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Cho WR, Wang CC, Tsai MJ, Lin CC, Yen YH, Chen CH, Kuo YH, Yao CC, Hung CH, Huang PY, Liu AC, Tsai MC. Smoking as a Risk Factor for Very Late Recurrence in Surgically Resected Early-Stage Primary Hepatocellular Carcinoma. Clin Med Insights Oncol 2024; 18:11795549241228232. [PMID: 38450293 PMCID: PMC10916494 DOI: 10.1177/11795549241228232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 01/07/2024] [Indexed: 03/08/2024] Open
Abstract
Background The risk of first recurrence of hepatocellular carcinoma (HCC) within years 5 to 10 after curative hepatectomy remains unknown. We aimed to assess the incidence and prognostic factors for very late recurrence among patients who achieved 5 years' recurrence-free survival (RFS) after primary resection. Methods We retrospectively analyzed 337 patients with early-stage HCC underwent primary tumor resection and achieved more than 5 years' RFS. Results A total of 77 patients (22.8%) developed very late recurrence. The cumulative very late recurrence rate increased from 6.9% and 11.7% to 16.6% at 6, 7, and 8 years, respectively. Patients stopped smoking had a higher rate of very late RFS. Conclusions The high rates of very late recurrence in HCC indicate that patients warrant continued surveillance, even after 5 recurrence-free years. Moreover, smoking is a risk factor for very late HCC recurrence, and quitting smoking may reduce the risk of very late recurrence.
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Affiliation(s)
- Wei-Ru Cho
- Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Yunlin
| | - Chih-Chi Wang
- Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Mu-Jung Tsai
- Kaohsiung Municipal Kaohsiung Senior High School, Kaohsiung
| | - Chih-Che Lin
- Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Yi-Hao Yen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Chien Hung Chen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Yuan-Hung Kuo
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Chih-Chien Yao
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Chao-Hung Hung
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - An-Che Liu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
| | - Ming-Chao Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung
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Tai WC, Wu IT, Wang HM, Huang PY, Yao CC, Wu CK, Yang SC, Liang CM, Hsu PI, Chuah SK. The multicenter real-world report of the efficacies of 14-day esomeprazole-based and rabeprazole-based high-dose dual therapy in first-line Helicobacter pylori eradication in Taiwan. J Microbiol Immunol Infect 2024:S1684-1182(24)00046-X. [PMID: 38461114 DOI: 10.1016/j.jmii.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/04/2024] [Accepted: 02/24/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND High-dose dual therapy (HDDT) using proton-pump inhibitors (PPI) and amoxicillin attracted attention for its simplicity and lower adverse event profile. Besides, vonoprazan is not available worldwide. This real-world study aims to compare the efficacy of esomeprazole-based and rabeprazole-based HDDT regimens and to identify clinical factors influencing outcomes. METHODS A retrospective study enrolled 346 Helicobacter pylori-infected naïve patients from January 2016 to August 2023. Patients were assigned to either a 14-day esomeprazole-based HDDT (EA-14; esomeprazole 40 mg t.i.d. and amoxicillin 750 mg q.i.d. for 14 days, n = 173) or a 14-day rabeprazole-based HDDT (RA-14; rabeprazole 20 mg and amoxicillin 750 mg q.i.d. for 14 days, n = 173). RESULTS Five patients from the EA-14 group and 10 from the RA-14 group were lost to follow-up, resulting in 168 and 163 patients for the per-protocol (PP) analysis, respectively. Eradication rates for the EA-14 and RA-14 groups were 90.2% and 80.9% (P = 0.014) in intention-to-treat (ITT) analysis; and 92.9% and 85.9% (P = 0.039) in PP analysis. Adverse event rates were similar between the two groups (11.9% vs 11.7%, P = 0.944). In multiple logistic regression analysis, age≧60 was associated with eradication failure (P = 0.046) and a trend of significance for smoking (P = 0.060) in the EA-14 group but not in the RA-14 group. A trend of significance was also observed for eradication regimens (EA-14 vs RA-14) (P = 0.071). The antibiotic resistance rates were amoxicillin (2.3%), clarithromycin (14.7%), metronidazole (40.3%), and dual resistance to clarithromycin and metronidazole (7.0%). CONCLUSIONS Esomeprazole-based HDDT achieved over 90% eradication rates but rabeprazole-based HDDT, which failed.
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Affiliation(s)
- Wei-Chen Tai
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Chang Gung University College of Medicine, Taiwan
| | - I-Ting Wu
- Division of Gastroenterology, Department of Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Hsin-Ming Wang
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Pao-Yuan Huang
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Chih-Chien Yao
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Cheng-Kun Wu
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Chang Gung University College of Medicine, Taiwan
| | - Shih-Cheng Yang
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Chih-Ming Liang
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Chang Gung University College of Medicine, Taiwan.
| | - Pin-I Hsu
- Division of Gastroenterology, Department of Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan
| | - Seng-Kee Chuah
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Taiwan; Chang Gung University College of Medicine, Taiwan
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Wang HM, Huang PY, Yang SC, Wu MK, Tai WC, Chen CH, Yao CC, Lu LS, Chuah SK, Lee YC, Liang CM. Correlation between Psychosomatic Assessment, Heart Rate Variability, and Refractory GERD: A Prospective Study in Patients with Acid Reflux Esophagitis. Life (Basel) 2023; 13:1862. [PMID: 37763266 PMCID: PMC10533115 DOI: 10.3390/life13091862] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) affects a significant proportion of individuals, with life stress being a contributing factor. This study aimed to investigate the correlation between psychosomatic evaluations, heart rate variability (HRV), and GERD in a cohort of individuals. Additionally, the study aimed to analyze the sequencing changes following proton pump inhibitor (PPI) treatment and identify predictive factors associated with refractory GERD. METHODS A prospective cohort of 105 individuals with reflux esophagitis and a control group of 50 participants without acid reflux symptoms were enrolled. Psychosomatic evaluations, including GERDQ, GERDQLQ, RSI, BAI, BDI, and SSS-8, were assessed at baseline and during treatment. HRV parameters were also evaluated. Multivariate analysis was used to identify predictive factors for refractory GERD. PPIs were administered regularly for the initial 2 months and then used on-demand. Refractory GERD was defined as less than 50% improvement in symptom relief or GERDQLQ score ≥ 20 after 8 weeks of PPI treatment. RESULTS The GERD group had higher scores in all psychosomatic evaluations compared to the control group (all p-values < 0.001). There were no significant changes in any parameters of HRV before and after treatment in the GERD group. Strong and consistent correlations were observed between GERD symptoms and psychological scores (BAI, BDI, and SSS-8) across all time points (W0, W4, and W8). Sequential reductions in GERD symptom scores and psychosomatic evaluations were observed during the initial eight weeks of treatment. Higher GERDQ (≥10) and SSS-8 (≥12) scores were predictive of refractory GERD (p = 0.004 and p = 0.009, respectively). CONCLUSIONS This study emphasizes the importance of considering physiological and psychological factors in the management of GERD. Psychosomatic evaluations provide valuable insights for assessing and treating GERD patients. Integrating stress management and comprehensive assessments into personalized treatment strategies is crucial.
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Affiliation(s)
- Hsin-Ming Wang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Shih-Cheng Yang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Ming-Kung Wu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan;
| | - Wei-Chen Tai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Chih-Hung Chen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Chih-Chien Yao
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Lung-Sheng Lu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Seng-Kee Chuah
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Yu-Chi Lee
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
| | - Chih-Ming Liang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; (H.-M.W.); (P.-Y.H.); (S.-C.Y.); (W.-C.T.); (C.-H.C.); (C.-C.Y.); (L.-S.L.); (S.-K.C.)
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Luo YC, Tang QL, Yang XM, Xiao ZA, Zhu GC, Yin DH, Yang Q, Huang PY, Zeng SY, Li SS. [Application of supraclavicular fasciocutaneous island flap for reconstruction after removal of tumors in parotid and auricle area]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 58:486-491. [PMID: 37150996 DOI: 10.3760/cma.j.cn115330-20221012-00606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Objective: To evaluate the efficacy of supraclavicular fasciocutaneous island flap (SIF) for repairing the defect of parotid or auricle regions after tumor resection. Methods: From February 2019 to June 2021, 12 patients (11 males and 1 female, aged 54-77 years old), of whom 4 with parotid adenoid cystic carcinoma and 8 with auricular basal cell carcinoma underwent reconstruction surgery for postoperative defects in the parotid gland area and auricular area with SIF in the Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University and their clinical data were retrospectively analyzed. Size of the SIF, time for harvesting SIF, neck lymph node dissection and postoperative complications were recorded. Results: The flap areas were (6-9) cm × (8-13) cm, and the harvesting time for SIF ranged from 40 to 80 min, averaging 51.7 min. The donor sites were directly closed. All patients underwent ipsilateral levels Ⅰ-Ⅲ neck dissection, with 4 cases undergoing additional level Ⅳ neck dissection and 2 cases undergoing level Ⅳ-Ⅴ neck dissection. Of the 12 SIF, 10 were completely survival and 2 had flap arterial crisis with partial flap necrosis, in addition, 1 had donor site wound dehiscence. With follow-up of 10-42 months, there were no tumor recurrences in 10 patients, 1 patient was lost to follow-up at 10 months postoperatively, and 1 patient experienced local tumor recurrence at 11 months after surgery and died 15 months later. Conclusion: SIF is an easily harvested flap with good skin features matching the skin in parotid and auricle regions and less damage to donor site, and this flap has no need for microvascular anastomosis technique. SIF is feasible and effective for repairing defects in parotid and auricle area.
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Affiliation(s)
- Y C Luo
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Q L Tang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - X M Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Z A Xiao
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - G C Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - D H Yin
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Q Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - P Y Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - S Y Zeng
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - S S Li
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
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Huang PY, Chen CH, Tsai MJ, Yao CC, Wang HM, Kuo YH, Chang KC, Hung CH, Chuah SK, Tsai MC. Effects of direct anti-viral agents on the gut microbiota in patients with chronic hepatitis C. J Formos Med Assoc 2023; 122:157-163. [PMID: 36155707 DOI: 10.1016/j.jfma.2022.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/21/2022] [Accepted: 08/30/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND/PURPOSE Gut microbiology is associated with liver disease due to gut-liver circulation via the gut microbial-liver axis. There is a paucity of data regarding the effects of treatment to cure hepatitis C virus (HCV) infection on the gut microbiota. The aim of this study was to evaluate the fecal microbiota before and after treatment with direct antiviral agents (DAA) in patients with HCV infection. METHODS This prospective study was conducted at Kaohsiung Chung-Gung Memorial Hospital, Taiwan, between December 2019 and November 2020. We recruited patients with chronic hepatitis C (CHC) receiving DAA treatment. Fecal samples were collected twice: at baseline (before DAA treatment; CHC group) and 24 weeks after the end of treatment (EOT; SVR24 group), and once from healthy controls at baseline (control group). The taxonomic composition of the gut microbiota was determined using 16 S ribosomal RNA gene sequencing of stool samples. RESULTS A total of 60 patients with CHC and 60 healthy controls matched by age and gender were enrolled. All patients achieved a sustained virologic response (SVR). Alpha diversity was not significantly difference between any groups. Analysis of similarities (ANOSIM) revealed minor differences in the microbial community structure between the control group and CHC group (R = 0.0146, P = 0.098) and less significant differences between the CHC group and SVR24 group (R = -0.0139; P = 0.94). Three phyla and eight genera were differentially abundant between the control group and CHC group. CONCLUSION Individuals with CHC do not exhibit significant gut microbiota alterations and eradication of HCV by DAA is not associated with significant modification of the gut microbiota.
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Affiliation(s)
- Pao-Yuan Huang
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Chien-Hung Chen
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Mu-Jung Tsai
- Kaohsiung Municipal Kaohsiung Senior High School, Kaohsiung 807, Taiwan
| | - Chih-Chien Yao
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Hsin-Ming Wang
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Yuan-Hung Kuo
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Kuo-Chin Chang
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chao-Hung Hung
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Seng-Kee Chuah
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Ming-Chao Tsai
- Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung 804, Taiwan.
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Yang Q, Li SS, Tang QL, Yang XM, Xiao ZA, Peng X, Zhu GC, Yin DH, Huang PY, Zeng SY. [Feasibility and efficacy of preserving internal branch of superior laryngeal nerve in endoscopic surgery for hypopharyngeal squamous cancer: an observational study]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 57:1463-1469. [PMID: 36707951 DOI: 10.3760/cma.j.cn115330-20220401-00162] [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: 01/29/2023]
Abstract
Objective: This study was performed to investigate the feasibility of preservation of internal branch of superior laryngeal nerve(ibSLN) during transoral endoscopic surgery for hypopharyngeal squamous cancer(HSCC) and the influence on patient's swallowing function after operation. Methods: From May 2020 to June 2021, the data of 29 HSCC patients who required for transoral endoscopic surgery in the Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University were prospectively included, and the included patients were divided into two groups randomly by lottery. According to whether ibSLN was actively dissected during operation, they were divided into ibSLN preservation group (n=15) and control group (n=14, without ibSLN preservation). Operation time, intraoperative hemorrhage, intraoperative neck dissection, postoperative radiotherapy, postoperative recurrence within 1 year, retention and swallowing function, the recovery of oral soft diet and the quality of life were compared between two groups. SPSS 25.0 software was used for statistical analysis. Results: The study included 29 eligible patients, including 25 males and 4 females.The age ranged from 42 to 67 (56.07±5.93) years. There were no significant differences(P>0.05) between 2 groups in the following data,including age(t=-0.56), gender(χ2=0.01), TNM stage(T stageχ2=0.29, N stage χ2=0.02), pathological diagnosis(χ2=0.03), preoperative swallowing function(χ2=0.00) and M. D. Anderson Dysphagia Inventory(MDADI) score(global t=0.55, emotional t=0.16, functional t=0.60, physical t=0.64), operation time(t=1.62) and intraoperative hemorrhage(t=-1.46), intraoperative neck dissection(χ2=0.01), postoperative radiotherapy(χ2=0.32), postoperative recurrence within 1 year(P>0.050). The swallowing function was evaluated by water swallowing test after operation. The swallowing function of ibSLN preservation group was better than control group, and the difference between two groups was statistically significant on the 1st (χ2=4.44, P=0.035), 5th (χ2=4.24, P=0.039) and 7th (χ2=4.55, P=0.033) day after operation. On the 14th day after operation, the MDADI scores of patients in the ibSLN preservation group were higher than those in the control group in global (t=2.45, P=0.021), functional (t=2.54, P=0.017) and physical (t=2.24, P=0.034) dimensions, except for emotional dimension (t=1.89, P=0.070). The median time of oral soft diet(U=23.00, P<0.001), normal oral diet(U=21.00, P<0.001) and the nasogastric tube removal time (U=18.50, P<0.001) in ibSLN preservation group was 2 days, 5 days and 6 days respectively, earlier than that in control group, which had statistically significant difference. Conclusion: Our results show that it is feasible to preserve the ibSLN during HSCC transoral endoscopic surgery, which can achieve rapid recovery of postoperative swallowing function.
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Affiliation(s)
- Q Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - S S Li
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Q L Tang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - X M Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Z A Xiao
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - X Peng
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - G C Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - D H Yin
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - P Y Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - S Y Zeng
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
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Lin YP, Wang PM, Chuang CH, Yong CC, Liu YW, Huang PY, Yao CC, Tsai MC. Metabolic Risks Are Increasing in Non-B Non-C Early-Stage Hepatocellular Carcinoma: A 10-Year Follow-Up Study. Front Oncol 2022; 12:816472. [PMID: 35186751 PMCID: PMC8848276 DOI: 10.3389/fonc.2022.816472] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/11/2022] [Indexed: 12/11/2022] Open
Abstract
Background Non-B, non-C hepatocellular carcinoma (NBNC-HCC) may be related to metabolic syndrome, and the incidence of this tumor type is increasing annually. The definition of metabolic-associated fatty liver disease (MAFLD) proposed in 2020 may help to more accuratelyassess the association between metabolic syndrome and NBNC-HCC. However, this new concept has not yet been applied in NBNC-HCC research. Therefore, this study aimed to compare the clinicopathological characteristics of patients with NBNC-HCC and CHB-HCC diagnosed between 2009-13 and 2014-18, focusing on metabolic risk factors and the new concept of MAFLD. Method Patients with BCLC-0/A-HCC who received curative hepatectomy between January 2009 and December 2018 were retrospectively assessed; the associations between clinicopathological characteristics and clinical outcomes of NBNC-HCC and CHB-HCC were analyzed by multivariate analysis. Result Compared to patients diagnosed in 2009-13, the frequency of metabolic disorders in NBNC-HCC was significantly higher in 2014-18 [DM (p=0.049), HTN (p=0.004), BMI (p=0.017) and MAFLD (p=0.003)]; there was no significant change in patients with CHB-HCC. Moreover, CHB-HCC was an independent risk factor for HCC recurrence (HR, 1.339; 95% CI, 1.010-1.775, p=0.043) and death (HR, 1.700; 95% CI, 1.017-2.842, p=0.043) compared to NBNC-HCC. Conclusions Therisk of MAFLD, obesity, DM, and hypertension in patients with early-stage NBNC have significantly increased in recent years, thus metabolic syndrome should be monitored in this special population. Moreover, NBNC-HCC tend to had a better prognosis than CHB-HCC, probably due to their distinct clinicopathological features.
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Affiliation(s)
- Yen-Po Lin
- School of Medicine, Chung-Shan Medical University, Taichung, Taiwan
| | - Pei-Ming Wang
- Department of Family Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | | | - Chee-Chen Yong
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yueh-Wei Liu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Chien Yao
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Chao Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Tsai YC, Sou FM, Liu YW, Wu YJ, Yong CC, Chen DW, Huang PY, Cho WR, Chuang CH, Hsiao CC, Hu TH, Tsai MC. Preoperative ALBI grade predicts the outcomes in non-B non-C HCC patients undergoing primary curative resection. BMC Gastroenterol 2021; 21:386. [PMID: 34666694 PMCID: PMC8524867 DOI: 10.1186/s12876-021-01944-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/27/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The albumin-bilirubin (ALBI) grade has been validated as a significant prognostic predictor for hepatocellular carcinoma (HCC). However, there is little information about the ALBI grade in patients with non-B non-C HCC (NBNC-HCC) receiving surgery. AIM This study aimed to evaluate the prognostic significance of the ALBI grade in patients with NBNC-HCC after primary curative resection. METHOD From January 2010 to April 2016, 2137 patients with HCC who received hepatectomy were screened for study eligibility. Finally, a total of 168 NBNC-HCC patients who received primary curative resection were analyzed. The impacts of the ALBI grade on disease-free survival (DFS) and overall survival (OS) were analyzed by multivariate analysis. RESULTS There were 66 (39.3%), 98 (58.3%), and 4 (2.4%) patients with an ALBI grade of I, II, and III, respectively. Patients with an ALBI grade II/III were older (p = 0.002), more likely to have hypoalbuminemia (p < 0.001), and more commonly had Child-Pugh class B (p = 0.009) than patients with an ALBI grade I. After a median follow-up of 76 months, 74 (44%) patients experienced recurrence, and 72 (42.9%) patients died. Multivariate analysis revealed that alpha-fetoprotein (AFP) > 200 ng/mL (p = 0.021), number of tumors (p = 0.001), and tumor stage (p = 0.007) were independent prognostic factors for DFS. Additionally, AFP > 200 ng/mL (p = 0.002), ALBI grade II/III (p = 0.002), and tumor stage (p < 0.001) were independent risk factors for poor OS. CONCLUSION The preoperative ALBI grade can be used to predict mortality in patients with NBNC-HCC after primary curative resection.
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Affiliation(s)
- Yu-Chieh Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, 83301, Taiwan
| | - Fai-Meng Sou
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, 83301, Taiwan
| | - Yueh-Wei Liu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Ju Wu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chee-Chien Yong
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ding-Wei Chen
- Center for Translational Research in Biomedical Sciences, Liver Transplantation Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, 83301, Taiwan
| | - Wei-Ru Cho
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, 83301, Taiwan
| | | | - Chang-Chun Hsiao
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tsung-Hui Hu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, 83301, Taiwan
| | - Ming-Chao Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, 83301, Taiwan. .,Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Huang PY, Wang JH, Hung CH, Lu SN, Hu TH, Chen CH. The role of hepatitis B virus core-related antigen in predicting hepatitis B virus relapse after cessation of entecavir in hepatitis B e antigen-negative patients. J Viral Hepat 2021; 28:1141-1149. [PMID: 33932245 DOI: 10.1111/jvh.13528] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/12/2021] [Accepted: 04/17/2021] [Indexed: 12/29/2022]
Abstract
This study investigated the ability of hepatitis B core-related antigen (HBcrAg) to predict hepatitis B virus (HBV) relapse in HBeAg-negative patients after cessation of entecavir therapy. A total of 301 HBeAg-negative patients without cirrhosis who had stopped entecavir therapy for at least 12 months were recruited. All patients fulfilled the stopping criteria proposed by the APASL 2012 guidelines. The five-year cumulative rates of virological relapse, clinical relapse and HBsAg loss were 71.6%, 57.3% and 18.7%, respectively. Serum HBsAg at end of treatment (EOT) was an independent predictor of virological relapse, clinical relapse and HBsAg loss; an EOT HBsAg of 150 IU/ml was the optimal cut-off value. The 5-year virological relapse rates for patients with <150 and ≥150 IU/ml HBsAg at EOT were 43.3% and 82.2% (p < 0.001), clinical relapse rates were 32.3% and 66.3% (p < 0.001), and HBsAg loss rates were 46.1% and 5.2% (p < 0.001), respectively. A baseline HBcrAg of 4 IU/ml was the optimal cut-off value for predicting HBV relapse. Among patients with an EOT HBsAg <150 IU/ml, the five-year virological relapse rates for patients with baseline HBcrAg levels ≤4 and >4 log U/ml were 27.9% and 59.1% (p = 0.006) and the clinical relapse rates were 18% and 48.1% (p = 0.014), respectively. EOT HBcrAg was not a significant predictor of virological or clinical relapse after cessation of entecavir. In conclusion, the combination of an EOT HBsAg of 150 IU/ml and baseline HBcrAg of 4 log U/ml can effectively predict the risk of HBV relapse after stopping entecavir therapy.
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Affiliation(s)
- Pao-Yuan Huang
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jing-Houng Wang
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chao-Hung Hung
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sheng-Nan Lu
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tsung-Hui Hu
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chien-Hung Chen
- Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Lin YP, Lin SH, Wang CC, Lin CC, Chen DW, Chuang CH, Huang PY, Hung CH, Yang SY, Cho WR, Chen YS, Tsai MC. Impact of MAFLD on HBV-Related Stage 0/A Hepatocellular Carcinoma after Curative Resection. J Pers Med 2021; 11:jpm11080684. [PMID: 34442328 PMCID: PMC8398387 DOI: 10.3390/jpm11080684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022] Open
Abstract
Backgrounds and Aim: Metabolic-associated fatty liver dis-ease (MAFLD) is a novel term proposed in 2020 to avoid the exclusion of certain subpopulations, though the application of this term in the real world is very limited. Here, we aimed to evaluate the impact of MAFLD on hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after curative resection. Methods: Patients with chronic hepatitis B (CHB)-related HCC who received hepatectomy between January 2010 and December 2019 were consecutively selected. The association between histologically proven concurrent MAFLD and clinical outcomes were retrospectively analyzed. Results: Among the 812 eligible patients with CHB-related HCC, 369 (45.4%) were diagnosed with concurrent MAFLD. After a mean follow-up of 65 months, 303 patients (37.3%) developed HCC recurrence, 111 (13.7%) died, and 12 (1.5%) received liver transplantation. Although no differences in the incidences of HCC recurrence (HR: 0.902, 95% CI: 0.719–1.131, p = 0.370) and death or liver transplantation (HR: 0.743, 95% CI: 0.518–1.006, p = 0.107) were observed between patients with and without MAFLD in multivariate analysis, the patients with MAFLD tended to achieve better recurrent-free survival compared to patients without MAFLD. Notably, lean MAFLD (BMI < 23 kg/m2) was a relative risk factor for tumor recurrence (HR: 2.030, 95% CI: 1.117–3.690, p = 0.020) among patients with MAFLD. Conclusions: The overall prognosis in HBV-related early-stage HCC, in terms of HCC recurrence and death or liver transplantation, was not significantly different between patients with and without MAFLD. Among patients with MALFD, lean-MAFLD was a risk factor for HCC recurrence. Further studies are warranted to validate these results.
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Affiliation(s)
- Yen-Po Lin
- School of medicine, Chung-Shan Medical University, Taichung 40201, Taiwan; (Y.-P.L.); (Y.-S.C.)
| | - Shu-Hsien Lin
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-H.L.); (P.-Y.H.); (C.-H.H.); (S.-Y.Y.); (W.-R.C.)
| | - Chih-Chi Wang
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.W.); (C.-C.L.)
| | - Chih-Che Lin
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.W.); (C.-C.L.)
| | - Ding-Wei Chen
- Center for Translational Research in Biomedical Sciences, Liver Transplantation Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Ching-Hui Chuang
- Department of Nursing, Meiho University, Pingtung 91202, Taiwan;
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-H.L.); (P.-Y.H.); (C.-H.H.); (S.-Y.Y.); (W.-R.C.)
| | - Chao-Hung Hung
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-H.L.); (P.-Y.H.); (C.-H.H.); (S.-Y.Y.); (W.-R.C.)
| | - Shih-Yu Yang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-H.L.); (P.-Y.H.); (C.-H.H.); (S.-Y.Y.); (W.-R.C.)
| | - Wei-Ru Cho
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-H.L.); (P.-Y.H.); (C.-H.H.); (S.-Y.Y.); (W.-R.C.)
| | - Yu-Syuan Chen
- School of medicine, Chung-Shan Medical University, Taichung 40201, Taiwan; (Y.-P.L.); (Y.-S.C.)
| | - Ming-Chao Tsai
- School of medicine, Chung-Shan Medical University, Taichung 40201, Taiwan; (Y.-P.L.); (Y.-S.C.)
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Correspondence:
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Tsai MC, Lin CC, Chen DW, Liu YW, Wu YJ, Yen YH, Huang PY, Yao CC, Chuang CH, Hsiao CC. The Role of Protease-Activated Receptor 2 in Hepatocellular Carcinoma after Hepatectomy. ACTA ACUST UNITED AC 2021; 57:medicina57060574. [PMID: 34199695 PMCID: PMC8229727 DOI: 10.3390/medicina57060574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/26/2021] [Accepted: 06/02/2021] [Indexed: 01/27/2023]
Abstract
Background and Objectives: Protease activated receptor-2 (PAR2) is elevated in a variety of cancers and has been promoted as a potential therapeutic target. However, the clinical and prognostic values of PAR2 in hepatocellular carcinoma (HCC) are poorly characterized. This study aimed to evaluate the expression of PAR2 in HCC tissues and examine the prognostic value of PAR2 after resection in HCC. Materials and Methods: Two hundred and eight resected specimens were collected from HCC patients at Kaohsiung Chang Gung Memorial Hospital. PAR2 protein expression was assessed by western blotting in HCC tissues and matched normal tissues. The correlation between PAR2 expression and clinicopathological parameters was analyzed. Disease-free survival (DFS) and overall survival (OS) were compared using the log-rank test. A Cox regression model was used to identify independent prognostic factors. Results: PAR2 was expressed at higher levels in HCC tissues than the paired adjacent nontumor tissues. High expression of PAR2 was associated with advanced tumor, node, metastasis (TNM )stage and histological grade. Kaplan-Meier analysis indicated high PAR2 expression was associated with poorer DFS and OS compared to low PAR2 expression. Multivariate analyses indicated high PAR2 expression [hazard ratio (HR), 1.779, p = 0.006), α-fetoprotein (AFP) (HR, 1.696, p = 0.003), liver cirrhosis (HR, 1.735, p = 0.002), and advanced TNM stage (HR, 2.061, p < 0.001) were prognostic factors for DFS, and advanced TNM stage (HR, 2.741, p < 0.001) and histological grade (HR, 2.675, p = 0.002) and high PAR2 expression (HR, 1.832, p = 0.012) were significant risk factors for OS. In subgroup analyses, the combination of PAR2 expression and serum AFP provided improved prognostic ability for OS and DFS. Conclusion: Combination PAR2 and AFP predict HCC outcomes after resection. PAR2 represents a potentially clinically relevant biomarker for HCC.
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Affiliation(s)
- Ming-Chao Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (M.-C.T.); (Y.-H.Y.); (P.-Y.H.); (C.-C.Y.)
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Chih-Che Lin
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.L.); (Y.-W.L.); (Y.-J.W.)
| | - Ding-Wei Chen
- Center for Translational Research in Biomedical Sciences, Liver Transplantation Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Yueh-Wei Liu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.L.); (Y.-W.L.); (Y.-J.W.)
| | - Yi-Ju Wu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.L.); (Y.-W.L.); (Y.-J.W.)
| | - Yi-Hao Yen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (M.-C.T.); (Y.-H.Y.); (P.-Y.H.); (C.-C.Y.)
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (M.-C.T.); (Y.-H.Y.); (P.-Y.H.); (C.-C.Y.)
| | - Chih-Chien Yao
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (M.-C.T.); (Y.-H.Y.); (P.-Y.H.); (C.-C.Y.)
| | - Ching-Hui Chuang
- Department of Nursing, Meiho University, Pingtung 91202, Taiwan;
| | - Chang-Chun Hsiao
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niao-Sung District, Kaohsiung 833, Taiwan
- Correspondence: ; Tel.: +886-7-7317123 (ext. 8979) or +886-955906053; Fax: +886-7-7311696
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Bai Z, Zhang DS, Zhang R, Yin C, Wang RN, Huang WY, Ding J, Yang JL, Huang PY, Liu N, Wang YF, Cheng N, Bai YN. [A nested case-control study on relationship of traditional and combined lipid metabolism indexes with incidence of diabetes]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:656-661. [PMID: 34814446 DOI: 10.3760/cma.j.cn112338-20200401-00490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the relationship between lipid indicators and the incidence of diabetes, and to compare the diabetes prediction and identification power of traditional lipid combined lipid indicators, in order to explore the best alternative indicators for identifying and predicting diabetes. Methods: Based on the Jinchang cohort, a nested case-control study was conducted in 1 025 new cases of diabetes after excluding patients with malignant tumor and related endocrine, circulatory system disease, then an age (±2 years), gender matched 1∶1 control group of 1 025 cases was set to analyze the relationship between the incidence of diabetes and lipid parameters. Results: Among the traditional lipid parameters, the fourth quartile of TG, TC, and LDL-C indicated higher risks of developing diabetes, which was 14.00 times (95%CI: 9.73-20.15), 2.15 times (95%CI: 1.65-2.79) and 1.66 times (95%CI: 1.29-2.14) than that of the first quartile, respectively. The risk of developing diabetes indicated by the fourth quartile of HDL-C was 0.21 times than that indicated by the first quartile (95%CI: 0.15-0.28). In the combined lipid parameters, the fourth quartile of TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C indicated higher risks of developing diabetes, which was 14.86 times (95%CI: 10.35-21.34), 8.12 times (95%CI: 5.94-11.01), 5.85 times (95%CI:4.34-7.88) and 5.20 times (95%CI: 3.85-7.03) than that indicated by the first quartile, respectively. The areas under the ROC curve of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 0.76 (95%CI: 0.74-0.78), 0.59 (95%CI: 0.57-0.61), 0.67 (95%CI: 0.65-0.69), 0.57 (95%CI: 0.55-0.59), 0.77 (95%CI: 0.75-0.78), 0.73 (95%CI: 0.71-0.75), 0.69 (95%CI: 0.67-0.71) and 0.66 (95%CI: 0.64-0.68), respectively. The optimal diabetes predicting point cuts of TG, TC, HDL-C, LDL-C, TG/HDL-C, TC/HDL-C, LDL-C/HDL-C and non-HDL-C were 1.40, 4.70, 1.28, 3.25, 1.17, 3.43, 2.46, and 3.58 mmol/L, respectively. Conclusions: Lipid metabolic disorder is a risk factor for diabetes. TG and TG/HDL-C are the good lipid metabolism indicators for the prediction of diabetic.
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Affiliation(s)
- Z Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - D S Zhang
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - R Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - C Yin
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - R N Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - W Y Huang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - J Ding
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - J L Yang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - P Y Huang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - N Liu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y F Wang
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - N Cheng
- School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
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Zhang R, Zhang DS, Wang RN, Yin C, Bai Z, Huang WY, Yang JL, Huang PY, Liu N, Chen XL, Wang YF, Cheng N, Bai YN. [Relationship of body mass index and blood pressure with diabetes: a nested case-control study]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:662-667. [PMID: 34814447 DOI: 10.3760/cma.j.cn112338-20200401-00493] [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: 06/13/2023]
Abstract
Objective: To explore the relationship of body mass index and blood pressure with the incidence of diabetes in Jinchang cohort. Methods: We designed a nested case-control study, a total of 29 572 workers who had no history of diabetes in baseline survey in Jinchang cohort were selected as the study cohort from June 2011 to December 2013. After 2 year follow-up, 1 021 workers with first diagnosed diabetes were selected as the case group, after 1∶1 matching according to the same gender and age ±2 years among those without diabetes, circulatory system, or endocrine system diseases during the same follow-up period, 1 021 controls was selected and 2 042 subjects were finally included. We used multivariate conditional logistic regression model, additive interaction model and multiplicative interaction model to explore the relationship of body mass index and blood pressure with the incidence of diabetes. Results: After adjusting for factors such as occupation, alcohol use, family history of diabetes, hyperuricemia, hypercholesterolemia, hypertriglyceridemia, low-HDL cholesterolemia and high-LDL cholesterolemia, multivariate conditional logistic regression analysis showed that the risk of diabetes increased with body mass index and blood pressure. Hypertension and overweight/obesity had a multiplicative interaction on the incidence of diabetes. The risks of diabetes in men and women with hypertension and overweight/obese were 2.04 times (95%CI: 1.54-2.69) and 3.88 times (95%CI: 2.55-5.91) higher than those in men and women with normal body weight and blood pressure, respectively. In the combination of BMI and blood pressure, obese individuals with SBP≥160 mmHg were 4.57 times (95%CI: 2.50-8.34) more likely to have diabetes than those with normal BMI and SBP, obese individuals with DBP≥90 mmHg were 3.40 times (95%CI: 2.19-5.28) more likely to have diabetes than those with normal BMI and DBP. Conclusions: Overweight/obesity and hypertension can increase the risk of diabetes. Health education about body weight and blood pressure controls should be strengthened to reduce the risk of diabetes.
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Affiliation(s)
- R Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - D S Zhang
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - R N Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - C Yin
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - Z Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - W Y Huang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - J L Yang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - P Y Huang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - N Liu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X L Chen
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y F Wang
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - N Cheng
- School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
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14
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Wang RN, Zhang DS, Bai Z, Yin C, Zhang R, Yang JL, Bao KF, Huang WY, Huang PY, Liu N, Wang YF, Cheng N, Bai YN. [Prospective cohort study of relationship of triglyceride, fasting blood-glucose and triglyceride glucose product index with risk of hypertension]. Zhonghua Liu Xing Bing Xue Za Zhi 2021; 42:482-487. [PMID: 34814417 DOI: 10.3760/cma.j.cn112338-20200401-00491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: To investigate the relationship of triglyceride (TG), fasting blood glucose (FPG) and triglyceride glucose product index (TyG) with the incidence of hypertension, and provide basic data for the prevention and treatment of hypertension in the population. Methods: A total of 23 581 individuals who met the research criteria in Jinchang cohort were selected as the research subjects, the Cox proportional hazard model was used to analyze the relationship of TG, FPG, and TyG with the risk of hypertension. A stratified analysis was conducted by sex. Results: After adjusting for confounding factors, compared with the normal TG group, the HR(95%CI) of the elevated TG margin group and the elevated group were 1.16 (1.01-1.34) and 1.49 (1.30-1.70), respectively in the total population. Among men, they were 1.13 (1.01-1.27) and 1.17 (1.06-1.30), and among women, they were 1.05 (0.88-1.26) and 1.06 (0.88-1.28). Compared with the normal FPG group, the HR (95%CI) of the FPG-impaired group were 1.29 (1.13-1.48) in the total population, 1.26 (1.08-1.48) in men and 1.59 (1.14-2.21) in women. Taking the lowest quartile array as a reference, the HR (95%CI) of the highest quartile array of TyG was 1.73 (1.45-2.07) in the total population, 1.32 (1.14-1.53) in men and 1.87 (1.37-2.54) in women. TG, FPG had a nonlinear dose-response relationship with the risk of hypertension, while TyG had a linear correlation with the risk of hypertension. Conclusions: Higher TG, FPG, and TyG levels are independent risk factors for the incidence of hypertension. People with higher TG, FPG and TyG are at high risk for hypertension, to which close attention should be paid in the prevention and treatment of hypertension.
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Affiliation(s)
- R N Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - D S Zhang
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - Z Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - C Yin
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - R Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - J L Yang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - K F Bao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - W Y Huang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - P Y Huang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - N Liu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y F Wang
- Workers' Hospital of Jinchuan Group, Jinchang 737100, China
| | - N Cheng
- School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
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15
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Cho WR, Wang CC, Tsai MY, Chou CK, Liu YW, Wu YJ, Lin MT, Chen KD, Chuang CH, Huang PY, Hu TH, Tsai MC. Impact of metformin use on the recurrence of hepatocellular carcinoma after initial liver resection in diabetic patients. PLoS One 2021; 16:e0247231. [PMID: 33661912 PMCID: PMC7932176 DOI: 10.1371/journal.pone.0247231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 02/03/2021] [Indexed: 12/13/2022] Open
Abstract
Background Metformin is proposed to have chemopreventive effect of various cancer currently. However, the anti-cancer effect of metformin for diabetic patients with hepatocellular carcinoma (HCC) undergoing liver resection remains unclear. The aim of our cohort study was to assess whether metformin influence the recurrence of HCC. Methods We retrospectively enrolled 857 HCC patients who received primary resection from April 2001 to June 2016. 222 patients were diagnosed with diabetes mellitus (DM) from medical record. Factors influence the overall survival (OS) and recurrence-free survival (RFS) were analyzed by multivariate analysis. Results During the follow-up period (mean, 75 months), 471 (54.9%) patients experienced recurrence, and 158 (18.4%) patients died. Multivariate analysis revealed that DM (p = 0.015), elevated AST (p = 0.006), hypoalbuminemia (p = 0.003), tumor number (p = 0.001), tumor size (p < 0.001), vascular invasion (p <0.001), high Ishak fibrosis score (p <0.001), hepatitis B (p = 0.014), hepatitis C (p = 0.001) were independent predictors for RFS. In diabetic patients, only HbA1c>9% (p = 0.033), hypoalbuminemia (p = 0.030) and vascular invasion (p = 0.001) were independent risk factors for HCC recurrence; but the metformin use revealed no significance on recurrence. DM is a risk factor of HCC recurrence after resection. Adequate DM control can reduce the recurrence of HCC. However, the use of metformin does not reduce the risk of HCC recurrence in diabetic patient after initial resection. Hence, metformin may not have protective influences on HCC recurrence in diabetic patients who undergo initial liver resection.
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Affiliation(s)
- Wei-Ru Cho
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Chi Wang
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Medical College, Kaohsiung, Taiwan
| | - Meng-Yun Tsai
- Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chen-Kai Chou
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yueh-Wei Liu
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Medical College, Kaohsiung, Taiwan
| | - Yi-Ju Wu
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University Medical College, Kaohsiung, Taiwan
| | - Ming-Tsung Lin
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuang-Den Chen
- Center for Translational Research in Biomedical Sciences, Liver Transplantation Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | | | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tsung-Hui Hu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Chao Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan
- * E-mail:
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16
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Guo L, Li SS, Yang XM, Tang QL, Yin DH, Tang XJ, Huang PY, Guo ZT. [Repair of laryngocutaneous fistula by thyroid lobe flap: feasibility, safety and efficacy]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020; 55:1065-1068. [PMID: 33210888 DOI: 10.3760/cma.j.cn115330-20200703-00554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- L Guo
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - S S Li
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - X M Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Q L Tang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - D H Yin
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - X J Tang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - P Y Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Z T Guo
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
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Lin CY, Lin CC, Wang CC, Chen CL, Hu TH, Hung CH, Huang PY, Tsai MC. The ALBI Grade is a Good Predictive Model for Very Late Recurrence in Patients with Hepatocellular Carcinoma Undergoing Primary Resection. World J Surg 2020; 44:247-257. [PMID: 31559485 DOI: 10.1007/s00268-019-05197-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) patients still have risk for very late recurrence after curative resection. This study assesses prognostic factors in HCC patients with recurrence-free survival (RFS) for 5 years after primary resection. METHODS We enrolled 383 HCC patients who received primary tumor resection and achieved more than 5 years without recurrence after resection between January 2001 and April 2013. Predictive factors, including albumin-bilirubin (ALBI) grade, for RFS and overall survival (OS) were analyzed. RESULTS After a median follow-up of 103 months, 57 patients (14.9%) had recurrent HCC, and 14 (3.7%) died. Independent predictors for HCC recurrence were male sex (p = 0.035), pre-operative liver cirrhosis (LC) (p = 0.025), serum creatinine > 1.5 mg/dL (p = 0.045), post-operative 5th-year alpha-fetoprotein (AFP) > 15 ng/ml (p < 0.001), LC (p = 0.004), and ALBI grades 2 and 3 (p < 0.001). I ndependent risk factors for poor survival were age >70 years (p = 0.002), post-operative 5th-year AFP > 15 ng/ml (p = 0.003), and ALBI grades 2 and 3 (p = 0.002). Patients whose deteriorated ALBI grades 5 years after resection had adverse RFS outcomes compared to those with constant (p = 0.056) and improved ALBI grades (p = 0.008). In subgroup analysis, patients with post-operative 5th-year ALBI grades 2 and 3 had significantly poorer RFS and OS (both p < 0.001) than those with grade 1 among patients with low post-operative 5th-year AFP (<15 ng/mL). CONCLUSION In HCC patients without recurrence for 5 years after curative resection, post-operative 5th-year ALBI grade is useful for predicting outcomes, even with low AFP during follow-up.
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Affiliation(s)
- Chun-Yu Lin
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan
| | - Chih-Che Lin
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chih-Chi Wang
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chao-Long Chen
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Tsung-Hui Hu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan
| | - Chao-Hung Hung
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan
| | - Ming-Chao Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan.
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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18
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Huang WY, Yang JL, Huang PY, Liu N, Bao KF, Ding J, Chen XL, Cheng N, Zheng S, Bai YN. [Progress of cohort studies in countries from Asia and Europe]. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41:962-967. [PMID: 32564568 DOI: 10.3760/cma.j.cn112338-20190722-00539] [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 share related knowledge and experiences with countries along the line, literature regarding current cohort studies was summarized. Distribution, establishment and development of cohort studies among large prospective general population were analyzed in 17 countries of Western Asia and the 16 countries of Central and Eastern Europe. Methods: Literature review was conducted to collect basic information on cohort studies, with descriptive study used to analyze the characteristics of these cohort studies. Results: There were 562 cohort studies with sample size as more than 1 000 stated in Western Asia and Central and Eastern Europe, including 468 (83.27%) carried out in the nation itself and 94 (16.73%) with international multicentered collaboration. According to the nature of cohort studies, 347 (61.74%) were etiologically based. As for the contents involved, 310 (55.16%) of them targeted on chronic/non-communicable diseases, 125 (22.24%) concentrated on maternal and child health. Among those on chronic/non-communicable diseases, 51 (16.45%) were on cancers and 83 (26.77%) on cardiovascular disease studies. There appeared 10 large prospective cohort studies targeting on general population, mainly ongoing in Iran and European countries, with a duration of 8-29 years, including 4 of them with sample size as more than 50 000. In terms of the contents, epidemiological investigation, physical examination and biological samples collection took the major parts. Few papers were published in 9 out of the 10 cohort studies at the early stage of those projects but the number of papers increased annually and stabilized to certain extent. Conclusions: The regional distribution of cohort studies carried out in countries from the Western Asia and Central and Eastern European areas appeared unbalanced. Contents of these designs would mainly involve etiological studies, with focus on non-communicable diseases as cancer, cardiovascular disease, diabetes, respiratory diseases, mental and psychological diseases, and maternal and infant health etc.. However, only few large prospective cohort studies would base on general population.
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Affiliation(s)
- W Y Huang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - J L Yang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - P Y Huang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - N Liu
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - K F Bao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - J Ding
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - X L Chen
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - N Cheng
- School of Basic Medical, Lanzhou University, Lanzhou 730000, China
| | - S Zheng
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Y N Bai
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, China
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Tai WC, Liang CM, Kuo CM, Huang PY, Wu CK, Yang SC, Kuo YH, Lin MT, Lee CH, Hsu CN, Wu KL, Hu TH, Chuah SK. A 14 day esomeprazole- and amoxicillin-containing high-dose dual therapy regimen achieves a high eradication rate as first-line anti-Helicobacter pylori treatment in Taiwan: a prospective randomized trial. J Antimicrob Chemother 2020; 74:1718-1724. [PMID: 30768161 DOI: 10.1093/jac/dkz046] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 01/10/2019] [Accepted: 01/13/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The first-line eradication rate of standard triple therapy for Helicobacter pylori infection has declined to <80%, and alternative therapies with >90% success rates are needed. Inconsistent eradication rates were reported for proton pump inhibitor- and amoxicillin-containing high-dose dual therapy. OBJECTIVES We performed a prospective, randomized controlled study to assess the efficacy of esomeprazole- and amoxicillin-containing high-dose dual therapy and investigated the influencing clinical factors. PATIENTS AND METHODS We recruited 240/278 eligible H. pylori-infected patients after exclusion. They were randomly assigned to 14 day high-dose dual therapy (esomeprazole 40 mg three times daily and amoxicillin 750 mg four times daily for 14 days; EA group) or 7 day non-bismuth quadruple therapy (esomeprazole 40 mg twice daily, clarithromycin 500 mg twice daily, amoxicillin 1 g twice daily and metronidazole 500 mg twice daily for 7 days; EACM group). Urea breath tests were followed up 8 weeks later. RESULTS The eradication rates for the EA and EACM groups were 91.7% (95% CI = 85.3%-96.0%) and 86.7% (95% CI = 79.3%-92.2%) (P = 0.21) in ITT analysis; and 95.7% (95% CI = 90.2%-98.6%) and 92.0% (95% CI = 85.4%-96.3%) (P = 0.26) in PP analysis. The adverse event rates were 9.6% versus 23.0% in the two groups (P = 0.01). The H. pylori culture positivity rate was 91.8%. The antibiotic resistance rates were amoxicillin, 0%; clarithromycin, 14.6%; and metronidazole, 33.7%. CONCLUSIONS A 14 day esomeprazole- and amoxicillin-containing high-dose dual therapy achieves a high eradication rate as first-line anti-H. pylori therapy, comparable to that with 7 day non-bismuth quadruple therapy but with fewer adverse events.
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Affiliation(s)
- Wei-Chen Tai
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Ming Liang
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chung-Mou Kuo
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Pao-Yuan Huang
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cheng-Kun Wu
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Shih-Cheng Yang
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yuan-Hung Kuo
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ming-Tsung Lin
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chen-Hsiang Lee
- Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Division of Infectious Diseases, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Gang Gung Memorial Hospital, Kaohsiung, Taiwan.,School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Keng-Liang Wu
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tsung-Hui Hu
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Seng-Kee Chuah
- Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
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20
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Tsai MC, Liu YY, Lin CC, Wang CC, Wu YJ, Yong CC, Chen KD, Chuah SK, Yao CC, Huang PY, Chen CH, Hu TH, Chen CL. Gut Microbiota Dysbiosis in Patients with Biopsy-Proven Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study in Taiwan. Nutrients 2020; 12:nu12030820. [PMID: 32204538 PMCID: PMC7146257 DOI: 10.3390/nu12030820] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 12/15/2022] Open
Abstract
The gut microbiota plays a role in nonalcoholic fatty liver disease (NAFLD), but data about gut dysbiosis in Asians with NAFLD remains scarce. We analyzed the differences in fecal microbiota between adults with and without NAFLD. This cross-sectional study examined adults with histology-proven NAFLD (25 nonalcoholic fatty liver (NAFL) patients, 25 nonalcoholic steatohepatitis (NASH) patients, and 25 living liver donors (healthy controls)). The taxonomic composition of the gut microbiota was determined by 16S ribosomal RNA gene sequencing of stool samples. The NAFL and NASH groups showed lower total bacterial diversity and richness than the controls. NAFLD patients had higher levels of the phylum Bacteroidetes and lower levels of Firmicutes than controls. The genus Ruminococcaceae UCG-010, family Ruminococcaceae, order Clostridiales, and class Clostridia were less abundant in patients with NAFL or NASH than healthy individuals. The lipopolysaccharide biosynthesis pathway was differentially enriched in the NASH group. This study examined the largest number of Asian patients with biopsy-proven NAFL and NASH in terms of dysbiosis of the gut microbiota in NAFLD patients. NAFLD patients had higher levels of Bacteroidetes and lower levels of Firmicutes. These results are different from research from western countries and could provide different targets for therapies by region.
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Affiliation(s)
- Ming-Chao Tsai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 123 Ta Pei Road, Niao Sung Dist., Kaohsiung City 83301, Taiwan; (S.-K.C.); (C.-C.Y.); (P.-Y.H.); (C.-H.C.)
- Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Correspondence: ; Tel.: +886-7-731-7123 (ext. 8310); Fax: +886-7-732-2402
| | - Yu-Yin Liu
- Department of General Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Chih-Che Lin
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.L.); (C.-C.W.); (Y.-J.W.); (C.-L.C.)
| | - Chih-Chi Wang
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.L.); (C.-C.W.); (Y.-J.W.); (C.-L.C.)
| | - Yi-Ju Wu
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.L.); (C.-C.W.); (Y.-J.W.); (C.-L.C.)
| | - Chee-Chien Yong
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.L.); (C.-C.W.); (Y.-J.W.); (C.-L.C.)
| | - Kuang-Den Chen
- Center for Translational Research in Biomedical Sciences, Liver Transplantation Program and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
| | - Seng-Kee Chuah
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 123 Ta Pei Road, Niao Sung Dist., Kaohsiung City 83301, Taiwan; (S.-K.C.); (C.-C.Y.); (P.-Y.H.); (C.-H.C.)
| | - Chih-Chien Yao
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 123 Ta Pei Road, Niao Sung Dist., Kaohsiung City 83301, Taiwan; (S.-K.C.); (C.-C.Y.); (P.-Y.H.); (C.-H.C.)
| | - Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 123 Ta Pei Road, Niao Sung Dist., Kaohsiung City 83301, Taiwan; (S.-K.C.); (C.-C.Y.); (P.-Y.H.); (C.-H.C.)
| | - Chien-Hung Chen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 123 Ta Pei Road, Niao Sung Dist., Kaohsiung City 83301, Taiwan; (S.-K.C.); (C.-C.Y.); (P.-Y.H.); (C.-H.C.)
| | - Tsung-Hui Hu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 123 Ta Pei Road, Niao Sung Dist., Kaohsiung City 83301, Taiwan; (S.-K.C.); (C.-C.Y.); (P.-Y.H.); (C.-H.C.)
| | - Chao-Long Chen
- Liver Transplantation Center and Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (C.-C.L.); (C.-C.W.); (Y.-J.W.); (C.-L.C.)
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21
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Tang XJ, Wang B, Huang PY, Guo ZT, Tang QL, Li SS, Yang XM. [Effects of chronic intermittent hypoxia on blood pressure and vascular remodeling]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 54:601-605. [PMID: 31434374 DOI: 10.3760/cma.j.issn.1673-0860.2019.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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 blood pressure and vascular remodeling of OSAS by establishing the chronic-intermittent hypoxia model in rat. Methods: Experiments were performed on 35 adult male Sprague-Dawley rats. Animals were randomly divided into four groups: unhandled control group (with 5 rats in it), CIH group at 9/6/3 weeks (with 10 ratsin each group). Rats in CIH group went through 8-hour intermittent hypoxia everyday, and those in control group were raising normally. After 9-week experiment, blood pressure was measured. The changes of the following indexes were observed: pathological changes of aorta and the middle aorta thickness (HE staining), the collagen of aorta wall (Masson staining). The experimental data were analyzed by SPSS 24.0 statistical software. The variance was analyzed by one-way analysis of variance, and the irregularity was selected using the calibration t test. Results: The systolic and diastolic blood pressures of the CIH9, 6, and 3 weeks groups and the control group were: (127±13) and (79±9), (124±11) and (81±7), (101±11) and (75±9), (91±10) and (65±9) mmHg (1 mmHg=0.133 kPa). The systolic blood pressure and diastolic blood pressure of the rats in the week of CIH 9 and 6 weeks were significantly higher than the control group (F=14.64, P=0.000; F=6.81, P=0.000). There was no significant difference in the mean blood pressure between the three groups of CIH and the control group. Membrane thickness in CIH9, 6 and 3 weeks and control group were: (20±2), (19±2), (14±2), (13±3) μm. Compared with the control group, the aortic pathology and thickness of the middle layer of the CIH9 and 6 weeks group were significantly thicker (F=20.24, P=0.000), but there was no significant difference between the CIH3 week group and the control group; the collagen deposition was unchanged compared with the control group. Conclusion: Intermittent hypoxia for 6 weeks or more in rats resulted in the increasement of blood pressure, morphological changes of aorta and vascular remodeling in thickened media.
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Affiliation(s)
- X J Tang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - B Wang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - P Y Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Z T Guo
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Q L Tang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - S S Li
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - X M Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital, Central South University, Changsha 410011, China
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22
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Huang PY, Li YZ, Yang XM, Yu BQ, Guo L, Guo ZT, Li SS. [Tumor-induced osteomalacia caused by nasal hemangiopericytoma: a case report]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2019; 54:615-617. [PMID: 31434378 DOI: 10.3760/cma.j.issn.1673-0860.2019.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- P Y Huang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Y Z Li
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - X M Yang
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - B Q Yu
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - L Guo
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Z T Guo
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - S S Li
- Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University, Changsha 410011, China
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23
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Huang PY, Tsai KL, Liang CM, Tai WC, Rau KM, Wu KL, Huang CC, Chuah SK. Prognostic factors of patients with gastroenteropancreatic neuroendocrine neoplasms. Kaohsiung J Med Sci 2018; 34:650-656. [PMID: 30392572 DOI: 10.1016/j.kjms.2018.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/28/2018] [Accepted: 05/30/2018] [Indexed: 01/30/2023] Open
Abstract
There is an increasing trend in the incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) worldwide. The aim of the present study was to identify the prognostic factors of patients with GEP-NENs. A cross-sectional, retrospective chart review study was conducted among patients with pathologically proven GEP-NENs between January 2003 and December 2016 at Kaohsiung Chung-Gung Memorial Hospital. A total of 97 patients who met the inclusion criteria were included (male/female = 56/41, age: 57.7 ± 15.4 years). The presentation, clinical characteristics, and disease outcomes were reviewed and analyzed. The most common primary site of the GEP-NENs was the rectum (49.5%), followed by the pancreas (17.5%), duodenum (11.3%), stomach (10.3%), colon (6.2%), and appendix (5.2%), and most GEP-NENs were hormonally nonfunctional (94.8%). There were 56 tumors classified as G1 neuroendocrine tumors (NETs), 9 as G2 NETs, and 14 as G3 neuroendocrine carcinoma (NEC). Metastasis was found in 15 patients (15%). Curative treatments, such as surgery or endoscopic resection, were performed in 83.5% of patients (n = 81). The mean overall survival duration was 107.2 ± 7.8 months. The estimated 3- and 5-year overall survival rates for all patients were 84% and 82%, respectively. Logistic regression analysis showed that large tumor size, non-rectal NENs, high histopathological grading, lymphatic metastases and distant metastases were associated with poor survival. This study suggested that the presence of lymphatic or distant metastases at diagnosis is an independent risk factor for poor prognosis in patients with GEP-NENs.
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Affiliation(s)
- Pao-Yuan Huang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kai-Lung Tsai
- Division of Colon and Rectal Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Chih-Ming Liang
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Chen Tai
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kun-Ming Rau
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Keng-Liang Wu
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chao-Cheng Huang
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Seng-Kee Chuah
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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24
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Lin PL, Huang PY, Huang PW. Automatic methods for alveolar bone loss degree measurement in periodontitis periapical radiographs. Comput Methods Programs Biomed 2017; 148:1-11. [PMID: 28774432 DOI: 10.1016/j.cmpb.2017.06.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/14/2017] [Accepted: 06/23/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis involves progressive loss of alveolar bone around the teeth. Hence, automatic alveolar bone loss measurement in periapical radiographs can assist dentists in diagnosing such disease. In this paper, we propose an automatic length-based alveolar bone loss measurement system with emphasis on a cementoenamel junction (CEJ) localization method: CEJ_LG. METHOD The bone loss measurement system first adopts the methods TSLS and ABLifBm, which we presented previously, to extract teeth contours and bone loss areas from periodontitis radiograph images. It then applies the proposed methods to locate the positions of CEJ, alveolar crest (ALC), and apex of tooth root (APEX), respectively. Finally the system computes the ratio of the distance between the positions of CEJ and ALC to the distance between the positions of CEJ and APEX as the degree of bone loss for that tooth. The method CEJ_LG first obtains the gradient of the tooth image then detects the border between the lower enamel and dentin (EDB) from the gradient image. Finally, the method identifies a point on the tooth contour that is horizontally closest to the EDB. RESULTS Experimental results on 18 tooth images segmented from 12 periodontitis periapical radiographs, including 8 views of upper-jaw teeth and 10 views of lower-jaw teeth, show that 53% of the localized CEJs are within 3 pixels deviation (∼ 0.15 mm) from the positions marked by dentists and 90% have deviation less than 9 pixels (∼ 0.44 mm). For degree of alveolar bone loss, more than half of the measurements using our system have deviation less than 10% from the ground truth, and all measurements using our system are within 25% deviation from the ground truth. CONCLUSION Our results suggest that the proposed automatic system can effectively estimate degree of horizontal alveolar bone loss in periodontitis radiograph images. We believe that our proposed system, if implemented in routine clinical practice, can serve as a valuable tool for early and accurate diagnosis of alveolar bone loss in periodontal diseases and also for assessing the status of alveolar bone following various types of non surgical and surgical and regenerative therapy. For overall system improvement, a more objective comparison by using transgingival bone measurement with a periodontal probe as the ground truth and enhancing the localization algorithms of these three critical points are the two major tasks.
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Affiliation(s)
- P L Lin
- Department of Computer Science and Information Engineering, Providence University, 200, Taiwan Bld., Shalu, Taichung 43301, Taiwan.
| | - P Y Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - P W Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
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25
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Rhodes D, Chenet DA, Janicek BE, Nyby C, Lin Y, Jin W, Edelberg D, Mannebach E, Finney N, Antony A, Schiros T, Klarr T, Mazzoni A, Chin M, Chiu YC, Zheng W, Zhang QR, Ernst F, Dadap JI, Tong X, Ma J, Lou R, Wang S, Qian T, Ding H, Osgood RM, Paley DW, Lindenberg AM, Huang PY, Pasupathy AN, Dubey M, Hone J, Balicas L. Engineering the Structural and Electronic Phases of MoTe 2 through W Substitution. Nano Lett 2017; 17:1616-1622. [PMID: 28145719 DOI: 10.1021/acs.nanolett.6b04814] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
MoTe2 is an exfoliable transition metal dichalcogenide (TMD) that crystallizes in three symmetries: the semiconducting trigonal-prismatic 2H- or α-phase, the semimetallic and monoclinic 1T'- or β-phase, and the semimetallic orthorhombic γ-structure. The 2H-phase displays a band gap of ∼1 eV making it appealing for flexible and transparent optoelectronics. The γ-phase is predicted to possess unique topological properties that might lead to topologically protected nondissipative transport channels. Recently, it was argued that it is possible to locally induce phase-transformations in TMDs, through chemical doping, local heating, or electric-field to achieve ohmic contacts or to induce useful functionalities such as electronic phase-change memory elements. The combination of semiconducting and topological elements based upon the same compound might produce a new generation of high performance, low dissipation optoelectronic elements. Here, we show that it is possible to engineer the phases of MoTe2 through W substitution by unveiling the phase-diagram of the Mo1-xWxTe2 solid solution, which displays a semiconducting to semimetallic transition as a function of x. We find that a small critical W concentration xc ∼ 8% stabilizes the γ-phase at room temperature. This suggests that crystals with x close to xc might be particularly susceptible to phase transformations induced by an external perturbation, for example, an electric field. Photoemission spectroscopy, indicates that the γ-phase possesses a Fermi surface akin to that of WTe2.
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Affiliation(s)
- D Rhodes
- National High Magnetic Field Laboratory, Florida State University , Tallahassee, Florida 32310, United States
- Department of Physics, Florida State University , Tallahassee, Florida 32306, United States
| | - D A Chenet
- Department of Mechanical Engineering, Columbia University , New York, New York 10027, United States
| | - B E Janicek
- Department of Materials Science and Engineering, University of Illinois Urbana-Champaign , Urbana, Illinois 61801, United States
| | - C Nyby
- Department of Chemistry, Stanford University , Stanford, California 94305-4401, United States
| | | | | | | | - E Mannebach
- Department of Materials Science and Engineering, Stanford University , Stanford, California 94305, United States
| | - N Finney
- Department of Mechanical Engineering, Columbia University , New York, New York 10027, United States
| | - A Antony
- Department of Mechanical Engineering, Columbia University , New York, New York 10027, United States
| | - T Schiros
- Materials Research Science and Engineering Center, Columbia University , New York, New York 10027 United States
- Department of Science and Mathematics, SUNY Fashion Institute of Technology , New York, New York 10001 United States
| | - T Klarr
- Sensors and Electronic Devices Directorate, United States Army Research Laboratory , Adelphi, Maryland 20723, United States
| | - A Mazzoni
- Sensors and Electronic Devices Directorate, United States Army Research Laboratory , Adelphi, Maryland 20723, United States
| | - M Chin
- Sensors and Electronic Devices Directorate, United States Army Research Laboratory , Adelphi, Maryland 20723, United States
| | - Y-C Chiu
- National High Magnetic Field Laboratory, Florida State University , Tallahassee, Florida 32310, United States
- Department of Physics, Florida State University , Tallahassee, Florida 32306, United States
| | - W Zheng
- National High Magnetic Field Laboratory, Florida State University , Tallahassee, Florida 32310, United States
- Department of Physics, Florida State University , Tallahassee, Florida 32306, United States
| | - Q R Zhang
- National High Magnetic Field Laboratory, Florida State University , Tallahassee, Florida 32310, United States
- Department of Physics, Florida State University , Tallahassee, Florida 32306, United States
| | - F Ernst
- Department of Applied Physics, Stanford University , Stanford, California 94305-4090, United States
- Stanford PULSE Institute, SLAC National Accelerator Laboratory , Menlo Park, California 94025, United States
| | - J I Dadap
- Department of Electrical Engineering, Columbia University , New York, New York 10027, United States
| | - X Tong
- Center for Functional Nanomaterials, Brookhaven National Laboratory , Upton, New York 11973-5000, United States
| | - J Ma
- Beijing National Laboratory for Condensed Matter Physics, and Institute of Physics, Chinese Academy of Sciences , Beijing 100190, China
| | - R Lou
- Department of Physics, Renmin University of China , Beijing 100872, China
| | - S Wang
- Department of Physics, Renmin University of China , Beijing 100872, China
| | - T Qian
- Beijing National Laboratory for Condensed Matter Physics, and Institute of Physics, Chinese Academy of Sciences , Beijing 100190, China
| | - H Ding
- Beijing National Laboratory for Condensed Matter Physics, and Institute of Physics, Chinese Academy of Sciences , Beijing 100190, China
| | - R M Osgood
- Department of Electrical Engineering, Columbia University , New York, New York 10027, United States
| | | | - A M Lindenberg
- Department of Materials Science and Engineering, Stanford University , Stanford, California 94305, United States
- Stanford PULSE Institute, SLAC National Accelerator Laboratory , Menlo Park, California 94025, United States
- Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory , Menlo Park, California 94025, United States
| | - P Y Huang
- Department of Mechanical Science and Engineering, University of Illinois Urbana-Champaign , Urbana, Illinois 61801, United States
| | | | - M Dubey
- Sensors and Electronic Devices Directorate, United States Army Research Laboratory , Adelphi, Maryland 20723, United States
| | - J Hone
- Department of Mechanical Engineering, Columbia University , New York, New York 10027, United States
| | - L Balicas
- National High Magnetic Field Laboratory, Florida State University , Tallahassee, Florida 32310, United States
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26
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Lin PL, Huang PW, Huang PY, Hsu HC. Alveolar bone-loss area localization in periodontitis radiographs based on threshold segmentation with a hybrid feature fused of intensity and the H-value of fractional Brownian motion model. Comput Methods Programs Biomed 2015; 121:117-126. [PMID: 26078207 DOI: 10.1016/j.cmpb.2015.05.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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: 09/15/2014] [Revised: 05/11/2015] [Accepted: 05/19/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND AND OBJECTIVE Periodontitis involves progressive loss of alveolar bone around the teeth. Hence, automatic alveolar bone-loss (ABL) measurement in periapical radiographs can assist dentists in diagnosing such disease. In this paper, we propose an effective method for ABL area localization and denote it as ABLIfBm. METHOD ABLIfBm is a threshold segmentation method that uses a hybrid feature fused of both intensity and texture measured by the H-value of fractional Brownian motion (fBm) model, where the H-value is the Hurst coefficient in the expectation function of a fBm curve (intensity change) and is directly related to the value of fractal dimension. Adopting leave-one-out cross validation training and testing mechanism, ABLIfBm trains weights for both features using Bayesian classifier and transforms the radiograph image into a feature image obtained from a weighted average of both features. Finally, by Otsu's thresholding, it segments the feature image into normal and bone-loss regions. RESULTS Experimental results on 31 periodontitis radiograph images in terms of mean true positive fraction and false positive fraction are about 92.5% and 14.0%, respectively, where the ground truth is provided by a dentist. The results also demonstrate that ABLIfBm outperforms (a) the threshold segmentation method using either feature alone or a weighted average of the same two features but with weights trained differently; (b) a level set segmentation method presented earlier in literature; and (c) segmentation methods based on Bayesian, K-NN, or SVM classifier using the same two features. CONCLUSION Our results suggest that the proposed method can effectively localize alveolar bone-loss areas in periodontitis radiograph images and hence would be useful for dentists in evaluating degree of bone-loss for periodontitis patients.
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Affiliation(s)
- P L Lin
- Department of Computer Science and Information Engineering, Providence University, Shalu, Taichung 43301, Taiwan.
| | - P W Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - P Y Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - H C Hsu
- College of Oral Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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Lin PL, Huang PY, Huang PW, Hsu HC, Chen CC. Teeth segmentation of dental periapical radiographs based on local singularity analysis. Comput Methods Programs Biomed 2014; 113:433-445. [PMID: 24252317 DOI: 10.1016/j.cmpb.2013.10.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2013] [Revised: 09/12/2013] [Accepted: 10/22/2013] [Indexed: 06/02/2023]
Abstract
Teeth segmentation for periapical raidographs is one of the most critical tasks for effective periapical lesion or periodontitis detection, as both types of anomalies usually occur around tooth boundaries and dental radiographs are often subject to noise, low contrast, and uneven illumination. In this paper, we propose an effective scheme to segment each tooth in periapical radiographs. The method consists of four stages: image enhancement using adaptive power law transformation, local singularity analysis using Hölder exponent, tooth recognition using Otsu's thresholding and connected component analysis, and tooth delineation using snake boundary tracking and morphological operations. Experimental results of 28 periapical radiographs containing 106 teeth in total and 75 useful for dental examination demonstrate that 105 teeth are successfully isolated and segmented, and the overall mean segmentation accuracy of all 75 useful teeth in terms of (TP, FP) is (0.8959, 0.0093) with standard deviation (0.0737, 0.0096), respectively.
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Affiliation(s)
- P L Lin
- Department of Computer Science and Information Engineering, Providence University, Shalu, Taichung 43301, Taiwan.
| | - P Y Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - P W Huang
- Department of Computer Science and Engineering, National Chung Hsing University, Taichung 40227, Taiwan.
| | - H C Hsu
- College of Oral Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - C C Chen
- College of Oral Medicine, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
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28
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Wu X, Huang PY, Peng PJ, Lu LX, Han F, Wu SX, Hou X, Zhao HY, Huang Y, Fang WF, Zhao YY, Xue C, Hu ZH, Zhang J, Zhang JW, Ma YX, Liang WH, Zhao C, Zhang L. Long-term follow-up of a phase III study comparing radiotherapy with or without weekly oxaliplatin for locoregionally advanced nasopharyngeal carcinoma. Ann Oncol 2013; 24:2131-6. [PMID: 23661293 DOI: 10.1093/annonc/mdt163] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Previous results from our trial showed that adding oxaliplatin to radiotherapy (RT) increased survival in patients with locoregionally advanced nasopharyngeal carcinoma (NPC) at 2 years. Here, we present the data of long-term efficacy and late toxic effects. PATIENTS AND METHODS Between January 2001 and January 2003, 115 Patients with nonkeratinizing/undifferentiated locoregionally advanced NPC were randomly to receive either RT alone (n = 56) or plus concurrent oxaliplatin 70 mg/m(2) weekly for six cycles (n = 59). RESULTS After a median follow-up of 114 months (range 18-139 months), the 5-year overall survival (OS) and metastasis-free survival (MFS) rates in the concurrent chemoradiotherapy (CCRT) group were significantly higher than those observed in the RT-alone group (OS, 73.2% versus 60.2%, P = 0.028; MFS, 74.7% versus 63.0%, P = 0.027). However, CCRT did not improve locoregional failure-free survival significantly. Subgroup analyses showed that the superiorities of CCRT mainly existed in the T3-4N0-1 stage subgroup (OS: HR = 0.394, P = 0.034). The grade 3/4 late toxic effects were similar in the two groups. CONCLUSION(S) The long-term follow-up data confirms the role of CCRT as a treatment of locoregionally advanced NPC. Oxaliplatin can be considered as an alternative optional therapeutic regimen for these patients due to its high efficiency and low toxic effect.
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Affiliation(s)
- X Wu
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, People's Republic of China
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Xue C, Huang Y, Huang PY, Yu QT, Pan JJ, Liu LZ, Song XQ, Lin SJ, Wu JX, Zhang JW, Zhao HY, Xu F, Liu JL, Hu ZH, Zhao LP, Zhao YY, Wu X, Zhang J, Ma YX, Zhang L. Phase II study of sorafenib in combination with cisplatin and 5-fluorouracil to treat recurrent or metastatic nasopharyngeal carcinoma. Ann Oncol 2012; 24:1055-61. [PMID: 23172635 DOI: 10.1093/annonc/mds581] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND We aimed to investigate the efficacy and tolerability of sorafenib combined with cisplatin and 5-fluorouracil (5-FU) in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS It was a Simon two-stage designed trial. Chemotherapy-naive patients with recurrent or metastatic disease were enrolled. The regimen was sorafenib 400 mg orally b.i.d., cisplatin 80 mg/m(2) i.v. day 1, and 5-FU 1000 mg/m(2)/day CIV for 4 days, repeated every 21 days. After a maximum of six cycles of chemotherapy, patients received maintenance of sorafenib. RESULTS In total, 54 patients were enrolled. The objective response rate reached 77.8%, including 1 complete response and 41 partial responses. The median progression-free survival was 7.2 months (95% CI 6.8-8.4 months), and the median overall survival was 11.8 months (95% CI 10.6-18.7 months). Major toxic effects included hand-foot skin reaction, myelosuppression, and gastrointestinal (GI) reaction. The incidence of hemorrhage was 22.2%, and one patient with liver metastases died of GI bleeding. Contrast-enhanced ultrasonography was carried out in a subset of patients with liver metastases. CONCLUSION Combination of sorafenib, cisplatin (80 mg/m(2)) and 5-FU (3000 mg/m(2)) was tolerable and feasible in recurrent or metastatic NPC. Further randomized trials to compare sorafenib plus cisplatin and 5-FU with standard dose of cisplatin plus 5-FU in NPC are warranted.
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Affiliation(s)
- C Xue
- State Key Laboratory of Oncology in South China
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Abstract
A toxin isolated from apple fruit tissue infected by Erwinia amylovora is 98 percent galactose in polymeric form, 0.375 percent protein, and has an average molecular weight of approximately 165,000. Young shoots of rosaceous, but not nonrosaceous, species wilt in a manner characteristic of the disease when placed in toxin solutions with concentrations as low as 10 micrograms per milliliter. Varieties of apple and pear susceptible to Erwinia amylovora wilt in 1 to 3 hours, whereas resistant varieties display symptoms 12 to 24 hours after treatment.
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31
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Zang WQ, Li B, Huang PY, Lai MM, Yen TS. Role of polypyrimidine tract binding protein in the function of the hepatitis B virus posttranscriptional regulatory element. J Virol 2001; 75:10779-86. [PMID: 11602719 PMCID: PMC114659 DOI: 10.1128/jvi.75.22.10779-10786.2001] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.2] [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: 12/15/2022] Open
Abstract
The hepatitis B virus posttranscriptional regulatory element (PRE) is an RNA element that increases the expression of unspliced mRNAs, apparently by facilitating their export from the nucleus. We have identified a cellular protein that binds to the PRE as the polypyrimidine tract binding protein (PTB), which shuttles rapidly between the nucleus and the cytoplasm. Mutants of the PRE with mutations in PTB binding sites show markedly decreased activity, while cells that stably overexpress PTB show increased PRE-dependent gene expression. Export of PTB from the nucleus, like PRE function, is blocked by a mutant form of Ran binding protein 1 but not by leptomycin B. Therefore, PTB is important for PRE activity and appears to function as an export factor for PRE-containing mRNAs.
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Affiliation(s)
- W Q Zang
- Department of Pathology, VA Medical Center 113B, University of California School of Medicine, San Francisco, 94121, USA
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32
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Abstract
Ultrahigh molecular weight polyethylene (UHMWPE) fibers were treated with argon plasma for 5 min, followed by uv irradiation in methyl methacrylate (MMA)-chloroform solution for 5 h to obtain MMA-g-UHMWPE grafted fiber. The grafting content was estimated by the titration of esterification method. The grafting amount of 5280 nmol/g was the largest for the MMA concentration at 18.75 vol%. To improve the mechanical properties of acrylic bone cement, pure UHMWPE fiber and MMA-g-UHMWPE fiber were added to the surgical Simplex. P radiopaque bone cement. The mechanical properties including tensile strength, tensile modulus, compressive strength, bending strength, and bending stiffness were measured. Dynamic mechanical analysis was also performed. By comparing the effect of the pure UHMWPE fiber and MMA-g-UHMWPE grafted fiber on the mechanical properties of acrylic bone cement, it was found that the acrylic bone cement with MMA-g-UHMWPE grafted fiber had a more significant reinforcing effect than that with untreated UHMWPE fiber. This might be due to the improvement of the interfacial bonding between the grafted fibers and the acrylic bone cement matrix.
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Affiliation(s)
- J M Yang
- Department of Chemical Engineering, Chang Gung University, Tao-Yuan, Taiwan, Republic of China.
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33
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Huang PY, Carbonell RG. Affinity chromatographic screening of soluble combinatorial peptide libraries. Biotechnol Bioeng 1999; 63:633-41. [PMID: 10397820] [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: 02/13/2023]
Abstract
Affinity chromatography using immobilized S-protein was used for the screening of affinity peptide ligands from two soluble peptide libraries. Peptide library I consisted of octamers with glycine (G) at both termini of each peptide, i.e. GXXXXXXG. The six center positions were constructed using random sequences of six L-amino acids (Y, N, F, E, V, and L). Peptide library II also consisted of octamers but with glycine and valine (V) at both termini of each peptide (GVZZZZVG). The four variable center positions of peptide library II were random sequences of 18 L-amino acids. Peptides that were retained specifically on the immobilized S-protein column were eluted by 2% acetic acid. The peptides in the acid eluate were further separated using reversed-phase HPLC. Each separated peptide fraction was collected and the peptide sequences deconvoluted by mass spectrometry (MS/MS). The screenings of peptide libraries I and II resulted in 12 and 7 affinity peptides, respectively. Eight out of the twelve peptides from peptide library I contained the clear consensus sequence NFEV. Peptide library II resulted in affinity peptides with the sequences GVNFEVVG, GVNFTVVG and GVFFEL(I)VG. The advantages and limitations of affinity chromatography in peptide library screening are discussed.
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Affiliation(s)
- P Y Huang
- Department of Chemical Engineering, North Carolina State University, Raleigh, North Carolina 27695-7905, USA
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34
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Pang WW, Huang PY, Chang DP, Huang MH. The peripheral analgesic effect of tramadol in reducing propofol injection pain: a comparison with lidocaine. Reg Anesth Pain Med 1999; 24:246-9. [PMID: 10338176 DOI: 10.1016/s1098-7339(99)90136-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Tramadol and metoclopramide have a local anesthetic effect similar to lidocaine following intradermal injection. When metoclopramide was retained in the venous system for 1 minute, it was found to be as effective as lidocaine in reducing propofol injection pain. Using this metoclopramide model, the effects of tramadol in reducing pain on propofol injection was investigated. METHODS One hundred five patients were randomly allocated to receive 50 mg tramadol (group T), 60 mg lidocaine (group L), or normal saline (group NS) as pretreatment to reduce pain on propofol injection. Following venous occlusion with a tourniquet (70 mm Hg), one of the drugs was intravenously administered. Venous retention of the drug was maintained for 1 minute. Immediately after the tourniquet release, intravenous injection of 100 mg propofol (10 mL) at a rate of 0.5 mL/s followed. Pain assessment was made after each injection. RESULTS Transient minor injection pain and local skin reactions were significantly greater with tramadol than with lidocaine (P < .05). Both tramadol and lidocaine significantly reduced the incidence and intensity of propofol injection pain when compared with normal saline (P < .05). CONCLUSIONS Using -minute retention in veins, both tramadol and lidocaine significantly reduced propofol injection pain. A local anesthetic activity is postulated.
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Affiliation(s)
- W W Pang
- Department of Anesthesia, Show-Chwan Memorial Hospital, Changhua, Taiwan, ROC
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35
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Aranha-Creado H, Peterson J, Huang PY. Clearance of murine leukaemia virus from monoclonal antibody solution by a hydrophilic PVDF microporous membrane filter. Biologicals 1998; 26:167-72. [PMID: 9811524 DOI: 10.1006/biol.1998.0130] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [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: 11/22/2022] Open
Abstract
Continuous cell lines (used in the manufacture of monoclonal antibodies and other therapeutic proteins) may harbour retroviral particles; nevertheless, they are deemed acceptable if the production system is validated for clearance of these contaminants. As part of a campaign to evaluate and validate appropriate virus removal methodologies for monoclonal immunoglobulin G (IgG) products, studies were undertaken with a hydrophilic polyvinylidene fluoride (PVDF) microporous membrane-the Ultipor(R) VF grade DV50 virus removal membrane. Testing conducted with murine leukaemia virus, a specific model virus used in viral validation studies to document removal of retroviruses, demonstrated a greater that 7 log clearance by the Ultipor(R) VR grade DV50 membrane. Filterability testing established the feasibility of positioning the filter at either of two different stages during manufacture. The results presented in this study demonstrate that membrane filtration through the Ultipor VF grade DV50 virus removal filter can constitute part of the purification regimen to effect removal of endogenous retrovirus-like contaminants from monoclonal IgG products.
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Affiliation(s)
- H Aranha-Creado
- Scientific and Laboratory Services Dept., Pall Corporation, Port Washington, NY 11050, USA
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36
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Huang PY, Baumbach GA, Dadd CA, Buettner JA, Masecar BL, Hentsch M, Hammond DJ, Carbonell RG. Affinity purification of von Willebrand factor using ligands derived from peptide libraries. Bioorg Med Chem 1996; 4:699-708. [PMID: 8804536 DOI: 10.1016/0968-0896(96)00066-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The chromatographic purification of vWF (von Willebrand Factor) from human plasma represents a challenge because it consists of multimers with molecular weights ranging from 0.5 to 10 million Daltons. Phage peptide library screening yielded a lead peptide (RLRSFY) that interacts with vWF. Conservative substitutions of terminal residues of the lead peptide led to a second peptide, RVRSFY, which was more efficient in the affinity chromatographic purification of vWF from protein mixtures. Adsorption isotherm measurements indicated multiple interactions between vWF and the immobilized peptide RVRSFY. Increases in peptide density on the chromatographic supports resulted in stronger association constants and higher maximum protein binding capacities. When the peptide density was lower than 32 mg/mL, there was no measurable interaction between vWF and immobilized peptide RVRSFY in HEPES buffer containing 0.5 M NaCl at pH 7. An increase in peptide density from 32 to 60 mg/mL increased the association constants from 0.9 x 10(6) to 2 x 10(6) (M-1). Divalent salts (calcium and magnesium chloride) were used to elute the retained vWF with 82.5% of the activity recovered. The interactions between vWF and the immobilized peptide RVRSFY are dominated by ionic attractions and also involve hydrophobic interactions at close contact. Finally, the purification of vWF from crude material PEG filtrate of a cryoprecipitate of human plasma is demonstrated using affinity chromatography with immobilized N-acetyl-RVRSFYK.
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Affiliation(s)
- P Y Huang
- Department of Chemical Engineering, North Carolina State University, Raleigh 27695-7905, USA
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37
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Tang XW, Yarom M, Carlson RG, Vander Velde D, Huang PY, Lee YH, Seah EC, Deupree D, Wu JY. Isolation of endogenous modulators for the GABAA and taurine receptors. Neurochem Int 1993; 23:485-93. [PMID: 7902750 DOI: 10.1016/0197-0186(93)90134-q] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Several endogenous brain substances which inhibit [3H]muscimol binding were isolated, and one of them has been purified to apparent homogeneity. The purification involved the extraction of brain tissue with water, followed by several steps of gel filtration column chromatography and high performance liquid chromatography (HPLC). The muscimol binding inhibitor (MBI) thus obtained appeared to be homogeneous as judged from the elution profile of an HPLC column, in which a symmetrical peak was obtained when the eluate was monitored at either 220 or 280 nm. Furthermore, the MBI activity coincided with the absorption peak. The purified MBI is not gamma-amino butyric acid (GABA), beta-alanine or taurine since these amino acids are clearly separated from the MBI in the purification procedures. The MBI has no effect on benzodiazepine (BZ) binding or glutamate binding to their respective receptors. However, the MBI is a more potent inhibitor for [3H]taurine binding than that of [3H]muscimol binding. The MBI appears to be a small molecule (< 2000 Da) that is heat and acid/base stable. The chemical nature of the MBI is currently under investigation.
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Affiliation(s)
- X W Tang
- Department of Physiology, University of Kansas, Lawrence 66045-2106
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38
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Abstract
A population balance equation (PBE) mathematical model for analyzing platelet aggregation kinetics was developed in Part I (Huang, P. Y., and J. D. Hellums. 1993. Biophys. J. 65: 334-343) of a set of three papers. In this paper, Part II, platelet aggregation and related reactions are studied in the uniform, known shear stress field of a rotational viscometer, and interpreted by means of the model. Experimental determinations are made of the platelet-aggregate particle size distributions as they evolve in time under the aggregating influence of shear stress. The PBE model is shown to give good agreement with experimental determinations when either a reversible (aggregation and disaggregation) or an irreversible (no disaggregation) form of the model is used. This finding suggests that for the experimental conditions studied disaggregation processes are of only secondary importance. During shear-induced platelet aggregation, only a small fraction of platelet collisions result in the binding together of the involved platelets. The modified collision efficiency is approximately zero for shear rates below 3000 s-1. It increases with shear rates above 3000 s-1 to about 0.01 for a shear rate of 8000 s-1. Addition of platelet chemical agonists yields order of magnitude increases in collision efficiency. The collision efficiency for shear-induced platelet aggregation is about an order of magnitude less at 37 degrees C than at 24 degrees C. The PBE model gives a much more accurate representation of aggregation kinetics than an earlier model based on a monodispersed particle size distribution.
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Affiliation(s)
- P Y Huang
- Cox Laboratory for Biomedical Engineering, Rice University, Houston, Texas 77251-1892
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39
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Huang PY, Hellums JD. Aggregation and disaggregation kinetics of human blood platelets: Part III. The disaggregation under shear stress of platelet aggregates. Biophys J 1993; 65:354-61. [PMID: 8369443 PMCID: PMC1225730 DOI: 10.1016/s0006-3495(93)81080-4] [Citation(s) in RCA: 36] [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: 01/30/2023] Open
Abstract
In the preceding two papers (1, 2), a population balance equation (PBE) mathematical model was developed, validated, and applied to the analysis of platelet aggregation kinetics under the influence of hydrodynamic shear stress. The present work involves the application of the model to the analysis of platelet reactions under shear stress in circumstances where disaggregation processes are of dominant importance: the disaggregation of aggregates formed in response to added agonists. Aggregation-disaggregation experiments were performed in the constant shear field of a rotational viscometer, and the evolution of the particle size distribution was determined by use of an electronic particle counter. The PBE model was used to simulate the experimental results. Exploratory calculations made it possible to reduce a rather complete, complex model to a more tractable form which retains the capability of simulating the experimental observations. For the experimental conditions studied, disaggregation by a splitting mechanism was found to be of dominant importance. The surface erosion mechanism can be neglected without significant impact on results. Physical reasoning confirmed by exploratory calculations showed that a discontinuous form of the breakage rate expression which incorporates a minimum friable particle size, gives significantly better results than a continuous expression. A simple step function void fraction parameter was found to be at least as successful as a more complicated, continuous function. The resulting simplified model has the potential of increasing our understanding of kinetics and mechanisms of platelet reactions, and of characterizing the state of platelet activity. Hence, it may be useful in efforts to understand thrombotic and hemostatic processes.
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Affiliation(s)
- P Y Huang
- Cox Laboratory for Biomedical Engineering, Rice University, Houston, Texas 77251-1892
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40
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Abstract
Hydrodynamic shear stress of sufficient intensity is known to cause platelet activation and aggregation and to alter the effects of biochemical platelet agonists and antagonists. In this work, a population balance equation (PBE) model is developed for analysis of platelet aggregation and disaggregation kinetics under the influence of a shear field. The model incorporates both aggregation and disaggregation by splitting and/or erosion mechanisms. This paper, the first of a series of three, deals with the formulation, simplification, and validation of the PBE and with the estimation of parameters involved in the PBE. These population parameters include collision efficiency, void fraction (related to the particle collision diameter), and the breakage rate coefficient. The platelet particle size distribution is determined experimentally, both initially and at some later times. The PBE can then be used to match satisfactorily the observed particle histograms, by appropriate choice of parameters of the model as functions of time, platelet size, and magnitude of physical or chemical stimuli. Besides providing information on adhesive forces and on the rates of aggregation and disaggregation, these parameters infer the physical properties of platelets and platelet aggregates. These properties are of potential value in increasing our understanding of the processes involved in thrombotic disease and/or therapy. A numerical procedure for solving the PBE is validated by application to simple cases for which analytical solutions are available. The model is applied to analysis of experiments, and parameter sensitivity studies are used to order the importance of the parameters and to reduce the complexity of the model. The simplified model is shown to give good agreement with experimental observations.
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Affiliation(s)
- P Y Huang
- Cox Laboratory for Biomedical Engineering, Rice University, Houston, Texas 77251-1892
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Abstract
A concept involving the use of antibodies conjugated with reporter molecules for the direct sensing on the subtle changes in the local electrostatic environment of antigen-antibody complexes due to the antigen binding was proposed and demonstrated. The studies including the effect of solution conditions on the extent and magnitude of the electrostatic potentials around the antigen-antibody complex and the quantitative dependence of the distance between the reporter molecule and the antigen-antibody binding site on the effectiveness of the reporter molecule for sensing the antigen-antibody binding event are presented and discussed. Basic understanding of induced changes in the electrostatic potentials on the antigen-antibody complex is essential for implementing the proposed direct sensing mechanism.
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Affiliation(s)
- P Y Huang
- Department of Chemical and Biochemical Engineering, University of Maryland, Baltimore 21228
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42
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Lu YQ, Huang CH, Hu HL, Huang PY. Studies on function of Hb Jianghua [beta 120 (GH3) Lys----Ile]. Chin Med J (Engl) 1990; 103:3-6. [PMID: 2112440] [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: 12/30/2022] Open
Abstract
Hemoglobin Jianghua (Hb Jianghua) is a new fast--moving hemoglobin variant found in China, being named after the county where it was detected. Having its primary structure analysed, we report in this paper the results of studies on its function. The absorption spectrum, response to allosteric effectors and oxygen equilibrium of the chromatographically purified Hb Jianghua showed its characteristics similar to those of purified Hb A. Its alkaline Bohr effect was normal. This indicates that a substitution of isoleucine for the 120th lysine residue of the beta chain had no significant influence upon the function of Hb molecule.
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Affiliation(s)
- Y Q Lu
- Department of Biochemistry, Human Medical University, Changsha
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Lin DC, Hsu L, Huang PY. Insidious onset of airway obstruction of an endotracheal tube by blood-mucus plugs. Ma Zui Xue Za Zhi 1989; 27:293-6. [PMID: 2607918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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44
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Liu JF, Lu YQ, Liu XQ, Huang PY, Huang CH, Chen SS, Jia PC, Liang CC, Zuo CR. Hb G-Taichung [alpha 74(EF3)Asp----His] in a Hunanese family in China. Hemoglobin 1989; 13:163-7. [PMID: 2737911 DOI: 10.3109/03630268908998066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- J F Liu
- Department of Biochemistry, Hunan Medical University, Changsha, People's Republic of China
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45
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Ko MP, Huang PY, Huang JS, Barker KR. The occurrence of phytoferritin and its relationship to effectiveness of soybean nodules. Plant Physiol 1987; 83:299-305. [PMID: 16665240 PMCID: PMC1056352 DOI: 10.1104/pp.83.2.299] [Citation(s) in RCA: 7] [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: 05/09/2023]
Abstract
Polyacrylamide gel electrophoresis and electron microscopy revealed that accumulation of iron-protein in soybean nodules is influenced by nodule age, mutation in bradyrhizobia, and rhizobial/bradyrhizobial strain-soybean cultivar interactions. Iron-protein concentrations (micrograms per milligram protein) were inversely related to heme concentrations (nanomoles per milligram protein), with correlation coefficients (r values) ranging from -0.98 in young nodules to -0.83 in mature ones. Bradyrhizobium japonicum symbiotic mutants HS 129 and HS 145 (Nod(+) Fix(-)) produced nodules high in iron-protein. Electrophoresis of homogenate prepared from nodules on Lee 68 produced by B. japonicum HS 129 yielded two different forms of the iron-proteins, 570 and 600 kilodaltons. The 570 kilodalton iron-protein isolated by preparative polyacrylamide gel electrophoresis behaved like horse-spleen-ferritin in responses to iron-stains, heat stability, ultraviolet absorption spectrum, iron unloading and reloading, and characteristic appearance in electron micrographs. These properties led to the conclusion that the 570 kilodalton iron-protein is phytoferritin. The nodule phytoferritin differed from horse-spleen-ferritin in electrophoretic mobility, serological properties, and molecular size and was distinct from most other known phytoferritins in that it was composed of different subunit types.
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Affiliation(s)
- M P Ko
- Department of Plant Pathology, North Carolina State University, Raleigh, North Carolina 27695-7616
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46
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Abstract
Thin sectioned cells of Erwinia amylovora revealed two electron-dense layers in their walls when fixed at 24 to 27 C and three when fixed at 4 C.
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47
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Abstract
Filamentous cells of Erwinia amylovora were usually 3 to 35 times longer than the normal rod-shaped ones, and only the former produced minicells.
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