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Zhang T, Zhao L, Wang Z, Sun XH, Wang W, Duan J, Chen LT. Dosimetric Validation of 3D-Printed Bolus at Different Printing Infill Percentage in VMAT Plan. Int J Radiat Oncol Biol Phys 2023; 117:e746. [PMID: 37786163 DOI: 10.1016/j.ijrobp.2023.06.2286] [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) The 3D printed bolus technology is rapidly evolving in external beam radiotherapy and printing parameters can have a significant impact on absorbed dose. In this study, a novel 3D printed bolus was designed to evaluate the time and material cost effects, dosimetry differences, and surface dose modulation capabilities in the volumetric-modulated arc therapy (VMAT) plan at different print filling percentages. MATERIALS/METHODS A hollow-type bolus, the middle 2.36 mm of 5 mm thickness infilled with different ratio, was designed and printed with polylactic acid (PLA). The ratio of printed material was defined by the infill percentage parameter ranging from 10% to 90%. For each bolus, two treatment plans were designed with AAA algorithm, considering the real computed tomography (CT) scan of the 3D printed bolus and modeling the 3D printed bolus as a virtual bolus structure. Percentage depth dose (PDD) profiles were calculated to build up the mapping equivalent CT value in treatment plan system (TPS). Measurement dose was performed by radiographic films. The PDD profiles were then compared between measured and calculated. A simulation VMAT treatment plan with planning target volume (PTV) close to the body surface was designed on a water-equivalent phantom, and the modulation capabilities of epidermal dose under different filling percentage was compared. RESULTS Compared with 100% percent infill 3D printed bolus, The maximum printing time could be reduced by 47.8% and material consumption could be reduced by 42.5%. The surface dose at single field irradiation can reach 69.6% to 85.8% of the maximum dose in different filling boluses. The PDD measurement and mapping equivalent CT calculation deviation was less than 3% when the infill percentage of the middle region is greater than 30%. The dose distribution of the VMAT plan is satisfying for infill percentages greater than 30%. CONCLUSION Using the 3D printing technology is possible to modulate the amount of shift of the build-up region by tuning the infill percentage of the 3D printed bolus. Patients could undergo CT simulation without bolus. Appropriate bolus could be selected according to the location of the PTV region and dose requirement.
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Affiliation(s)
- T Zhang
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L Zhao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Z Wang
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - X H Sun
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - W Wang
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - J Duan
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - L T Chen
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Wang Z, Sun XH, Wang W, Chen LT, Duan J, Chen Y, Xiao F, Zhao L. First Demonstration of the Commissioning of a New Multi-Modality Radiotherapy Platform. Int J Radiat Oncol Biol Phys 2023; 117:e736-e737. [PMID: 37786138 DOI: 10.1016/j.ijrobp.2023.06.2264] [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) A new multi-modality radiotherapy platform was developed and introduced into clinical application, which has received US FDA 510k(K210921) and National Medical Products Administration (NMPA) clearance in China (20223050973). This study, for the first time, presents the technological characteristics and commissioning results of the new platform. MATERIALS/METHODS The platform consists of 3 modules: linear accelerator, rotating gamma system, and a kV imaging system within an O-ring gantry. The O-ring gantry can rotate continuously achieved by using a slip ring. The Linac delivers a 6 MV FFF photon beam with a variable dose rate of 50 to 1400 MU/min. The delivery techniques include 3D-CRT, IMRT, and VMAT. The rotating gamma system utilizes 18 Co-60 sources with a reference dose rate of 350 cGy/min. The image-guided techniques consist of kV-kV pairs and kV-CBCT. The X-ray intensity-modulated radiotherapy and γ-ray stereotactic radiotherapy can be delivered on the same platform. The acceptance test and commissioning were performed following the vendor's customer acceptance tests (CAT) and several AAPM Task Group reports/guidelines. Regarding the Linac, all applicable validation tests recommended by the MPPG 5.a (basic photon beam model validation, IMRT/VMAT validation, E2E tests, and patient-specific QA) were performed. For the rotating gamma system, the absorbed doses were measured using a PTW31014 and PTW60016. EBT3 films were employed to measure the relative output factors (ROFs). The E2E tests were performed using a PTW31014 and EBT3 films. The coincidence between the imaging isocenter and the Linac/gamma treatment isocenter was investigated using EBT3 films. The image quality was evaluated regarding the contrast-to-noise ratio (CNR), spatial resolution, and uniformity. RESULTS All tests included in the CAT met the vendor's specifications. All MPPG 5.a tests complied with the tolerances. The confidence limits for IMRT/VMAT validation were achieved according to TG-119. The point dose differences were below 1.68% and gamma pass rates (3%/2 mm) were above 95.9% for the Linac E2E tests. All plans of patient-specific QA had point dose differences below 1.79% and gamma pass rates (3%/2 mm) above 96.1% suggested by TG-218. For the rotating gamma system, the differences between the calculated and measured absorbed doses were below 1.86%. The ROFs calculated by the TPS were independently confirmed within 2% using EBT3 films. The point dose differences were below 2.57% and gamma pass rates (2%/1 mm) were above 95.3% for the E2E tests. The coincidence between the imaging isocenter and the Linac/gamma treatment isocenter was within 0.5 mm. The image quality fully complied with the vendor's specifications regarding the CNR, spatial resolution, and uniformity. CONCLUSION This is the first report about the commissioning of a new multi-modality radiotherapy platform. The platform has been successfully commissioned and exhibits good performance in mechanical and dosimetry accuracy.
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Affiliation(s)
- Z Wang
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - X H Sun
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - W Wang
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L T Chen
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - J Duan
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Y Chen
- OUR UNITED CORPORATION, Xi'an, Shaanxi, China
| | - F Xiao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - L Zhao
- Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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Li W, Chen LT, Yu Y, Wang J, Li CY, Cai TE, Lu CJ, Li DX, Tian XJ. [Molecular genetic characteristics of a family which coinheritance of rare-88 C>G ( HBB:c.-138 C>G) β-thalassemia mutation with α-thalassemia and review of the literature]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:253-258. [PMID: 36797585 DOI: 10.3760/cma.j.cn112150-20220818-00823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The molecular genetic characteristics of a family with rare -88 C>G (HBB: c.-138 C>G) β-thalassemia gene mutation were studied using cohort study. The cohort study was conducted from June to August 2022 by Prenatal Diagnosis Center of Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center. The phenotype and genotype were analyzed by hematological cytoanalyzer, automatic electrophoretic analysis system, and next-generation sequencing (NGS). And then, Sanger sequencing was used to verify the rare gene results. The results showed that the proband, her father, her uncle and her younger male cousin had discrete microcytosis (MCV 70.1 fl, 71.9 fl, 73.1 fl and 76.6 fl, respectively) and hypochromia (MCH 21.5 pg,22.0 pg,22.6 pg and 23.5 pg, respectively), elevated hemoglobin A2 level (5.3%, 5.4%, 5.4% and 5.5%, respectively), slightly elevated or normal fetal hemoglobin (Hb F), but no anemia. The proband was identified to have co-inherited ɑ-thalassemia (Hb Westmead gene heterozygous mutation, ɑwsɑ/ɑɑ) and β-thalassemia with a rare -88 C>G (HBB: c.-138 C>G) heterozygous mutation (β-88 C>G/βN). Her mother had the same α-thalassemia as the proband. Her father, her uncle and her younger male cousin had the same rare -88 C>G heterozygous mutations as the proband. While her grandmother and younger brother were not carrier of thalassemia. In conclusion, 4 cases of rare -88 C>G(HBB:c.-138 C>G) heterozygous mutation had been detected in a Chinese family. Carriers of this beta-thalassemia are clinically asymptomatic. This study enriches the knowledge of the thalassemia mutation spectrum in Chinese people and provides valuable information for genetic counseling, prenatal diagnosis, and prevention of thalassemia, providing a scientific basis for improving the quality of birth population and preventing birth defects.
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Affiliation(s)
- W Li
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
| | - L T Chen
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
| | - Y Yu
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
| | - J Wang
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
| | - C Y Li
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
| | - T E Cai
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
| | - C J Lu
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
| | - D X Li
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
| | - X J Tian
- Department of Prenatal Diagnosis, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya 572000,China
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Guo JQ, Wang S, Zhou WJ, Xu BL, Chen LT. [Correlation between single nucleotide polymorphisms of rs4778137 located in OCA2 gene and clinical response of breast cancer patients receiving neoadjuvant chemotherapy]. Zhonghua Yi Xue Za Zhi 2019; 99:1712-1716. [PMID: 31216817 DOI: 10.3760/cma.j.issn.0376-2491.2019.22.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the correlation between single nucleotide polymorphisms (SNPs) of rs4778137 located in OCA2 gene and clinical response of breast cancer patients receiving neoadjuvant chemotherapy. Methods: A total of 140 breast cancer patients receiving neoadjuvant chemotherapy were enrolled to detect DNA in blood sample by DNA extraction kit and the rs4778137 polymorphism by sequenom. The relationship between SNPs of rs4778137 and pathologic complete response (pCR) were analyzed. Results: The frequency of CC, GC and GG genetype of rs4778137 was 48.6%, 31.4% and 20.0%,respectively. Thirty cases (21.4%) achieved pCR with CC allele in 9 cases(13.2%),GC allele in 10 cases (22.7%) and GG allele in 11 cases (39.3%),respectively,with a statistically significant difference(P<0.05). When conducting stratified analysis in accordance with the estrogen receptor (ER) status,only in ER negative group pCR was significantly associated with SNPs of rs4778137 (P<0.05). SNPs of Rs4778137, targeted therapy,subtypes,tumor stage were independent predictors of pCR in multivariate logistic regression analysis (P<0.05),and SNPs of rs4778137 was an independent predictors of pCR in ER negative group (P<0.05), but not in ER positive group group (P>0.05). Conclusion: SNPs of rs4778137 was associated with pCR only in ER negative patients receiving neoadjuvant therapy, and breast cancer patients with the GG allele were more likely to achieve pCR.
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Affiliation(s)
- J Q Guo
- Department of Emergency, Huaihe Hospital of Henan University, Kaifeng 475000, China
| | - S Wang
- Department of Thyroid and Breast Surgery, Huaihe Hospital of Henan University, Kaifeng 475000, China
| | - W J Zhou
- Department of Thyroid and Breast Surgery, Huaihe Hospital of Henan University, Kaifeng 475000, China
| | - B L Xu
- Department of Biological Treatment, Henan Cancer Hospital, Zhengzhou 450000, China
| | - L T Chen
- Department of Emergency Medicine, Kaifeng City Center Hospital, Kaifeng 475000, China
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Chang TC, Shiah HS, Yang CH, Yeh KH, Cheng AL, Shen BN, Wang YW, Yeh CG, Chiang NJ, Chang JY, Chen LT. Phase I study of nanoliposomal irinotecan (PEP02) in advanced solid tumor patients. Cancer Chemother Pharmacol 2015; 75:579-86. [PMID: 25577133 PMCID: PMC4341010 DOI: 10.1007/s00280-014-2671-x] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 12/30/2014] [Indexed: 12/18/2022]
Abstract
Purpose
To define the dose-limiting toxicity (DLT), maximum tolerated dose (MTD) and pharmacokinetics (PK) of PEP02, a novel liposome-encapsulated irinotecan, in patients with advanced refractory solid tumors. Methods Patients were enrolled in cohorts of one to three to receive escalating dose of PEP02 in a phase I trial. PEP02, from 60 to 180 mg/m2, was given as a 90-min intravenous infusion, every 3 weeks. Results A total of 11 patients were enrolled into three dose levels: 60 (one patient), 120 (six patients) and 180 mg/m2 (four patients). DLT was observed in three patients, one at 120 mg/m2 (grade 3 catheter-related infection) and two at 180 mg/m2 (grade 4 neutropenia lasting for >3 days in one, grade 4 hematological toxicities and grade 4 diarrhea in the other). MTD was determined as 120 mg/m2. Comparing with those after free-form irinotecan in the literature, the dose-normalized PK of SN-38 (the active metabolite) after PEP02 was characterized by lower Cmax, prolonged terminal half-life and higher AUC but with significant inter-individual variation. One patient who died of treatment-related toxicity had significantly higher Cmax and AUC levels of SN-38 than those of the other three patients at 180 mg/m2. Post hoc pharmacogenetic study showed that the patient had a combined heterozygosity genotype of UGT1A1*6/*28. Two patients had objective tumor response. Conclusions PEP02 apparently modified the PK parameters of irinotecan and SN-38 by liposome encapsulation. The MTD of PEP02 monotherapy at 3-week interval is 120 mg/m2, which will be the recommended dose for future studies.
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Affiliation(s)
- T C Chang
- Department of Gynecology, Linkuo Chang-Gung Memorial Hospital, No.5, Fu-Hsing Street, Kuei-shan Hsiang, Taoyuan, 33305, Taiwan
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Koronkiewicz M, Romiszewska A, Kazimierczuk Z, Chilmonczyk Z, Neto MDS, Ramos SP, Curvello R, Bin M, Domingues NLC, Rinaldi AW, de Souza ACS, Dyshlovoy SA, Venz S, Guzii A, Makarieva T, Tabakmakher K, Stonik V, Balabanov S, Bokemeyer C, Honecker F, Flis S, Flis K, Statkiewicz M, Curvello R, Neto MDS, Ramos SP, Bin MEL, Shishido SM, de Souza ACS, Dovat S, Song C, Gowda C, Petrovic-Dovat L, Payne J, Chen LT, Tsai HJ, Kuo SH, Cheng AL, Chen J, Fu L, Kwong D, Guan X, Zalietok S, Samoylenko O, Zhuravel O, Gulua L, Orlovsky O, Chekhun V, Chekhun V, Zalietok S, Gulua L, Orlovsky O, Milinevska V, Karnaushenko O, Priya S, Reshma RS, Rakesh SN, Sreelatha KH, Veena S, Nand K, Gupta JC, Panda AK, Jain SK, Talwar GP, Riva P, Oreal P, Lima RT, Sousa D, Choosang K, Pakkong P, Palmeira A, Paiva AM, Seca H, Cerqueira F, Pedro M, Pinto MM, Sousa E, Vasconcelos MH. Poster session 3. Drug profiles - preclinical. Ann Oncol 2013. [DOI: 10.1093/annonc/mdt045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Roy AC, Park SR, Cunningham D, Kang YK, Chao Y, Chen LT, Rees C, Lim HY, Tabernero J, Ramos FJ, Kujundzic M, Cardic MB, Yeh CG, de Gramont A. A randomized phase II study of PEP02 (MM-398), irinotecan or docetaxel as a second-line therapy in patients with locally advanced or metastatic gastric or gastro-oesophageal junction adenocarcinoma. Ann Oncol 2013; 24:1567-73. [PMID: 23406728 DOI: 10.1093/annonc/mdt002] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND PEP02 is a novel highly stable liposomal nanocarrier formulation of irinotecan. This randomized phase II study evaluated the efficacy and safety of single agent PEP02 compared with irinotecan or docetaxel in the second-line treatment of advanced oesophago-gastric (OG) cancer. PATIENTS AND METHODS Patients with locally advanced/metastatic disease who had failed one prior chemotherapy regimen were randomly assigned to PEP02 120 mg/m(2), irinotecan 300 mg/m(2) or docetaxel (Taxotere) 75 mg/m(2) every 3 weeks. The primary end point was objective response rate (ORR). Simon's two-stage design was used and the ORR of interest was 20% (α = 0.05, type II error β = 0.10, null hypothesis of ORR was 5%). RESULTS Forty-four patients per arm received treatment, and 124 were assessable for response. The ORR statistical threshold for the first stage was reached in all arms. In the intent-to-treat (ITT) population, ORRs were 13.6% (6/44), 6.8% (3/44) and 15.9% (7/44) in the PEP02, irinotecan and docetaxel arms, respectively. The median progression-free survival (PFS) and overall survival were similar between the trial arms. Commonest grade 3-4 adverse event reported was diarrhoea in the PEP02 and irinotecan groups (27.3% versus 18.2%). CONCLUSION The ORR associated with PEP02 was comparable with docetaxel and numerically greater than that of irinotecan. PEP02 warrants further evaluation in the advanced gastric cancer setting.
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Affiliation(s)
- A C Roy
- Department of Medicine, The Royal Marsden Hospital, Sutton, UK
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Kuo SH, Chen LT, Wu MS, Lin CW, Kuo KT, Wang HP, Hsu PN, Lin JT, Cheng AL. H pylori-positive gastric diffuse large B-cell lymphomas are potentially curable by H pylori eradication therapy. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8093 Background: We have recently demonstrated that early-stage gastric diffuse large B-cell lymphomas (DLBCLs) with MALToma, as well as their MALToma counterparts, may respond to H pylori eradication therapy (HPET). The present study was conducted to evaluate the effect of HPET in stage IE gastric DLBCLs without MALToma. Methods: Seven patients (4 men and 3 women; age range, 35 to 83 years) with H pylori infection and stage IE gastric DLBCL without MALToma received HPET as first-line treatment from June 2002 through May 2006. Additional immunohistochemical reaction with anticytokeratin was performed to exclude lymphoepithelial lesions (minimal MALToma components) in DLBCL. All patients received intensive endoscopic follow-up examinations with biopsy to evaluate tumor response. Patients with significant improvement of gross lesions that accompanied regression of tumor cells were followed up without additional treatment. Patients without significant improvement were immediately referred to systemic chemotherapy. Tumors that resolved to Wotherspoon grade 2 or less after successful HPET were considered as complete histologic remission. Results: Successful HPET was achieved in all patients. There were 5 patients with complete histologic remission. The complete remission rate was 71.4% (95% confidence interval, 45.1% to 97.7%). The median duration between HPET and complete histologic remission was 2.6 months (range, 1.1 to 5.7 months). At a median follow-up of 24.2 months (range, 5.7 to 56.8 months), all patients with complete histologic remission after HPET were alive and free of lymphoma. Conclusions: A substantial portion of early-stage gastric DLBCLs without MALToma remain H pylori-dependent and can potentially be cured by HPET. No significant financial relationships to disclose.
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Affiliation(s)
- S. H. Kuo
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
| | - L. T. Chen
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
| | - M. S. Wu
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
| | - C. W. Lin
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
| | - K. T. Kuo
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
| | - H. P. Wang
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
| | - P. N. Hsu
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
| | - J. T. Lin
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
| | - A. L. Cheng
- National Taiwan University Hospital, Taipei, Taiwan; National Health Research Institutes, Taipei, Taiwan
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Chao Y, Li CP, Chao TY, Su WC, Hsieh RK, Wu MF, Yeh KH, Kao WY, Chen LT, Cheng AL. An open, multi-centre, phase II clinical trial to evaluate the efficacy and safety of paclitaxel, UFT, and leucovorin in patients with advanced gastric cancer. Br J Cancer 2006; 95:159-63. [PMID: 16804524 PMCID: PMC2360611 DOI: 10.1038/sj.bjc.6603225] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The aim of the study was to evaluate the response rate and safety of weekly paclitaxel (Taxol((R))) combination chemotherapy with UFT (tegafur, an oral 5-fluorouracil prodrug, and uracil at a 1 : 4 molar ratio) and leucovorin (LV) in patients with advanced gastric cancer. Patients with histologically confirmed, locally advanced or recurrent/metastatic gastric cancer were studied. Paclitaxel 1-h infusion at a dose of 100 mg m(-2) on days 1 and 8 and oral UFT 300 mg m(-2) day(-1) plus LV 90 mg day(-1) were given starting from day 1 for 14 days, followed by a 7-day period without treatment. Treatment was repeated every 21 days. From February 2003 to October 2004, 55 patients were enrolled. The median age was 62 years (range: 32-82). Among the 48 patients evaluated for tumour response, two achieved a complete response and 22 a partial response, with an overall response rate of 50% (95% confidence interval: 35-65%). All 55 patients were evaluated for survival and toxicities. Median time to progression and overall survival were 4.4 and 9.8 months, respectively. Major grade 3-4 toxicities were neutropenia in 25 patients (45%) and diarrhoea in eight patients (15%). Although treatment was discontinued owing to treatment-related toxicities in nine patients (16%), there was no treatment-related mortality. Weekly paclitaxel plus oral UFT/LV is effective, convenient, and well tolerated in treating patients with advanced gastric cancer.
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Affiliation(s)
- Y Chao
- Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan
- Central Clinic Hospital, Taipei, Taiwan
- National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - C P Li
- National Yang-Ming University School of Medicine, Taipei, Taiwan
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - T Y Chao
- Division of Hematology and Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - W C Su
- Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - R K Hsieh
- Division of Hematology and Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - M F Wu
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - K H Yeh
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan
- Division of Oncology and Hematology, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
| | - W Y Kao
- Division of Hematology and Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - L T Chen
- Institute of Cancer Research, National Health Research Institutes, Taipei, Taiwan
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Institute of Cancer Research, National Health Research Institutes, Taipei Veterans General Hospital, Ward 191, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan. E-mail:
| | - A L Cheng
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
- Cancer Research Center, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Internal Medicine and Department of Oncology, National Taiwan University Hospital, No. 2, Chung-Shan S Rd, Taipei 100, Taiwan. E-mail:
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Chao Y, Li CP, Chao TY, Su WC, Hsieh RK, Wu MF, Yeh KH, Chen LT, Cheng AL. An open, multi-center, phase II clinical trial to evaluate efficacy and safety of paclitaxel, UFT, and leucovorin in patients with advanced gastric cancer - preliminary report. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Y. Chao
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
| | - C. P. Li
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
| | - T. Y. Chao
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
| | - W. C. Su
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
| | - R. K. Hsieh
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
| | - M. F. Wu
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
| | - K. H. Yeh
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
| | - L. T. Chen
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
| | - A. L. Cheng
- Taipei Veterans Gen Hosp, Taipei, Taiwan Republic of China; Tri-Service Gen Hosp, Taipei, Taiwan Republic of China; National Cheng Kung Univ Hosp, Tainan, Taiwan Republic of China; Mackay Memorial Hosp, Taipei, Taiwan Republic of China; Chung Shan Medcl Univ Hosp, Taichung, Taiwan Republic of China; National Taiwan Univ Hosp, Taipei, Taiwan Republic of China; National Health Research Institute, Taipei, Taiwan Republic of China
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11
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Chao Y, Yeh KH, Chang CJ, Chen LT, Chao TY, Wu MF, Chang CS, Chang JY, Chung CY, Kao WY, Hsieh RK, Cheng AL. Phase II study of weekly oxaliplatin and 24-h infusion of high-dose 5-fluorouracil and folinic acid in the treatment of advanced gastric cancer. Br J Cancer 2004; 91:453-8. [PMID: 15226770 PMCID: PMC2409850 DOI: 10.1038/sj.bjc.6601985] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
To investigate the efficacy and safety of combining weekly oxaliplatin with weekly 24-h infusion of high-dose 5-fluorouracil (5-FU) and folinic acid (FA) in treatment of patients with advanced gastric cancer. Patients with histologically confirmed, locally advanced or recurrent/metastatic gastric cancer were studied. Oxaliplatin 65 mg m−2 2-h intravenous infusion, and 5-FU 2600 mg m−2 plus FA 300 mg m−2 24-h intravenous infusion, were given on days 1 and 8, repeated every 3 weeks. Between January 2001 through January 2002, 55 patients were enrolled. The median age was 64 years (range: 22–75). In all, 52 patients (94.5%) had recurrent or metastatic disease and three patients had locally advanced disease. Among 50 patients evaluable for tumour response, 28 patients achieved partial response, with an overall response rate of 56% (95% confidence interval (CI): 41.8–70.3%). All 55 patients were evaluated for survival and toxicities. Median time to progression and overall survival were 5.2 and 10.0 months, respectively, during median follow-up time of 24.0 months. Major grades 3–4 toxicities were neutropenia in 23 cycles (7.1%) and thrombocytopenia in 16 cycles (5.0%). Treatment was discontinued for treatment-related toxicities in nine patients (16.4%), of whom eight were due to oxaliplatin-related neurotoxicity. One patient (1.8%) died of neutropenic sepsis. This oxaliplatin-containing regimen is effective in the treatment of advanced gastric cancer. Except for neurotoxicity that often develops after prolonged use of oxaliplatin, the regimen is well tolerated.
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Affiliation(s)
- Y Chao
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - K H Yeh
- National Taiwan University Hospital, Taipei, Taiwan
- Far Eastern Memorial Hospital, Taipei, Taiwan
| | - C J Chang
- National Taiwan University Hospital, Taipei, Taiwan
| | - L T Chen
- Taipei Veterans General Hospital, Taipei, Taiwan
- National Health Research Institutes, Taipei, Taiwan
| | - T Y Chao
- Tri-Service General Hospital, Taipei, Taiwan
| | - M F Wu
- Chung Shan Medical and Dental College Hospital, Taipei, Taiwan
| | - C S Chang
- Changhua Christian Hospital, Taipei, Taiwan
| | - J Y Chang
- National Taiwan University Hospital, Taipei, Taiwan
- National Health Research Institutes, Taipei, Taiwan
| | - C Y Chung
- Changhua Christian Hospital, Taipei, Taiwan
| | - W Y Kao
- Tri-Service General Hospital, Taipei, Taiwan
| | - R K Hsieh
- Mackay Memorial Hospital, Taipei, Taiwan
| | - A L Cheng
- National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine and Department of Oncology, National Taiwan University Hospital, No 7, Chung-Shan South Road, Taipei, Taiwan. E-mail:
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12
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Chen LT, Phelps CP, Bryant MW, Chen ME. Cellular response to an intravascular catheter. J Submicrosc Cytol Pathol 2003; 35:303-7. [PMID: 14690179] [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] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Central venous catheters are commonly used in clinics for the administration of infusion therapy and total parenteral nutrition. Catheter occlusion is the most common noninfectious complication associated with the long-term use of such devices. The cause of catheter occlusion is the formation of a tissue sleeve around the catheter. In this study, a rat model was used to investigate the effects of integrin antagonist peptide on the growth of the tissue sleeve around the jugular catheters. When integrin antagonist peptide was injected subcutaneously, twice daily, for 3 days, at a dosage of 10 mg/kg of body weight/day, the growth of the tissue sleeve was reduced by 40%, as compared to rats injected with saline or control peptide. Morphological study of the tissue sleeve indicated that catheter-related damage to the nearby endothelial cells was associated with the adhesion of platelets and leukocytes to the injured endothelium and accumulation of fibrin in the vicinity. This proposed sequence of events resulted in an increase in the thickness of the tissue sleeve and changes in sleeve transparency.
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MESH Headings
- Animals
- Catheterization, Central Venous/adverse effects
- Catheterization, Central Venous/instrumentation
- Catheters, Indwelling
- Disease Models, Animal
- Endothelium, Vascular/drug effects
- Endothelium, Vascular/injuries
- Endothelium, Vascular/ultrastructure
- Equipment Failure
- Equipment Failure Analysis
- Injections, Subcutaneous
- Integrin alphaVbeta3/antagonists & inhibitors
- Peptides, Cyclic/administration & dosage
- Peptides, Cyclic/pharmacology
- Rats
- Rats, Sprague-Dawley
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Affiliation(s)
- L T Chen
- Department of Anatomy, College of Medicine, University of South Florida, Tampa, FL 33612, USA.
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13
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Cheng KI, Chu KS, Chen LT, Tang CS. Correct positioning of the venous port-a-cath catheter: comparison of intravascular electrocardiography signal from guidewire and sodium bicarbonate flushed catheter. Anaesth Intensive Care 2002; 30:603-7. [PMID: 12413260 DOI: 10.1177/0310057x0203000510] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A prospective study comparing the efficacy of wire-conducted intravascular ECG (IVECG) signal and signal from the port with a sodium bicarbonate (NaHCO3) flushed catheter to correctly place a catheter tip was carried out in 100 patients. The correct position of the catheter tip was confirmed as follows: with technique G, the IVECG signal was conducted from a guide wire to identify the tip position. With technique P, the IVECG signal was conducted from the port with a NaHCO3 (0.8 mmol/ml) flushed catheter to ascertain the tip position. Each patient received both technique G and technique P in a randomized sequence. The quality of IV-ECG signals, which included baseline drift, P wave pattern and QRS wave pattern, were assessed for ten seconds. Satisfactory quality of these IVECG signals was observed in all of the patients with technique P and 90 of the 100 patients with technique G, and this difference was significant (P=0.001). There was no obvious difference between the techniques in catheter tip placement time or the measured optimal catheter length. The incidence of atrial premature contractions was higher with technique G than with technique P (13% vs 2%; P=0.003). Therefore, technique P is a practical alternative for correctly placing the catheter tip of a Port-A-Cath.
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Affiliation(s)
- K I Cheng
- Department of Anaesthesiology, Kaohsiung Medical University, Kaohsiung City, Taiwan
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14
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Abstract
Mechanical perturbations serve as extracellular signals to a variety of cells, including bone cells. Low-intensity pulsed ultrasound produces significant multifunctional effects that are directly relevant to bone formation and resorption. Ultrasound stimulation has been shown to accelerate bone-defect healing and trabecular bone regeneration. In this study, we use an in vitro bone cell culture model to investigate the effect of low-intensity pulsed ultrasound. The rat alveolar mononuclear cell-calvaria osteoblast coculture system was used in this study. Before treatment, the bone cells were cultured for 3 days to facilitate their attachment and differentiation. Then, ultrasound exposure (frequency = 1 MHz, intensity = 0.068 W/cm(2)) or sham exposure for 20 min per day was applied until the end of the experiment. Half of the culture media were obtained on the 4th, 5th, 6th, 7th, 8th, 9th, and 10th days for the analysis of cytokines and biochemical parameters. At the end of the experiment, cells were fixed and stained for identification and quantification of the osteoblast and osteoclast cells. After low-intensity pulse ultrasound stimulation, the osteoblast cell counts were significantly increased, whereas the osteoclast cell counts were significantly decreased. The total alkaline phosphatase amount in the culture medium was increased after 7 days of ultrasound stimulation, and tumor necrosis factor-alpha in ultrasound-stimulated bone cells was significantly increased after the 7th day of culture and reached 474.77% of the control medium on the 10th day of culture. The results of this study suggest that low-intensity ultrasound treatment may have a stimulatory effect on bone-healing processes.
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Affiliation(s)
- J S Sun
- Department of Orthopaedic Surgery, National Taiwan University Hospital, No 7, Chung-Shan South Road, Taipei, Taiwan, Republic of China
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15
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Chen LT, Lin JT, Shyu RY, Jan CM, Chen CL, Chiang IP, Liu SM, Su IJ, Cheng AL. Prospective study of Helicobacter pylori eradication therapy in stage I(E) high-grade mucosa-associated lymphoid tissue lymphoma of the stomach. J Clin Oncol 2001; 19:4245-51. [PMID: 11709568 DOI: 10.1200/jco.2001.19.22.4245] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE High-grade mucosa-associated lymphoid tissue (MALT) lymphomas of the stomach are generally believed to be Helicobacter pylori-independent, autonomously growing tumors. However, anecdotal cases of regression of high-grade lymphomas after the cure of H pylori infection had been described. The present prospective study was conducted to evaluate the effect of anti-H pylori therapy in stage I(E) high-grade gastric MALT lymphomas. PATIENTS AND METHODS Sixteen patients with H pylori infection and stage I(E) gastric high-grade MALT lymphoma consented to a brief antibiotic therapy as first-line treatment from June 1995 through April 2000. Then, patients underwent intensive endoscopic follow-up examinations (+/- endoscopic ultrasonography) with biopsy to evaluate tumor response. Patients with significant improvement of gross lesions that accompanied regression of large cells were followed up without additional treatment. Patients without significant improvement were immediately referred to systemic chemotherapy. RESULTS Eradication of H pylori was achieved in 15 patients and was accompanied by rapid gross tumor regression and disappearance of large cells in 10. All 10 of these patients with early response had subsequent complete histologic remission of lymphoma. The complete remission rate was 62.5% (95% confidence interval, 35.8% to 89.1%). The response rate was not affected by the tumor grading (proportion of large blast cells within the tumor) but was adversely affected by the depth of tumor invasion. At a median follow-up of 43.5 months (range, 21.1 to 67.4 months), all 10 of these patients remained lymphoma-free. The median duration of complete response was 31.2 months (range, 14.4 to 49.1 months). CONCLUSION These results suggest that high-grade transformation is not necessarily associated with the loss of H pylori dependence in early-stage MALT lymphomas of the stomach.
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Affiliation(s)
- L T Chen
- Taiwan Cooperative Oncology Group, Division of Cancer Research, National Health Research Institutes, Taipei, Taiwan, ROC
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16
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Yao Q, Chen LT, Li J, Brungardt K, Squier TC, Bigelow DJ. Oligomeric interactions between phospholamban molecules regulate Ca-ATPase activity in functionally reconstituted membranes. Biochemistry 2001; 40:6406-13. [PMID: 11371203 DOI: 10.1021/bi002891t] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Phospholamban (PLB) is a major target of the beta-adrenergic cascade in the heart, and functions as an endogenous inhibitor of Ca-ATPase transport activity. To identify whether oligomeric interactions between PLB molecules are involved in regulating Ca-ATPase transport activity, we have investigated functional interactions between PLB and the Ca-ATPase in proteoliposomes of purified PLB functionally co-reconstituted with the SERCA2a isoform of the Ca-ATPase isolated from cardiac sarcoplasmic reticulum (SR). The calcium sensitivity of this reconstituted preparation and functional stimulation by cAMP-dependent protein kinase (PKA) are virtually identical to those of the Ca-ATPase in cardiac SR microsomes, ensuring the functional relevance of this reconstituted preparation. Interactions between PLB molecules were measured following covalent modification of the single lysine (i.e., Lys(3)) in PLB isolated from cardiac SR membranes with fluorescein isothiocyanate (FITC) prior to co-reconstitution with the Ca-ATPase. FITC modification of PLB does not interfere with the ability of PLB to inhibit the Ca-ATPase, since FITC-PLB co-reconstituted with the Ca-ATPase exhibits a similar calcium dependence of Ca-ATPase activation to that observed in native SR membranes. Thus, the functional arrangement of PLB with the Ca-ATPase is not modified by FITC modification. Using changes in the anisotropy of FITC-PLB resulting from fluorescence resonance energy transfer (FRET) between proximal PLB molecules to measure the average size and spatial arrangement of FITC chromophores, we find that PLB self-associates to form oligomers whose spatial arrangement with respect to one another is in agreement with earlier suggestions that PLB exists predominantly as a homopentamer. The inability of PKA to activate PLB following covalent modification with FITC permits functional interactions between PLB molecules associated with the Ca-ATPase activation to be identified. A second-order loss of Ca-ATPase activation by PKA is observed as a function of the fractional contribution of FITC-PLB, indicating that PKA-dependent activation of two PLB molecules within a quaternary complex containing the Ca-ATPase is necessary for activation of the Ca-ATPase. We suggest that the requirement for activation of two PLB molecules by PKA represents a physiological mechanism to ensure that activation of the Ca-ATPase following beta-adrenergic stimulation in the heart only occurs above a threshold level of PKA activation.
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Affiliation(s)
- Q Yao
- Biochemistry and Biophysics Section, Department of Molecular Biosciences, University of Kansas, Lawrence 66045-2106, USA
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17
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Huang TS, Shu CH, Chao Y, Chen LT. Evaluation of GL331 in combination with paclitaxel: GL331's interference with paclitaxel-induced cell cycle perturbation and apoptosis. Anticancer Drugs 2001; 12:259-66. [PMID: 11290873 DOI: 10.1097/00001813-200103000-00011] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Combination of selecting agents that act on different cellular mechanisms is a common strategy in cancer chemotherapy. GL331 is a new potent topoisomerase II (Topo II) poison; distinctly, paclitaxel is a microtubule-interfering cancer chemotherapeutic agent. In this study, we intended to evaluate the efficacy of combining GL331 with paclitaxel in cell killing and apoptotic induction in nasopharyngeal carcinoma NPC-TW01 cells. By MTT and internucleosomal DNA cleavage assays, we found that pretreatment or simultaneous treatment of NPC-TW01 cells with GL331 could significantly interfere with paclitaxel's cell killing and apoptosis-inducing activity. When the administration schedule was reversed, the cytotoxicity of GL331 was attenuated by paclitaxel pretreatment. The anti-cancer activity produced by combining GL331 with paclitaxel was obviously lower than the addition of the activities of two individual agents. NPC-TW01 cells were treated with GL331 and 3H-labeled paclitaxel simultaneously or with GL331 before 3H-labeled paclitaxel. In both conditions, GL331 did not reduce the [3H]paclitaxel level in the cells, suggesting that GL331's interference with paclitaxel's cell-killing and apoptosis-inducing efficacy did not result from any inhibition of cellular uptake or retention of paclitaxel. In addition, we found that GL331-induced perturbation of cell cycle progression dramatically over-rode the patterns of mitotic arrest induced by paclitaxel, and the mechanism could be the inhibition of cyclin B1/CDC2 kinase and MAD2 checkprotein activities.
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Affiliation(s)
- T S Huang
- Cooperative Laboratory, Cancer Research Division, National Health Research Institutes; Taipei, Taiwan, ROC.
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18
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Hsu C, Chen CL, Chen LT, Liu HT, Chen YC, Jan CM, Liu CS, Cheng AL. Comparison of MALT and non-MALT primary large cell lymphoma of the stomach: does histologic evidence of MALT affect chemotherapy response? Cancer 2001; 91:49-56. [PMID: 11148559 DOI: 10.1002/1097-0142(20010101)91:1<49::aid-cncr7>3.0.co;2-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Although the clinicopathologic features of low grade gastric MALToma (lymphoma of mucosa-associated lymphoid tissue) recently have been well delineated, the significance of identifying histologic evidence of MALT origin in a primary high grade gastric lymphoma is less clear. The authors sought to address this issue and, in particular, to clarify if MALT and non-MALT primary large cell gastric lymphoma might have a different response to systemic chemotherapy. METHODS The authors reviewed the pathologic specimens of all patients who had a diagnosis of primary large cell lymphoma of the stomach and who had been treated primarily by systemic chemotherapy in our institutions January 1, 1988-December 31, 1998. The patients were divided into two groups by experienced hematopathologists, based on the presence or absence of histologic features suggestive of MALToma, including typical lymphoepithelial lesions and infiltration of characteristic centrocyte-like cells. Disease staging was done according to the AJCC/UICC system with Musshoff modification. The median number of gastric biopsies for each patient was 7 (range, 1-21). RESULTS Seventeen patients with and 26 patients without histologic evidence of MALToma were identified. Clinical features were similar between the two groups except that a greater proportion of patients without evidence of MALToma had elevated levels of serum lactate dehydrogenase (50% vs. 12%, P = 0.01). The median duration of follow-up for the 43 patients was 46.5 months (range, 17-124 mos). All patients received standard systemic chemotherapy including anthracyclines or anthracenedione. The response rate was 88.2% for patients with evidence of MALToma and 57.7% for those without (P = 0.03). The 5-year overall survival rate was 80.5% for patients with evidence of MALToma and 48.9% for those without (P = 0.02). Multivariate analysis indicated that response to chemotherapy, disease stage (Stage I and II-1 vs. Stage II-2, III, and IV), and the presence of MALToma features were independent prognostic factors for overall survival. CONCLUSION The results of this relatively small study series suggested that the presence of histologic features of MALToma in patients with primary large cell gastric lymphoma might have been associated with a better response to systemic chemotherapy and a better prognosis. Further studies to consolidate this conclusion are necessary.
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Affiliation(s)
- C Hsu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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19
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Phelps CP, Dong JM, Chen LT, Menzies RA. Plasma interleukin-1beta, prolactin, ACTH and corticosterone responses to endotoxin after damage of the anterior hypothalamic area. Neuroimmunomodulation 2001; 9:340-51. [PMID: 12045362 DOI: 10.1159/000059392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This report concerns the use of an animal model described by us [J Submicrosc Cytol Pathol 1995;27:83-89] to investigate neural and endocrine sites for endotoxin (ENDO, E. coli 055:B5, 200 microg/100 g body weight in saline intravenously) effects on immunomodulatory hormone and cytokine release. Plasma interleukin-1beta (IL-1beta), prolactin (PRL), ACTH and corticosterone responses to ENDO after neurotoxic damage of neurons residing in the anterior hypothalamic area (AHA) were studied in freely behaving male rats. Excitotoxic cell damage in the AHA was produced by bilaterally injecting N-methyl-DL-aspartate (NMA) in artificial cerebrospinal fluid (aCSF) into this brain site. Injections of comparable volumes of aCSF alone served as controls for brain damage associated with the treatment. In both experimental brain manipulations before ENDO challenge the rise in plasma IL-1beta concentrations in response to ENDO was reduced by 2-fold at 1 h and 3- to 5-fold at 3 h when compared to controls. Nevertheless, experimental and control brain manipulations did not modulate the expected rise in corticosterone concentrations after ENDO exposure which rose 5-fold above the baseline level in all animals. However, AHA manipulation did reduce plasma ACTH and prolactin concentrations differentially. Introduction of either NMA or the control injection of aCSF alone into AHA reduced plasma ACTH concentrations by 2-fold at 0.5 and 1 h after ENDO. However, there was a greater reduction in the rise of plasma PRL concentrations after ENDO found in NMA-treated groups versus rats receiving control aCSF. These results demonstrate that variable-size hypothalamic damage (a larger lesion produced in AHA by NMA treatment vs. a smaller lesion control after aCSF) can result in a differential blunting of PRL, IL-1beta and ACTH release into blood in the face of robust, unmodulated corticosterone increases. In summary, these findings revealed a consistent predominant influence of ENDO on adrenal release of corticosterone as a concomitant to differential IL-1beta, ACTH and PRL release after AHA cell loss. In conclusion, these results constitute further evidence for hypothalamic orchestration of a balance between immunotropic and immunosuppressive neuroendocrine-immune events during acute bacterial infection of mammals.
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Affiliation(s)
- C P Phelps
- Department of Anatomy, University of South Florida, College of Medicine, Tampa, FL 33612-4799, USA.
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Abstract
Cytokines produced by macrophages in the periprosthetic membranes surrounding joint replacements have been implicated as causal agents in osteolysis and prosthetic loosening. The present study characterizes the response of human peripheral blood monocytes to titanium particles. Monocytes were obtained from donated blood and were cultured in the presence of different-sized titanium particles. Exposure to titanium-aluminum-vanadium particles significantly changed the release of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-1 (IL-1), whereas there was no significant effect on the release of prostaglandin E(2) (PGE(2)). When monocytes were cultured with particles, the titanium alloy particles induced significantly more release of TNF-alpha and less IL-1 secretion. Ciprofloxacin inhibited production of TNF-alpha, IL-6, IL-1, and PGE(2) in human monocytes exposed to titanium particles. In contrast to ciprofloxacin, indomethacin was not a potent inhibitor of TNF-alpha production but potentiated IL-6 production in titanium-stimulated monocytes. Indomethacin had no effect on the production of IL-1 and was a potent inhibitor of PGE(2) production in titanium-stimulated monocytes. Pentoxifylline had an inhibitor effect on TNF-alpha production in titanium-stimulated monocytes. Pentoxifylline potentiated IL-6 and IL-1 production in monocytes exposed to titanium particles and had a biphasic effect on the PGE(2) production. The results of this study support our hypothesis that human monocytes release bone resorption mediators after in vitro exposure to TiAlV alloy particles. The results also demonstrate the differences of bone-resorbing mediators in response to different wear particle size. The pharmacologic agents (ciprofloxacin, pentoxifylline, and indomethacin) that can modulate the release of bone resorbing mediators such as PGE(2), TNF-alpha, IL-1, and IL-6 release from human monocytes. The results help to elucidate the differences in cellular response to wear particles but may not be directly transposed to the human situation.
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Affiliation(s)
- J S Sun
- Department of Orthopedic Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan, 10002, Republic of China
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21
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Wang WM, Lee SC, Wu DC, Chen LT, Liu CS, Peng CF, Ding HJ, Chen CY, Jan CM. Simplified 13C-urea breath test for the diagnosis of Helicobacter pylori infection--the availability of without fasting and without test meal. Kaohsiung J Med Sci 2000; 16:607-13. [PMID: 11392100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
The conventional 13C-urea breath test (13C-UBT) for detecting Helicobacter pylori infection was performed during fasting state and with a test meal to delay gastric emptying during the test. For the convenience of propagating this test, we assessed the availability of non-fast and without test meal in 13C-UBT for the diagnosis of H. pylori infection. One hundred and five consecutive patients who received endoscopic examination were studied. All of them received endoscopic biopsy for urease test, culture and histopathology to determine whether there was a presence of H. pylori infection. Each patient received four separate 13C-UBT under the following four testing conditions. Test I) fasting state with test meal (100 ml fresh milk), Test II) non-fast (taking usual food) but with test meal, Test III) fasting state without test meal, and Test IV) non-fast and without test meal. The excess delta 13CO2 values were calculated via the breathed samples that were collected at 15 minutes after ingestion of 13C-urea. There were 61 H. pylori positive and 44 negative patients in this study, with an excess delta 13CO2 values 3.0, 4.0, 3.5 and 4.0 as a cut-off value in the four tests respectively, according to the ROC curve. The results of test I, a conventional procedure, had a good correlation with the gold standard. The sensitivity and specificity were 100% and 95% respectively. The alternative procedures in other tests also have high sensitivity and specificity at 15-minute detecting time. The sensitivity of the tests II, III and IV at 15-minute detecting times were 98%, 98% and 100%, and the specificities of those were 95%, 98% and 95% respectively. We therefore suggest that fasting and test meal possibly be omitted when the cut-off value is 4.0 per mil in the simplified 13C-UBT (non-fast and without test meal, and detection at 15 minutes after ingestion of 13C-urea) which is a simple and available procedure for clinical diagnosis of H. pylori infection.
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Affiliation(s)
- W M Wang
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Road, Kaohsiung, 80708, Taiwan.
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Su YC, Wang WM, Wang SY, Lu SN, Chen LT, Wu DC, Chen CY, Jan CM, Horowitz M. The association between Helicobacter pylori infection and functional dyspepsia in patients with irritable bowel syndrome. Am J Gastroenterol 2000; 95:1900-5. [PMID: 10950033 DOI: 10.1111/j.1572-0241.2000.02252.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Irritable bowel syndrome (IBS) is associated with an exaggerated response to a variety of physiological and nonphysiological gastrointestinal stimuli. Many patients with IBS also have functional dyspepsia. Our aim was to examine the hypothesis that Helicobacter pylori (H. pylori) infection may predispose IBS patients to functional dyspepsia. METHODS In 69 IBS patients, dyspeptic symptoms, H. pylori status, and sociodemographic and psychological variables (perceived stress, trait anxiety, and depression) were assessed. Sociodemographic and psychological variables were also evaluated in 52 control subjects. RESULTS Mean scores for perceived stress (17.1 +/- 6.0 vs 14.9 +/- 6.0, p = 0.05), trait anxiety (45.6 +/- 9.1 vs 41.1 +/- 7.8, p = 0.004) and depression (9.9 +/- 8.4 vs 5.0 +/- 5.5, p = 0.0002) were higher in IBS patients than in controls. In all, 33 of the 69 patients (47.8%) had H. pylori infection, and this was associated with relevant symptoms of epigastric pain (odds ratio [OR] = 6.77, 95% confidence interval [CI] 1.89-24.3) and postprandial upper abdominal fullness (OR = 4.23, 95% CI 1.38-13.2). H. pylori infection and female gender were independent predictors of the presence of relevant dyspepsia (OR = 8.31, 95% CI 2.35-29.5 and 6.06, 95% CI 1.71-21.5, respectively). Symptom intensity was associated with the level of perceived stress (total relevant symptom number > or =3 vs <3, OR = 1.16 per point on a 40-point perceived stress scale, 95% CI 1.01-1.34). CONCLUSIONS In IBS patients, the presence of dyspepsia is associated with H. pylori infection, female gender, and perceived stress.
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Affiliation(s)
- Y C Su
- Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan
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23
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Liu HT, Hsu C, Chen CL, Chiang IP, Chen LT, Chen YC, Cheng AL. Chemotherapy alone versus surgery followed by chemotherapy for stage I/IIE large-cell lymphoma of the stomach. Am J Hematol 2000. [PMID: 10861812 DOI: 10.1002/1096-8652(200007)64:3<175::aid-ajh6>3.0.co;2-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The optimal treatment of localized large-cell lymphoma of the stomach remains controversial. In particular, the role of surgical resection of the primary tumor needs to be clearly defined. We have reviewed all patients with a diagnosis of gastric lymphoma and treated in our institutions between 1988 and 1998. Patients fulfilling the following criteria were included in this study: (1) histologically proven large-cell lymphoma of the stomach; (2) adequate pathological materials and complete clinical information for analysis; (3) clinical stage I/II disease according to the Musshoff modification of Ann Arbor system; and (4) received primary chemotherapy alone with anthracycline- or anthracenedione-containing regimens (group A) or curative surgery followed by adjuvant chemotherapy (group B). There were 38 and 21 patients in group A and group B, respectively. All pertinent clinicopathologic features were similar between the two groups of patients, except that patients of group A had significantly more stage II-2 disease (P = 0.004). Of group A, among 36 patients who could be evaluated for response to chemotherapy, there were 29 complete and 1 partial responses, with an overall response rate of 83.3% (95% CI, 71.1-95.5%). The projected 5-year relapse-free survival (RFS) and overall survival (OS) were 86.0% (95% CI, 73.3-98.7%) and 72.6% (95% CI, 57.0-88.2%), respectively. On the other hand, the projected 5-year RFS and OS of group B were 77.9% (95% CI, 58.0-97.8%) and 77.8% (95% CI, 57.9-97. 7%), respectively, not significantly different from that of group A. Our data suggest that systemic chemotherapy alone may be a reasonable alternative treatment for stage I/II large-cell lymphoma of the stomach. Resection of the primary tumor before systemic chemotherapy does not appear to improve the cure rate of this group of patients.
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Affiliation(s)
- H T Liu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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24
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Liu HT, Hsu C, Chen CL, Chiang IP, Chen LT, Chen YC, Cheng AL. Chemotherapy alone versus surgery followed by chemotherapy for stage I/IIE large-cell lymphoma of the stomach. Am J Hematol 2000. [PMID: 10861812 DOI: 10.1002/1096-8652(200007)64:3%3c175::aid-ajh6%3e3.0.co;2-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The optimal treatment of localized large-cell lymphoma of the stomach remains controversial. In particular, the role of surgical resection of the primary tumor needs to be clearly defined. We have reviewed all patients with a diagnosis of gastric lymphoma and treated in our institutions between 1988 and 1998. Patients fulfilling the following criteria were included in this study: (1) histologically proven large-cell lymphoma of the stomach; (2) adequate pathological materials and complete clinical information for analysis; (3) clinical stage I/II disease according to the Musshoff modification of Ann Arbor system; and (4) received primary chemotherapy alone with anthracycline- or anthracenedione-containing regimens (group A) or curative surgery followed by adjuvant chemotherapy (group B). There were 38 and 21 patients in group A and group B, respectively. All pertinent clinicopathologic features were similar between the two groups of patients, except that patients of group A had significantly more stage II-2 disease (P = 0.004). Of group A, among 36 patients who could be evaluated for response to chemotherapy, there were 29 complete and 1 partial responses, with an overall response rate of 83.3% (95% CI, 71.1-95.5%). The projected 5-year relapse-free survival (RFS) and overall survival (OS) were 86.0% (95% CI, 73.3-98.7%) and 72.6% (95% CI, 57.0-88.2%), respectively. On the other hand, the projected 5-year RFS and OS of group B were 77.9% (95% CI, 58.0-97.8%) and 77.8% (95% CI, 57.9-97. 7%), respectively, not significantly different from that of group A. Our data suggest that systemic chemotherapy alone may be a reasonable alternative treatment for stage I/II large-cell lymphoma of the stomach. Resection of the primary tumor before systemic chemotherapy does not appear to improve the cure rate of this group of patients.
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Affiliation(s)
- H T Liu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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25
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Abstract
The optimal treatment of localized large-cell lymphoma of the stomach remains controversial. In particular, the role of surgical resection of the primary tumor needs to be clearly defined. We have reviewed all patients with a diagnosis of gastric lymphoma and treated in our institutions between 1988 and 1998. Patients fulfilling the following criteria were included in this study: (1) histologically proven large-cell lymphoma of the stomach; (2) adequate pathological materials and complete clinical information for analysis; (3) clinical stage I/II disease according to the Musshoff modification of Ann Arbor system; and (4) received primary chemotherapy alone with anthracycline- or anthracenedione-containing regimens (group A) or curative surgery followed by adjuvant chemotherapy (group B). There were 38 and 21 patients in group A and group B, respectively. All pertinent clinicopathologic features were similar between the two groups of patients, except that patients of group A had significantly more stage II-2 disease (P = 0.004). Of group A, among 36 patients who could be evaluated for response to chemotherapy, there were 29 complete and 1 partial responses, with an overall response rate of 83.3% (95% CI, 71.1-95.5%). The projected 5-year relapse-free survival (RFS) and overall survival (OS) were 86.0% (95% CI, 73.3-98.7%) and 72.6% (95% CI, 57.0-88.2%), respectively. On the other hand, the projected 5-year RFS and OS of group B were 77.9% (95% CI, 58.0-97.8%) and 77.8% (95% CI, 57.9-97. 7%), respectively, not significantly different from that of group A. Our data suggest that systemic chemotherapy alone may be a reasonable alternative treatment for stage I/II large-cell lymphoma of the stomach. Resection of the primary tumor before systemic chemotherapy does not appear to improve the cure rate of this group of patients.
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Affiliation(s)
- H T Liu
- Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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26
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Abstract
The push-pull cannula (PPC) technique was applied to examine the kinetics of in vivo concentration changes in male rat brain extracellular fluid (ECF) of endogenous interleukin-1beta (IL-1beta) and corticotrophin releasing hormone (CRH) after a peripheral injection of lipopolysaccharide (LPS) (25 microg/100 g b.wt. intravenously). In addition, IL-1beta, adrenocorticotropin hormone (ACTH) and corticosterone concentrations in plasma were also measured at selected intervals after LPS challenge. Administration of LPS resulted in a progressive increase in the concentrations of IL-1beta in brain hypothalamic ECF. A significant increase from the zero time mean value of 77+/-10 to 393+/-88 pg/ml at the 15-min interval was recorded. The increase in IL-1beta concentration in hypothalamic ECF reached a peak of 883+/-237 pg/ml at 30 min post-LPS. CRH concentration in the same hypothalamic ECF was 41+/-17 pg/ml at time zero, 97+/-15 pg/ml at 15 min and at 30 min was significantly increased (215+/-56 pg/ml). A time course of significant increases at 30 min in plasma concentrations of IL-1beta, ACTH and corticosterone was also recorded in the same animals described above. The data show that a peripherally administered LPS bolus elicited an early (over 15 min post-injection) increase in brain ECF IL-1beta concentration; additional significant increases in hormones released from the hypothalamic-pituitary-adrenal (HPA) axis were recorded at 30 min post-LPS injection. These observations support the concept of an early change in hypothalamic ECF concentration of IL-1beta preceding LPS-induced activation of the HPA axis.
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Affiliation(s)
- X C Ma
- Department of Anatomy, College of Medicine, University of South Florida, Tampa, FL 33612-4799, USA
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27
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Su YC, Lu SN, Wu DC, Chen LT, Wang WM, Wu DK, Chen CY, Jan CM. Severe gastric mucosa injury after percutaneous pure ethanol injection therapy for hepatocellular carcinoma. Gastrointest Endosc 2000; 51:350-3. [PMID: 10699789 DOI: 10.1016/s0016-5107(00)70369-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 02/08/2023]
Affiliation(s)
- Y C Su
- Department of Internal Medicine, Kaohsiung Medical College Hospital, Kaohsiung, Taiwan
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28
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Huang TS, Shu CH, Lee CC, Chen LT, Whang-Peng J. In vitro evaluation of GL331's cancer cell killing and apoptosis-inducing activity in combination with other chemotherapeutic agents. Apoptosis 2000; 5:79-85. [PMID: 11227495 DOI: 10.1023/a:1009693811093] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
GL331 is a novel podophyllotoxin-derived compound and is more efficacious than its congener VP-16 in killing several types of cancer cells, that has promoted considerable interest in its possibility of clinical use. In this study, we found that the higher cytotoxicity of GL331 in nasopharyngeal carcinoma NPC-TW01 cells was attributed to the elevated ability to induce apoptotic cell death. In addition to evaluation of GL331's single agent activity, the use of GL331 in combination with other established therapeutic agents was also evaluated. We found that GL331-induced cell cycle perturbation occurred upon initial 8-h exposure, and pretreatment of NPC-TW01 cells with GL331 for 8 h significantly interfered with the cytotoxicities of VP-16, cisplatin, 5-fluorouracil and adriamycin. When the schedule of drug administration was reversed, high-toxic concentrations of these agents revealed an antagonistic effect on GL331; however, their low-toxic doses had the additive or even more-than-additive effect on the cytotoxicity induced by GL331 at 0.1 microM or less, but for GL331 concentrations of greater than 1 microM, the effect became less than additive. These data suggest that overlapping mechanisms could be elicited by GL331 and other agents, and additional preclinical studies are needed to determine the optimal dose combination and administration schedule that will enhance, rather than interfere with, the efficacy of GL331 in combination with other anti-cancer agents.
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Affiliation(s)
- T S Huang
- Cooperative Laboratory, Cancer Research Division, National Health Research Institutes, Taipei, Taiwan, Republic of China.
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29
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Abstract
An effector candidate for G protein action, GRIN1, was identified by screening a cDNA expression library with phosphorylated GTPgammaS-G(z)alpha as a probe. GRIN1 is a novel protein without substantial homology to known protein domains. It is expressed largely in brain and binds specifically to activated G(z)alpha, G(o)alpha, and G(i)alpha through its carboxyl-terminal region. The protein KIAA0514 (GRIN2) is homologous to GRIN1 at its carboxyl terminus and also binds to activated G(o)alpha. Both GRIN1 and G(o)alpha are membrane-bound proteins that are enriched in the growth cones of neurites. Coexpression of GRIN1 or GRIN2 with activated G(o)alpha causes formation of a network of fine processes in Neuro2a cells, suggesting that these pathways may function downstream of G(o)alpha to control growth of neurites.
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Affiliation(s)
- L T Chen
- Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, Texas 75235-9041, USA
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30
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Liu JM, Lin WC, Chen YM, Wu HW, Yao NS, Chen LT, Whang-Peng J. The status of the do-not-resuscitate order in Chinese clinical trial patients in a cancer centre. J Med Ethics 1999; 25:309-314. [PMID: 10461593 PMCID: PMC479239 DOI: 10.1136/jme.25.4.309] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN Retrospective descriptive study. SETTING A cancer clinical trials unit in a large teaching hospital. PATIENTS From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom.
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Affiliation(s)
- J M Liu
- National Health Research Institutes, Veterans General Hospital, Taipei, Taiwan, Republic of China
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31
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Chang CS, Chen LT, Yang JC, Lin JT, Chang KC, Wang JT. Isolation of a Helicobacter pylori protein, FldA, associated with mucosa-associated lymphoid tissue lymphoma of the stomach. Gastroenterology 1999; 117:82-8. [PMID: 10381913 DOI: 10.1016/s0016-5085(99)70553-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS The growth of gastric mucosa-associated lymphoid tissue lymphoma (MALToma) seems to depend on the stimulation of Helicobacter pylori. We attempted to identify specific antigen(s) from H. pylori strains associated with MALToma. METHODS Membranous and secreted proteins of H. pylori were compared on sodium dodecyl sulfate-polyacrylamide gel electrophoresis by Western blot using sera from patients with MALToma. RESULTS A 19-kilodalton protein was seen in all strains isolated from patients with MALToma but uncommonly in other strains. The protein was purified and sequenced. Amino acid sequence comparison showed it was an FldA homologue, a putative flavodoxin protein. DNA sequencing in 26 strains revealed that a nucleotide G insertion at position 481 of the fldA gene was more frequently observed in strains associated with MALToma than other strains (9/9 vs. 6/17; P = 0.002). The mutation caused a short truncation. A recombinant protein with this truncation was expressed and tested. Sera of 12 (70.6%) of 17 patients with MALToma were positive for the antibody to the recombinant protein, and 7 (16.7%) of 42 control patients were positive (12/17 vs. 7/42; P < 0.0001). CONCLUSIONS Truncated FldA of H. pylori is associated with gastric MALToma. It may be involved in the pathogenesis of gastric MALToma. Antibody to this antigen could be used as a serological marker of the disease.
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Affiliation(s)
- C S Chang
- Graduate Institute of Microbiology, College of Medicine, National Taiwan University, Taipei, Taiwan
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32
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Huang TS, Lee CC, Chao Y, Shu CH, Chen LT, Chen LL, Chen MH, Yuan CC, Whang-Peng J. A novel podophyllotoxin-derived compound GL331 is more potent than its congener VP-16 in killing refractory cancer cells. Pharm Res 1999; 16:997-1002. [PMID: 10450922 DOI: 10.1023/a:1018971313256] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE GL331 is a new homolog of VP-16, and has demonstrated more efficacious anti-cancer activity in both the in vitro and in vivo lymphoma systems. To extensively explore GL331's clinical value, we furthermore evaluate the cytotoxicity and apoptosis-inducing activity of GL331 in several human cell lines from cancers that are not normally treated with VP-16. METHODS By MTT and clonogenic survival assays, the cytotoxicities of GL331 and VP-16 were evaluated in a variety of cell lines including nasopharyngeal, hepatocellular, gastric, colon, cervical, and neuroblastoma cancer types. Western blot analysis was performed to detect the MDR-1 level in these cell lines. By Annexin V-staining flow cytometry and detection of DNA ladders, the apoptosis-inducing activities of GL331 and VP-16 were also evaluated. RESULTS GL331 showed more efficacy than its congener VP-16 in killing cancer cells. The estimated ID50 of GL331 were 2.5 to 17-fold lowerthan those of VP-16. GL331 possessed more cell-killing activity even in MDR-1-overexpressing cell lines such as HCC36 and SW620. Its higher cytotoxicity could be attributed by the elevated ability to induce apoptotic cell death. CONCLUSION GL331's overriding drug resistance and higher cancer cell-killing activity suggest its superiority in clinical cancer therapy.
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Affiliation(s)
- T S Huang
- Cooperative Laboratory, Cancer Research Division, National Health Research Institutes, Taipei, Taiwan, Republic of China.
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Abstract
Myocardial involvement by malignant neoplasm is rare and often not clinically manifested. The diagnosis is usually made only at autopsy. A 71-year-old man with squamous cell lung cancer presented with chest discomfort. His electrocardiogram was diagnostic of acute myocardial infarction. However, because of the lack of classic symptoms and signs of acute myocardial infarction and normal serum levels of cardiac enzymes, an echocardiography was performed before initiation of thrombolytic therapy. The echocardiography showed a huge hyperechoic mass located in the posterolateral aspect of the left ventricle with myocardium invasion. Thrombolytic therapy was withheld. In patients with lung cancer, an electrocardiogram representative of acute myocardial infarction can rarely be induced by myocardial involvement with lung cancer.
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Affiliation(s)
- N S Yao
- Cancer Clinical Research Center, National Health Research Institutes, Veterans General Hospital, Taipei, Taiwan
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34
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Hoff JM, Borgoul PV, Tuncel G, Ondov JM, Kelly WR, Chen LT. Feasibility of Applying a Stable Isotopic Tracer for Direct Determination of Dry Particulate Deposition to Soybean Plants. J Air Waste Manag Assoc 1998; 48:721-728. [PMID: 28060683 DOI: 10.1080/10473289.1998.10463720] [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: 06/06/2023]
Abstract
A stable rare-earth isotopic tracer was used to measure the deposition of KNO3 particles on soybean leaves by direct measurement of the tracer on the plant surfaces by thermal-ionization mass spectrometry. Submicrometer particles, made from a solution containing 3 |mg mL-1 neodymium isotope (148Nd, 87.9%) and 1,000 mg mL-1 KNO3, were dispersed with a two-fluid nozzle and released upwind of a soybean field. Total suspended- and size-fractionated-aerosol particles were collected on an open-face filter and in a micro-orifice impactor, respectively, at a distance of 40 m from the release point. Soybean leaves exposed to the plume were collected at distances ranging from 25 to 100 m. As little as 5.5 pg of the tracer (i.e., excess 148Nd) was detected in soybean leaves at signal-to-noise ratios ranging from 7,500 to 240,000, in the presence of 200 to 2,700 pg of naturally occurring Nd. The dry-particle deposition velocity, determined from the ratio of the aerial concentration and directly deposited aerosol (geometric mass mean diameter, 0.20 mm) flux, and its corresponding analytical uncertainty were 0.30 cm sec-1 and 2.5%, respectively.
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Affiliation(s)
- J M Hoff
- a Department of Chemistry and Biochemistry , University of Maryland , College Park , Maryland , USA
| | - P V Borgoul
- a Department of Chemistry and Biochemistry , University of Maryland , College Park , Maryland , USA
| | - G Tuncel
- a Department of Chemistry and Biochemistry , University of Maryland , College Park , Maryland , USA
| | - J M Ondov
- a Department of Chemistry and Biochemistry , University of Maryland , College Park , Maryland , USA
| | - W R Kelly
- b Analytical Chemistry Division , National Institute for Standards and Technology , Gaithersburg , Maryland , USA
| | - L T Chen
- b Analytical Chemistry Division , National Institute for Standards and Technology , Gaithersburg , Maryland , USA
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35
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Abstract
We report the isolation of the functional form of the Ca-ATPase from porcine cardiac sarcoplasmic reticulum (SR) membranes, taking advantage of the ability of this enzyme to bind to the nucleotide site affinity dye, Reactive Red 120. Conditions that optimize the solubility and functional stability of the cardiac Ca-ATPase in detergent during the purification procedure are essential to its recovery. The purified Ca-ATPase migrates as a single band on Coomassie blue-stained polyacrylamide gels and exhibits high specific activity (2.5 IU at 25 degreesC) and functional stability. Similar enrichment of the Ca-ATPase estimated from either relative amounts of the 100-kDa protein band on polyacrylamide gels or steady-state concentrations of phosphorylated enzyme intermediate (E-P) demonstrate that neither nonfunctional Ca-ATPases nor non-Ca-ATPase proteins migrating with an apparent molecular weight of 100 kDa constitute a significant fraction of these preparations. Steady-state levels of E-P are 1.3 and 8.6 nmol/mg protein, respectively, for native cardiac SR membranes and the final purified fraction. These values, in comparison to the maximum value (9.1 nmol/mg) for the 110-kDa protein, agree well with estimates of total Ca-ATPase abundance from gel densitometry for both preparations and indicate full site reactivity, i.e., one phosphorylation site for each 110-kDa cardiac Ca-ATPase polypeptide chain.
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Affiliation(s)
- Q Yao
- Department of Biochemistry, University of Kansas, Lawrence, Kansas, 66045, USA
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Yao NS, Wu CW, Tiu CM, Liu JM, Whang-Peng J, Chen LT. Percutaneous transhepatic duodenal drainage as an alternative approach in afferent loop obstruction with secondary obstructive jaundice in recurrent gastric cancer. Cardiovasc Intervent Radiol 1998; 21:350-3. [PMID: 9688809 DOI: 10.1007/s002709900277] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [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: 02/08/2023]
Abstract
Two cases are reported of chronic, partial afferent loop obstruction with resultant obstructive jaundice in recurrent gastric cancer. The diagnosis was made by characteristic clinical presentations, abdominal computed tomography, and cholescintigraphy. Percutaneous transhepatic duodenal drainage (PTDD) provided effective palliation for both afferent loop obstruction and biliary stasis. We conclude that cholescintigraphy is of value in making the diagnosis of partial afferent loop obstruction and in differentiating the cause of obstructive jaundice in such patients, and PTDD provides palliation for those patients in whom surgical intervention is not feasible.
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Affiliation(s)
- N S Yao
- Division of Cancer Research, National Health Research Institutes, A191, Veterans General Hospital, 201, Shih-Pai Road, Sec. 2, Taipei 112, Taiwan
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Liu JM, Chen YM, Chao Y, Liu SM, Tiu CM, Wu HW, Chiou TC, Hsieh RK, Chen LT, Whang-Peng J. Continuous infusion cisplatin and etoposide chemotherapy for cancer of unknown primary site (CUPS) in Taiwan, a region with a high prevalence of endemic viral infections. Jpn J Clin Oncol 1998; 28:431-5. [PMID: 9739784 DOI: 10.1093/jjco/28.7.431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To evaluate the efficacy and toxicity of cisplatin/etoposide continuous infusion chemotherapy for cancer of unknown primary site in Taiwan, a region with a high prevalence of endemic viral infections. METHOD Between April 1994 and February 1996, 20 patients with a diagnosis of CUPS were treated, including 15 males and five females, of average age 63.3 years (range 41-83 years). Continuous intravenous infusion of etoposide 80 mg/m2 and cisplatin 25 mg/m2 was given for 3 days every 3 weeks. Pretreatment tumor marker and viral serology studies were performed for baseline evaluation. Nearly two-thirds of the patients had poorly differentiated carcinoma. The average number of metastatic sites was 2.65 (range 1-4), with liver and lymph node involvement predominating. RESULTS The overall response rate was 25% (95% CI 17.7-32.3%); 30.7% for poorly differentiated cancers and 25% for well differentiated cancers. Median survival was 4 months (range 1-12 months), 4.8 months for patients attaining partial response. Toxicity was moderate, grade 3 and 4 neutropenia occurred in 55% and grade 3 and 4 thrombocytopenia in 40%; other toxicities were mild. CA125 and CA199 were elevated in more than 50% of patients. Viral serology studies were not significantly different from those of the indigenous population. CONCLUSION Etoposide and cisplatin combination chemotherapy has modest activity in patients with extensive CUPS and, at the schedule and dosage given, it is associated with moderate toxicity.
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Affiliation(s)
- J M Liu
- Division of Cancer Research, National Health Research Institutes, Taipei, Taiwan
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38
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Wang WM, Lee SC, Ding HJ, Jan CM, Chen LT, Wu DC, Liu CS, Peng CF, Chen YW, Huang YF, Chen CY. Quantification of Helicobacter pylori infection: Simple and rapid 13C-urea breath test in Taiwan. J Gastroenterol 1998; 33:330-5. [PMID: 9658310 DOI: 10.1007/s005350050092] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [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: 02/08/2023]
Abstract
The 13C-urea breath test (13C-UBT) is a non-invasive method for detecting Helicobacter pylori. This study was performed to determine the cutoff value and evaluate the sensitivity and specificity of 13C-UBT in Taiwan. 13C-Urea (100 mg of 99% 13C-labeled urea) was dissolved in 50 ml sterile water for the test. The test meal for delaying gastric emptying was 100 ml fresh milk. Patients fasted for at least 6h. A baseline breath sample was collected 5 min after they had the test meal. Two other samples were collected at 15 and 30 min after the patients ingested the 13C-urea. The test was evaluated in 352 patients after routine upper gastrointestinal endoscopy, and the urease test, culture, and histopathology were taken as the gold standards for detecting H. pylori. According to the receiver operating characteristic (ROC) curves, we chose values of 2.8 and 4.2 excess delta 13CO2 per mil as the cut-off values for 15 and 30 min, respectively, post 13C-urea. The sensitivity and specificity of 13C-UBT were 99% and 93% at 15 min, and 98% and 93% at 30 min post 13C-urea, respectively. The 13C-UBT breath test is an efficient non-invasive method of high sensitivity and high specificity for detecting H. pylori infection. We suggest that the use of fresh milk as the test meal and the detection of excess delta 13CO2 15 min after the ingestion of 13C-urea are suitable for the clinical use of 13C-UBT. This test is simple and rapid.
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Affiliation(s)
- W M Wang
- Department of Internal Medicine, Kaohsiung Medical College, Taiwan, ROC
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39
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Ishikawa N, Chiba T, Chen LT, Shimizu A, Ikeguchi M, Sugai S. Remarkable destabilization of recombinant alpha-lactalbumin by an extraneous N-terminal methionyl residue. Protein Eng 1998; 11:333-5. [PMID: 9681864 DOI: 10.1093/protein/11.5.333] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
A recombinant bovine alpha-lactalbumin, possessing an additional N-terminal methionyl residue, was expressed in Escherichia coli. In order to address the effects of the N-terminal methionyl residue on conformational stability, the thermal stability of the recombinant alpha-lactalbumin was investigated by measuring temperature-dependence of circular dichroism spectra, and it was compared with that of authentic alpha-lactalbumin from bovine milk. The thermal stability of the recombinant alpha-lactalbumin was significantly lower than that of authentic alpha-lactalbumin. The enthalpy change of unfolding of the recombinant protein was found to be the same as that of the authentic one when compared at the same temperature. Therefore, the N-terminal methionyl residue seems to destabilize the conformation of recombinant alpha-lactalbumin through some entropic effects.
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Affiliation(s)
- N Ishikawa
- Department of Bioengineering, Faculty of Engineering, Soka University, Tokyo, Japan
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40
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Abstract
The effect of pre- and postnatal maternal dietary fatty acid composition on neurodevelopment in rat pups was studied. Timed pregnant dams were fed, beginning on d 2 of gestation and throughout lactation, either nonpurified diet (reference) or a purified diet whose fat source (22% of energy) was either corn oil or menhaden fish oil. On postnatal d 3, pups were randomly cross-fostered among dams of the same diet group and culled to 10 pups per dam. Milk was removed from stomachs of culled pups for fatty acid analyses. From postnatal d 4 to 30, pups were assessed daily for the appearance of neurodevelopmental reflexes. Auditory brainstem conduction times were measured on postnatal d 23 and 29. Pups were killed on postnatal d 30, and cerebrums were removed for fatty acid analyses. The fatty acid composition of maternal milk and pup cerebrums reflected maternal diet with higher levels of (n-3) and (n-6) fatty acids in the fish oil and corn oil groups, respectively. The time of appearance of auditory startle was significantly delayed (P = 0.004), and auditory brainstem conduction times on postnatal d 23 and 29 were significantly longer in pups of the fish oil- than corn oil-fed dams (P </= 0.05). A delay in the appearance of the auditory startle reflex and longer auditory brainstem conduction times in pups of dams fed fish oil-supplemented diet may be due to negative effects on myelination of the auditory brainstem pathway.
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Affiliation(s)
- M D Saste
- Department of Pediatrics, Division of Neonatology, University of South Florida College of Medicine, Tampa, FL 33612, USA
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41
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Abstract
Oxygen-derived free radical injury has been associated with several cytopathic conditions. Oxygen radicals produced by chondrocytes is an important mechanism by which chondrocytes induce matrix degradation. In the present study, we extend these observations by studying oxidative processes against osteoblasts. Osteoblasts were mixed in in vitro culture with 200 microM menadione. The cytotoxic effect of menadione-induced oxidative stress was monitored by lucigenin- or luminol-amplified chemiluminescence, tetrazolium assay and immunocytochemical study. Results showed that adding menadione induces an oxidative stress on osteoblasts, via superoxide and hydrogen peroxide production, that can be eradicated by superoxide dismutase (SOD) and catalase in a dose-dependent manner. Catalase and the appropriate concentration of dimethyl sulfoxide have a protective effect on cytotoxicity induced by menadione, whereas SOD does not. Menadione-treated osteoblasts have a strong affinity for annexin V, and the nuclei are strongly stained by TUNEL (TdT-mediated dUTP nick-end labelling). The results suggest that menadione-triggered production of reactive oxygen species leads to apoptosis of osteoblasts.
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Affiliation(s)
- J S Sun
- Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, ROC
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42
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Huang C, Hepler JR, Chen LT, Gilman AG, Anderson RG, Mumby SM. Organization of G proteins and adenylyl cyclase at the plasma membrane. Mol Biol Cell 1997; 8:2365-78. [PMID: 9398661 PMCID: PMC25713 DOI: 10.1091/mbc.8.12.2365] [Citation(s) in RCA: 173] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/1997] [Accepted: 09/15/1997] [Indexed: 02/05/2023] Open
Abstract
There is mounting evidence for the organization and compartmentation of signaling molecules at the plasma membrane. We find that hormone-sensitive adenylyl cyclase activity is enriched in a subset of regulatory G protein-containing fractions of the plasma membrane. These subfractions resemble, in low buoyant density, structures of the plasma membrane termed caveolae. Immunofluorescence experiments revealed a punctate pattern of G protein alpha and beta subunits, consistent with concentration of these proteins at distinct sites on the plasma membrane. Partial coincidence of localization of G protein alpha subunits with caveolin (a marker for caveolae) was observed by double immunofluorescence. Results of immunogold electron microscopy suggest that some G protein is associated with invaginated caveolae, but most of the protein resides in irregular structures of the plasma membrane that could not be identified morphologically. Because regulated adenylyl cyclase activity is present in low-density subfractions of plasma membrane from a cell type (S49 lymphoma) that does not express caveolin, this protein is not required for organization of the adenylyl cyclase system. The data suggest that hormone-sensitive adenylyl cyclase systems are localized in a specialized subdomain of the plasma membrane that may optimize the efficiency and fidelity of signal transduction.
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Affiliation(s)
- C Huang
- Department of Pharmacology, The University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75235-9041, USA
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43
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Rayon JI, Carver JD, Wyble LE, Wiener D, Dickey SS, Benford VJ, Chen LT, Lim DV. The fatty acid composition of maternal diet affects lung prostaglandin E2 levels and survival from group B streptococcal sepsis in neonatal rat pups. J Nutr 1997; 127:1989-92. [PMID: 9311955 DOI: 10.1093/jn/127.10.1889] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Dietary fatty acid effects upon the immune system may be mediated in part by effects upon the synthesis of proinflammatory mediators. The effects of maternal dietary fatty acid composition upon lung prostaglandin (PG) E2 levels and survival from group B streptococcal (GBS) infection were investigated in neonatal rat pups. Beginning on d 2 of gestation and throughout lactation, pregnant dams were fed a purified diet whose fat source (22% of energy) was either corn oil or menhaden fish oil. On postnatal d 3, pups were randomly cross-fostered to dams of the same diet group to minimize litter effects; litters were then culled to 10 pups per dam. On postnatal d 7, pups were either injected with 1 x 10(7.5) GBS organisms or were killed for determination of lung tissue levels of PGE2 and lung and erythrocyte fatty acid composition. Arachidonic acid and PGE2 levels were significantly higher in the lungs of pups in the corn oil group compared with the fish oil group. Forty-nine percent of pups in the corn oil group survived the GBS challenge compared with 79% of pups in the fish oil group (P = 0.0005). These data suggest that the fatty acid composition of pre- and/or postnatal diet affects the neonatal response to immune challenge, which may be due in part to effects upon the synthesis of pro-inflammatory mediators.
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Affiliation(s)
- J I Rayon
- Department of Pediatrics, Division of Neonatology, University of South Florida College of Medicine, Tampa FL 33606, USA
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44
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Hsu CH, Yeh KH, Chen LT, Liu JM, Jan CM, Lin JT, Chen YC, Cheng AL. Weekly 24-hour infusion of high-dose 5-fluorouracil and leucovorin in the treatment of advanced gastric cancers. An effective and low-toxic regimen for patients with poor general condition. Oncology 1997; 54:275-80. [PMID: 9216850 DOI: 10.1159/000227702] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Systemic chemotherapy for advanced gastric cancer is frequently associated with significant treatment-related toxicity, which is particularly serve in patients presenting with a poor general condition. A search for effective and low-toxic regimens for this group of patients is mandatory. A weekly 24-hour infusion of high-dose 5-fluorouracil (5-FU) and leucovorin (HDFL) has previously been demonstrated to be an effective treatment for advanced colorectal cancer with minimal toxicity. In the past 3 years, this regimen has been tested at our institutes in patients with advanced gastric cancer, the general condition of whom had made the use of intensive combination chemotherapy impossible. The regimen consisted of a weekly 24-hour infusion of 2,600 mg/m2 of 5-FU and 300 mg/m2 of leucovorin. From August 1992 to December 1995, 34 patients had been treated with this regimen for a total of 488 courses (average: 14.4 per patient). Hematological toxicity of this regimen was minimal, with grade 3 or 4 leukopenia developing in only 1 (2.9%) patient. Other nonhematological toxicities were also negligible except a reversible neurotoxicity which developed in 2 patients. Twenty-five patients were eligible for response analysis. One complete response, 11 partial responses, 5 stable diseases, and 8 progressive diseases were observed. The response rate was 48% (32-72%, 95% CI). The median overall survival (OS) of the whole group was 7 months (range: 1-18+). The median OS and time to progression of the responders were 8.5 months (range: 2-18) and 5 months (range: 2-10+), respectively. The palliative effect was satisfactory with the Karnofsky performance status of the responders improving from a median of 50% (range: 20-90%) to 70% (range: 50-100%). Our retrospective data suggested that HDFL is an effective and low-toxic palliative treatment even in patients with a very poor general condition. We advocated that this regimen should be further tested in ordinary patients with advanced gastric cancer.
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Affiliation(s)
- C H Hsu
- Department of Oncology, National Taiwan University Hospital, Taipei
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45
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Hwang WS, Hsiung CA, Ko WS, Wang CC, Chang JY, Lai GM, Hsieh RK, Tsao CJ, Chen LT, Law CK, Cheng AL, Fan SF, Tzeng CH, Chiou TJ, Whang-Peng J. Weekly CAF chemotherapy for advanced breast cancer patients. Oncology 1997; 54:293-7. [PMID: 9216853 DOI: 10.1159/000227706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In a prospective phase II study, 102 women with advanced breast cancer were treated with low doses of cyclophosphamide, Adriamycin and 5-fluorouracil (CAF) at weekly intervals by intravenous injection. Seventy-five patients were evaluable for treatment response and the overall response rate was 52% (95% confidence interval, 41-63%). Of the evaluable patients, 15% had complete response and 37% had partial response. The median survival after therapy was 15.6 months, the median time to progression was 6.8 months and the median duration of response was 9.1 months. The main toxicities were mild vomiting and moderate myelosuppression. There was only 1 patient who experienced heart failure. Weekly CAF appears to have an efficacy with tolerable side effects comparable to standard CAF with an every-3-week schedule.
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Affiliation(s)
- W S Hwang
- Chi-Mei Foundation Hospital, Taiwan Cooperative Oncology Group, Tainan, Taiwan, ROC
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46
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Wu DC, Liu JM, Chen YM, Yang S, Liu SM, Chen LT, Whang-Peng J. Mitomycin-C induced hemolytic uremic syndrome: a case report and literature review. Jpn J Clin Oncol 1997; 27:115-8. [PMID: 9152802 DOI: 10.1093/jjco/27.2.115] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Hemolytic uremic syndrome spontaneously arises in a few patients with advanced cancer, but it is more commonly related to the use of certain chemotherapeutic agents. Mitomycin-C is, etiologically, the most common causative agent inducing hemolytic uremic syndrome, in a dose dependent manner. We report this syndrome, attributable to mitomycin-C at a cumulative dose of 40 mg/m2, in a gastric cancer patient. A 42-year-old female with stage III gastric cancer underwent radical gastrectomy and was given mitomycin-C at 10 mg/m2 intravenously every four weeks as adjuvant therapy. Hemolytic uremic syndrome was diagnosed three months after the last dose of mitomycin-C administration. The most prominent symptoms included pallor, hypertension and anasarca, with laboratory evidence of microangiopathic hemolytic anemia, azotemia and hyperkalemia. Her disease was progressive, but fortunately stabilized after staphylococcus column A dialysis. Her disease remained in remission for 24 months from the time of diagnosis, and then relapsed in the form of peritoneal carcinomatosis with partial intestinal obstruction.
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Affiliation(s)
- D C Wu
- Department of Internal Medicine, Veterans' General Hospital-Taipei, Taiwan, Republic of China
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47
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Chang CS, Chen LT, Huang SM, Liu TC, Lin SF, Chen TP, Wei TC. Comparison of intravenous granisetron with metoclopramide plus dexamethasone in the prevention of nausea and vomiting associated with emetogenic cytotoxic chemotherapy. Kaohsiung J Med Sci 1997; 13:97-102. [PMID: 9099048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Fifty-one patients who received their first course of chemotherapy were studied to compare the respective efficacy and safety of granisetron and metoclopramide plus dexamethasone in the prevention of nausea and vomiting induced by emetogenic cytotoxic drugs. The results showed the response rate of antiemesis in the first 24 hours was higher in the metoclopramide plus dexamethasone group than in the granisetron group: 95% vs 84%. For the next six days of the study period, the response rate of the granisetron group was shown to be more effective than that of metoclopramide plus dexamethasone group: 77% vs 60%. Furthermore, the granisetron seemed to display enhanced tolerability with less drug-related side effects and no extrapyramidal effects which appeared in 2 cases of the metoclopramide plus dexamethasone group. In conclusion, a single dose of granisetron can be as effective as the gold standard of metoclopramide plus dexamethasone regimen in preventing and treating acute nausea and vomiting. For preventing delayed nausea and vomiting, granisetron is shown to be more effective than metoclopramide plus dexamethasone.
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Affiliation(s)
- C S Chang
- Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China
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48
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Negash S, Chen LT, Bigelow DJ, Squier TC. Phosphorylation of phospholamban by cAMP-dependent protein kinase enhances interactions between Ca-ATPase polypeptide chains in cardiac sarcoplasmic reticulum membranes. Biochemistry 1996; 35:11247-59. [PMID: 8784178 DOI: 10.1021/bi960864q] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We have used spin-label EPR spectroscopy to examine possible alterations in protein-protein interactions that accompany the activation of the cardiac sarcoplasmic reticulum (SR) Ca-ATPase following the phosphorylation of phospholamban (PLB). Using a radioactive derivative of a maleimide spin label (MSL), we have developed conditions for the selective spin-labeling of the Ca-ATPase in both native cardiac and skeletal sarcoplasmic reticulum membranes. The rotational dynamics of the cardiac and skeletal Ca-ATPase isoforms in native SR membranes were measured using saturation transfer EPR. We report that the phosphorylation of PLB in cardiac SR results in a (1.8 +/- 0.2)-fold reduction in the overall rotational mobility of the Ca-ATPase. The alteration in the rotational dynamics of the Ca-ATPase is the direct result of the phosphorylation of PLB, and is not related to the phosphorylation of the Ca-ATPase or any other SR proteins since no alteration in the ST-EPR spectrum is observed as a result of conditions that phosphorylate the cardiac Ca-ATPase with ATP. Neither do the use of conditions that activate the Ca-ATPase in cardiac SR result in the alteration of the rotational dynamics or catalytic properties of the Ca-ATPase in skeletal SR where PLB is not expressed. Measurements of the rotational dynamics of stearic acid spin labels (SASL) incorporated into cardiac SR membranes with a nitroxide at the 5- and 12-positions using conventional EPR indicate that there is virtually no difference in the lipid acyl chain dynamics in cardiac SR membranes upon the phosphorylation of PLB. These results indicate that the decrease in the rotational dynamics of the Ca-ATPase in cardiac SR membranes associated with the phosphorylation of PLB is related to enhanced interactions between individual Ca-ATPase polypeptide chains due to (i) an alteration in the spatial arrangement of cardiac Ca-ATPase polypeptide chains within a defined oligomeric state or (ii) increased protein-protein associations. We suggest that altered interactions between Ca-ATPase polypeptide chains and PLB serves to modulate the activation barrier associated with calcium activation of the Ca-ATPase in cardiac SR membranes.
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Affiliation(s)
- S Negash
- Department of Biochemistry, University of Kansas, Lawrence 66045-2106, USA
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49
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Perng DS, Jan CM, Wang WM, Chen LT, Liu CS, Huang TJ, Chen CY. Clinicopathologic study of gastric carcinoma with duodenal invasion. Kaohsiung J Med Sci 1996; 12:461-5. [PMID: 8774114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Clinicopathologic features of 319 patients who underwent gastrectomy for adenocarcinoma of stomach were studied whether disease involved duodenum or not. Thirty-eight patients (11.9%) had duodenum invasion. Gastric carcinoma with duodenal invasion was most often Borrmann III or Borrmann IV (65.8%) type, with pylorous invasion by endoscopy (39.5%), large tumor size (73.7% > or = 5cm), lymph node metastasis (78.9%), serosal invasion (97.4%) and the incidence of the resection line not being free was high (13.2%). Duodenal invasion was most often (55.3%) direct through the deep layer or through lymphatics or venules. We need to pay more attention to finding duodenum invasion. More than 3 cm width of duodenal resection is recommended if duodenum invasion is suspected.
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Affiliation(s)
- D S Perng
- Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China
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50
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Abstract
A prospective survey to investigate the seroprevalence of IgG against Helicobacter pylori among endoscopists in Taiwan was conducted by analyzing blood samples of 70 study subjects and 64 nonendoscopist physicians with quantitative ELISA. Personal information and the practices of infection control related to gastroscopy examination were obtained by a self-administered questionnaire. Significant differences were detected in the IgG prevalence between study and control subjects (80.0% vs 51.6%; P < 0.05). The serum level of antibody in endoscopists (385.2 +/- 36.1 unit/ml) was significantly higher than that of nonedoscopists (211.8 +/- 33.0 unit/ml; P = 0.018). Endoscopists performing 30 or more sessions of gastroscopy per week had higher seroprevalence than those performing less than 30 sessions (90.9% vs 70.3%; P = 0.0126). In conclusion, endoscopists in Taiwan had a high prevalence of H. pylori infection. The cause might be related to the frequency of gastroscopies performed.
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Affiliation(s)
- Y C Su
- Department of Internal Medicine, Kaohsiung Medical College Hospital, Taiwan
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