. Sociodemographic, clinical, and treatment variables were evaluated. Surgical outcomes were evaluated. Margin status was determined for those who underwent breast conservation.
Results: The average age of the 266 patients was 45 years. 93% of the patients were insured with Medicaid or uninsured (70%). Only 24% of patients underwent screening mammography. 133 underwent PC and 133 had primary operations. Patients who underwent PC presented with larger cancers (5cm vs 3.5cm, p < 0.001). 96% of patients in PC group were not candidates for lumpectomy at presentation. However, lumpectomy was performed more often in those who underwent PC (75% vs. 57%, p = 0.01). Re-excision for margins were necessary less often in those who underwent PC (10.3% vs 27%, p = 0.01). Patients who underwent PC were also less likely to require an ALND (33% vs 47%, p = 0.04). Despite presentation at higher average clinical stage in patients who underwent PC, at average follow up of 52 months, risk of IBTR and risk of regional recurrence were similar in the PC and no-PC groups (IBTR: 4.4% vs 3%, p = 0.99 and Regional: 1.5% vs. 1.5%, p = 0.99). Breast cancer specific survival was 86.5% in the PC group compared to 84% in the no-PC group (p = 0.68). Patients in the no-PC group were less likely to comply with recommended chemotherapy.Conclusions: In this underinsured, Hispanic population who did not use screening mammography, preoperative chemotherapy allowed many women to undergo breast conservation, undergo fewer operations, and were less likely to require ALND. Risk of local and regional recurrence is low in these patients and comparable to those who underwent primary operation.
Citation Format: Komenaka IK, Djenic B, Walters J, Hsu C-H, Nodora JN, Martinez ME, Bouton M, Mehta D. The benefit of preoperative chemotherapy in an underinsured Hispanic population with poor use of screening mammography. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-12-07.
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Affiliation(s)
- IK Komenaka
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfornia, San Diego, San Diego, CA
| | - B Djenic
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfornia, San Diego, San Diego, CA
| | - J Walters
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfornia, San Diego, San Diego, CA
| | - C-H Hsu
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfornia, San Diego, San Diego, CA
| | - JN Nodora
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfornia, San Diego, San Diego, CA
| | - ME Martinez
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfornia, San Diego, San Diego, CA
| | - M Bouton
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfornia, San Diego, San Diego, CA
| | - D Mehta
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of Calfornia, San Diego, San Diego, CA
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Affiliation(s)
- H-J Hsu
- Division of Gastroenterology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City, Taiwan and Tri-Service General Hospital, Taipei, Taiwan
| | - C-K Hsu
- Department of Ophthalmology, Tri-Service General Hospital, Taipei, Taiwan
| | - T-S Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - C-H Hsu
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan,
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Affiliation(s)
- P-L Lay
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, No. 2, Zhongzheng 1st. Rd., Lingya District, Kaohsiung City 802, Taiwan and Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, No. 325, Sec 2, Cheng-Gong Rd., Neihu, Taipei 114, Taiwan
| | - T-Y Huang
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, No.325, Sec 2, Cheng-Gong Rd., Neihu, Taipei 114, Taiwan.
| | - C-H Hsu
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, No.325, Sec 2, Cheng-Gong Rd., Neihu, Taipei 114, Taiwan.
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Ray S, Hsu CH, Lin FC, Li Z, Kim T, Lin YY. Contrast enhancement for early cancer imaging by Gd-nanoparticles and active feedback MRI. Cancer Imaging 2015. [PMCID: PMC4601756 DOI: 10.1186/1470-7330-15-s1-p2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Hsu CH, Lin PC, Kuo FC, Wang JW. A regime of two intravenous injections of tranexamic acid reduces blood loss in minimally invasive total hip arthroplasty: a prospective randomised double-blind study. Bone Joint J 2015; 97-B:905-10. [PMID: 26130344 DOI: 10.1302/0301-620x.97b7.35029] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [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] [Indexed: 01/04/2023]
Abstract
Tranexamic acid (TXA), an inhibitor of fibrinolysis, reduces blood loss after total knee arthroplasty. However, its effect on minimally invasive total hip arthroplasty (THA) is not clear. We performed a prospective, randomised double-blind study to evaluate the effect of two intravenous injections of TXA on blood loss in patients undergoing minimally invasive THA. In total, 60 patients (35 women and 25 men with a mean age of 58.1 years; 17 to 84) who underwent unilateral minimally invasive uncemented THA were randomly divided into the study group (30 patients, 20 women and ten men with a mean age of 56.5 years; 17 to 79) that received two intravenous injections 1 g of TXA pre- and post-operatively (TXA group), and a placebo group (30 patients, 15 women and 15 men with a mean age of 59.5 years; 23 to 84). We compared the peri-operative blood loss of the two groups. Actual blood loss was calculated from the maximum reduction in the level of haemoglobin. All patients were followed clinically for the presence of venous thromboembolism. The TXA group had a lower mean intra-operative blood loss of 441 ml (150 to 800) versus 615 ml (50 to 1580) in the placebo (p = 0.044), lower mean post-operative blood loss (285 ml (120 to 570) versus 392 ml (126 to 660) (p = 0.002), lower mean total blood loss (1070 ml (688 to 1478) versus 1337 ml (495 to 2238) (p = 0.004) and lower requirement for transfusion (p = 0.021). No patients in either group had symptoms of venous thromboembolism or wound complications. This prospective, randomised controlled study showed that a regimen of two intravenous injections of 1 g TXA is effective for blood conservation after minimally invasive THA.
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Affiliation(s)
- C-H Hsu
- Kaohsiung Chang Gung Memorial Hospital, 123, Ta Pei Road, Niao Sung Dist, Kaohsiung City, Taiwan
| | - P-C Lin
- Kaohsiung Chang Gung Memorial Hospital, 123, Ta Pei Road, Niao Sung Dist, Kaohsiung City, Taiwan
| | - F-C Kuo
- Kaohsiung Chang Gung Memorial Hospital, 123, Ta Pei Road, Niao Sung Dist, Kaohsiung City, Taiwan
| | - J-W Wang
- Kaohsiung Chang Gung Memorial Hospital, 123, Ta Pei Road, Niao Sung Dist, Kaohsiung City, Taiwan
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Wei SH, Lin JD, Hsu CH, Wu CZ, Hsieh CH, Pei D, Chang JB, Liang YJ, Hsia TL, Chen YL. Higher normal range of fasting plasma glucose still has a higher risk for metabolic syndrome: a combined cross-sectional and longitudinal study in elderly. Int J Clin Pract 2015; 69:863-70. [PMID: 25757152 DOI: 10.1111/ijcp.12633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION It is well known that higher fasting plasma glucose (FPG) is associated with metabolic syndrome (MetS). This relationship still exists even the FPG is within the normal range. However, most of these studies did not exclude subjects who were on medications which would affect the results of the studies. At the same time, there is no longitudinal study done to validate this correlation, especially in elderly. In this study, the relationships between normal FPG and MetS were evaluated. METHOD We randomly selected 57,517 subjects who were ≥ 60-years old from health screening centre. In the first part of study, subjects were enrolled in the cross-sectional study to find out the optimal cut-off value of FPG with higher chances to have MetS. In the second part of current study, subjects with MetS at baseline were excluded from the same study group, and performed a median 5.3-year longitudinal study. RESULTS There were 18,287 subjects enrolled in this study. In the first part of study, the cross-sectional study, optimal cut-off values of FPG were determined by the ROC curve and the sensitivity for these cut-off values were 56.6% in men and 60.9% in women, respectively. The result showed that lower FPG is healthier than the higher (log-rank test, p < 0.001). During the follow-up period, 5039 subjects showed hazard ratios of 2.09 for men and 1.884 for women developing future MetS. CONCLUSION Our study is the first longitudinal design in elderly and showed that older subjects with higher FPG proved to have higher risk of Mets even the FPG is still within its normal range.
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Affiliation(s)
- S-H Wei
- Department of Family Medicine, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - J-D Lin
- Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - C-H Hsu
- Department of Family Medicine, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - C-Z Wu
- Division of Endocrinology and Metabolism, Department of Medicine, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - C-H Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - D Pei
- Department of Internal Medicine, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - J-B Chang
- Division of Clinical Pathology, Department of Pathology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Y-J Liang
- Department of Life-Science, Fu-Jen Catholic University, Taipei, Taiwan
| | - T-L Hsia
- Department of Internal Medicine, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Y-L Chen
- Department of Pathology, School of Medicine, Cardinal Tien Hospital, Fu-Jen Catholic University, New Taipei City, Taiwan
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Lin HT, Hsu CH, Tsai HJ, Lin CH, Lo PY, Wang SL, Wang LC. Influenza A plasma and serum virus antibody detection comparison in dogs using blocking enzyme-linked immunosorbent assay. Vet World 2015; 8:580-3. [PMID: 27047138 PMCID: PMC4774716 DOI: 10.14202/vetworld.2015.580-583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 03/31/2015] [Accepted: 04/07/2015] [Indexed: 11/18/2022] Open
Abstract
Background and Aim: The influenza A virus (IAV) is an important zoonotic pathogen with infections also reported in dogs. IAV infections can be detected through the presence of antibodies using the enzyme-linked immunosorbent assay (ELISA). Serum is the only standard sample source; however, there is no information on the availability of other sample sources for IAV antibody detection in dogs. Compared with serum, plasma is more widely employed in most animal hospitals. The object of this study is to investigate whether plasma collected in ethylenediaminetetraacetic acid (EDTA) tubes (EDTA plasma) or heparin tubes (heparin plasma) could be used in the ELISA protocol instead of serum for IAV antibody detection in dogs. Materials and Methods: Totally, 82 matched EDTA plasma and serum sample pairs and 79 matched heparin plasma and serum sample pairs were employed using blocking enzyme-linked immunosorbent assay (bELISA). The agreement and correlation between the plasma (EDTA or heparin plasma) and serum were assessed using the agreement index kappa (kD) calculation and Pearson correlation coefficient, respectively. Results: The agreement index kD of EDTA plasma and serum was 1.0, and that of heparin plasma and serum was 0.85. The Pearson correlation coefficient of EDTA plasma and serum was 0.87 (p<0.01), and that of heparin plasma and serum was 0.82 (p<0.01). Conclusion: The results proved that plasma, especially EDTA plasma, could be substituted for serum in the bELISA test. This might greatly expand the clinical applicability of IAV antibody detection in dogs.
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Affiliation(s)
- H T Lin
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, 1 Sec. 4, Roosevelt Road, Taipei 10617, Taiwan
| | - C H Hsu
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, 1 Sec. 4, Roosevelt Road, Taipei 10617, Taiwan
| | - H J Tsai
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, 1 Sec. 4, Roosevelt Road, Taipei 10617, Taiwan
| | - C H Lin
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, 1 Sec. 4, Roosevelt Road, Taipei 10617, Taiwan
| | - P Y Lo
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, 1 Sec. 4, Roosevelt Road, Taipei 10617, Taiwan
| | - S L Wang
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, 1 Sec. 4, Roosevelt Road, Taipei 10617, Taiwan
| | - L C Wang
- Institute of Veterinary Clinical Sciences, School of Veterinary Medicine, National Taiwan University, 1 Sec. 4, Roosevelt Road, Taipei 10617, Taiwan
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Jeng LB, Thorat A, Hsieh YW, Yang HR, Yeh CC, Chen TH, Hsu SC, Hsu CH. Experience of using everolimus in the early stage of living donor liver transplantation. Transplant Proc 2015; 46:744-8. [PMID: 24767339 DOI: 10.1016/j.transproceed.2013.11.068] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 11/22/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of our study was to review the experience of early use of everolimus for recipients after adult-to-adult living donor liver transplantation. METHODS From February 2012 to December 2012, 80 recipients underwent living donor liver transplantation. Forty-three of them used everolimus as an adjunct to the calcineurin inhibitors (CNIs) in the early postoperative period. Thirty-nine patients had hepatocellular carcinoma (HCC) and poor renal function was noted in 9 patients. Ten of them were females and 33 were males. The age varied from 39 to 75 years old. The starting date of use was within 1 week in 33 patients, 2 weeks in 9 patients, and 1 patient was administered on postoperative day 20. The initial doses of everolimus were 0.25 mg every 12 hours and increased to 0.5 mg every 12 hours to target the level at 3-5 ng/mL. Doppler ultrasound was performed regularly postoperative days 1, 4, and 14. RESULTS The mean time between liver transplantation and everolimus treatment was 12 ± 8 days. The maximum dose of everolimus used was 1 mg/d with a target trough level between 3 and 5 ng/mL. At 3 months, a target trough level of 3 ng/mL was achieved. Six of 9 renal failure patients showed significant recovery of renal function, whereas 3 of them showed further deterioration and 1 required hemodialysis. During the follow-up period of 9 ± 6 months, all showed good patency of hepatic artery without thrombosis. Three patients (7%) developed HCC recurrence, whereas 1 patient died at the 10th month postoperative due to sepsis. Elevation of lipid profile was noted in 5 patients. Stomatitis was the most frequent side effect and occurred in 15 patients. CONCLUSIONS The early use of everolimus was safe and feasible. Also, it can be safely used in patients with prior renal failure while reducing the doses of CNIs. Although the recurrence rate of HCC was reduced, further study is ongoing to evaluate the long-term impact of everolimus on prevention of HCC recurrence.
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Affiliation(s)
- L-B Jeng
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan; China Medical University, Taichung, Taiwan.
| | - A Thorat
- Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan
| | - Y-W Hsieh
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - H-R Yang
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan; China Medical University, Taichung, Taiwan
| | - C-C Yeh
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan; China Medical University, Taichung, Taiwan
| | - T-H Chen
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan
| | - S-C Hsu
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan
| | - C-H Hsu
- Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Organ Transplantation Center, China Medical University Hospital, Taichung, Taiwan
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Hsu SC, Jeng LB, Thorat A, Li PC, Poon KS, Hsu CH, Yeh CC, Chen TH, Yang HR. Management of extensive retrohepatic vena cava defect in recipients of living donor liver transplantation. Transplant Proc 2015; 46:699-704. [PMID: 24767328 DOI: 10.1016/j.transproceed.2013.11.118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 11/07/2013] [Indexed: 01/03/2023]
Abstract
Certain complexities, such as extensive vena caval injury, unexpected dense adhesions between liver and retrohepatic vena cava, and liver tumor abutting retrohepatic vena cava, sometimes warrant resection of vena cava during living-donor liver transplantation. Because the donor graft is devoid of vena cava, reconstruction of the retrohepatic cava is required, which can be done with the use of either a cryopreserved venous graft or an artificial conduit. With only a few published reports, the experience in vena cava reconstruction with the use of expanded polytetrafluoroethylene (ePTFE) during living-donor liver transplantation remains limited. We present our experience of 4 patients who successfully underwent vena caval resection during liver transplantation for various indications, which was subsequently reconstructed with the use of ePTFE grafts. All of these patients except 1 recovered well without any undue complications, such as thrombosis or outflow inadequacies, thus proving this extensive surgical treatment to be a successful and life-saving procedure, though meticulous skills are prerequisite.
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Affiliation(s)
- S-C Hsu
- Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan
| | - L-B Jeng
- Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan; China Medical University Hospital, China Medical University, Taichung, Taiwan.
| | - A Thorat
- Organ Transplantation Center, China Medical University, Taichung, Taiwan
| | - P-C Li
- Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan; China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - K-S Poon
- Department of Anesthesiology, China Medical University, Taichung, Taiwan
| | - C-H Hsu
- Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan
| | - C-C Yeh
- Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan; China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - T-H Chen
- Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan
| | - H-R Yang
- Department of Surgery, China Medical University, Taichung, Taiwan; Organ Transplantation Center, China Medical University, Taichung, Taiwan; China Medical University Hospital, China Medical University, Taichung, Taiwan
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Nguyen HQ, Yu HW, Luc QH, Tang YZ, Phan VTH, Hsu CH, Chang EY, Tseng YC. Control of metamorphic buffer structure and device performance of In(x)Ga(1-x)As epitaxial layers fabricated by metal organic chemical vapor deposition. Nanotechnology 2014; 25:485205. [PMID: 25396303 DOI: 10.1088/0957-4484/25/48/485205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Using a step-graded (SG) buffer structure via metal-organic chemical vapor deposition, we demonstrate a high suitability of In0.5Ga0.5As epitaxial layers on a GaAs substrate for electronic device application. Taking advantage of the technique's precise control, we were able to increase the number of SG layers to achieve a fairly low dislocation density (∼10(6) cm(-2)), while keeping each individual SG layer slightly exceeding the critical thickness (∼80 nm) for strain relaxation. This met the demanded but contradictory requirements, and even offered excellent scalability by lowering the whole buffer structure down to 2.3 μm. This scalability overwhelmingly excels the forefront studies. The effects of the SG misfit strain on the crystal quality and surface morphology of In0.5Ga0.5As epitaxial layers were carefully investigated, and were correlated to threading dislocation (TD) blocking mechanisms. From microstructural analyses, TDs can be blocked effectively through self-annihilation reactions, or hindered randomly by misfit dislocation mechanisms. Growth conditions for avoiding phase separation were also explored and identified. The buffer-improved, high-quality In0.5Ga0.5As epitaxial layers enabled a high-performance, metal-oxide-semiconductor capacitor on a GaAs substrate. The devices displayed remarkable capacitance-voltage responses with small frequency dispersion. A promising interface trap density of 3 × 10(12) eV(-1) cm(-2) in a conductance test was also obtained. These electrical performances are competitive to those using lattice-coherent but pricey InGaAs/InP systems.
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Affiliation(s)
- H Q Nguyen
- Department of Materials Science and Engineering, National Chiao Tung University, 1001 University Road, Hsinchu, Taiwan
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Lu PH, Hsu CH. Body mass index is negatively associated with acne lesion counts in Taiwanese women with post-adolescent acne. J Eur Acad Dermatol Venereol 2014; 29:2046-50. [PMID: 25266447 DOI: 10.1111/jdv.12754] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 08/18/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acne in adult women tends to be chronic, refractory to treatment and associated with psychosocial problems. Body mass index (BMI) has been reported to be a risk factor for acne in school children and adolescents, but not in adult women. OBJECTIVES The aim of this study was to demonstrate the relationship between BMI and acne lesion counts in women with post-adolescent acne. METHODS Hundred and four women between 25 and 45 years of age, with moderate or severe acne vulgaris were enrolled in this study. The main outcome evaluated was the number of acne lesions, which were then assessed using multiple linear regression analysis. RESULTS The coefficients of multiple regression analysis with stepwise model showed that BMI (β = -0.36; p = 0.001) and family history (β = 0.21; p = 0.04) were the main predictors of the number of acne lesions. CONCLUSION Initial findings indicate that BMI is negatively associated with the number of acne lesions in Taiwanese women with moderate to severe post-adolescent acne.
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Affiliation(s)
- P H Lu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Dermatology, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - C H Hsu
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Branch of Linsen and Chinese Medicine, Taipei City Hospital, Taipei, Taiwan
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Abstract
BACKGROUND The discovery of asynchronous or synchronous double or multiple malignancies in patients is not uncommon. The co-occurrence of second primary malignancy (SPM) could be randomly occurring or association with risk factors such as environmental, genetic predisposition and therapy-related. MATERIALS AND METHODS We retrieved ∼782 million claim records consisting of 10.8 million males and 10.6 million females from Taiwan's National Health Insurance, which were collected for a period of 3 years (January 2000-December 2002). All the patient records were stratified by gender and ages at a 20-year interval with SPMs and specific groups. Interestingness or Q-value was used to measure strength of the disease-disease associations. RESULTS A total of 9423 thyroid cancer (female: 7483, male: 1940), 276 184 SPM (female: 141 023, male: 135 161) and 861 co-occurrence cases (female: 583, male: 278) were recorded. The co-occurrence incidence rate of head and neck, breast, digestive system and lung was 1.93%, 1.59%, 1.44% and 1.18%, respectively. Malignancy of salivary glands, laryngx, sarcoma, lymphoid tissue, mouth, central nervous system and lungs found Q-value >10. Malignancies with intermediate Q-values (5.0-9.9) were observed in nasopharynx, kidney and ureter, breast, stomach and skin. Prostate, leukemia, urinary bladder, ovary, colon, liver and uterine cervix cancer have lower Q-values (1.0-4.9). CONCLUSION Co-occurrence ratio of thyroid cancer and SPM was high, occurred in all organ systems. We postulated that the aggressive use of modern diagnostic modalities, aggressive radioiodine treatment, pre-existing molecular oncogen mutations, and thyroid hormone for simultaneously supple-mentary and suppressive therapies were responsible.
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Affiliation(s)
- C-H Hsu
- From the Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, School of Medicine, College of Medicine, Taipei Medical University, Taipei, School of Health Care Administration, Taipei Medical University, Taipei and Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, TaiwanFrom the Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, School of Medicine, College of Medicine, Taipei Medical University, Taipei, School of Health Care Administration, Taipei Medical University, Taipei and Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, TaiwanFrom the Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, School of Medicine, College of Medicine, Taipei Medical University, Taipei, School of Health Care Administration, Taipei Medical University, Taipei and Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - C-L Huang
- From the Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, School of Medicine, College of Medicine, Taipei Medical University, Taipei, School of Health Care Administration, Taipei Medical University, Taipei and Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Y-H Hsu
- From the Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, School of Medicine, College of Medicine, Taipei Medical University, Taipei, School of Health Care Administration, Taipei Medical University, Taipei and Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - U Iqbal
- From the Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, School of Medicine, College of Medicine, Taipei Medical University, Taipei, School of Health Care Administration, Taipei Medical University, Taipei and Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - P-A Nguyen
- From the Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, School of Medicine, College of Medicine, Taipei Medical University, Taipei, School of Health Care Administration, Taipei Medical University, Taipei and Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - W-S Jian
- From the Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Division of Endocrinology and Metabolism, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, School of Medicine, College of Medicine, Taipei Medical University, Taipei, School of Health Care Administration, Taipei Medical University, Taipei and Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
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Lin CC, Su WC, Yen CJ, Hsu CH, Su WP, Yeh KH, Lu YS, Cheng AL, Huang DCL, Fritsch H, Voss F, Taube T, Yang JCH. A phase I study of two dosing schedules of volasertib (BI 6727), an intravenous polo-like kinase inhibitor, in patients with advanced solid malignancies. Br J Cancer 2014; 110:2434-40. [PMID: 24755882 PMCID: PMC4021529 DOI: 10.1038/bjc.2014.195] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 03/04/2014] [Accepted: 03/17/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Polo-like kinase 1 (Plk1) has an important role in mitosis. Volasertib (BI 6727), a potent and selective cell cycle kinase inhibitor, induces mitotic arrest and apoptosis by targeting Plk; this phase I study sought to determine its maximum tolerated dose (MTD) in Asian patients with advanced solid tumours. METHODS Patients were enrolled simultaneously into two 3-week schedules of volasertib: a 2-h infusion on day 1 (schedule A) or days 1 and 8 (schedule B). Dose escalation followed a 3+3 design. The MTD was determined based on dose-limiting toxicities (DLT) in the first treatment course. RESULTS Among 59 treated patients, the most common first course DLTs were reversible thrombocytopenia, neutropenia and febrile neutropenia; MTDs were 300 mg for schedule A and 150 mg for schedule B. Volasertib exhibited multi-exponential pharmacokinetics (PK), a long terminal half-life of ∼135 h, a large volume of distribution (>3000 l), and a moderate clearance. Partial responses were observed in two pre-treated patients (ureteral cancer; melanoma). Volasertib was generally well tolerated, with an adverse event profile consistent with its antimitotic mode of action and a favourable PK profile. CONCLUSIONS These data support further development of volasertib and a harmonised dosing for Asian and Caucasian patients.
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Affiliation(s)
- C-C Lin
- Department of Oncology, National Taiwan University Hospital, 7 Chung Shan S Road, Taipei 100, Taiwan
| | - W-C Su
- Department of Internal Medicine, National Cheng Kung University, Medical College and Hospital, 138 Sheng-Li Road, Tainan 704, Taiwan
| | - C-J Yen
- Department of Internal Medicine, National Cheng Kung University, Medical College and Hospital, 138 Sheng-Li Road, Tainan 704, Taiwan
| | - C-H Hsu
- Department of Oncology, National Taiwan University Hospital, 7 Chung Shan S Road, Taipei 100, Taiwan
- Graduate Institute of Oncology and Cancer Research Centre, National Taiwan University College of Medicine, 2 Xuzhou Road, Taipei 100, Taiwan
| | - W-P Su
- Department of Internal Medicine, National Cheng Kung University, Medical College and Hospital, 138 Sheng-Li Road, Tainan 704, Taiwan
| | - K-H Yeh
- Department of Oncology, National Taiwan University Hospital, 7 Chung Shan S Road, Taipei 100, Taiwan
- Graduate Institute of Oncology and Cancer Research Centre, National Taiwan University College of Medicine, 2 Xuzhou Road, Taipei 100, Taiwan
| | - Y-S Lu
- Department of Oncology, National Taiwan University Hospital, 7 Chung Shan S Road, Taipei 100, Taiwan
| | - A-L Cheng
- Department of Oncology, National Taiwan University Hospital, 7 Chung Shan S Road, Taipei 100, Taiwan
- Graduate Institute of Oncology and Cancer Research Centre, National Taiwan University College of Medicine, 2 Xuzhou Road, Taipei 100, Taiwan
| | - D C-L Huang
- Boehringer Ingelheim Taiwan Limited, 12F, 49/51 Min Sheng East Road, Taipei 100, Taiwan
| | - H Fritsch
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, 88397 Biberach, Germany
| | - F Voss
- Boehringer Ingelheim Pharma GmbH & Co. KG., Binger Strasse 173, Ingelheim, Germany 55216
| | - T Taube
- Boehringer Ingelheim Pharma GmbH & Co. KG, Birkendorfer Strasse 65, 88397 Biberach, Germany
| | - J C-H Yang
- Department of Oncology, National Taiwan University Hospital, 7 Chung Shan S Road, Taipei 100, Taiwan
- Graduate Institute of Oncology and Cancer Research Centre, National Taiwan University College of Medicine, 2 Xuzhou Road, Taipei 100, Taiwan
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Abstract
AIM Periodontal disease encompasses gingivitis and periodontitis, which exerts systemic effects. We conducted a population-based study to evaluate the association between periodontal disease and the risk of cancer. METHODS We used insurance claims data from 1997 to 2010, accessing a database of 1 million randomly selected insurants in Taiwan. All patients were older than 20 and newly diagnosed with periodontitis between 1 January 1997 and 31 December 2010. The comparison cohort comprised patients older than 20, who were newly diagnosed with gingivitis in the same period. Both cohorts were followed until a cancer diagnosis, lost to follow-up, death, termination of insurance, or the end of 2010. RESULTS The incidence rate of cancer was 1.14 times higher in the study cohort than in the comparison cohort [confidence interval (CI) = 1.11-1.17]. The adjusted hazard ratio (HR) was 1.05 (95% CI = 1.00-1.11). A multivariable analysis showed that the periodontitis patients exhibited an elevated risk of developing oral cancer (adjusted HR = 1.79, 95% CI = 1.42-2.25). CONCLUSION The findings indicated that patients in the periodontitis cohort exhibited a higher risk of developing oral cancer than those in the gingivitis cohort.
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Affiliation(s)
- B-W Wen
- M.D., Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 404, Taiwan.
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Komenaka IK, Hsu CH, Bouton ME, Olson L, Pond E, Nodora J, Martinez ME, Nesset EM, Maffi TR. Abstract P2-18-16: Patients’ impression of the expected appearance of breasts in 2013. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-18-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Concern exists about the increasing rate of bilateral mastectomy for patients with unilateral breast cancer. Patient concern for second primary, use of breast MRI, and increased genetic cancer risk assessment all may influence choice of operation. In recent years, cosmetic breast augmentation has also become more common. This study was performed to evaluate women's perception of the current expected appearance of breasts.
Methods: From April 2012 to May 2013, all patients seen at a Breast Clinic were shown two pictures (A “natural” and B “augmented”) and asked “What is the expected appearance of breasts in 2012(2013)?” Sociodemographic, clinical, and treatment variables were collected. Univariate analysis was performed to identify variables which were associated with picture choice. All of the variables with a p-value <0.10 were included in the multivariate analysis.
Results: 1,177 consecutive patients were seen with mean age 45 years. 93% of the patients were insured with Medicaid or uninsured and 19% were non-Hispanic White (NHW). The mean monthly income was only $1104. Overall 70% of patients felt that the augmented appearance is “expected in 2013.” Age was strongly associated with augmented appearance as younger patients were significantly more likely to choose picture B: age less than 40 years (85%), age 40-49 years (67%), age 50-59 years (65%), and age 60+ years (51%). Patients of all race/ethnic groups felt that the augmented appearance was expected. NHW 65%, AA 67%, and Hispanic 71%. Multivariate analysis found that more years of education (p = 0.001), younger age and lower BMI were strongly associated (p < 0.0001) with choosing the augmented appearance as “expected in 2013.”
Of the 1177 patients, 337 breast cancer patients were seen. Overall 62% felt that the augmented appearance was expected. Of those who underwent an operation, 178 (58%) patients underwent breast conservation and 62% felt the augmented appearance was expected. Of 128 patients who underwent mastectomy, 36 (28%) underwent reconstruction. 23 patients underwent bilateral mastectomy. Of those who underwent mastectomy alone (41/83 = 49%) only about half felt the augmented appearance was expected. By contrast those who underwent reconstruction (33/36 = 92%; p < 0.001) or bilateral mastectomy (17/23 = 74%; p = 0.057), were significantly more likely than those who underwent mastectomy alone to feel the augmented appearance was expected.
Conclusions: The current study suggests women's perception of the expected appearance of breasts is changing. Younger age was strongly associated with the perception that the “augmented” appearance is expected. This change may affect patients’ choice in surgical operations with more mastectomies and reconstructions in the future. In October 2012 from a common women's periodical, when asked about her choice of operation for a small area of unilateral DCIS, one woman responded, “Just take them off and give me implants. Everybody has implants; it's no big deal.”
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-18-16.
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Affiliation(s)
- IK Komenaka
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
| | - C-H Hsu
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
| | - ME Bouton
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
| | - L Olson
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
| | - E Pond
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
| | - J Nodora
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
| | - ME Martinez
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
| | - EM Nesset
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
| | - TR Maffi
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tuscon, AZ; University of California - San Diego, San Diego, CA
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Komenaka IK, Wikholm L, Hsu CH, Wells K, Bouton ME, Thompson PA, Schwab R, Nodora J, Martinez ME. Abstract P1-09-15: Perception of breast cancer risk in an underinsured safety net population. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p1-09-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Patient perception of breast cancer risk can affect compliance with screening mammography. In an underinsured population, we have previously found that being insured and adequate health literacy were strong predictors of use of screening mammography. Previous studies in other populations have found that patients with heighted perceived risk also have increased use of screening. Previous studies have found an average perceived risk of 30%. “Risk” and risk assessment are difficult concepts for many people and this may be problematic in undereducated populations. The current study was performed to evaluate women's perception of their lifetime risk of breast cancer in a safety net population.
Methods: From May 2012 to May 2013, all patients seen at a safety net Breast Clinic were asked to estimate their lifetime risk of breast cancer. “If 0 = no chance and 100% = for sure, what are your chances of getting breast cancer in your life?” Sociodemographic, clinical, and treatment variables were collected. Univariate analysis was performed to identify variables which were associated with picture choice. All of the variables with a p-value <0.10 were included in the multivariate analysis.
Results: 1,089 consecutive patients were seen. After exclusion of men and patients known to have breast cancer, 838 patients were included. The mean age was 43 years. 93% of the patients were uninsured or insured with Medicaid. Average education 10 years and 17% were non-Hispanic White (NHW). Overall the average perceived lifetime risk for the population was 29.7%. For all patients age 35 years+, the average Gail model Risk Assessment scores were 1.1% (5 year) and 9% (LT). Only 17% of patients would be considered at increased risk according to Gail model 5 year risk (> 1.6%).
In univariate analysis, continuous variables associated with higher perceived risk were higher BMI (p = 0.003), more years of education (p = 0.0009), and higher 5 year Gail model score (p = 0.0005). Categorical variables associated with higher perceived lifetime risk were being insured (34% vs 27%; p = 0.004) and NonHispanic patients (34% vs 27%; p = 0.003). Adequate health literacy (38% vs 27%; p = 0.0001) and family history of breast cancer in a first degree relative (FDR; 43% vs 27%; p = 0.0001) were the variables with the strongest association with perceived risk. In multivariate analysis after adjustment for the above factors, only family history in FDR remained significant (p = 0.003).
Over a similar time period, being insured (OR 1.52; 95% CI 1.18 – 1.95; p = 0.001) and adequate health literacy (OR 3.75; 95% CI 2.71 – 5.19; p < 0.0001) were the only variables significantly associated with the use of screening mammography.
Conclusions: Underinsured, minority women overestimate their lifetime risk of breast cancer (30%) at a magnitude similar to other populations. Family history has a strong influence on an underinsured populations’ perception of breast cancer risk. Patients who were insured or had adequate health literacy perceived a higher lifetime risk of breast cancer and were significantly more likely to use screening mammography.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P1-09-15.
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Affiliation(s)
- IK Komenaka
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
| | - L Wikholm
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
| | - C-H Hsu
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
| | - K Wells
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
| | - ME Bouton
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
| | - PA Thompson
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
| | - R Schwab
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
| | - J Nodora
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
| | - ME Martinez
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; University of California San Diego, San Diego, CA
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Algotar AM, Thompson PA, Ranger-Moore J, Stratton MS, Hsu CH, Ahmann FR, Nagle RB, Stratton SP. Differences in characteristics of men with localised prostate cancer who demonstrate low, intermediate or high prostate-specific antigen velocity. Intern Med J 2013; 42:374-80. [PMID: 21395960 DOI: 10.1111/j.1445-5994.2011.02473.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)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Current diagnostic tools are inadequate for reliable prediction of prostate cancer (PCa) aggressiveness in patients with localised disease. This results in many patients being exposed to potentially unnecessary invasive treatment and its associated morbidities. In order to develop appropriate treatment strategies, it is essential to understand the differences between patients who will develop aggressive disease and those who will not. METHODS A longitudinal study was conducted in men with localised PCa on active surveillance for their disease in which 140 subjects were followed every 3 months for up to 5 years. Change in prostate-specific antigen (PSA) over time (PSA velocity) was used as a marker for PCa progression. Subjects were categorised as slow, intermediate and fast progressors based on tertiles of PSA velocity. Differences in baseline markers were investigated using logistic regressions. Two approaches were used, slow progressors were compared with fast progressors (model 1) and slow progressors were compared with combination of intermediate and fast progressors (model 2). RESULTS Aspirin was negatively associated with high PSA velocity in model 1 (odds ratio (95% confidence interval): 0.24 (0.06, 0.94), P-value = 0.04) and model 2 (odds ratio = 0.22 (0.08, 0.59), P-value = 0.003), whereas smoking was positively associated with high PSA velocity in model 1 (1.03 (0.92, 1.13), P-value = 0.01). CONCLUSIONS These findings highlight the role of aspirin and smoking in PCa progression. They have potential towards risk stratification as well as PCa prevention and hence need to be investigated further.
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Lian WC, Lin JD, Hsia TL, Hsu CH, Wu CZ, Hsieh CH, Pei D, Chen YL. Metabolic syndrome in normoglycaemic elderly men. Int J Clin Pract 2013; 67:964-70. [PMID: 24073972 DOI: 10.1111/ijcp.12166] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 03/10/2013] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Type-2 diabetes is mainly the metabolic defect involving multiple organs. To conclude their intricate relationships, the term 'ominous octet' had been proposed to denote this phenomenon. In this study, we enrolled older men without any medications for MetS components to further elucidate the relationships between normoglycaemic state and MetS. METHODS We enrolled male subjects with FPG less than 100 mg/dl and aged 65 and older undergoing routine health check-ups in Taiwan. After excluding subjects taking medications that might affect the components of MetS, a total of 6679 men were eligible for the analysis. Study subjects were further grouped into FPG tertiles (< 91 mg/dl, 92-95 mg/dl and > 95 mg/dl for tertil 1, tertil 2 and tertil 3, respectively). RESULTS There was a significant trend between the FPG and percentages of subjects having MetS (p = 0.009). The relationships between the MetS components were higher in FPG 2 and FPG 3 than FPG 1. In simple correlation, all of the MetS and LDL-C were positively correlated with FPG level and multiple regression further confirmed the same result except for HDL-C that became non-significant. Subjects in FPG3 had significantly higher ORs (ORs = 1.19) for having MetS than those in FPG1. CONCLUSIONS In conclusion, higher FPG still had higher risk of having MetS in normoglycaemic range in elderly male. More strict FPG level control may be valuable in CVD prevention and warrants further investigations.
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Affiliation(s)
- W-C Lian
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Buddhist Dalin Tzu Chi General Hospital and School of Medicine, Tzu Chi University, Hualian, Taiwan
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Kuo CC, Liu WR, Lin BH, Hsieh WF, Hsu CH, Lee WC, Hong M, Kwo J. Vertical-cavity and randomly scattered lasing from different thicknesses of epitaxial ZnO films grown on Y₂O₃-buffered Si (111). Opt Express 2013; 21:1857-1864. [PMID: 23389170 DOI: 10.1364/oe.21.001857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Two different types of lasing modes, vertical Fabry-Perot cavity and random lasing, were observed in ZnO epi-films of different thicknesses grown on Si (111) substrates. Under optical excitation at room temperature by a frequency tripled Nd:YVO₄ laser with wavelength of 355 nm, the lasing thresholds are low due to high crystalline quality of the ZnO epitaxial films, which act as microresonators. For the thick ZnO layer (1,200 nm), its lasing action is originated from the random scattering due to the high density of crack networks developed in the thick ZnO film. However, the low crack density of the thin film (555 nm) fails to provide feedback loops essential for random scattering. Nevertheless, even the lower threshold lasing is achieved by the Fabry-Perot cavity formed by two interfaces of the thin ZnO film. The associated lasing modes of the thin ZnO film can be characterized as the transverse Gaussian modes attributed to the smooth curved surfaces.
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Affiliation(s)
- C C Kuo
- Department of Photonics & Institute of Electro-Optical Engineering National Chiao Tung University, 1001 Tahsueh Rd., Hsinchu 30010, Taiwan
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Shao KT, Lai KC, Lin YC, Chen LS, Li HY, Hsu CH, Lee H, Hsu HW, Mai GS. Experience and Strategy of Biodiversity Data Integration in Taiwan. Data Sci J 2013. [DOI: 10.2481/dsj.wds-008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Komenaka IK, Olsen L, Klemens AE, Hsu CH, Nodora J, Martinez ME, Thompson PA, Bouton M. Abstract PD08-04: Factors which affect surgical management in an underinsured, county hospital population. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-pd08-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Significant variation exists between institutions in the use of lumpectomy, mastectomy, and reconstruction. Much less is known about minorities and populations outside the large academic institutions. The current study was performed to evaluate variables that affect patient choice in surgical management in a county hospital population.
Methods: A retrospective review of all patients seen at the county, safety net institution with breast cancer from January 2010 to May 2012. Sociodemographic, clinical, and treatment variables were evaluated. Univariate analysis was performed to identify variables which were associated with type of operation. All of the variables with a p-value <0.10 were included in the multivariate analysis.
Results: 403 patients were seen with mean age 53 years. 92% of the patients were insured with Medicaid or uninsured and 29% were non-Hispanic White. Only 20% of patients underwent screening mammography and therefore presentation with palpable, Stage 2A/B cancer was most common (46%). 54 patients presented with T4 tumors and 13 (24%) were found to have metastases. Only 2 of 340 (0.6%) patients who presented at Stage 3A or earlier presented with metastatic disease. Patients with operable cancer underwent lumpectomy in 65%, mastectomy in 26%, and 9% mastectomy with reconstruction. With respect to breast conservation vs mastectomy, in adjusted analysis, married patients (OR 2.59, p = 0.003) and patients with larger tumors (p = 0.003) were more likely to undergo mastectomy, while patients who were Hispanic (OR 0.38, p = 0.004), underwent preoperative chemotherapy (OR 0.25, p = 0.002), or had their operation by breast surgical oncologist (OR 0.30, p = 0.005) were more likely to undergo breast conservation. When patients who underwent mastectomy alone were compared to those who underwent reconstruction, unadjusted analysis suggested that reconstruction patients were more likely to speak English, have adequate health literacy (HL), lower clinical stage, and be seen by a breast surgical oncologist. Adjusted analysis demonstrated that having been seen by a breast surgical oncologist (OR 18.4, p = 0.007), younger age (p = 0.05) and adequate HL (OR 3.13, p = 0.06) were associated with likelihood of reconstruction compared to mastectomy alone.
Conclusions: Breast conservation and mastectomy with reconstruction can be achieved in a significant proportion (74%) of underscreened and underinsured patients. Patients who underwent preoperative chemotherapy were more likely to undergo breast conservation. Younger patients and patients with adequate HL were more likely to choose reconstruction after mastectomy. Patients treated by breast surgical oncologists were more likely to have breast conservation or mastectomy with reconstruction. Even in an underscreened population, presentation with metastatic disease is uncommon in patients with operable breast cancer.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr PD08-04.
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Affiliation(s)
- IK Komenaka
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; Moores Cancer Center, University of California, San Diego, CA
| | - L Olsen
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; Moores Cancer Center, University of California, San Diego, CA
| | - AE Klemens
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; Moores Cancer Center, University of California, San Diego, CA
| | - C-H Hsu
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; Moores Cancer Center, University of California, San Diego, CA
| | - J Nodora
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; Moores Cancer Center, University of California, San Diego, CA
| | - ME Martinez
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; Moores Cancer Center, University of California, San Diego, CA
| | - PA Thompson
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; Moores Cancer Center, University of California, San Diego, CA
| | - M Bouton
- Maricopa Medical Center, Phoenix, AZ; University of Arizona, Tucson, AZ; Moores Cancer Center, University of California, San Diego, CA
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Hsu CM, Hsu CH, Yang MY, Lin HC, Lai CC, Hsu CY, Tsou YA. Glottal insufficiency with thyroid cartilage implantation: our experience in eight patients. Clin Otolaryngol 2012; 37:399-405. [PMID: 23164267 DOI: 10.1111/j.1749-4486.2012.02495.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lin BH, Liu WR, Lin CY, Hsu ST, Yang S, Kuo CC, Hsu CH, Hsieh WF, Chien FSS, Chang CS. Single domain m-plane ZnO grown on m-plane sapphire by radio frequency magnetron sputtering. ACS Appl Mater Interfaces 2012; 4:5333-5337. [PMID: 22989018 DOI: 10.1021/am301271k] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
High-quality m-plane orientated ZnO films have been successfully grown on m-plane sapphire by using radio frequency magnetron sputtering deposition. The introduction of a nanometer-thick, low-temperature-grown ZnO buffer layer effectively eliminates inclusions of other undesirable orientations. The structure characteristics of the ZnO epi-layers were thoroughly studied by synchrotron X-ray scattering and transmission electron microscopy (TEM). The in-plane epitaxial relationship between ZnO and sapphire follows (0002)(ZnO) [parallel] (112[overline]0)(sapphire) and (112[overline]0)(ZnO) [parallel] (0006)(sapphire) and the ZnO/sapphire interface structure can be described by the domain matching epitaxy along the [112[overline]0](ZnO) direction. The vibrational properties of the films were investigated by polarization dependent micro-Raman spectroscopy. Both XRD and micro-Raman results reveal that the obtained m-ZnO layers are under an anisotropic biaxial strain but still retains a hexagonal lattice.
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Affiliation(s)
- B H Lin
- Department of Photonics and Institute of Electro-Optical Engineering, National Chiao Tung University, Hsinchu 30010, Taiwan
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Hsu CH, Peng KL, Jhang HC, Lin CH, Wu SY, Chiang CM, Lee SC, Yu WCY, Juan LJ. The HPV E6 oncoprotein targets histone methyltransferases for modulating specific gene transcription. Oncogene 2012; 31:2335-49. [PMID: 21963854 PMCID: PMC3349118 DOI: 10.1038/onc.2011.415] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Expression of viral proteins causes important epigenetic changes leading to abnormal cell growth. Whether viral proteins directly target histone methyltransferases (HMTs), a key family enzyme for epigenetic regulation, and modulate their enzymatic activities remains elusive. Here we show that the E6 proteins of both low-risk and high-risk human papillomavirus (HPV) interact with three coactivator HMTs, CARM1, PRMT1 and SET7, and downregulate their enzymatic activities in vitro and in HPV-transformed HeLa cells. Furthermore, these three HMTs are required for E6 to attenuate p53 transactivation function. Mechanistically, E6 hampers CARM1- and PRMT1-catalyzed histone methylation at p53-responsive promoters, and suppresses the binding of p53 to chromatinized DNA independently of E6-mediated p53 degradation. p53 pre-methylated at lysine-372 (p53K372 mono-methylation) by SET7 protects p53 from E6-induced degradation. Consistently, E6 downregulates p53K372 mono-methylation and thus reduces p53 protein stability. As a result of the E6-mediated inhibition of HMT activity, expression of p53 downstream genes is suppressed. Together, our results not only reveal a clever approach for the virus to interfere with p53 function, but also demonstrate the modulation of HMT activity as a novel mechanism of epigenetic regulation by a viral oncoprotein.
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Affiliation(s)
- C-H Hsu
- Genomics Research Center, Academia Sinica, Taipei, Taiwan, ROC
| | - K-L Peng
- Genomics Research Center, Academia Sinica, Taipei, Taiwan, ROC
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, Taiwan, ROC
| | - H-C Jhang
- Genomics Research Center, Academia Sinica, Taipei, Taiwan, ROC
| | - C-H Lin
- Genomics Research Center, Academia Sinica, Taipei, Taiwan, ROC
- Institute of Molecular Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
- Institute of Cancer Research, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan, ROC
| | - S-Y Wu
- Simmons Comprehensive Cancer Center, Departments of Pharmacology and Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C-M Chiang
- Simmons Comprehensive Cancer Center, Departments of Pharmacology and Biochemistry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - S-C Lee
- Institute of Molecular Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
| | - W C Y Yu
- National Institute of Cancer Research, National Health Research Institutes, Miaoli County, Taiwan, ROC
| | - L-J Juan
- Genomics Research Center, Academia Sinica, Taipei, Taiwan, ROC
- Institute of Biochemistry and Molecular Biology, National Yang-Ming University, Taipei, Taiwan, ROC
- Institute of Molecular Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
- Genomics Research Center, Academia Sinica, 128, Academia Rd, Sec. 2, Nankang, Taipei 115, Taiwan, ROC. E-mail:
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Yen TJ, Chung CS, Wu YW, Yen RF, Cheng MF, Lee JM, Hsu CH, Chang YL, Wang HP. Comparative study between endoscopic ultrasonography and positron emission tomography-computed tomography in staging patients with esophageal squamous cell carcinoma. Dis Esophagus 2012; 25:40-7. [PMID: 21595776 DOI: 10.1111/j.1442-2050.2011.01204.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Treatment strategy of esophageal cancer mainly depends on accurate staging. At present, no single ideal staging modality is superior to another in preoperative tumor-node-metastasis (TNM) staging of patients with esophageal cancer. We aimed to investigate the efficacy of endoscopic ultrasonography (EUS) and positron emission tomography-computed tomography (PET-CT) for staging of esophageal cancer. We retrospectively studied 118 consecutive patients with esophageal squamous cell carcinoma who underwent esophagectomy with or without neoadjuvant chemoradiotherapy (CRT) over a near 3-year period between January 2005 and November 2008 at a tertiary hospital in Taiwan. Patients were separated into two groups: without neoadjuvant CRT (group 1, n= 28) and with CRT (group 2, n= 90). Medical records of demographic data and reports of EUS and PET-CT of patients before surgery were reviewed. A database of clinical staging by EUS and PET-CT was compared with one of pathological staging. The accuracies of T staging by EUS in groups 1 and 2 were 85.2% and 34.9%. The accuracies of N staging by EUS in groups 1 and 2 were 55.6% and 39.8%. The accuracies of T and N staging by means of PET-CT scan were 100% and 54.5% in group 1, and were 69.4% and 86.1% in group 2, respectively. In group 2, 38 of 90 patients (42.2%) achieved pathologic complete remission. Among them, two of 34 (5.9%) and 12 of 17 (70.6%) patients were identified as tumor-free by post-CRT EUS and PET-CT, respectively. EUS is useful for initial staging of esophageal cancer. PET-CT is a more reliable modality for monitoring treatment response and restaging. Furthermore, the accuracy of PET-CT with regard to N staging is higher in patients who have undergone CRT than those who have not.
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Affiliation(s)
- T-J Yen
- Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
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