1
|
Jian TZ, Shi LK, Cui SS, Sun CC, Jian XD, Kan BT. [A case of dimethylformamide poisoning caused by skin contact]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2023; 41:312-314. [PMID: 37248190 DOI: 10.3760/cma.j.cn121094-20210906-00444] [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: 05/31/2023]
Abstract
In this paper, the clinical data of a case of accidental poisoning of dimethylformamide in a traffic accident was analyzed. The patient was trapped in the driving room, his limbs were soaked in dimethylformamide for a long time, and dimethylformamide was inhaled at the same time. After 4 days of treatment in a local hospital, he was transferred to the Department of Poisoning & Occupational Diseases, Emergency Medicine of Qilu Hospital of Shandong University for treatment. The main clinical manifestation of the patient was liver damage and intractable abdominal pain, which was cured by active treatment.
Collapse
Affiliation(s)
- T Z Jian
- Department of Poisoning & Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Jinan 250012, China
| | - L K Shi
- Department of Poisoning & Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Jinan 250012, China School of Public Health, Shandong University, Jinan 250012, China
| | - S S Cui
- Department of Poisoning & Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Jinan 250012, China School of Public Health, Shandong University, Jinan 250012, China
| | - C C Sun
- Department of Poisoning & Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Jinan 250012, China
| | - X D Jian
- Department of Poisoning & Occupational Diseases, Emergency Medicine, Qilu Hospital of Shandong University, Jinan 250012, China School of Public Health, Shandong University, Jinan 250012, China
| | - B T Kan
- Department of Geriatrics, Nursing Department, Qilu Hospital of Shandong University, Jinan 250012, China
| |
Collapse
|
2
|
Sun CC, Jian TZ, Yu GC, Li YQ, Jian XD, Kan BT. [A case of acute fish gallbladder poisoning with multiple organ dysfunction]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2022; 40:700-702. [PMID: 36229219 DOI: 10.3760/cma.j.cn121094-20210520-00260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Fish bile poisoning may damage human liver and kidney, causing degeneration and necrosis. Can also damage brain cells and heart muscle, resulting in nervous system and cardiovascular system lesions. This paper reports a case of a patient who developed multiple organ dysfunction syndrome (MODS) after oral administration of fish bile with Xiexin folk prescription for eye disease. In January 2020, he went to the poisoning and occupational diseases department of the emergency department of Qilu hospital. After receiving hemoperfusion, continuous renal replacement therapy (CRRT) and symptomatic support treatment, the patient was improved and discharged. CRRT combined with HP is one of the rapid and effective methods for the treatment of acute fish bile poisoning.
Collapse
Affiliation(s)
- C C Sun
- Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - T Z Jian
- Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - G C Yu
- Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Y Q Li
- Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - X D Jian
- Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - B T Kan
- Department of Poisoning and Occupational Diseases, Emergency, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| |
Collapse
|
3
|
Wu F, Li MC, Sun CC, Liu Y, Wu LG. [Influence of environmental factors on the two-species biofilm formed by Streptococcus oligofermentans and Streptococcus mutans]. Zhonghua Kou Qiang Yi Xue Za Zhi 2019; 54:456-462. [PMID: 31288325 DOI: 10.3760/cma.j.issn.1002-0098.2019.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To study the influence of environmental factors on the two-species biofilm formed by the combinations of Streptococcus oligofermentans (So) with Streptococcus mutans (Sm) and Streptococcus sanguinis (Ss) with Sm so as to evaluate the role of So in maintaining the microecological balance of the oral cavity. Methods: Single-and two-species biofilms were grown on saliva-coated surfaces (glass tube and 96-well plate). Colony-counting method and safranin staining method were used to measure the biofilms formed under various oxygen conditions (aerobic and anaerobic), sucrose conditions (0%, 1% and 5% sucrose concentrations) and pH conditions (5.5, 6.0, 6.5, 7.0, 7.5 and 8.0). Results: Comparing the numbers of Sm in two co-cultures under various conditions, Sm counts in So+Sm group [(7.70±2.46)×10(8) CFU/ml] were significantly lower than those in Ss+Sm group [(9.00±1.13)×10(8) CFU/ml] in aerobic environment (P<0.05). Sm counts in So+Sm group [(2.80±0.52)×10(8) CFU/ml] were also significantly lower than those in the Ss+Sm group [(4.00±1.25)×10(8) CFU/ml] in anaerobic environment (P<0.05). The Sm counts in So+Sm group [(8.90±0.82)×10(8) CFU/ml] were significantly higher than those in Ss+Sm group [(7.50±1.73)×10(8) CFU/ml] in 0% sucrose environment (P<0.05). The Sm counts in So+Sm group [(5.70±2.94)×10(8) CFU/ml] were significantly lower than those in Ss+Sm group [(10.30±3.21) ×10(8) CFU/ml] in 1% sucrose environment (P<0.05). The Sm counts in So+Sm group [(6.10±1.71)×10(8) CFU/ml] were also significantly lower than those in Ss+Sm group [(7.40±1.20)×10(8) CFU/ml] in 5% sucrose environment (P<0.05). The Sm counts in So+Sm group [(3.50±1.50)×10(8) CFU/ml] were significantly lower than those in Ss+Sm group [(10.70±2.80)×10(8) CFU/ml] in pH7.0 environment (P<0.05). Comparing the formation of biofilm after 24 h cultivation, the Sm counts in So+Sm group were significantly lower than those in Ss+Sm group both in aerobic and anaerobic environments (P<0.05). The Sm counts in So+Sm group were significantly higher than those in Ss+Sm group in 0% sucrose environment (P<0.05). The Sm counts in So+Sm group were significantly lower than those in Ss+Sm group in 1% and 5% sucrose and pH 7.0 environments (P<0.05). Both So and Ss had no inhibitory effect on Sm in pH5.5 and pH8.0 environments. Conclusions: In the in vitro two-species co-culture systems, So showed stronger inhibitory effects than Ss on Sm and its inhibitory ability might influenced by various environmental factors.
Collapse
Affiliation(s)
- F Wu
- Department of Endodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai 265500, China
| | - M C Li
- Department of Endodontics, Tianjin Stomatological Hospital, Tianjin 300041, China
| | - C C Sun
- Department of Endodontics, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, China
| | - Y Liu
- Department of Endodontics, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, China
| | - L G Wu
- Department of Endodontics, Stomatological Hospital, Tianjin Medical University, Tianjin 300070, China
| |
Collapse
|
4
|
Chen XZ, Lou QB, Sun CC, Zhu WS, Li J. [Effect of intravenous infusion with lidocaine on rapid recovery of laparoscopic cholecystectomy]. Zhonghua Yi Xue Za Zhi 2017; 97:934-939. [PMID: 28355756 DOI: 10.3760/cma.j.issn.0376-2491.2017.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of intravenous infusion with lidocaine on rapid recovery of laparoscopic cholecystectomy. Methods: This study was a prospective randomized controlled trial. From February to August 2016 in Affiliated Yiwu Hospital of Wenzhou Medical University, 60 patients scheduled for laparoscopic cholecystectomy under general anesthesia were involved and randomly divided into control group (n=30) and lidocaine group (n=30). Patients in lidocaine group received lidocaine 1.5 mg/kg intravenously before induction and followed by 2.0 mg·kg(-1)·h(-1) to the end of surgery. Patients in control group received equal volumes of saline intravenously. Anesthesia induction in both groups were given intravenous midazolam 0.03 mg/kg, sufentanil 0.2 μg/kg, propofol 2.0 mg/kg and cisatracuium 0.2 mg/kg. Anesthesia was maintained with propofol 0.05-0.20 mg·kg(-1)·min(-1) and remifentanil 0.1-0.5 μg·kg(-1)·min(-1) for laryngeal mask airway which bispectral index (BIS) value maintained at 40-60. BIS, heart rate(HR) and mean arterial pressure(MAP) were recorded before anesthesia induction, before and immediately after laryngeal mask implantation, intraoperative 30 min and anesthesia awake. Pain scores were assessed using visual analogue scales (VAS) at postoperation immediately, 30 min during postanesthesia care unit (PACU), 2, 6, 12, and 24 h after surgery. The time of PACU retention, postoperative ambulation, first intestine venting and discharge were recorded. The dosage of propofol and remifentanil, the frequency of sufentanil used, the incidence of postoperative nausea and vomiting were also recorded. Patient satisfaction was evaluated by using Simple Restoration Quality Score (QoR-9). Results: BIS values before and after laryngeal mask implantation in lidocaine group were 50.50±3.47 and 54.63±1.25 respectively, which was lower than those in control group(54.30±4.78, 55.80±2.33; t=3.542, 2.423, all P<0.05). The VAS score at postoperation immediately, PACU 30 min, postoperative 2, 6, 12 h in lidocaine group were 2.76±0.97, 2.37±0.93, 2.10±1.12, 1.76±0.97, 1.20±0.76 respectively, which was lower than those in control group (3.83±1.34, 3.27±1.26, 3.06±1.20, 2.63±0.88, 1.90±0.84; t=3.528, 3.154, 3.217, 3.603, 3.372, all P<0.05 ). The frequency of additional sufentanil at postoperation immediately and PACU 30 min in lidocaine group was 5(17%), 3(10%), which were less than those in control group(12(40%), 9(30%); χ(2)=4.022, 3.950, all P<0.05). The dosage of propofol and remifentanil in lidocaine group were (4.33±0.75) mg·kg(-1)·h(-1) and (9.00±1.66) μg·kg(-1)·h(-1) respectively, which were less than those in control group ((5.20±1.39) mg·kg(-1)·h(-1) and (10.43±2.20) μg·kg(-1)·h(-1;) t= 2.982, 2.842, all P<0.05). The time of PACU retention, postoperative ambulation and first intestine venting were (39.90 ± 8.06) min, (11.93±1.68) h and (10.16±1.05) h respectively in lidocaine group, which were shorter than those in control group ((48.23±10.04) min, (13.16±1.58) h and (11.13±1.30) h; t=3.514, 2.931, 3.156, all P<0.05). The QoR-9 score in lidocaine group was 15.60±1.07, which was higher than that in control group(14.73±0.74, t=-3.649, P<0.05). There was no significant difference in the incidence of postoperative nausea/vomiting and the discharge time between two groups (all P>0.05). Conclusion: Intravenous infusion of lidocaine can effectively reduce the dosages of propofol and remifentanil, postoperative early VAS score, postoperative ambulation time and first intestine venting time which could improve the satisfaction of patients.
Collapse
Affiliation(s)
- X Z Chen
- Department of Anesthesiology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | | | | | | | | |
Collapse
|
5
|
Zhu S, An WB, Wan Y, Ren YY, Zhang RR, Zhang JL, Liu C, Sun CC, Chang LX, Chen XJ, Yang WY, Guo Y, Chen YM, Zou Y, Zhu XF. [Analysis of clinical characteristics and prognosis of non-severe aplastic anemia children with chromosomal abnormalities]. Zhonghua Er Ke Za Zhi 2016; 54:814-818. [PMID: 27806787 DOI: 10.3760/cma.j.issn.0578-1310.2016.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical characteristics and prognosis of non-severe aplastic anemia (NSAA) with chromosomal abnormalities in children. Method: A retrospective analysis of 304 cases with NSAA with successful karyotyping from 2001 to 2014 in the Institute of Hematology & Blood Disease Hospital was carried out. The treatment response, condition of blood transfusion were analyzed using χ2 test, the cumulative survival was estimated by the Kaplan-Meier method. Result: Out of 304 patients, 28 patients had chromosomal abnormalities with trisomy 8 (7 cases, 25.0%), abnormalities in chromosome 7 (5 cases, 17.9%), and other types (16 cases, 57.1%). There were no significant differences in the treatment response(40.9% (9/22)vs. 58.6%(119/203), χ2=2.539, P=0.111), the rate of getting rid of blood transfusion(54.5%(6/11) vs. 65.0%(39/60), χ2=6.455, P=0.086), five-year progression-free survival (49.2% vs.70.8%, χ2=0.849, P=0.357), and five-year cumulative survival (79.1% vs. 92.8%, χ2=0.330, P=0.556) between the patients with or without chromosomal abnormalities. There were significant differences in the rate of disease progression(41.7%(10/24) vs. 22.3%(48/215), χ2=4.394, P=0.045), the incidence of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) (20.8%(5/24)vs. 0.9%(2/215), χ2=30.082, P=0.000)and the five-year cumulative incidence of MDS or AML(33.4% vs. 0.8%, χ2=17.798, P=0.000)between children with and without chromosomal abnormalities. Conclusion: The incidence of chromosomal abnormalities in children with NSAA is 9.2%. The clinical features and treatment response are similar, but children with chromosomal abnormalities have a poorer prognosis, and have higher risk of progressing to MDS or AML.
Collapse
Affiliation(s)
- S Zhu
- Pediatric Blood Disease Center, Institute of Hematology & Blood Disease Hospital, Tianjin 300020, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Ren L, Fang XP, Sun CC, Chen KR, Liu F, Li M, Xu L. First Report of Clubroot on Capsella bursa-pastoris Caused by Plasmodiophora brassicae in Sichuan Province of China. Plant Dis 2014; 98:687. [PMID: 30708514 DOI: 10.1094/pdis-04-13-0395-pdn] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Shepherd's purse (Capsella bursa-pastoris (L.) Medicus) is an edible and wild medicinal plant widely distributed in China. This plant has been cultivated in Shanghai, China, since the end of the 19th century. Infection of C. bursa-pastoris by Plasmodiophora brassicae, the causal agent of clubroot disease on Brassica spp. has been reported in Korea (2), but is not known to occur in China. In February of 2011, stunted and wilted shepherd's purse (SP) plants were observed in a field planted to oilseed rapes (B. napus) in Sichuan Province of China. Symptomatic SP plants also exhibited root galls. Disease incidence was 6.2% and 100% for SP and B. napus, respectively. Root galls on diseased SP plants were collected for pathogen identification. Many resting spores were observed when the root galls were examined under a light microscope. The resting spores were circular in shape, measuring 2.0 to 3.1 μm in diameter (average 2.6 μm). PCR amplification was conducted to confirm the pathogen. DNA was extracted from root galls and healthy roots (control) of SP. Two primers, TC2F (5'-AAACAACGAGTCAGCTTGAATGCTAGTGTG-3') and TC2R (5'-CTTTAGTTGTGTTTCGGCTAGGATGGTTCG-3') were used to detect P. brassicae (1). No PCR amplifications were observed with the control DNA as template. A fragment of the expected size (approximately 520 bp) was obtained when DNA was amplified from diseased roots of SP. These results suggest that the pathogen in the galled roots of SP is P. brassicae. Pathogenicity of P. brassicae in SP was tested on plants of both SP and Chinese cabbage (CC) (B. campestris ssp. pekinensis). A resting spore suspension prepared from naturally infected SP roots was mixed with a sterilized soil in two plastic pots, resulting in a final concentration of 5 × 106 spores/g soil. Soil treated with the same volume of sterile water was used as a control. Seeds of SP and CC were pre-germinated on moist filter paper for 2 days (20°C) and seeded into the infested and control pots, one seed per pot for planted for CC and four seeds per pot for SP. The pots were placed in a chamber at 15 to 25°C under 12 h light and 12 h dark. Plants in each pot were uprooted after 4 weeks and the roots of each plant were washed under tap water and rated for clubroot disease. No disease symptoms were observed in the control treatments of SP or CC. Plants of both species showed symptoms of clubroot, with the disease incidence of 62.5% and 100% on SP and CC, respectively. The pathogen was isolated from diseased roots of each plant and confirmed as P. brassicae based on morphological characteristics and PCR detection. To our knowledge, this is the first report of clubroot disease on C. bursa-pastoris in Sichuan Province of China. This finding suggests that it may be necessary to manage C. bursa-pastoris in cruciferous vegetable (cabbage, turnip) and oilseed rape production fields. References: (1) T. Cao et al. Plant Dis. 91:80, 2007. (2) W. G. Kim et al. Microbiology 39:233, 2011.
Collapse
Affiliation(s)
- L Ren
- Oil Crops Research Institute of Chinese Academy of Agricultural Sciences, Key Laboratory of Biology and Genetics Improvement of Oil Crops, Ministry of Agriculture, Wuhan 430062, Hubei, China
| | - X P Fang
- Oil Crops Research Institute of Chinese Academy of Agricultural Sciences, Key Laboratory of Biology and Genetics Improvement of Oil Crops, Ministry of Agriculture, Wuhan 430062, Hubei, China
| | - C C Sun
- Oil Crops Research Institute of Chinese Academy of Agricultural Sciences, Key Laboratory of Biology and Genetics Improvement of Oil Crops, Ministry of Agriculture, Wuhan 430062, Hubei, China
| | - K R Chen
- Oil Crops Research Institute of Chinese Academy of Agricultural Sciences, Key Laboratory of Biology and Genetics Improvement of Oil Crops, Ministry of Agriculture, Wuhan 430062, Hubei, China
| | - F Liu
- Oil Crops Research Institute of Chinese Academy of Agricultural Sciences, Key Laboratory of Biology and Genetics Improvement of Oil Crops, Ministry of Agriculture, Wuhan 430062, Hubei, China
| | - M Li
- Oil Crops Research Institute of Chinese Academy of Agricultural Sciences, Key Laboratory of Biology and Genetics Improvement of Oil Crops, Ministry of Agriculture, Wuhan 430062, Hubei, China
| | - L Xu
- Oil Crops Research Institute of Chinese Academy of Agricultural Sciences, Key Laboratory of Biology and Genetics Improvement of Oil Crops, Ministry of Agriculture, Wuhan 430062, Hubei, China
| |
Collapse
|
7
|
Sun CC, Shen ZY, Xiong M, Ma FB, Li YY, Chen L, Liu RM. Trend of dissolved inorganic nitrogen at stations downstream from the Three-Gorges Dam of Yangtze River. Environ Pollut 2013; 180:13-18. [PMID: 23727562 DOI: 10.1016/j.envpol.2013.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 04/27/2013] [Accepted: 05/01/2013] [Indexed: 06/02/2023]
Abstract
The TRAMO/SEATS program, combined with the Hodrick-Prescott (HP) filter, was used to detect trends and potential change points in time series of dissolved inorganic nitrogen (DIN) at three stations along the Yangtze River. The trend components were extracted, and two change points were successfully detected. The components revealed that DIN has been increasing at all the stations since the 1990s, although variations exist. Changes visible before 2002 illustrate the differences in agriculture development among regions upstream from the stations. The Three-Gorges Dam (TGD), which began to impound in 2003, led to years of different trends. The DIN concentration, which had been trending upward prior to that date, began a slightly downward trend because of NH4(+) depletion. Readings at the Yichang station revealed this trend most strongly; those at the Hankou station less so. The Datong station was far enough away from the TGD so that no obvious effects were seen.
Collapse
Affiliation(s)
- C C Sun
- State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875, PR China
| | | | | | | | | | | | | |
Collapse
|
8
|
Burton-Chase AM, Hovick SR, Sun CC, Boyd-Rogers S, Lynch PM, Lu KH, Peterson SK. Gynecologic cancer screening and communication with health care providers in women with Lynch syndrome. Clin Genet 2013; 86:185-9. [PMID: 23906188 DOI: 10.1111/cge.12246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/15/2013] [Accepted: 07/29/2013] [Indexed: 01/06/2023]
Abstract
We evaluated knowledge of gynecologic cancer screening recommendations, screening behaviors, and communication with providers among women with Lynch syndrome (LS). Women aged ≥25 years who were at risk for LS-associated cancers completed a semi-structured interview and a questionnaire. Of 74 participants (mean age 40 years), 61% knew the appropriate age to begin screening, 75-80% correctly identified the recommended screening frequency, and 84% reported no previous screening endometrial biopsy. Women initiated discussions with their providers about their LS cancer risks, but many used nonspecific terms or relied on family history. Most were not offered high-risk screening options. While many women were aware of risk-appropriate LS screening guidelines, adherence was suboptimal. Improving communication between women and their providers regarding LS-related gynecologic cancer risk and screening options may help improve adherence.
Collapse
|
9
|
Ready K, Arun BK, Schmeler KM, Uyei A, Litton JK, Lu KH, Sun CC, Peterson SK. Communication of BRCA1 and BRCA2 genetic test results to health care providers following genetic testing at a tertiary care center. Fam Cancer 2011; 10:673-9. [PMID: 21681553 DOI: 10.1007/s10689-011-9460-z] [Citation(s) in RCA: 6] [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: 02/03/2023]
Abstract
Individuals at high risk for hereditary cancers often receive genetic counseling and testing at tertiary care centers; however, they may receive care for long-term management of their cancer risk in community settings. Communication of genetic test results to health care providers outside of tertiary care settings can facilitate the long-term management of high risk individuals. This study assessed women's communication of BRCA1/BRCA2 genetic test results to health care providers outside of tertiary care settings (termed "outside" health care providers, or OHCPs) and women's perceptions regarding communication of results. Women (n = 312) who underwent BRCA1/BRCA2 genetic counseling and testing completed a questionnaire assessing whether or not they shared test results with OHCPs and perceptions regarding the communication of test results to OHCPs. Most (72%) shared genetic test results with OHCPs. Women with no personal history of cancer were more likely to have shared results compared to women with a personal history of cancer. Mutation status did not significantly predict sharing of genetic information. Most reported positive perceptions regarding the disclosure of genetic test results to OHCPs. The majority did not report any concerns about potential insurance discrimination (88%) and indicated that OHCPs were able to appropriately address their questions (81%). Although most women shared their genetic test results with OHCPs, those with a personal history of cancer may need further encouragement to share this information. Tertiary care centers should facilitate outreach and education with OHCPs in order to assure appropriate long-term cancer risk management for high risk populations.
Collapse
Affiliation(s)
- K Ready
- Department of Breast Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77230, USA
| | | | | | | | | | | | | | | |
Collapse
|
10
|
|
11
|
Huang M, Djordjevic B, Urbauer D, Westin SN, Sun CC, Burzawa JK, Meyer L, Bodurka DC, Broaddus R, Lu KH. Molecular analysis of endometrial pathogenesis in Lynch syndrome. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.5095] [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: 11/20/2022] Open
|
12
|
Pentz RD, Farmer ZL, Green MJ, Daugherty C, Hlubocky FJ, Peterson SK, Sun CC, Lewis CM, Owonikoko TK, Khuri FR, Harvey RD. Assessing patients’ values when standard-of-care options are exhausted. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.9108] [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: 11/20/2022] Open
|
13
|
Gershenson DM, Sun CC, Malpica A, Deavers M, Bodurka DC, Schmeler KM. Low-grade serous primary peritoneal carcinoma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.5057] [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: 11/20/2022] Open
|
14
|
Schlumbrecht MP, Sun CC, Westin SN, Zandstra F, Denton K, Rhodes H, Gonzales DA, Garcia EA, Levenback C, Bodurka DC. Importance of lifestyle modification in cervical cancer survivors. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e15521] [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: 11/20/2022] Open
|
15
|
Huang M, Sun CC, Boyd-Rogers S, Burzawa JK, Milbourne A, Keeler E, Yzquierdo R, Lynch PM, Peterson SK, Lu KH. A prospective study of combined colon and endometrial cancer screening in women with Lynch syndrome: A novel, patient-centered approach. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1563] [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: 11/20/2022] Open
|
16
|
Schmeler KM, Tao X, Sun CC, Malpica A, Deavers M, Sood A, Coleman RL, Bodurka DC, Kavanagh JJ, Gershenson DM. Encouraging responses with bevacizumab in recurrent low-grade serous ovarian cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e15503] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
17
|
Sun CC, Jhingran A, Ramondetta LM, Eifel PJ, Crane CH, Phan AT, Urbauer D, Frumovitz MM, Elting LS, Bodurka DC. Gynecologic versus gastrointestinal patients: Preferences (prefs) over time for chemoradiation (chemoXRT) side effects (SE) using visual analog scale (VAS) and time trade-off (TTO). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e19616] [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: 11/20/2022] Open
|
18
|
Bodurka DC, Jhingran A, Ramondetta LM, Eifel PJ, Crane CH, Phan AT, Urbauer D, Frumovitz MM, Elting LS, Sun CC. Visual analog scale (VAS) and time trade-off (TTO) preferences for side effects (SE) of chemoradiation (chemoXRT): A comparison of patients (pts) and caregivers (CG). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9056] [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: 11/20/2022] Open
|
19
|
Sun CC, Ramondetta LM, Jhingran A, Eifel PJ, Crane C, Phan AT, Frumovitz MM, Elting LS, Bodurka DC. Patient preferences for chemoradiation-related side effects. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20604] [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
e20604 Background: Patients (pts) undergoing chemoradiation (CRT) face intense treatment (tx) schedules and adverse tx- related side-effects (SEs). We conducted this study to determine whether pts’ preferences (PREFs) for CRT-related SEs changed over tx duration. Methods: We used the visual analog scale (VAS) and modified time trade-off (TTO) to assess PREFs of newly diagnosed pts with gynecologic (GYN) and gastrointestinal (GI) cancers scheduled to receive CRT. Pts evaluated 16 SE health state scenarios during interviews conducted at 3 points in time: T1=prior to starting CRT; T2=2–3 weeks after starting CRT; and T3=4–6 weeks after completing CRT. Using the VAS, pts ranked SEs on a scale of 0=worst to 100=best. The TTO asked pts whether they would accept a hypothetical tx for a specified time with the SE in question or a tx for a shorter length of time that involved a worse SE profile. PREF scores were converted to 0.0=least preferred to 1.0=most preferred. Mann-Whitney and Kruskal-Wallis tests were used to analyze data. P- values were adjusted for multiple comparisons. Results: PREFs were collected from 93 pts (GYN=43; GI=50). 46/93 pts were female (3 women were GI pts). Median age was 53.7 yrs. Pts received a median of 5 chemo cycles (31/50 GI and all GYN pts received platinum) and 5.4 wks of external beam radiation. Median time between T1-T2 was 2.6 wks and T2-T3 was 9.1 wks. TTO PREFs were stable over time regardless of disease group or tx regimen. VAS scores for 7 SEs worsened significantly after initiation of CRT and remained low despite completion of CRT ( table ). Pts gave low baseline PREF scores for diarrhea, fatigue, and loss of appetite; these did not change significantly over time. Conclusions: Pts receiving CRT were willing to accept tx of longer duration with less severe SEs instead of shorter tx with more severe SEs. Relative to other SEs, pts rated GI-associated SEs lower after initiation of CRT. Ratings remained low 4–6 weeks after tx completion. Further studies are needed to determine whether pts’ experiences with and perceptions of SEs influence tx compliance. [Table: see text] [Table: see text]
Collapse
Affiliation(s)
- C. C. Sun
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | | | - A. Jhingran
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - P. J. Eifel
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - C. Crane
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - A. T. Phan
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - M. M. Frumovitz
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - L. S. Elting
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| | - D. C. Bodurka
- University of Texas M. D. Anderson Cancer Center, Houston, TX
| |
Collapse
|
20
|
Tung CS, Sun CC, Cohen L, Frenkel M, Ramondetta LM, Smith JA, Parker P, Bodurka DC. Complementary and alternative medicine: What do oncology healthcare providers think? J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e20614] [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
e20614 Background: The use of complementary and alternative medicine (CAM) is growing as the oncology patient (pt) population increases. The purpose of this study was to assess current CAM practice patterns of oncology healthcare providers. Methods: We distributed a 20-page anonymous survey to all physicians (), mid-level practitioners, clinical pharmacists, and dietitians at a comprehensive cancer center. The survey examined factors influencing a provider's inquiry towards pt CAM use, as well as current perception and use of 15 different CAM modalities, such as meditation, acupuncture, chiropractic, and herbal therapy. Descriptive statistics, chi-square, and Student's t-test were used for analysis. Results: 671/1,601 (42%) surveys were returned with s comprising 50% of the responses. 83% of respondents believed CAM has a role in cancer care. Over 70% indicated that massage, meditation/prayer, relaxation techniques, and acupuncture have potential uses, primarily to relieve symptoms not controlled by conventional therapy (tx) (47%) and as psycho-social-spiritual support (47%). Respondents estimated 28% of pts utilize CAM; 25% of respondents and 19% of pts initiated CAM discussions during pt visits. Those in medicine-based fields were more likely to discuss pt CAM use compared to surgical specialities (30% vs. 19%, p<0.01), but there was no significant difference in comfort level to discuss CAM modalities. s were less likely to discuss CAM use compared to all other providers (21% vs. 31%, p<0.01). s were also less comfortable discussing herbs (37% vs. 51%, p<0.01), massage (73% vs. 82%, p<0.05), meditation/prayer (71% vs. 82%, p<0.05), and relaxation tx (67% vs. 77%, p<0.01) compared to all other providers but more comfortable discussing acupuncture (63% vs. 55%, p<0.05). Respondents cited lack of knowledge in CAM as the primary reason for not discussing CAM with pts. Conclusions: Past studies estimate that >50% of patients use at least one form of CAM. Our study suggests that oncology providers critically underestimate the number of patients incorporating CAM into their treatment. Improving provider education on CAM therapies is essential to improve patient-physician communication regarding potential risks and benefits of CAM with traditional cancer therapies. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- C. S. Tung
- M. D. Anderson Cancer Center, Houston, TX
| | - C. C. Sun
- M. D. Anderson Cancer Center, Houston, TX
| | - L. Cohen
- M. D. Anderson Cancer Center, Houston, TX
| | - M. Frenkel
- M. D. Anderson Cancer Center, Houston, TX
| | | | | | - P. Parker
- M. D. Anderson Cancer Center, Houston, TX
| | | |
Collapse
|
21
|
Meyer L, Westin SN, Lacour RA, Urbauer DL, Schmeler KM, Daniels MS, Sun CC, Gershenson DM, Lu KH. Evaluating women with ovarian cancer for BRCA 1/2: Missed opportunities. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
22
|
Schmeler KM, Jhingran A, Iyer RB, Sun CC, Eifel PJ, Soliman PT, Ramirez PT, Frumovitz MM, Bodurka DC, Sood AK. Pelvic fractures following radiation therapy for cervical cancer: Implications for survivors. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5530] [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: 11/20/2022] Open
|
23
|
Sun CC, Westin SN, Lacour RA, Meyer LA, Tung CS, Urbauer DL, Frumovitz MM, Gershenson DM, Lu KH, Bodurka DC. Health concerns of long-term survivors of gynecologic cancers. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20535] [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: 11/20/2022] Open
|
24
|
Westin SN, Sun CC, Lacour RA, Meyer LA, Tung CS, Urbauer DL, Frumovitz MM, Lu KH, Gershenson DM, Bodurka DC. Survivors of gynecologic malignancies (GYN CA): Impact of treatment on health and well-being. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5527] [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: 11/20/2022] Open
|
25
|
Du XL, Sun CC, Milam MR, Bodurka DC, Fang S. Ethnic differences in socioeconomic status, diagnosis, treatment, and survival among older women with epithelial ovarian cancer. Int J Gynecol Cancer 2007; 18:660-9. [PMID: 17892451 DOI: 10.1111/j.1525-1438.2007.01081.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [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] [Indexed: 11/28/2022] Open
Abstract
The purpose of the study was to determine the ethnic disparities in socioeconomic status (SES) and in receiving definitive surgical treatment and adjuvant chemotherapy and to examine if these differences contribute to ethnic disparities in survival. We studied a population-based cohort of 5131 women diagnosed with epithelial ovarian cancer at age >or=65 between 1992 and 1999, identified from the Surveillance, Epidemiology and End Results-Medicare linked databases with up to 11 years of follow-up. The percentage of women diagnosed with epithelial ovarian cancer at advanced stage (stage III or IV) was 71.6% in Caucasians and 69.7% in African-Americans. Of these 4264 with stage IC-IV disease who are recommended for chemotherapy, fewer African-Americans received chemotherapy compared to Caucasians (50.2% versus 64.7%, P < 0.001). The risk of all-cause mortality in African-Americans was not significantly different from Caucasians (hazard ratio [HR] = 1.00, 95% CI = 0.88-1.13) after controlling for patient demographics, tumor characteristics, and comorbidity. The HR remained not significant in African-Americans compared to Caucasians after additionally adjusting for treatments (0.93, 0.82-1.06) or SES (0.94, 0.82-1.08) or both (0.88, 0.77-1.01). Women who underwent cancer-directed surgery and received adjuvant chemotherapy were 50% less likely to die than those who did not. The survival benefits from these therapies were similar in Caucasian and African-American women with ovarian cancer. There was no significant difference in survival between African-American and Caucasian women with ovarian cancer after adjusting for tumor characteristics, treatment, and sociodemographic factors. Although adjuvant chemotherapy was effective in prolonging survival, substantial numbers of women with ovarian cancer still did not receive chemotherapy.
Collapse
Affiliation(s)
- X L Du
- School of Public Health, The University of Texas Health Science Center, Houston, Texas 77030, USA.
| | | | | | | | | |
Collapse
|
26
|
Burke TW, Navo MA, Smith JA, Jung MS, Broaddus R, Iyer RB, Lu KH, Sun CC, Atkinson EN, Ramondetta LM. Phase II trial of mifepristone (RU-486) in advanced or recurrent endometrioid adenocarcinoma or low-grade endometrial stromal sarcoma (LGESS). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5595] [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
5595 Background: Endometrial cancer is the most common cancer of the female genital tract. It affected 41,200 women in the year 2006 and caused 7,350 deaths. Therapy options for recurrent/advanced endometrial cancer are limited. Treatment with radiation and chemotherapy has shown only limited success. Methods: In a phase II IRB approved trial, Mifepristone was given to patients with progesterone receptor positive advanced or recurrent endometrioid adenocarcinoma or low-grade endometrial stromal sarcoma at a dose of 200mg/day orally. Patients were evaluated every 4 weeks to assess treatment-related toxicities and response. Imaging was obtained initially at 8 weeks then every 12 weeks for evaluation of response. Common Terminology Criteria for Adverse Events (CTCAE), version 3.0 was used to assess toxicity. Results: Twelve of 13 enrolled patients were evaluable for response in the first phase of accrual. Stable disease was noted in 3/12 (16, 20, and 44+ weeks). Two were endometrioid endometrial cancer and one with LGESS. No complete responses were seen, one patient remains in treatment. The most frequently reported grade 1–2 tumor related toxicities were anorexia, mood alterations, and fatigue (55%). Twenty-seven percent had asymptomatic elevations of ACTH. The most common Grade 3 toxicities were fatigue and dyspnea (27% and 18%). Only one patient experienced a Grade 4 dyspnea. No serious treatment-related adverse events occurred. Conclusions: Single agent mifepristone in patients with recurrent endometrioid adenocarcinoma or low-grade endometrial stromal sarcoma showed no complete responses. Stable disease was reported 25%, one patient remains stable at 44 weeks. Recent reports suggests that mifepristone may also work via non hormonal targets while single agent mifepristone has minimal activity in this setting. Further evaluation in combination therapy in endometrial cancer should be considered. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- T. W. Burke
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - M. A. Navo
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - J. A. Smith
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - M. S. Jung
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - R. Broaddus
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - R. B. Iyer
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - K. H. Lu
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - C. C. Sun
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - E. N. Atkinson
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| | - L. M. Ramondetta
- UT MD Anderson Cancer Ctr, Houston, TX; Mayo Clinic, Rochester, MN
| |
Collapse
|
27
|
Lacour RA, Westin SN, Daniels MS, Milam MR, Sun CC, Urbauer DL, Ramirez PT, Bodurka DC, Gershenson DM, Lu KH. Survival in advanced-stage ovarian cancer patients with non-Ashkenazi Jewish BRCA mutations. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5514] [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
5514 Background: Previous studies have shown a survival advantage in ovarian cancer patients with Ashkenazi-Jewish BRCA founder mutations compared to sporadic ovarian cancer patients. The purpose of this study is to determine if this association exists in ovarian cancer patients with non- Ashkenazi Jewish (non-AJ) BRCA1 or BRCA2 mutations. Methods: Patients with stage III or IV ovarian, fallopian tube, or primary peritoneal cancer and a BRCA1 or BRCA2 mutation, seen for genetic testing between January 1996 and October 2006, were identified from the institutional and genetics databases. Medical records were reviewed for clinical factors including response to initial chemotherapy. Response is defined as no clinical evidence of disease with normalization of serum CA-125 and no radiographic evidence of disease or a negative second-look surgery. Patients with sporadic ovarian cancer, without a family history of breast or ovarian cancer, were compared to similar cases, matched by age, stage, and year of diagnosis. Progression-free and overall survival were calculated by the method of Kaplan-Meier. Chi-square tests and univariate logistic regression were also used in the data analysis. Results: Thirty-nine advanced-stage ovarian cancer patients with non-AJ BRCA mutations and 47 matched, advanced-stage sporadic ovarian cancer patients have been analyzed. Compared to patients with sporadic ovarian cancer, non-AJ BRCA mutation carriers had a longer progression-free survival (PFS, 32.4 mos. vs. 22.1 mos., p = 0.0303) and overall survival (OS, 101.4 mos. vs. 51.3 mos., p < 0.001). Similarly, 72% of the non-AJ BRCA mutation carriers had a complete response to initial treatment, compared to 45% of the sporadic ovarian cancer patients (p = 0.01). The odds of complete response to initial treatment were 3.2 times greater in the non-AJ BRCA group than in the sporadic group (OR 3.2; 95% CI 1.27 - 8.15). Conclusions: This study demonstrates a significant survival advantage in advanced-stage ovarian cancer patients with non-AJ BRCA mutations when compared to similar patients with sporadic ovarian cancer. Response to initial treatment appears to impact this improved survival. No significant financial relationships to disclose.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - K. H. Lu
- MD Anderson Cancer Ctr, Houston, TX
| |
Collapse
|
28
|
Sun CC, Westin SN, Lu KH, Schmeler KM, White KG, Daniels MS, Arun BK, Peterson SK, Bodurka DC. Impact of BRCA 1/2 testing: Body image, sexual functioning, and quality of life (QOL). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.1525] [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
1525 Background: Management strategies for women at high risk of breast and ovarian cancer (OVCA) may affect sensitive QOL issues. Methods: As part of a larger study, 540 women who underwent testing for BRCA 1/2 prior to July 2005 were sent follow- up surveys, including FACT-Endocrine Symptom subscale (FACT-ES), Sexual Activity Questionnaire (SAQ), and a modified Body Image Scale. Chi-square, Mann-Whitney and Kruskal-Wallis tests were used to analyze the data. Results: To date, 309 patients (pts) have responded. Pts with previous oophorectomies were excluded (n=68). The final analysis included 241 pts categorized into 4 groups: Group 1=no breast CA, no prophylactic (proph) surgery (n=39); Group 2=no breast CA, + proph surgery (either proph oophorectomy (PO), proph mastectomy (PM), or PO+PM) (n=20); Group 3= + breast CA, no PO or PM (n=90); and Group 4= + breast CA, + proph surgery (n=92). Median age at time of survey = 50 yrs. Median age at time of PO = 46 yrs. Of 65 BRCA + pts, 36 chose PO, while 32/176 BRCA- pts chose PO (p<.001). 155 pts reported being sexually active at time of survey. Women with PO (n=68) had more endocrine symptoms by the FACT-ES vs pts who chose screening (n=173) (p=.005). Women in Group 2 reported more endocrine symptoms compared to all other women (p=.02). The same trend was noted for sexually active women only (p=.06). There were no differences in activity or pleasure measured by the SAQ between women with PO vs screening; pts with PO reported higher levels of pain/discomfort (p=.04). Women in Group 1 reported the lowest level of pain/discomfort (p=.004) and highest level of pleasure. Higher levels of discomfort and less sexual activity were reported by women with breast CA vs those without breast CA (p<.001; p=.05). Women in Group 3 had the most negative body image while Group 2 had the most positive (p=.03). Women who chose screening reported a more negative body image vs women with PO (p=.01). Pts with breast CA had more negative body image scores than women without breast CA (p=.06). Conclusions: Choice of management strategy and personal hx of breast CA appear to influence sexual functioning, endocrine symptoms and body image in women at high risk of breast and OVCA. Baseline assessment of these factors and continued dialogue are critical aspects of comprehensive care for these women. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- C. C. Sun
- M. D. Anderson Cancer Center, Houston, TX
| | | | - K. H. Lu
- M. D. Anderson Cancer Center, Houston, TX
| | | | | | | | - B. K. Arun
- M. D. Anderson Cancer Center, Houston, TX
| | | | | |
Collapse
|
29
|
Westin SN, Sun CC, Lu KH, Schmeler KM, Soliman PT, White KG, Daniels MS, Arun BK, Peterson SK, Bodurka DC. Management strategies for women at high risk for breast and ovarian cancer: Are women satisfied? J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.1524] [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
1524 Background: Women at high risk for breast and ovarian cancer have two major management options to reduce their risk of ovarian cancer, periodic screening (PS) or prophylactic oophorectomy (PO). Little is known regarding patient satisfaction levels with choice of risk reduction strategy. Our objective was to determine levels of patient satisfaction with PO versus PS and to identify factors which may influence satisfaction. Methods: As part of a larger study, women who received BRCA1/2 testing before July 2005 were sent a follow-up patient questionnaire packet. We are reporting on the Cancer Worry Scale and Satisfaction With Decision (SWD) scale (range of possible scores, 6–30). The lowest 10th percentile of the SWD score (21) was used to define low satisfaction. Chi-square, t-Test and Mann-Whitney tests were used for statistical analyses. Results: A total of 540 surveys were mailed and 309 responses were received (57%). We excluded 127 patients due to history of an oophorectomy for benign or malignant indications or incomplete SWD scale. The median age of respondents was 48.2. 60/182 women (33%) had BRCA mutations and 64/182 (35.2%) underwent PO. The overall satisfaction rate among respondents was high (median score 29, range 14–30). Median SWD score was significantly higher in patients in the PO group compared to the PS group (30.0 vs. 26.5, p<.001). Patients with BRCA mutations had higher median SWD scores, regardless of management type (30.0 vs. 28.0, p=.013). Low satisfaction scores were associated with the perception that the decision between PO and PS was difficult to make (p=.001). Patients who expressed ongoing difficulty in their decision-making also had lower satisfaction scores (p=.016). Satisfaction was unrelated to demographics, clinical factors, or concerns of cancer risk. Conclusions: In our study, the majority of women at high risk for breast and ovarian cancer were satisfied with their choice of risk reduction strategy. In particular, women who chose PO had higher levels of overall satisfaction. Difficulty with decision-making was associated with lower satisfaction levels. Improved education and support of these women through the decision-making process may enhance overall levels of satisfaction with risk reduction strategy. No significant financial relationships to disclose.
Collapse
Affiliation(s)
| | - C. C. Sun
- UT MD Anderson Cancer Center, Houston, TX
| | - K. H. Lu
- UT MD Anderson Cancer Center, Houston, TX
| | | | | | | | | | - B. K. Arun
- UT MD Anderson Cancer Center, Houston, TX
| | | | | |
Collapse
|
30
|
Schmeler KM, Sun CC, Bodurka DC, Deavers MT, Coleman RL, Ramirez PT, Gershenson DM. Neoadjuvant chemotherapy for low-grade serous carcinoma of the ovary. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5571] [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
5571 Background: Neoadjuvant chemotherapy (NACT) has been associated with significant tumor reduction prior to interval debulking surgery, enabling optimal cytoreduction in up to 50% of patients with high-grade ovarian carcinomas deemed initially unresectable. Since low-grade serous carcinoma (LGSC) appears to be relatively less chemosensitive, we sought to evaluate the outcomes of women with ovarian LGSC treated with platinum-based NACT. Methods: Using institutional databases, we identified 18 women with low-grade serous carcinomas of the ovary who were treated with neoadjuvant platinum-based chemotherapy between 1978 and 2003. Patient demographic and clinical variables were abstracted from the medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the method of Kaplan-Meier. Results: The median age at diagnosis was 44 years (range, 21 to 81 years). NACT was given for extensive or non-resectable disease in 16 patients (89%) and for unknown reasons in 2 patients (11%). Ten patients (42%) underwent exploratory laparotomy with biopsy only prior to beginning chemotherapy. A median of 6 cycles of chemotherapy was given (range, 2 to 16) and included the following regimens: platinum/taxane (n=12 patients); platinum/cyclophosphamide (n=3 patients); and platinum/leuprolide acetate (n=3 patients). Of the 13 patients who had CA-125 levels available, 8 (62%) had a ≥50% reduction between pre- and post-NACT levels. However, response, determined by radiographic survey at completion of NACT, demonstrated one patient (6%) with a complete response, no patients (0%) with a partial response, and 16 patients (89%) with stable disease. One patient (6%) was not evaluable. Fifteen patients (83%) underwent interval cytoreductive surgery, which was optimal in 8 cases (53%), suboptimal in 4 cases (27%) and unknown in 3 cases (20%). Median PFS and OS for all patients were 18.6 and 56.1 months, respectively. Conclusions: A low response rate to platinum-based NACT was observed among women with LGSC of the ovary. These findings suggest that LGSC is not as responsive to conventional chemotherapy as high-grade serous carcinoma. Prospective clinical trials, focusing specifically on LGSC, are needed to make meaningful advances for this group of patients. No significant financial relationships to disclose.
Collapse
|
31
|
Sun CC, Peterson SK, White KG, Watts BG, Daniels MS, Boyd-Rogers SG, Schmeler KM, Bodurka DC, Lu KH. Preferences for cancer prevention strategies (CPS) in women with hereditary nonpolyposis colectal cancer (HNPCC). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.1018] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
1018 Background: Women with HNPCC have 40–60% lifetime risk of endometrial and colon cancer (CA) and 10–12% risk of ovarian CA. Because CPS have significant QOL implications, understanding how women evaluate CPS and personal risks of CA may facilitate physician and pt communication for medical decision making in this group of pts. Methods: Using the visual analog scale (VAS) and standard gamble (SG), women with HNPCC or with a family history (FHx) that fulfilled Amsterdam II criteria were asked to: 1) score CPS from 0.0=worst to 1.0=best; and 2) state the % personal risk of CA they would need to have in order to undergo each CPS. CPS included oral contraceptives ± COX-2 inhibitors (OC ± COX2); endometrial biopsy/transvaginal ultrasound/CA125 ± colonoscopy (Bx/US ± CSPY); pre- and post-menopausal total abdominal hysterectomy/oophorectomy ± subtotal colectomy (TAH/BSO ± COL). Results: To date, 32 women have enrolled (median age=38.4 yrs). Bx/US + CSPY was rated most favorably (0.95) followed by OC, Bx/US, and CSPY(.90). Pre-menopausal TAH/BSO, COL, and TAH/BSO+ COL had the least favorable ratings (0.50, 0.30, and 0.25, respectively). Women accepted non-surgical CPS if their personal risk of CA was at least 30%; pre- and post-menopausal TAH/BSO if the personal risk of CA was at least 73% and 50%, respectively. Women accepted COL and TAH/BSO + COL if their risks of CA were at least 78% and 80%, respectively. Women without FHx of HNPCC-gynecologic (GYN) CA would participate in all CPS more readily than women with FHx of HNPCC-GYN CA. Specifically, to accept COX2, women without FHx of HNPCC-GYN CA would do to if their personal CA risk was at least 10% compared to a 30% risk for women in the 2nd group (p=.04). For the 2 groups, risks for Bx/US, pre-menopausal TAH/BSO, post-menopausal TAH/BSO, TAH/BSO + COL and COL were 20% vs 30% (p=.06), 40% vs 80% (p=.03), 30% vs 55% (p=.02), 65% vs 80% (p=.06), and 80% vs 100% (p=.01), respectively. Conclusions: Our data indicate that women without FHx of HNPCC-GYN CA are more willing to undergo chemoprevention, screening and prophylactic surgery for HNPCC CA compared to women with a FHx of HNPCC-GYN CA. This may be due to the perception of a more favorable clinical outcome associated with endometrial CA, the more common of the HNPCC-GYN CA. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- C. C. Sun
- UT M. D. Anderson Cancer Center, Houston, TX
| | | | - K. G. White
- UT M. D. Anderson Cancer Center, Houston, TX
| | - B. G. Watts
- UT M. D. Anderson Cancer Center, Houston, TX
| | | | | | | | | | - K. H. Lu
- UT M. D. Anderson Cancer Center, Houston, TX
| |
Collapse
|
32
|
Abstract
The structures, binding energies, and electronic properties of one oxygen atom (O) and two oxygen atoms (2O) adsorption on silicon clusters Si(n) with n ranging from 5 to 10 are studied systematically by ab initio calculations. Twelve stable structures are obtained, two of which are in agreement with those reported in previous literature and the others are new structures that have not been proposed before. Further investigations on the fragmentations of Si(n)O and Si(n)O2 (n = 5-10) clusters indicate that the pathways Si(n)O --> Si(n-1) + SiO and Si(n)O2 --> Si(n-2) + Si2O2 are most favorable from thermodynamic viewpoint. Among the studied silicon oxide clusters, Si8O, Si9O, Si5O2 and Si8O2 correspond to large adsorption energies of silicon clusters with respect to O or 2O, while Si8O, with the smallest dissociation energy, has a tendency to separate into Si7 + SiO. Using the recently developed quasi-atomic minimal-basis-orbital method, we have also calculated the unsaturated valences of the neutral Si(n) clusters. Our calculation results show that the Si atoms which have the largest unsaturated valences are more attractive to O atom. Placing O atom right around the Si atoms with the largest unsaturated valences usually leads to stable structures of the silicon oxide clusters.
Collapse
Affiliation(s)
- H Wang
- Institute of Theoretical Chemistry, State Key Lab of Theoretical and Computational Chemistry, Jilin University, Changchun, 130023, PR China
| | | | | | | | | |
Collapse
|
33
|
Tangjitgamol S, Ramirez PT, Sun CC, See HT, Jhingran A, Kavanagh JJ, Deavers MT. Expression of HER-2/neu, epidermal growth factor receptor, vascular endothelial growth factor, cyclooxygenase-2, estrogen receptor, and progesterone receptor in small cell and large cell neuroendocrine carcinoma of the uterine cervix: a clinicopathologic and prognostic study. Int J Gynecol Cancer 2005; 15:646-56. [PMID: 16014119 DOI: 10.1111/j.1525-1438.2005.00121.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We studied the immunohistochemical expression of HER-2/neu, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2), estrogen receptor (ER), and progesterone receptor (PR) in uterine cervical small cell and large cell neuroendocrine carcinomas (SCNECs and LCNECs) from 24 patients seen at The University of Texas M.D. Anderson Cancer Center. The objectives were to determine their expression and prognostic role in survival. Twenty-three cases (95.8%) expressed VEGF. The tumors expressing EGFR, HER-2/neu, and COX-2 were modest in numbers: eight (33.3%), 10 (41.7%), and seven (29.2%), respectively. Only one tumor (4.2%) expressed ER, and only two tumors (8.3%) expressed PR. No significant differences in the expression of these factors were found between SCNECs and LCNECs or between stage I and stage II-III tumors. The median overall survival was 21.1 months (95% confidence interval [CI], 17.2-25.0 months). Only HER-2/neu expression was significantly associated with survival. Patients with negative HER-2/neu expression tumors had significantly shorter survival than those whose tumors were positive, 14.2 months (95% CI, 10.6-17.7 months) versus 33.1 months (95% CI, 0-76.92 months) (P = 0.03). There was a trend toward worse survival in patients with EGFR expression, but this finding was not significant. The combination of negative HER-2/neu expression and positive EGFR expression had the worst impact on survival.
Collapse
Affiliation(s)
- S Tangjitgamol
- Department of Gynecologic Medical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | | | | | | | | | | |
Collapse
|
34
|
Lu KH, Schorge JO, Rodabaugh KJ, Sun CC, Daniels MS, White KG, Soliman PT, Luthra R, Broaddus RR. Defining criteria for Lynch Syndrome/HNPCC in women under 50 with endometrial cancer: Final results of a prospective, multi-center study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
- K. H. Lu
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| | - J. O. Schorge
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| | - K. J. Rodabaugh
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| | - C. C. Sun
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| | - M. S. Daniels
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| | - K. G. White
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| | - P. T. Soliman
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| | - R. Luthra
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| | - R. R. Broaddus
- UT MD Anderson Cancer Ctr, Houston, TX; U. T. Southwestern, Dallas, TX; Roswell Park Cancer Institute, Buffalo, NY; UT M. D. Anderson Cancer Ctr, Houston, TX
| |
Collapse
|
35
|
Bodurka DC, Sun CC, Weaver CB, Bethancourt DL, Fitzgerald MA, Wolf JK, Gershenson DM, Kavanagh JJ, Munsell MF, Donato ML. Longitudinal assessment of quality of life (QOL) of patients (pts) with ovarian cancer (ovca) receiving high-dose or conventional-dose chemotherapy (CDCT). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5065] [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)
| | - C. C. Sun
- UT M. D. Anderson Cancer Ctr, Houston, TX
| | | | | | | | - J. K. Wolf
- UT M. D. Anderson Cancer Ctr, Houston, TX
| | | | | | | | | |
Collapse
|
36
|
Sun CC, Bodurka DC, Weaver CB, Bethancourt DL, Fitzgerald MA, Wolf JK, Gershenson DM, Kavanagh JJ, Munsell MF, Donato ML. Preferences (PREFs) over time of chemo-experienced versus chemo-naïve patients (pts) for treatment-related side effects (SEs). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.8222] [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)
- C. C. Sun
- UT M. D. Anderson Cancer Ctr, Houston, TX
| | | | | | | | | | - J. K. Wolf
- UT M. D. Anderson Cancer Ctr, Houston, TX
| | | | | | | | | |
Collapse
|
37
|
Tangjitgamol S, Ramirez PT, Sun CC, See HT, Jhingran A, Kavanagh JJ, Deavers MT. Expression of HER-2/neu, epidermal growth factor receptor, vascular endothelial growth factor, cyclooxygenase-2, estrogen receptor, and progesterone receptor in small cell and large cell neuroendocrine carcinoma of the uterine cervix: a clinicopathologic and prognostic study. Int J Gynecol Cancer 2005. [DOI: 10.1136/ijgc-00009577-200507000-00011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We studied the immunohistochemical expression of HER-2/neu, epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2), estrogen receptor (ER), and progesterone receptor (PR) in uterine cervical small cell and large cell neuroendocrine carcinomas (SCNECs and LCNECs) from 24 patients seen at The University of Texas M.D. Anderson Cancer Center. The objectives were to determine their expression and prognostic role in survival. Twenty-three cases (95.8%) expressed VEGF. The tumors expressing EGFR, HER-2/neu, and COX-2 were modest in numbers: eight (33.3%), 10 (41.7%), and seven (29.2%), respectively. Only one tumor (4.2%) expressed ER, and only two tumors (8.3%) expressed PR. No significant differences in the expression of these factors were found between SCNECs and LCNECs or between stage I and stage II–III tumors. The median overall survival was 21.1 months (95% confidence interval [CI], 17.2–25.0 months). Only HER-2/neu expression was significantly associated with survival. Patients with negative HER-2/neu expression tumors had significantly shorter survival than those whose tumors were positive, 14.2 months (95% CI, 10.6−17.7 months) versus 33.1 months (95% CI, 0−76.92 months) (P = 0.03). There was a trend toward worse survival in patients with EGFR expression, but this finding was not significant. The combination of negative HER-2/neu expression and positive EGFR expression had the worst impact on survival.
Collapse
|
38
|
Schmeler KM, Soliman PT, Munsell MF, Daniels MS, White KG, Boyd-Rogers SG, Sun CC, Slomovitz BM, Gershenson DM, Lu KH. Prophylactic surgery for the reduction of gynecologic cancer risk in women with Lynch Syndrome/HNPCC. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9531] [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)
| | | | | | | | - K. G. White
- Univ of Texas/MD Anderson Cancer Ctr, Houston, TX
| | | | - C. C. Sun
- Univ of Texas/MD Anderson Cancer Ctr, Houston, TX
| | | | | | - K. H. Lu
- Univ of Texas/MD Anderson Cancer Ctr, Houston, TX
| |
Collapse
|
39
|
Slomovitz BM, Coleman RL, Soliman PT, Ramondetta LM, Wolf J, Sun CC, Gershenson DM, Burke TW, Lu KH. Is there a survival difference between clear cell and serous carcinoma of the endometrium? A stage and age-matched cohort study. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.5081] [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)
| | | | | | | | - J. Wolf
- MD Anderson Cancer Ctr, Houston, TX
| | | | | | | | - K. H. Lu
- MD Anderson Cancer Ctr, Houston, TX
| |
Collapse
|
40
|
Sun CC, Donato ML, Wolf JK, Weaver CB, Fitzgerald MA, Gershenson DM, Bodurka DC. Preferences (PREF) over time of patients (pts) with ovarian cancer (OVCA) receiving conventional dose platinum-based chemotherapy (CDCT). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.8227] [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)
- C. C. Sun
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - M. L. Donato
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - J. K. Wolf
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - C. B. Weaver
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - M. A. Fitzgerald
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - D. M. Gershenson
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| | - D. C. Bodurka
- University of Texas M. D. Anderson Cancer Center, Houston, TX; TUniversity of Texas M. D. Anderson Cancer Center, Houston, TX
| |
Collapse
|
41
|
Soliman PT, Slomovitz BM, Sun CC, Gershenson DM, Lu KH. Characteristics of women who develop both colorectal and endometrial cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5052] [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)
- P. T. Soliman
- University of Texas, M. D. Anderson Cancer Center, Houston, TX
| | - B. M. Slomovitz
- University of Texas, M. D. Anderson Cancer Center, Houston, TX
| | - C. C. Sun
- University of Texas, M. D. Anderson Cancer Center, Houston, TX
| | | | - K. H. Lu
- University of Texas, M. D. Anderson Cancer Center, Houston, TX
| |
Collapse
|
42
|
Slomovitz BM, Wu W, Broaddus RR, Soliman PT, Wolf J, Sun CC, Bodurka DC, Gershenson DM, Lu KH. mTOR inhibition is a rational target for the treatment of endometrial cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5076] [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)
| | - W. Wu
- MD Anderson Cancer Center, Houston, TX
| | | | | | - J. Wolf
- MD Anderson Cancer Center, Houston, TX
| | - C. C. Sun
- MD Anderson Cancer Center, Houston, TX
| | | | | | - K. H. Lu
- MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
43
|
Tseng JF, Kronowitz SJ, Hunt KK, Sun CC, Babiera GV, Singletary E, Meric-Bernstam F, Ross MJ, Feig BW, Kuerer HM. The rate of immediate reconstruction following mastectomy for breast cancer varies by patient race. Ann Surg Oncol 2004. [DOI: 10.1007/bf02524097] [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: 11/25/2022]
|
44
|
|
45
|
Xiao XC, Li ZS, Sun CC, Tang AC. Invariant Property of the Distribution of Aa1, ..., Aas - Bb1, ..., Bbt-Type Ideal Polymerization. Macromolecules 2002. [DOI: 10.1021/ma00112a020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
46
|
Liao YH, Chen KH, Tseng MP, Sun CC. Pattern of skin diseases in a geriatric patient group in Taiwan: a 7-year survey from the outpatient clinic of a university medical center. Dermatology 2002; 203:308-13. [PMID: 11752818 DOI: 10.1159/000051778] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [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: 11/19/2022] Open
Abstract
BACKGROUND Geriatric health care has become a worldwide concern, but relatively few statistical studies are available about geriatric skin diseases. Moreover, no information exists regarding skin disorders among the elderly population in Taiwan that has become a geriatric country. OBJECTIVE To determine the characteristic pattern and the prevalence of various skin disorders for the elderly who visited the National Taiwan University in the last 7 years. METHODS Using a database from the Dermatology Outpatient Clinic of the National Taiwan University Hospital, 1993-1999 file, we conducted a retrospective cross-sectional study by evaluating the age, proportion, and gender of each specific cutaneous disease category, chi(2) tests were used for analyzing statistical significance. The analysis supplied odds ratios and 95% confidence intervals. RESULTS A total of 16,924 patients aged 65 years and older, which constituted 11% of the total patients seen at the Clinic of Dermatology from 1993 through 1999, were studied. The male to female ratio was 1.3 to 1. The most common cutaneous disorder in the elderly was dermatitis (58.7%), followed by fungal infections (38.0%), pruritus (14.2%), benign tumors (12.8%), and viral infections (12.3%). Cutaneous malignant tumors were found in 2.1%. Basal cell carcinoma occurred in 29.8%, actinic keratosis in 22.4%, Bowen's disease in 13.3% and squamous cell carcinoma 13.3%. Interestingly, our cases of extramammary Paget's disease showed a male predominance. Most melanomas were acral lentiginous melanoma located on the soles. The prevalence of common diseases in elderly patients compared with those outpatients of less than 65 years showed a 3-fold increased risk for pruritus. Moreover, the pattern of geriatric skin diseases in Taiwan was significantly different from Western countries. CONCLUSION The prevalence of skin diseases in elderly patients emphasizes the importance of health education in geriatric people in Taiwan concerning appropriate use of emollients, proper foot care, sun protection and early detection of skin cancers.
Collapse
Affiliation(s)
- Y H Liao
- Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | | | | | | |
Collapse
|
47
|
Abstract
BACKGROUND Glypican-3 (GPC3) is a heparan sulfate proteoglycan. When it is disrupted, it causes the X-linked gigantism-overgrowth Simpson-Golabi-Behmel syndrome. Its involvement in growth control is consistent with recent reports that it can bind to growth factors, possibly including insulin-like growth factor 2. Further, it has been hypothesized that it may function as a tumor suppressor gene in breast and ovarian carcinomas and mesotheliomas. PATIENTS AND METHODS RNA and protein were extracted from Wilms tumor and hepatoblastoma tissue samples and GPC3 levels were measured in these extracts by Northern blotting, reverse transcription polymerase chain reaction, and immunoblotting. RESULTS In contrast to published results with carcinomas, high levels of GPC3 expression were found in Wilms tumor and hepatoblastoma. Low or undetectable expressions of this gene were found in normal tissue surrounding the tumor. CONCLUSIONS Increased expression of GPC3 in Wilms tumor and hepatoblastoma suggests a growth-promoting or neutral activity for this gene product rather than a growth-suppressive effect.
Collapse
Affiliation(s)
- J A Toretsky
- Department of Pediatrics, and Greenebaum Cancer Center, University of Maryland School of Medicine and Baltimore VA Medical Center, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Affiliation(s)
- C Y Lu
- Department of Dermatology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan
| | | |
Collapse
|
49
|
Abstract
PURPOSE To report a case of myoepithelioma metastatic to the orbit in an 11-year-old boy. METHODS Interventional case report. An 11-year-old white male with a history of resection of a left thigh mass 10 months previously presented with a painless, rapid swelling of the left upper eyelid. Computed tomography scan and incisional biopsy of the orbital mass were performed. RESULTS Immunohistochemical stains of the tumor in the left orbit and the previously resected mass were consistent with myoepithelioma. As a result of widespread metastases, the patient died 4 months after initial presentation to the eye clinic. CONCLUSION Myoepithelioma should be included in the differential diagnosis of neoplasms that can metastasize to the orbit in the pediatric age group.
Collapse
Affiliation(s)
- C Waldrop
- Department of Ophthalmology, University of Maryland, Baltimore, Maryland, USA.
| | | | | | | |
Collapse
|
50
|
|