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Wang WC, Wu TH, Hung HC, Lee JC, Cheng CH, Wang YC, Lee CF, Wu TJ, Chou HS, Chan KM, Lee WC. Liver regeneration of living donor after liver donation for transplantation: Disparity in the left and right remnant liver. Medicine (Baltimore) 2024; 103:e37632. [PMID: 38579088 PMCID: PMC10994454 DOI: 10.1097/md.0000000000037632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/26/2024] [Indexed: 04/07/2024] Open
Abstract
Donor safety is crucial for living donor liver transplantation (LDLT), and sufficient liver regeneration significantly affects outcomes of living donors. This study aimed to investigate clinical factors associated with liver regeneration in living donors. The study retrospectively reviewed 380 living donors who underwent liver donation at Chang Gung Memorial Hospital in Linkou. The clinical characteristics and medical parameters of donors were analyzed and compared according to liver donation graft type. There were 355 donors (93.4%) with right hemi-liver donations and 25 donors (6.6%) with left hemi-liver donations. Left hemi-liver donors had a higher body mass index (BMI) and a larger ratio of remnant liver volume (RLV) to total liver volume (TLV). However, the 2 groups showed no significant difference in the liver regeneration ratio. The type of remnant liver (P < .001), RLV/body weight (P = .027), RLV/TLV (P < .001), serum albumin on postoperative day 7 and total bilirubin levels on postoperative day 30 were the most significant factors affecting liver regeneration in living donors. In conclusion, adequate liver regeneration is essential for donor outcome after liver donation. The remnant liver could eventually regenerate to an adequate volume similar to the initial TLV before liver donation. However, the remnant left hemi-liver had a faster growth rate than the remnant right hemi-liver in donors.
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Affiliation(s)
- Wei-Cheng Wang
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Su CW, Teng W, Shen EYL, Huang BS, Lin PT, Hou MM, Wu TH, Tsan DL, Hsieh CH, Wang CT, Chai PM, Lin CY, Lin SM, Lin CC. Concurrent Atezolizumab Plus Bevacizumab and High-Dose External Beam Radiotherapy for Highly Advanced Hepatocellular Carcinoma. Oncologist 2024:oyae048. [PMID: 38530254 DOI: 10.1093/oncolo/oyae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/23/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Atezolizumab plus bevacizumab (atezo-bev) has been recommended for advanced hepatocellular carcinoma (HCC). High-dose external beam radiotherapy (RT) is recognized for its excellent local tumor control. The efficacy and safety of concurrent atezo-bev with RT for highly advanced HCC has been minimally explored. METHODS In this preliminary retrospective study, we assessed patients with highly advanced HCC, characterized by Vp4 portal vein thrombosis or tumors exceeding 50% of liver volume, who received concurrent atezo-bev and RT (group A). Group A included 13 patients who received proton radiation at a dose of 72.6 GyE in 22 fractions, and one patient who received photon radiation at a dose of 54 Gy in 18 fractions. This group was compared with 34 similar patients treated atezo-bev alone as a control (group B). The primary objectives were to evaluate the objective response rate (ORR), overall survival (OS), and safety. RESULTS Baseline characteristics were similar between groups, except for a higher incidence of Vp4 portal vein thrombosis in group A (78.6% vs. 21.4%, P = .05). Group A achieved a higher ORR (50.0% vs. 11.8%, P < .01) and a longer OS (not reached vs. 5.5 months, P = .01) after a median follow-up of 5.2 months. Multivariate analysis indicated that concurrent RT independently favored longer OS (hazard ratio: 0.18; 95% CI, 0.05-0.63, P < .01). Group A did not increase any grade adverse events (78.6% vs. 58.8%, P = .19) or severe adverse events of grade ≥ 3 (14.3% vs. 14.7%, P = .97) compared to group B. CONCLUSIONS The concurrent high-dose external beam radiotherapy appears to safely enhance the effectiveness of atezolizumab plus bevacizumab for highly advanced patients with HCC. Further studies are warranted to confirm these findings.
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Affiliation(s)
- Chung-Wei Su
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei Teng
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Eric Yi-Liang Shen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Clinical Metabolomics Core Lab, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Bing-Shen Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Po-Ting Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Mo Hou
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Tsung-Han Wu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of General Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Din-Li Tsan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Radiation Oncology and Proton Therapy Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chia-Hsun Hsieh
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- Division of Hematology-Oncology, Department of Internal Medicine, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Memorial Hospital), New Taipei, Taiwan
| | - Ching-Ting Wang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Pei-Mei Chai
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chun-Yen Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shi-Ming Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chen-Chun Lin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Gastroenterology and Hepatology, New Taipei Municipal Tucheng Hospital (Built and Operated by Chang Gung Memorial Hospital), New Taipei, Taiwan
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Hung HC, Lai Y, Lee JC, Wang YC, Cheng CH, Wu TH, Wu TJ, Chou HS, Chan KM, Lee WC, Lee CF. Optimal treatment strategy and prognostic analysis of salvage liver transplantation for patients with early hepatocellular carcinoma recurrence after hepatectomy. Hepatol Res 2024. [PMID: 38451566 DOI: 10.1111/hepr.14033] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/11/2024] [Accepted: 02/16/2024] [Indexed: 03/08/2024]
Abstract
AIM We aimed to investigate the prognostic factors for salvage liver transplant in patients with early hepatocellular carcinoma recurrence after hepatectomy. METHODS This retrospective analysis included 53 patients who underwent salvage living-donor liver transplantation between January 2007 and January 2018. There were 24 and 29 patients in the early (recurrence ≤24 months after primary liver resection) and the late recurrence groups, respectively. RESULTS In the multivariate Cox regression model, pre-liver transplant downstaging therapy, early recurrence (ER) after primary liver resection , and recurrence-to-liver-transplant ≥12 months were independent risks to predict recurrent hepatocellular carcinoma recurrence after salvage living-donor liver transplantation. Compared with the late recurrence group, the ER group showed lower disease-free survival rates (p < 0.001); however, the overall survival rates did not differ between the two groups (p = 0.355). The 1-, 3-, and 5-year disease-free survival rates were 83.3%, 70.6%, and 66.2%, and 96.0%, 91.6%, and 91.6% in the early and late recurrence groups, respectively. When stratified by recurrence-to-liver transplant time and pre-liver transplant downstaging therapy in the ER group, disease-free survival and overall survival rates were significantly different. CONCLUSION ER after primary liver resection with advanced tumor status and a longer period of recurrence-to-liver-transplant (≥12 months) have a negative impact on salvage liver transplant. Our findings provide novel recommendations for treatment strategies and eligibility for salvage liver transplant candidates.
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Affiliation(s)
- Hao-Chien Hung
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Yin Lai
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- Chang-Gung University College of Medicine, Taoyuan, Taiwan
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Cheng YJ, Wu TH, Tseng YS, Chen WF. Development of hybrid 3D printing approach for fabrication of high-strength hydroxyapatite bioscaffold using FDM and DLP techniques. Biofabrication 2024; 16:025003. [PMID: 38226849 DOI: 10.1088/1758-5090/ad1b20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/04/2024] [Indexed: 01/17/2024]
Abstract
This study develops a hybrid 3D printing approach that combines fused deposition modeling (FDM) and digital light processing (DLP) techniques for fabricating bioscaffolds, enabling rapid mass production. The FDM technique fabricates outer molds, while DLP prints struts for creating penetrating channels. By combining these components, hydroxyapatite (HA) bioscaffolds with different channel sizes (600, 800, and 1000μm) and designed porosities (10%, 12.5%, and 15%) are fabricated using the slurry casting method with centrifugal vacuum defoaming for significant densification. This innovative method produces high-strength bioscaffolds with an overall porosity of 32%-37%, featuring tightly bound HA grains and a layered surface structure, resulting in remarkable cell viability and adhesion, along with minimal degradation rates and superior calcium phosphate deposition. The HA scaffolds show hardness ranging from 1.43 to 1.87 GPa, with increasing compressive strength as the designed porosity and channel size decrease. Compared to human cancellous bone at a similar porosity range of 30%-40%, exhibiting compressive strengths of 13-70 MPa and moduli of 0.8-8 GPa, the HA scaffolds demonstrate robust strengths ranging from 40 to 73 MPa, paired with lower moduli of 0.7-1.23 GPa. These attributes make them well-suited for cancellous bone repair, effectively mitigating issues like stress shielding and bone atrophy.
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Affiliation(s)
- Yu-Jui Cheng
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - Tsung-Han Wu
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
- Department of Orthopaedics, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan
| | - Yu-Sheng Tseng
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - Wen-Fan Chen
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
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Wu CX, Li CH, Shiao YH, Cheng HY, Wu TH, Lee CH, Chang ZY, Yeh YC. The effect of a helmet type, home-use low-level light therapy device for chemotherapy-induced alopecia: study protocol for a randomized controlled trial. Trials 2023; 24:789. [PMID: 38053197 DOI: 10.1186/s13063-023-07823-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/22/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Alopecia is one of the most common adverse effects of chemotherapy. It reduces the patient's self-esteem and quality of life and the effect of therapy. Scalp cooling is the only verified current method for prevention but success is not guaranteed, particularly after receiving anthracycline-based combinations. Low-level light therapy has been clinically proven to inhibit the progress of androgenic alopecia. A previous study using human subjects shows limited benefits for low-level light therapy for patients who suffer chemotherapy-induced alopecia but an increase in the number of probes and the optimization of light sources may improve the efficacy. This study determines the efficacy of low-level light therapy for the prevention of chemotherapy-induced hair loss for patients with breast cancer using a randomized controlled trial. METHODS One hundred six eligible breast cancer patients were randomly distributed into a low-level light therapy group and a control group, after receiving chemotherapy. Subjects in the low-level light therapy group received 12 courses of intervention within 4 weeks. Subjects in the control group received no intervention but were closely monitored. The primary outcome is measured as the difference in the hair count in a target area between the baseline and at the end of week 4, as measured using a phototrichogram (Sentra scalp analyzer). The secondary outcomes include the change in hair count at the end of week 1, week 2, and week 3 and hair width at the end of week 1, week 2, week 3, and week 4, as measured using a phototrichogram, and the change in distress, the quality of life, and self-esteem due to chemotherapy-induced alopecia, at the end of week 4, as measured using a questionnaire. DISCUSSION This study improves cancer patients' quality of life and provides clinical evidence. TRIAL REGISTRATION Registered at ClinicalTrials.gov- NCT05397457 on 1 June 2022.
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Affiliation(s)
- Cong-Xian Wu
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
| | - Cheng-Hsin Li
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
| | - Yi-Hsien Shiao
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
- Graduate Institute of Natural Products, Chang Gung University, Taoyuan, 333323, Taiwan
| | - Huan-Yu Cheng
- The Institute of Health Policy and Management, National Taiwan University, Taipei, 106319, Taiwan
| | - Tsung-Han Wu
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, 20401, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, 33320, Taiwan
| | - Chun-Hui Lee
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
| | - Zi-Yu Chang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan
| | - Yuan-Chieh Yeh
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung Medical Center, Keelung, 204201, Taiwan.
- Program in Molecular Medicine, College of Life Sciences, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan.
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Su CW, Teng W, Lin PT, Wu TH, Hsu YC, Hsieh YC, Huang CH, Chen WT, Lin CC, Lin CY, Lin SM. A combination of locoregional treatment with systemic therapy after atezolizumab plus bevacizumab failure for unresectable hepatocellular carcinoma provides survival benefit. Am J Cancer Res 2023; 13:5482-5492. [PMID: 38058809 PMCID: PMC10695777] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/28/2023] [Indexed: 12/08/2023] Open
Abstract
Atezolizumab plus bevacizumab (A+B) is used to treat unresectable hepatocellular carcinoma (HCC), but the optimal rescue therapy after A+B remains unclear. Combining locoregional therapy (LRT) with systemic treatment has been shown to improve tumor control, but the role in patients who fail A+B is unknown. We retrospectively enrolled patients who experienced radiological progression after A+B. Objective response rate (ORR), disease control rate (DCR), post progression survival (PPS), and secondary progression-free survival (PFS) were evaluated by modified RECIST. Inverse probability weighting (IPW) was used to balance baseline clinical features. A total of 61 patients were enrolled with a median age of 60.7 years, 83.6% male, 88.5% viral hepatitis-related, and 60.7% without prior systemic treatment before A+B. Patients receiving sequential therapies had significantly longer PPS than supportive care (10.5 vs. 2.3 months, P<0.0001). Among 37 patients received sequential systemic treatment, 18 received combined LRT. The median follow-up after post A+B failure was 6.6 months. The combined LRT group had higher ORR (27.8 vs. 0%, P=0.0197) and DCR (72.2 vs. 26.3%, P=0.0052) than systemic alone group. The median PPS and secondary PFS were significantly longer in combined LRT group (PPS: 12.2 vs. 5.8 months, P=0.0070; PFS: 5.0 vs. 2.6 months, P=0.0134) than systemic alone group. After IPW analysis, patients with combined LRT had superior PPS and secondary PFS. The incidence rates of AEs were higher in LRT combination compared to systemic alone (any grade AEs: 94.4 vs. 63.2%, P=0.0422; severe AEs: 33.3 vs. 5.3%, P=0.0422). No significant albumin-bilirubin index changed in the first 3 months in combined LRT group (0.966 [0.647-1.443], P=0.867) though a trend of deterioration in systemic alone group. In conclusion, sequential systemic therapy provides survival benefits after A+B failure. Furthermore, combining LRT with systemic treatment could provide better tumor responses and survival benefits with acceptable toxicity than systemic therapy alone.
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Affiliation(s)
- Chung-Wei Su
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Wei Teng
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Po-Ting Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Tsung-Han Wu
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
- Department of General Surgery, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
| | - Yu-Chun Hsu
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Yi-Chung Hsieh
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Chien-Hao Huang
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Wei-Ting Chen
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Chen-Chun Lin
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
- Department of Gastroenterology and Hepatology, New Taipei Municiplal Tucheng Hospital (Built and Operated by Chang Gung Memorial Hospital)Taiwan
| | - Chun-Yen Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
| | - Shi-Ming Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang Gung UniversityTaoyuan, Taiwan
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Chen SC, Jiang BC, Lu YJ, Chang CH, Wu TH, Lin SW, Yin HW, Lee TH, Hsu CH. Characterization and Crystal Structures of a Cubebol-Producing Sesquiterpene Synthase from Antrodia cinnamomea. J Agric Food Chem 2023; 71:13014-13023. [PMID: 37566786 DOI: 10.1021/acs.jafc.3c00570] [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] [Subscribe] [Scholar Register] [Indexed: 08/13/2023]
Abstract
Antrodia cinnamomea is an endemic species found in Taiwan, known for its medicinal properties in treating various discomforts, including inflammation, diarrhea, abdominal pain, and other diseases. A. cinnamomea contains terpenoids that exhibit numerous bioactivities, making them potential food additives. This discovery piqued our interest in uncovering their biosynthetic pathway. Herein, we conducted functional and structural characterization of a sesquiterpene synthase Cop4 from A. cinnamomea (AcCop4). Through gas chromatography-mass spectrometry analysis, we observed that AcCop4 catalyzes the cyclization of farnesyl pyrophosphate (FPP), primarily producing cubebol. Cubebol is widely used as a long-lasting cooling and refreshing agent in the food industry. The structure of AcCop4, complexed with pyrophosphate and magnesium ions, revealed the closure of the active site facilitated by R311. Interestingly, binding of pyrophosphate and magnesium ions did not cause any significant conformational change in the G1/2 helix of AcCop4, indicating that the apo form is not fully open. This high-resolution structure serves as a solid basis for understanding the biosynthetic mechanism of AcCop4 and supports further production and modification of cubebol for its applications in the food industry.
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Affiliation(s)
- Sheng-Chia Chen
- Department of Agricultural Chemistry, National Taiwan University, Taipei 10617, Taiwan
- Institute of Fisheries Sciences, National Taiwan University, Taipei 10617, Taiwan
| | - Bo-Chen Jiang
- Department of Agricultural Chemistry, National Taiwan University, Taipei 10617, Taiwan
| | - Yen-Ju Lu
- Institute of Biochemical Sciences, National Taiwan University, Taipei 10617, Taiwan
| | - Chia-Hao Chang
- Institute of Fisheries Sciences, National Taiwan University, Taipei 10617, Taiwan
| | - Tsung-Han Wu
- Genome and Systems Biology Degree Program, National Taiwan University and Academia Sinica, Taipei 10617, Taiwan
| | - Sheng-Wei Lin
- Institute of Biochemical Sciences, National Taiwan University, Taipei 10617, Taiwan
| | - Hua-Wen Yin
- Institute of Fisheries Sciences, National Taiwan University, Taipei 10617, Taiwan
| | - Tzong-Huei Lee
- Institute of Fisheries Sciences, National Taiwan University, Taipei 10617, Taiwan
| | - Chun-Hua Hsu
- Department of Agricultural Chemistry, National Taiwan University, Taipei 10617, Taiwan
- Institute of Biochemical Sciences, National Taiwan University, Taipei 10617, Taiwan
- Genome and Systems Biology Degree Program, National Taiwan University and Academia Sinica, Taipei 10617, Taiwan
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Lin YT, Lin PT, Lin CC, Wu TH, Liu LT, Su CW, Teng W, Tsai CY, Huang CH, Chen WT, Chan KM, Hsu CW, Lin CY, Lin SM, Chien RN. Adding nutritional status to the original BCLC stage improves mortality prediction for hepatocellular carcinoma patients in HBV-endemic regions. Am J Cancer Res 2023; 13:3618-3628. [PMID: 37693156 PMCID: PMC10492128] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/25/2023] [Indexed: 09/12/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is associated with high mortality, especially in Asian populations where chronic HBV infection is a major cause. Accurate prediction of mortality can assist clinical decision-making. We aim to (i) compare the predicting ability of Barcelona Clinic Liver Cancer classification (BCLC) stage, neutrophil-to-lymphocyte ratio (NLR), and Albumin-Bilirubin (ALBI) score in predicting short-term mortality (one- and two-year) and (ii) develop a novel model with improved accuracy compared to the conventional models. This study enrolled 298 consecutive HCC patients from our hepatology department. The prognostic values for mortality were assessed by area under the receiver operating characteristic curve (AUROC) analysis. A novel model was established and internally validated using 5-fold cross-validation, followed by external validation in a cohort of 100 patients. The primary etiology of cirrhosis was hepatitis B virus (HBV), with 81.2% of HCC patients having preserved liver function. Significant differences were observed in hemoglobin (Hb) and serum albumin levels, which reflect patients' nutrition status, between patients who survived for one year and those who died. BCLC exhibited superior predictive accuracy compared to NLR but had borderline superiority to the ALBI score. Therefore, a novel model incorporating BCLC, Hb, and serum albumin was developed, internally and externally validated, as well as subgroup sensitivity analysis. The model exhibited significantly higher predictive accuracy for one- and two-year mortality than conventional prognostic predictors, with AUROC values of 0.841 and 0.805, respectively. The novel "BCLC-Nutrition Model", which incorporates BCLC, Hb, and serum albumin, may provide improved predictive accuracy for short-term mortality in HCC patients compared to commonly used prognostic scores. This emphasizes the importance of nutrition in the management of HCC patients.
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Affiliation(s)
- Yan-Ting Lin
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
| | - Po-Ting Lin
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Chen-Chun Lin
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Tsung-Han Wu
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
- Department of General Surgery, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
| | - Li-Tong Liu
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
| | - Chung-Wei Su
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Wei Teng
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Chun-Yi Tsai
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
- Department of General Surgery, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
| | - Chien-Hao Huang
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Wei-Ting Chen
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Kun-Ming Chan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
- Department of General Surgery, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
| | - Chao-Wei Hsu
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Chun-Yen Lin
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Shi-Ming Lin
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
| | - Rong-Nan Chien
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical CenterTaoyuan, Taiwan
- College of Medicine, Chang-Gung UniversityTaoyuan, Taiwan
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9
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Lin YT, Chen WT, Wu TH, Liu Y, Liu LT, Teng W, Hsieh YC, Wu YM, Huang CH, Hsu CW, Chien RN. A Validated Composite Score Demonstrates Potential Superiority to MELD-Based Systems in Predicting Short-Term Survival in Patients with Liver Cirrhosis and Spontaneous Bacterial Peritonitis-A Preliminary Study. Diagnostics (Basel) 2023; 13:2578. [PMID: 37568941 PMCID: PMC10417459 DOI: 10.3390/diagnostics13152578] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/15/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Spontaneous bacterial peritonitis (SBP) is a severe complication in cirrhosis patients with ascites, leading to high mortality rates if not promptly treated. However, specific prediction models for SBP are lacking. AIMS This study aimed to compare commonly used cirrhotic prediction models (CTP score, MELD, MELD-Na, iMELD, and MELD 3.0) for short-term mortality prediction and develop a novel model to improve mortality prediction. METHODS Patients with the first episode of SBP were included. Prognostic values for mortality were assessed using AUROC analysis. A novel prediction model was developed and validated. RESULTS In total, 327 SBP patients were analyzed, with HBV infection as the main etiologies. MELD 3.0 demonstrated the highest AUROC among the traditional models. The novel model, incorporating HRS, exhibited superior predictive accuracy for in-hospital in all patients and 3-month mortality in HBV-cirrhosis, with AUROC values of 0.827 and 0.813 respectively, surpassing 0.8. CONCLUSIONS MELD 3.0 score outperformed the CTP score and showed a non-significant improvement compared to other MELD-based scores, while the novel SBP model demonstrated impressive accuracy. Internal validation and an HBV-related cirrhosis subgroup sensitivity analysis supported these findings, highlighting the need for a specific prognostic model for SBP and the importance of preventing HRS development to improve SBP prognosis.
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Affiliation(s)
- Yan-Ting Lin
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
| | - Wei-Ting Chen
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
- College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan
| | - Tsung-Han Wu
- College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan
- Department of General Surgery, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan
| | - Yu Liu
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
| | - Li-Tong Liu
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
| | - Wei Teng
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
- College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan
| | - Yi-Chung Hsieh
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
- College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan
| | - Yen-Mu Wu
- College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan
- Department of Infectious Disease, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan;
| | - Chien-Hao Huang
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
- College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan
| | - Chao-Wei Hsu
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
- College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan
| | - Rong-Nan Chien
- Department of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33305, Taiwan (Y.L.); (L.-T.L.); (Y.-C.H.)
- College of Medicine, Chang-Gung University, Taoyuan 33302, Taiwan
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10
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Lee CH, Hsu CY, Yen TH, Wu TH, Yu MC, Hsieh SY. Daily Aspirin Reduced the Incidence of Hepatocellular Carcinoma and Overall Mortality in Patients with Cirrhosis. Cancers (Basel) 2023; 15:cancers15112946. [PMID: 37296908 DOI: 10.3390/cancers15112946] [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: 04/03/2023] [Revised: 05/10/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Cirrhosis is the primary risk factor for hepatocellular carcinoma (HCC) and gastrointestinal bleeding (GI). We aimed to assess the efficacy and safety of daily aspirin on HCC occurrence, overall survival, and GI bleeding in cirrhotic patients. METHODS A total of 35,898 eligible cases were enrolled for analyses from an initial 40,603 cirrhotic patients without tumor history. Patients continuously treated with aspirin for at least 84 days were in the therapy group, whereas those without treatment were controls. A 1:2 propensity score matching by age, sex, comorbidities, drugs, and significant clinical laboratory tests with covariate assessment was used. RESULTS Multivariable regression analyses revealed that daily aspirin use was independently associated with a reduced risk of HCC (three-year HR 0.57; 95% CI 0.37-0.87; p = 0.0091; five-year HR 0.63, 95% CI 0.45-0.88; p = 0.0072) inversely correlated with the treatment duration [3-12 months: HR 0.88 (95% CI 0.58-1.34); 12-36 months: HR 0.56 (0.31-0.99); and ≥ 36 months: HR 0.37 (0.18-0.76)]. Overall mortality rates were significantly lower among aspirin users compared with untreated controls [three-year HR 0.43 (0.33-0.57); five-year HR 0.51 (0.42-0.63)]. Consistent results were obtained when the laboratory data were included in the propensity score for matching. CONCLUSIONS Long-term aspirin use significantly reduced the incidence of HCC and overall mortality without increasing gastrointestinal bleeding in cirrhotic patients.
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Affiliation(s)
- Chern-Horng Lee
- Division of General Medicine and Geriatrics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
| | - Chiu-Yi Hsu
- Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
| | - Tsung-Han Wu
- Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Ming-Chin Yu
- Department of General Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan
| | - Sen-Yung Hsieh
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
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11
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Ozdemir NK, Cline JP, Wu TH, Spangler LC, McIntosh S, Kiely CJ, Snyder MA. Bioinspired, Non-Enzymatic, Aqueous Synthesis of Size-Tunable CdS Quantum Dots for Sustainable Optoelectronic Applications. ACS Appl Nano Mater 2023; 6:7668-7678. [PMID: 37304254 PMCID: PMC10249337 DOI: 10.1021/acsanm.3c00805] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/21/2023] [Indexed: 06/13/2023]
Abstract
The enzymatic production of hydrogen sulfide (H2S) from cysteine in various metabolic processes has been exploited as an intrinsically "green" and sustainable mode for the aqueous biomineralization of functional metal sulfide quantum dots (QDs). Yet, the reliance on proteinaceous enzymes tends to limit the efficacy of the synthesis to physiological temperature and pH, with implications for QD functionality, stability, and tunability (i.e., particle size and composition). Inspired by a secondary non-enzymatic biochemical cycle that is responsible for basal H2S production in mammalian systems, we establish how iron(III)- and vitamin B6 (pyridoxal phosphate, PLP)-catalyzed decomposition of cysteine can be harnessed for the aqueous synthesis of size-tunable QDs, demonstrated here for CdS, within an expanded temperature, pH, and compositional space. Rates of H2S production by this non-enzymatic biochemical process are sufficient for the nucleation and growth of CdS QDs within buffered solutions of cadmium acetate. Ultimately, the simplicity, demonstrated robustness, and tunability of the previously unexploited H2S-producing biochemical cycle help establish its promise as a versatile platform for the benign, sustainable synthesis of an even wider range of functional metal sulfide nanomaterials for optoelectronic applications.
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Affiliation(s)
- Nur Koncuy Ozdemir
- Department
of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, Pennsylvania 18015, United States
| | - Joseph P. Cline
- Department
of Materials Science and Engineering, Lehigh
University, Bethlehem, Pennsylvania 18015, United States
| | - Tsung-Han Wu
- Department
of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, Pennsylvania 18015, United States
| | - Leah C. Spangler
- Department
of Chemical and Life Science Engineering, Virginia Commonwealth University, Richmond, Virginia 23284, United States
| | - Steven McIntosh
- Department
of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, Pennsylvania 18015, United States
| | - Christopher J. Kiely
- Department
of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, Pennsylvania 18015, United States
- Department
of Materials Science and Engineering, Lehigh
University, Bethlehem, Pennsylvania 18015, United States
| | - Mark A. Snyder
- Department
of Chemical and Biomolecular Engineering, Lehigh University, Bethlehem, Pennsylvania 18015, United States
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12
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Cheng CH, Hung HC, Lee JC, Wang YC, Wu TH, Lee CF, Wu TJ, Chou HS, Chan KM, Lee WC. Converting from Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in Patients with Hepatitis B Following Liver Transplantation. Ann Transplant 2023; 28:e938731. [PMID: 37081752 PMCID: PMC10127548 DOI: 10.12659/aot.938731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Taiwan has a high prevalence of hepatitis B virus (HBV) infection. HBV-related end-stage liver disease is the leading cause of liver transplantation (LT). Tenofovir alafenamide (TAF) is a recently approved agent for the treatment of chronic HBV infection that improves renal profiles compared with tenofovir disoproxil fumarate (TDF) in phase III trials. This study aimed to assess the outcomes of TAF treatment in LT recipients. MATERIAL AND METHODS This retrospective study analyzed 17 LT recipients who underwent treatment with TDF and TAF. Changes in baseline renal function were compared. RESULTS Seventeen LT recipients received TDF for ≥48 weeks and were switched to TAF. During TDF treatment, estimated glomerular filtration rate (eGFR) (using the Modification of Diet in Renal Disease [MDRD] formula) decreased significantly at weeks 24 and 48. At week 48, only 2 patients (11.8%) displayed improved renal function, whereas the other patients showed decreased eGFR ranging from 5.48% to 62.84%. After switching to TAF, the median eGFR increased by 3.01% at week 24 and decreased by 0.31% at week 48. Seven patients (47%) showed improved renal function at week 48 after TAF treatment. CONCLUSIONS Switching from TDF to TAF was associated with fewer short-term renal impairment while maintaining the antiviral efficacy in LT recipients.
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Affiliation(s)
- Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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13
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Chan KM, Lai Y, Hung HC, Lee JC, Cheng CH, Wang YC, Wu TH, Lee CF, Wu TJ, Chou HS, Wang CT, Chai PM, Lien HY, Lee WC. Significance of Physical Status and Liver Function Reserve for Outcome of Patients with Advanced Hepatocellular Carcinoma Receiving Lenvatinib Treatment. J Hepatocell Carcinoma 2023; 10:281-290. [PMID: 36845025 PMCID: PMC9946007 DOI: 10.2147/jhc.s393964] [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: 10/18/2022] [Accepted: 02/11/2023] [Indexed: 02/19/2023] Open
Abstract
Background Tyrosine kinase inhibitors (TKIs) remain the primary therapeutic option for patients with advanced-stage hepatocellular carcinoma (HCC). However, the selection of a suitable TKI is an issue in real-world clinical practice. Thus, this study aimed to identify patients most likely to benefit from lenvatinib treatment. Methods A retrospective review of 143 patients with unresectable advanced-stage HCC treated with lenvatinib between January 2020 and December 2021 was performed. Outcomes related to lenvatinib treatment were measured, and the clinical parameters affecting prognosis were analyzed. Results Overall, the median time of progression-free survival (PFS) and overall survival (OS) were 7.1 months and 17.7 months, respectively. Prognostic analyses found that Child-Pugh score > 5 (hazard ratio [HR] = 2.43, 95% confidence interval [CI] = 1.55-3.80, p = 0.001) was a significant factor affecting the PFS of HCC after lenvatinib treatment. Child-Pugh score > 5 (HR = 2.12, 95% CI = 1.20-3.74, p = 0.009), body weight ≥ 60 kg (HR = 0.54, 95% CI = 0.32-0.90, p = 0.020), and additional trans-arterial chemoembolization (TACE) treatment (HR = 0.38, 95% CI = 0.21-0.70, p = 0.003) were significant prognostic factors for OS. However, early α-fetoprotein reduction was not significantly correlated with patient outcomes. Additionally, patients with pre-treatment neutrophil-lymphocyte ratio > 4.07 showed a significant worse PFS and OS than other patients. Conclusion The outcome of patients with advanced-stage HCC remains poor. However, the host condition, including good physical status and better functional liver preservation, largely affected the outcome of patients receiving lenvatinib treatment. Moreover, additional locoregional therapy for intrahepatic HCC, other than TKI treatment, can be considered in certain patients to achieve a favorable outcome.
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Affiliation(s)
- Kun-Ming Chan
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan,Correspondence: Kun-Ming Chan, Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, No. 5 Fu-Hsing Street, Gui-Shan District, Taoyuan City, 33305, Taiwan, Tel +886-3-3281200 Ext 3366, Fax +886-3-3285818, Email
| | - Yin Lai
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ching-Ting Wang
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Pei-Mei Chai
- Department of Nursing, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hsin-Yi Lien
- Graduate School of Education, Ming Chuan University, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Lee WC, Wu TJ, Cheng CH, Wang YC, Hung HC, Lee JC, Wu TH, Chou HS, Lee CF, Chan KM. Elevation of Lipid Metabolites in Deceased Liver Donors Reflects Graft Suffering. Metabolites 2023; 13:metabo13010117. [PMID: 36677042 PMCID: PMC9866140 DOI: 10.3390/metabo13010117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/21/2022] [Accepted: 01/04/2023] [Indexed: 01/14/2023] Open
Abstract
Liver transplantation can be performed with deceased or living donor allografts. Deceased liver grafts are donated from brain- or circulation-death patients, and they have usually suffered from a certain degree of damage. Post-transplant graft function and patient survival are closely related to liver allograft recovery. How to define the damage of liver grafts is unclear. A total of 47 liver donors, 23 deceased and 24 living, were enrolled in this study. All deceased donors had suffered from severe brain damage, and six of them had experienced cardio-pulmonary-cerebral resuscitation (CPR). The exploration of liver graft metabolomics was conducted by liquid chromatography coupled with mass spectrometry. Compared with living donor grafts, the deceased liver grafts expressed higher levels of various diacylglycerol, lysophosphatidylcholine, lysophosphatidylethanolamine, oleoylcarnitine and linoleylcarnitine; and lower levels of cardiolipin and phosphatidylcholine. The liver grafts from the donors with CPR had higher levels of cardiolipin, phosphatidic acid, phosphatidylcholine, phatidylethanolamine and amiodarone than the donors without CPR. When focusing on amino acids, the deceased livers had higher levels of histidine, taurine and tryptophan than the living donor livers. In conclusion, the deceased donors had suffered from cardio-circulation instability, and their lipid metabolites were increased. The elevation of lipid metabolites can be employed as an indicator of liver graft suffering.
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16
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Lai Y, Lee JC, Hung HC, Wang YC, Cheng CH, Wu TH, Lee CF, Wu TJ, Chou HS, Chan KM, Kao CY, Lee WC. Modified preoperative score to predict disease-free survival for hepatocellular carcinoma patients with surgical resections. World J Hepatol 2022; 14:1778-1789. [PMID: 36185727 PMCID: PMC9521458 DOI: 10.4254/wjh.v14.i9.1778] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/30/2022] [Accepted: 08/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND No prognostic models specific to hepatocellular carcinoma patients receiving surgical resection have been considered strong and convincing enough for survival prediction thus far, and there are no models including only preoperative predictors. We derived a nomogram to predict disease-free survival in a previous study.
AIM To simplify our score and compare research outcomes among other scoring systems.
METHODS We retrospectively reviewed data from 1106 patients with hepatocellular carcinoma who underwent liver resection at the Linkou Chang Gung Memorial Hospital between April 2003 and December 2012. Multivariate analyses were conducted to identify the significant survival predictors. Homogeneity, Harrell’s C-index, and Akaike information criterion were compared between our score, AJCC 8th edition, Tokyo score, and Taipei Integrated Scoring System (TTV-CTP-AFP model).
RESULTS Among the 1106 patients, 731 (66.1%) had tumor recurrence at a median follow-up of 83.9 mo. Five risk factors were identified: platelet count, albumin level, indocyanine green retention rate, multiplicity, and radiologic total tumor volume. Patients were divided into three risk groups, and the 5-year survival rates were 61.7%, 39%, and 25.7%, respectively. The C-index was 0.617, which was higher than the Tokyo score (0.613) and the Taipei Integrated Scoring System (0.562) and equal to the value of the AJCC 8th edition (0.617).
CONCLUSION The modified score provides an easier method to predict survival. Appropriate treatment can be planned preoperatively by dividing patients into risk groups.
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Affiliation(s)
- Yin Lai
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Jin-Chiao Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Hao-Chien Hung
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
| | - Chen-Yao Kao
- Department of Special Education, National University of Tainan, Tainan 700, Taiwan
| | - Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan
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17
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Huang CH, Fan JH, Jeng WJ, Chang ST, Yang CK, Teng W, Wu TH, Hsieh YC, Chen WT, Chen YC, Sheen IS, Lin YC, Lin CY. Innate-like bystander-activated CD38 + HLA-DR + CD8 + T cells play a pathogenic role in patients with chronic hepatitis C. Hepatology 2022; 76:803-818. [PMID: 35060158 DOI: 10.1002/hep.32349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/07/2022] [Accepted: 01/12/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS HCV-specific T cells are few and exhausted in patients with chronic hepatitis C (CHC). Whether these T cells are responsible for the liver damage and fibrosis is still debated. However, cluster of differentiation 38-positive (CD38+ ) human leukocyte antigen DR-positive (HLA-DR+ ) CD8+ T cells are regarded as bystander CD8+ T cells that cause liver injury in acute hepatitis. We propose that these innate CD8+ T cells play a pathogenic role in CHC. METHODS Lymphocytes from peripheral blood were obtained from 108 patients with CHC and 43 healthy subjects. Immunophenotyping, functional assays, T-cell receptor (TCR) repertoire, and cytotoxic assay of CD38+ HLA-DR+ CD8+ T cells were studied. RESULTS The percentage of CD38+ HLA-DR+ CD8+ T cells increased significantly in patients with CHC. These cells expressed higher levels of effector memory and proinflammatory chemokine molecules and showed higher interferon-γ production than CD38- HLA-DR- CD8 T cells. They were largely composed of non-HCV-specific CD8+ T cells as assessed by HLA-A2-restricted pentamers and next-generation sequencing analysis of the TCR repertoire. In addition, these CD38+ HLA-DR+ CD8+ T cells had strong cytotoxicity, which could be inhibited by anti-DNAX accessory molecule 1, anti-NKG2 family member D, and anti-natural killer NKp30 antibodies. Lastly, the percentage of CD38+ HLA-DR+ CD8+ T cells was significantly associated with liver injury and fibrosis and decreased significantly along with serum alanine aminotransferase normalization after successful direct-acting antiviral treatment. CONCLUSIONS The TCR-independent, cytokine-responsive bystander CD38+ HLA-DR+ CD8+ T cells are strongly cytotoxic and play a pathogenic role in patients with CHC.
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Affiliation(s)
- Chien-Hao Huang
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Jian-He Fan
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Wen-Juei Jeng
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Shu-Ting Chang
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Chan-Keng Yang
- Division of Medical Oncology/Hematology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wei Teng
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Division of General Surgery, Chang-Gung Memorial Hospital, Linkou Medical Center, Taiwan
| | - Yi-Chung Hsieh
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Wei-Ting Chen
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Yi-Cheng Chen
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - I-Shyan Sheen
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| | - Yung-Chang Lin
- Division of Medical Oncology/Hematology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chun-Yen Lin
- Division of Hepatology, Department of Gastroenterology and Hepatology, Chang-Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
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Chan KM, Hung HC, Lee JC, Wu TH, Wang YC, Cheng CH, Lee CF, Wu TJ, Chou HS, Lee WC. Individualized Selection Criteria Based on Tumor Burden in Future Remnant Liver for Staged Hepatectomy of Advanced CRLM: Conventional TSH or ALPPS. Cancers (Basel) 2022; 14:cancers14143553. [PMID: 35884613 PMCID: PMC9324888 DOI: 10.3390/cancers14143553] [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: 06/08/2022] [Revised: 07/08/2022] [Accepted: 07/19/2022] [Indexed: 02/05/2023] Open
Abstract
Staged hepatectomy is a promising strategy for curative resection of advanced colorectal liver metastasis (CRLM) to prevent inadequate future remnant liver (FRL). However, the selection criteria for conventional two-stage hepatectomy (cTSH) and associating liver partitioning and portal vein ligation for staged hepatectomy (ALPPS) remain unclear. This study aimed to propose a selection criterion for determining the optimal staged hepatectomy for patients with advanced CRLM. A selection criterion based on the degree of metastatic tumors within the FRL was established to determine staged hepatectomy approaches. Generally, ALPPS is recommended for patients with ≤3 metastatic nodules and whose nodules do not measure >3 cm in the FRL. cTSH is performed for patients whose tumor burden in FRL beyond the selection criteria. Data of 37 patients who underwent staged hepatectomy and curative intent of CRLM were analyzed. The clinical characteristics and outcomes of the two approaches were compared. Overall, cTSH and ALPPS were performed for 27 (73.0%) and 10 (27.0%) patients, respectively. Of those, 20 patients in the cTSH group and all patients in the ALPPS group had completed staged hepatectomy. The 1-, 3-, and 5-year survival rates were 91.6%, 62.4%, and 45.4% for all patients, respectively. The outcomes of patients who had successfully completed the staged hepatectomy were significantly better than those of other patients who failed to achieve staged hepatectomy. However, no significant difference was observed in the overall survival of patients who underwent staged hepatectomy between the two groups, but those in the ALPPS group had 100% survival at the end of this study. The individualized selection criteria based on tumor burden in the FRL that could balance the operative risk and oncologic outcome appear to be a promising strategy for achieving complete staged hepatectomy in patients with advanced CRLM.
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Affiliation(s)
- Kun-Ming Chan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 3366); Fax: +886-3-3285818
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Cheng CH, Lai Y, Hung HC, Lee JC, Wang YC, Wu TH, Lee CF, Wu TJ, Chou HS, Chan KM, Lee WC. Recurrence Patterns After Hepatectomy With Very Narrow Resection Margins for Hepatocellular Carcinoma. Front Surg 2022; 9:926728. [PMID: 35910466 PMCID: PMC9330627 DOI: 10.3389/fsurg.2022.926728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background The extent of hepatic resection In HCC depends on the remnant liver reserve or the proximity of the tumor to major vessels. In this study, we evaluated the effects of very close resection margins on postoperative recurrence. Methods Consecutive LR for HCC between 2003 and 2009 were studied. Patients were divided into groups with very narrow (≤1 mm) or wider (>1 mm) resection margins. Propensity score matching (PSM) was used to balance demographic, surgical, and pathological factors. Results 983 patients were included in the study. After PSM, 173 patients were analyzed in each group. 5-year tumor recurrence and survival rates were comparable. Most recurrences were multiple intrahepatic. Section margin recurrences were similar in both groups. By multivariate analysis, tumor size >5 cm was associated with a very narrow resection margin, whereas low platelet count and tumor macrovascular invasion were significant factors related to tumor recurrence. Conclusions Patients with very narrow surgical margins showed outcomes comparable to those with wider surgical margins. Most recurrences were multiple intrahepatic and associated with the degree of portal hypertension and adverse tumor biology. Although wide surgical margins should be aimed whenever possible, a narrow tumor-free margin resection still represents an effective therapeutic strategy.
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Affiliation(s)
- Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yin Lai
- Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
- Correspondence: Wei-Chen Lee
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Wang CH, Chao K, Chen PT, Yeh KY, Chen YC, Chen YL, Yang SW, Wu TH, Chang PH, Young CK, Tsan DL, Tsai MH, Hsieh CY, Chen WC, Tsai YH, Hsu CM, Chang JWC, Yu WC, Shen BN. PEP503 (NBTXR3), a radioenhancer, in combination with concurrent chemoradiation (CCRT) in locally advanced or recurrent head and neck squamous cell carcinoma (HNSCC): Dose-finding of a phase 1b/2 trial. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e18041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e18041 Background: PEP503 (aka NBTXR3), a novel radioenhancer composed of functionalized hafnium oxide nanoparticles, is designed for intratumoral injection to increase radiation energy deposition within solid tumors and subsequent tumor cell killing, without increasing toxicity to surrounding healthy tissue. PEP503 nanoparticles plus RT has been tested in elderly HNSCC patients and has demonstrated a good safety profile. The phase 1b part of the study aimed to test the feasibility and the recommended phase 2 dose (RP2D) of PEP503 intratumoral injection when added with low-dose (LD) weekly cisplatin-containing chemoradiation (CCRT) in HNSCC. Methods: Patients who had T3-4 locally advanced HNSCC suitable for CCRT were eligible. An intratumoral single injection of PEP503 was performed 24 to 72 hours before the start of CCRT: consisting of IMRT (70̃72 Gy, 2-2.12 Gy/fraction) and weekly cisplatin (low dose, 40 mg/m2) concurrently during IMRT. Traditional 3+3 design was planned for dose escalation and 5 levels of PEP503 were planned, including 5%, 10%, 15%, 22%, and 33% of the baseline GTV by MRI. PEP503 Intra-tumor dispersion was anayzed by CT-scan. Results: Twelve (12) patients (male/female: 11/1; oral cavity/oropharynx: 11/1) were enrolled, with 3, 6, and 3 patients at 5%, 10%, and 15% PEP503 dose levels, respectively, in combination with LD cisplatin CCRT. DLTs were observed in one patient at 10% dose level which were G3 ALT and G3 AST increased. Common G3 AEs observed across dose levels were stomatitis (50.0%), WBC decreased (33.3%), decreased appetite (16.7%), neutrophil count decreased (16.7%), and leukopenia (16.7%), and only one G4 AE (hyponatraemia) was observed. CT images demonstrated PEP503 within the tumor contour after injection throughout the CCRT period. Hafnium, for all patients, was either not detected or below the Lower Limit of Quantification (LLOQ) in the circulation 60 minutes after PEP503 intratumoral injection, and not found in urine. DCR was achieved in 100% of patients with responding patients for an ORR of 58.3%. No subjects received salvage surgery after study treatment. Study was terminated early before MTD and RP2D could be determined. Conclusions: Adding PEP503, a radioenhancer, via a single intratumoral injection to weekly cisplatin-containing CCRT was feasible and safe for patients with locally advanced or recurrent LA-HNSCC. RP2D was not reached due to study early termination. Clinical trial information: NCT02901483.
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Affiliation(s)
- Cheng-Hsu Wang
- Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Keelung, Taiwan
| | | | | | - Kun-Yun Yeh
- Chang Gung Memorial Hospital, Keelung, Taiwan
| | | | | | - Shih-Wei Yang
- Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Tsung-Han Wu
- Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan
| | - Pei-Hung Chang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, College of Medicine, Keelung, Taiwan
| | | | - Din-Li Tsan
- Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ming-Hsui Tsai
- Cancer Center, China Medical University Hospital, Taichung, Taiwan
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Huang CW, Wu TH, Hsu HY, Pan KT, Lee CW, Chong SW, Huang SF, Lin SE, Yu MC, Chen SM. Reappraisal of the Role of Alkaline Phosphatase in Hepatocellular Carcinoma. J Pers Med 2022; 12:jpm12040518. [PMID: 35455635 PMCID: PMC9030712 DOI: 10.3390/jpm12040518] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Alkaline phosphatase (ALP) is a marker of liver function and is associated with biliary tract disease. It was reported as a prognostic factor for hepatocellular carcinoma (HCC). The genetic expression in tumor-tissue microarrays and the perioperative serologic changes in ALP have never been studied for their correlation with HCC prognosis. Methods: The genetic expression of ALP isoforms (placental (ALPP), intestinal (ALPI) and bone/kidney/liver (ALPL)) was analyzed in tumor and non-cancerous areas in 38 patients with HCC after partial hepatectomy. The perioperative change in ALP was further analyzed in a cohort containing 525 patients with HCC to correlate it with oncologic outcomes. A total of 43 HCC patients were enrolled for a volumetry study after major and minor hepatectomy. Results: The genetic expression of the bone/kidney/liver isoform was specifically and significantly higher in non-cancerous areas than in tumors. Patients with HCC with a higher ALP (>81 U/dL) had significantly more major hepatectomies, vascular invasion, and recurrence. Cox regression analysis showed that gender, major hepatectomies, the presence of satellite lesions, higher grades (III or IV) and perioperative changes in liver function tests were independent prognostic factors for recurrence-free survival, and a postoperative increase in the ALP ratio at postoperative day (POD) 7 vs. POD 0 > 1.46 should be emphasized. A liver regeneration rate more than 1.8 and correlation analysis revealed that the ALP level at POD 7 and 30 was significantly higher and correlated with remnant liver growth. Conclusions: This study demonstrated that the perioperative ALP change was an independent prognostic factor for HCC after partial hepatectomies, and the elevation of ALP represented a functional biomarker for the liver but not an HCC biomarker. The higher regeneration capacity was possibly associated with the elevation of ALP after operation.
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Affiliation(s)
- Chun-Wei Huang
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
| | - Tsung-Han Wu
- Department of Surgery, Chang Gung Memorial Hospital, Linkou and Chang-Gung University, Taoyuan 33305, Taiwan; (T.-H.W.); (C.-W.L.)
| | - Heng-Yuan Hsu
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
| | - Kuang-Tse Pan
- Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, Taoyuan 33305, Taiwan;
| | - Chao-Wei Lee
- Department of Surgery, Chang Gung Memorial Hospital, Linkou and Chang-Gung University, Taoyuan 33305, Taiwan; (T.-H.W.); (C.-W.L.)
| | - Sio-Wai Chong
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
| | - Song-Fong Huang
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
| | - Sey-En Lin
- Department of Pathology, New Taipei Municipal Tucheng Hospital, New Taipei 23652, Taiwan;
| | - Ming-Chin Yu
- Division of General Surgery, Department of Surgery, New Taipei Municipal Tucheng Hospital (by Chang Gung Medical Foundation, and Chang Gung University and Shen-Ming Chen), New Taipei 23652, Taiwan; (C.-W.H.); (H.-Y.H.); (S.-W.C.); (S.-F.H.)
- Correspondence: (M.-C.Y.); (S.-M.C.)
| | - Shen-Ming Chen
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei 106, Taiwan
- Correspondence: (M.-C.Y.); (S.-M.C.)
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Lee CS, Wang YC, Wu TH, Lee WC. Impact of waiting time for liver transplantation on acute hepatitis B flare-up in non-cirrhotic patients. Asian J Surg 2022; 45:1041-1042. [PMID: 35183416 DOI: 10.1016/j.asjsur.2022.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 01/20/2022] [Indexed: 11/02/2022] Open
Affiliation(s)
- Ching-Song Lee
- Department of Hepatology, Chang-Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan
| | - Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan; Chang-Gung University College of Medicine, Taoyuan, Taiwan.
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Lim AH, Chan JY, Yu MC, Wu TH, Hong JH, Ng CCY, Low ZJ, Liu W, Vikneswari R, Sung PC, Fan WL, Teh BT, Hsieh SY. Rare Occurrence of Aristolochic Acid Mutational Signatures in Oro-Gastrointestinal Tract Cancers. Cancers (Basel) 2022; 14:cancers14030576. [PMID: 35158844 PMCID: PMC8833562 DOI: 10.3390/cancers14030576] [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: 12/06/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Aristolochic acids (AAs) are potent mutagens commonly found in herbal plant-based remedies widely used throughout Asian countries. PATIENTS AND METHODS To understand whether AA is involved in the tumorigenesis of the oro-gastrointestinal tract, we used whole-exome sequencing to profile 54 cases of four distinct types of oro-gastrointestinal tract cancer (OGITC) from Taiwan. RESULTS A diverse landscape of mutational signatures including those from DNA mismatch repair and reactive oxygen species was observed. APOBEC mutational signatures were observed in 60% of oral squamous cell carcinomas. Only one sample harbored AA mutational signatures, contradictory to prior reports of cancers from Taiwan. The metabolism of AA in the liver and urinary tract, transient exposure time, and high cell turnover rates at OGITC sites may explain our findings. CONCLUSION AA signatures in OGITCs are rare and unlikely to be a major contributing factor in oro-gastrointestinal tract tumorigenesis.
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Affiliation(s)
- Abner Herbert Lim
- Cheng Kin Ku Herbal Biodiversity & Medicine Program, SingHealth Duke-NUS Institute of Biodiversity Medicine, Singapore 169610, Singapore; (A.H.L.); (J.H.H.); (C.C.Y.N.); (Z.J.L.); (W.L.)
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.C.); (R.V.)
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Jason Yongsheng Chan
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.C.); (R.V.)
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Ming-Chin Yu
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan; (M.-C.Y.); (T.-H.W.)
- Department of Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City 236, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Tsung-Han Wu
- Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan; (M.-C.Y.); (T.-H.W.)
| | - Jing Han Hong
- Cheng Kin Ku Herbal Biodiversity & Medicine Program, SingHealth Duke-NUS Institute of Biodiversity Medicine, Singapore 169610, Singapore; (A.H.L.); (J.H.H.); (C.C.Y.N.); (Z.J.L.); (W.L.)
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Cedric Chuan Young Ng
- Cheng Kin Ku Herbal Biodiversity & Medicine Program, SingHealth Duke-NUS Institute of Biodiversity Medicine, Singapore 169610, Singapore; (A.H.L.); (J.H.H.); (C.C.Y.N.); (Z.J.L.); (W.L.)
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.C.); (R.V.)
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Zhen Jie Low
- Cheng Kin Ku Herbal Biodiversity & Medicine Program, SingHealth Duke-NUS Institute of Biodiversity Medicine, Singapore 169610, Singapore; (A.H.L.); (J.H.H.); (C.C.Y.N.); (Z.J.L.); (W.L.)
| | - Wei Liu
- Cheng Kin Ku Herbal Biodiversity & Medicine Program, SingHealth Duke-NUS Institute of Biodiversity Medicine, Singapore 169610, Singapore; (A.H.L.); (J.H.H.); (C.C.Y.N.); (Z.J.L.); (W.L.)
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.C.); (R.V.)
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Rajasegaran Vikneswari
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.C.); (R.V.)
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore 169610, Singapore
| | - Pin-Cheng Sung
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
| | - Wen-Lang Fan
- Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
| | - Bin Tean Teh
- Cheng Kin Ku Herbal Biodiversity & Medicine Program, SingHealth Duke-NUS Institute of Biodiversity Medicine, Singapore 169610, Singapore; (A.H.L.); (J.H.H.); (C.C.Y.N.); (Z.J.L.); (W.L.)
- Cancer Discovery Hub, National Cancer Centre Singapore, Singapore 169610, Singapore; (J.Y.C.); (R.V.)
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore 169610, Singapore
- Oncology Academic Clinical Program, Duke-NUS Medical School, Singapore 169857, Singapore
- Correspondence: (B.T.T.); or (S.-Y.H.); Tel.: +65-6436-8000 (B.T.T.); +886-975368031 (S.-Y.H.)
| | - Sen-Yung Hsieh
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan;
- Correspondence: (B.T.T.); or (S.-Y.H.); Tel.: +65-6436-8000 (B.T.T.); +886-975368031 (S.-Y.H.)
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Wu TH, Wang YC, Hung HC, Lee JC, Wu CY, Cheng CH, Lee CF, Wu TJ, Chou HS, Chan KM, Lee WC. Preferred Treatment with Curative Intent for Left Lateral Segment Early Hepatocellular Carcinoma under the Era of Minimal Invasive Surgery. J Pers Med 2022; 12:jpm12010079. [PMID: 35055394 PMCID: PMC8779404 DOI: 10.3390/jpm12010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/25/2021] [Accepted: 01/04/2022] [Indexed: 12/07/2022] Open
Abstract
Background: Hepatocellular carcinoma (HCC) occurring at the left lateral segment (LLS) is relatively susceptible to treatment with curative intent in terms of tumor location. However, outcomes might vary depending on the selection of treatment modalities. This study aimed to analyze patients who had undergone curative treatment for early HCC at LLS. Methods: A retrospective analysis of 179 patients who underwent curative treatment for early HCC at LLS was performed. Patients were grouped based on treatment modalities, including radiofrequency ablation (RFA) and liver resection (LR). The long-term outcomes of the two groups were compared. Additionally, the impact of the LR approach on patient outcomes was analyzed. Results: Among these patients, 60 received RFA and 119 underwent LR as primary treatment with curative intent. During follow-up, a significantly higher incidence of HCC recurrence was observed in the RFA group (37/60, 61.7%) than in the LR group (45/119, 37.8%) (p = 0.0025). The median time of HCC recurrence was 10.8 (range: 1.1–60.9 months) and 17.6 (range: 2.4–94.8 months) months in the RFA and LR groups, respectively. In addition, multivariate analysis showed that liver cirrhosis, multiple tumors, and RFA treatment were significant risk factors for HCC recurrence. The 1-, 2-, and 5-year overall survival rates in the RFA and LR groups were 96.4%, 92.2%, and 71.5% versus 97.3%, 93.6%, and 87.7%, respectively. (p = 0.047). Moreover, outcomes related to LR were comparable between laparoscopic and conventional open methods. The 1-, 2-, and 5-year recurrence free survival rates in the laparoscopic (n = 37) and conventional open (n = 82) LR groups were 94.1%, 82.0%, and 66.9% versus 86.1%, 74.6%, and 53.1%, respectively. (p = 0.506) Conclusion: Early HCC at LLS had satisfactory outcomes after curative treatment, in which LR seems to have a superior outcome, as compared to RFA treatment. Moreover, laparoscopic LR could be considered a preferential option in the era of minimally invasive surgery.
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Affiliation(s)
- Tsung-Han Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
| | - Yu-Chao Wang
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
| | - Hao-Chien Hung
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
| | - Jin-Chiao Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
| | - Chia-Ying Wu
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan;
| | - Chih-Hsien Cheng
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
| | - Chen-Fang Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
| | - Ting-Jung Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
| | - Hong-Shiue Chou
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
| | - Kun-Ming Chan
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
- Correspondence: ; Tel.: +886-3-3281200 (ext. 3366); Fax: +886-3-3285818
| | - Wei-Chen Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33302, Taiwan; (T.-H.W.); (Y.-C.W.); (H.-C.H.); (J.-C.L.); (C.-H.C.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (W.-C.L.)
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Hsu PJ, Hung HC, Lee CS, Pan KT, Lee JC, Wang YC, Cheng CH, Wu TH, Lee CF, Chou HS, Chan KM, Lee WC, Wu TJ. Reconstruction of Separated Intrahepatic Ducts Using the Cystic and Common Hepatic Ducts in Right-Lobe Living-Donor Liver Transplantation: Experiences of Surgical Techniques, Biliary Complications, and Outcomes in a Single Institution. Ann Transplant 2021; 27:e934459. [PMID: 34983920 PMCID: PMC8744362 DOI: 10.12659/aot.934459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Duct-to-duct biliary reconstruction has been increasingly used in living-donor liver transplantation. Information regarding dual duct-to-duct biliary anastomoses is limited. We present the largest case series to date on the use of the cystic and common hepatic ducts as dual-ductal anastomosis, along with long-term follow-up results. Material/Methods In this study, 740 patients underwent right-lobe living-donor liver transplantation; 56 of them were documented as dual-ductal anastomoses. We analyzed recipient and donor characteristics, surgical procedures, appearance of biliary complications, corresponding interventions, and long-term biliary outcomes. Results Cystic and common hepatic ducts were utilized in 56 cases of dual-ductal biliary reconstruction, which we categorized into 2 types: A (78.6%), in which the right anterior intrahepatic duct was anastomosed to the common hepatic duct and the right posterior intrahepatic duct to the cystic duct; and B (21.4%), which was the reverse of A. After a median follow-up period of 46.4 months, 23 patients (41.1%) experienced complications, including biliary leakage and biliary stricture. However, after aggressive intervention (patent biliary anastomosis in most of them), 50 of 56 patients (89.3%) had patent biliary anastomosis and restored normal liver function at the end of follow-up. A small graft (graft-to-recipient weight ratio <0.9%) was the only predictor of biliary complications after multivariate analysis. Conclusions Dual-ductal biliary reconstruction in adult right-lobe living-donor liver transplantation is challenging but feasible. Our findings support the use of the cystic duct for reconstruction in selected patients. Good long-term results can be achieved with adequate management of patients with biliary complications.
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Affiliation(s)
- Po-Jung Hsu
- Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Ching-Sung Lee
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Kuang-Tse Pan
- Department of Radiology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Department of Gastroenterology, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University, College of Medicine, Taoyuan, Taiwan
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Lee WC, Cheng CH, Lee CF, Hung HC, Lee JC, Wu TH, Wang YC, Wu TJ, Chou HS, Chan KM. Quick preparation of ABO-incompatible living donor liver transplantation for acute liver failure. Clin Transplant 2021; 36:e14555. [PMID: 34874071 DOI: 10.1111/ctr.14555] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 11/09/2021] [Accepted: 11/25/2021] [Indexed: 11/29/2022]
Abstract
Acute liver failure is life-threatening and has to be treated by liver transplantation urgently. When deceased donors or ABO-compatible living donors are not available, ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) becomes the only choice. How to prepare ABO-I LDLT urgently is an unsolved issue. A quick preparation regimen was designed, which was consisted of bortezomib (3.5mg) injection to deplete plasma cells and plasma exchange to achieve isoagglutinin titer ≤ 1: 64 just prior to liver transplantation and followed by rituximab (375mg/m2 ) on post-operative day one to deplete B-cells. Eight patients received this quick preparation regimen to undergo ABO-I LDLT for acute liver failure from 2012 to 2019. They aged between 50 and 60 years. The median MELD score was 39 with a range from 35 to 48. It took 4.75 ± 1.58 days to prepare such an urgent ABO-I LDLT. All the patients had successful liver transplantations, but one patient died of antibody-mediated rejection at post-operative month 6. The 3-month, 6-month, and 1-year graft/patient survival were 100%, 87.5%, and 75%, respectively. In conclusion, this quick preparation regimen can reduce isoagglutinin titers quickly and make timely ABO-I LDLT feasible for acute liver failure. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Chang-Gung University College of Medicine, Taoyuan, Taiwan
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Wang YC, Lee JC, Wu TH, Cheng CH, Lee CF, Wu TJ, Chou HS, Chan KM, Lee WC. Improving outcomes of liver resection for hepatocellular carcinoma associated with portal vein tumor thrombosis over the evolving eras of treatment. World J Surg Oncol 2021; 19:313. [PMID: 34702312 PMCID: PMC8546954 DOI: 10.1186/s12957-021-02425-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/11/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The outcomes and management of hepatocellular carcinoma (HCC) have undergone several evolutionary changes. This study aimed to analyze the outcomes of patients who had undergone liver resection for HCC with portal vein tumor thrombosis (PVTT) in terms of the evolving era of treatment. MATERIALS AND METHODS A retrospective analysis of 157 patients who had undergone liver resection for HCC associated with PVTT was performed. The outcomes and prognostic factors related to different eras were further examined. RESULTS Overall, 129 (82.1%) patients encountered HCC recurrence after liver resection, and the median time of recurrence was 4.1 months. Maximum tumor size ≥ 5 cm and PVTT in the main portal trunk were identified as the major prognostic factors influencing HCC recurrence after liver resection. Although the recurrence-free survival had no statistical difference between the two eras, the overall survival of patients in the second era was significantly better than that of the patients in the first era (p = 0.004). The 1-, 2-, and 3-year overall survival rates of patients in the second era were 60.0%, 45.7%, and 35.8%, respectively, with a median survival time of 19.6 months. CONCLUSION The outcomes of HCC associated with PVTT remain unsatisfactory because of a high incidence of tumor recurrence even after curative resection. Although the management and outcomes of patients with HCC and PVTT have greatly improved over the years, surgical resection remains an option to achieve a potential cure of HCC in well-selected patients.
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Affiliation(s)
- Yu-Chao Wang
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
| | - Wei-Chen Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
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28
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Chan KM, Hung HC, Lee JC, Wu TH, Wang YC, Cheng CH, Lee CF, Wu TJ, Chou HS, Lee WC. A review of split liver transplantation with full right/left hemi-liver grafts for 2 adult recipients. Medicine (Baltimore) 2021; 100:e27369. [PMID: 34596151 PMCID: PMC8483827 DOI: 10.1097/md.0000000000027369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/09/2021] [Indexed: 01/05/2023] Open
Abstract
Liver transplantation has become a routine operation in many transplantation centers worldwide. However, liver graft availability fails to meet patient demands. Split liver transplantation (SPLT), which divides a deceased donor liver into 2 partial liver grafts, is a promising strategy for increasing graft availability for transplantation and ameliorating organ shortage to a certain degree. However, the transplantation community has not yet reached a consensus on SPLT because of the variable results. Specifically, SPLT for 2 adult recipients using full right/left hemi-liver grafts is clinically more challenging in terms of surgical technique and potential postoperative complications. Therefore, this review summarizes the current status of SPLT, focusing on the transplantation of adult recipients. Furthermore, the initiation of the SPLT program, donor allocation, surgical aspects, recipient outcomes, and obstacles to developing this procedure will be thoroughly discussed. This information might help provide an optimal strategy for implementing SPLT for 2 adult recipients among current transplantation societies. Meanwhile, potential obstacles to SPLT might be overcome in the near future with growing knowledge, experience, and refinement of surgical techniques. Ultimately, the widespread diffusion of SPLT may increase graft availability and mitigate organ donation shortages.
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29
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Wang H, Hsia S, Wu TH, Wu CJ. Fish Oil, Se Yeast, and Micronutrient-Enriched Nutrition as Adjuvant Treatment during Target Therapy in a Murine Model of Lung Cancer. Mar Drugs 2021; 19:262. [PMID: 34064322 PMCID: PMC8147838 DOI: 10.3390/md19050262] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/29/2021] [Accepted: 05/01/2021] [Indexed: 12/30/2022] Open
Abstract
Despite the effectiveness of primary treatment modalities for cancer, the side effects of treatments, medication resistance, and the deterioration of cachexia after disease progression lead to poor prognosis. A supportive treatment modality to overcome these limitations would be considered a major breakthrough. Here, we used two different target drugs to demonstrate whether a nutraceutical formula (fish oil, Se yeast, and micronutrient-enriched nutrition; NuF) can interfere with cancer cachexia and improve drug efficacy. After Lewis lung cancer (LLC) tumor injection, the C57BL/6 mice were orally administered targeted therapy drugs Iressa and Sutent alone or combined with NuF for 27 days. Sutent administration effectively inhibited tumor size but increased the number of lung metastases in the long term. Sutent combined with NuF had no significant difference in tumor weight and metastasis compare with Sutent alone. However, NuF slightly attenuated metastases number in lung may via mesenchymal marker N-cadherin suppression. NuF otherwise increased epithelial-like marker E-cadherin expression and induce NO-mediated intrinsic apoptotic pathway in tumor cells, thereby strengthening the ability of the targeted therapy drug Iressa for inhibiting tumor progression. Our results demonstrate that NuF can promote the anticancer effect of lung cancer to targeted therapy, especially in Iressa, by inhibiting HIF-1α and epithelial-mesenchymal transition (EMT) and inducing the apoptosis of lung cancer cells. Furthermore, NuF attenuates cancer-related cachectic symptoms by inhibiting systemic oxidative stress.
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MESH Headings
- Administration, Oral
- Animals
- Apoptosis/drug effects
- Cachexia/drug therapy
- Cachexia/etiology
- Carcinoma, Lewis Lung/complications
- Carcinoma, Lewis Lung/diet therapy
- Carcinoma, Lewis Lung/drug therapy
- Cell Line, Tumor
- Chemotherapy, Adjuvant/methods
- Disease Models, Animal
- Epithelial-Mesenchymal Transition/drug effects
- Fish Oils/administration & dosage
- Fish Oils/pharmacology
- Gefitinib/administration & dosage
- Gefitinib/pharmacology
- Inflammation/drug therapy
- Male
- Mice, Inbred C57BL
- Micronutrients/administration & dosage
- Micronutrients/pharmacology
- Neoplasm Metastasis/prevention & control
- Oxidation-Reduction/drug effects
- Protein Kinase Inhibitors/administration & dosage
- Protein Kinase Inhibitors/pharmacology
- Selenium/administration & dosage
- Selenium/pharmacology
- Sunitinib/administration & dosage
- Sunitinib/pharmacology
- Tumor Burden/drug effects
- Yeast, Dried/administration & dosage
- Yeast, Dried/pharmacology
- Mice
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Affiliation(s)
- Hang Wang
- Department of Nutrition, Institute of Biomedical Nutrition, Hung-Kuang University, Taichung 433, Taiwan
| | - Simon Hsia
- Taiwan Nutraceutical Association, Taipei 104, Taiwan;
| | - Tsung-Han Wu
- Division of Hemato-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
- Department of Food Science, Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung 202, Taiwan
| | - Chang-Jer Wu
- Department of Food Science, Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung 202, Taiwan
- Department of Health and Nutrition Biotechnology, Asia University, Taichung 413, Taiwan
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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30
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Wang HY, Li SW, Wu TH, Wu ZH, Guo JX. The effect of androgen on wool follicles and keratin production in Hetian sheep. BRAZ J BIOL 2021; 81:526-536. [PMID: 33470295 DOI: 10.1590/1519-6984.224056] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 03/18/2020] [Indexed: 12/14/2022] Open
Abstract
To investigate the optimal androgen concentration for culturing Hetian sheep wool follicle and to detect effects of androgen concentration on wool follicle cell proliferation and apoptosis using immunofluorescence labeling and real-time quantitative fluorescence determinations of wool keratin-associated protein gene expression levels. Wool follicles were isolated by microdissection and wool follicles and skin pieces were cultured in various concentrations of dihydrotestosterone (DHT) in culture medium. Next, daily lengthwise growth measurements of wool follicles were obtained using a microscopic micrometer. Cultured Hetian wool follicles were stained using the SACPIC method to reveal wool follicle structure, while sheep skin slices were used to observe cell proliferation by immunostaining and cell apoptosis using the TUNEL method. At the molecular biological level, keratin-associated protein (Kap) gene expression was studied using wool follicles cultured for various numbers of days in vitro. Effects of androgen concentrations on Hetian wool follicle growth and development were experimentally studied. EdU proliferation assays revealed that androgen promoted cell proliferation within wool follicle dermal papillae. TUNEL apoptosis detection demonstrated that androgen treatment could delay cell apoptosis. Quantitative reverse transcription polymerase chain reaction (qPCR) results demonstrated that gene expression level patterns of Hetian mountain sheep super-high sulfur protein. Kap1.1, KIF1.2, Kap2.12 and Kap4.2 gene expression level of the mountainous experimental group was significantly higher than plains Hetian sheep. An androgen concentration of 100 nM can promote the growth of Hetian wool follicle cells in vitro, resulting in overexpression of some genes of the Kap family.
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Affiliation(s)
- H Y Wang
- Tarim University, College of Life Sciences, Key Laboratory of Protection e Utilization of Biological Resources in Tarim Basin, Alar, Xinjiang, China
| | - S W Li
- Tarim University, College of Life Sciences, Key Laboratory of Protection e Utilization of Biological Resources in Tarim Basin, Alar, Xinjiang, China
| | - T H Wu
- Tarim University, College of Life Sciences, Key Laboratory of Protection & Utilization of Biological Resources in Tarim Basin, Alar, Xinjiang, China
| | - Z H Wu
- Tarim University, College of Life Sciences, Key Laboratory of Protection & Utilization of Biological Resources in Tarim Basin, Alar, Xinjiang, China
| | - J X Guo
- Tarim University, College of Life Sciences, Key Laboratory of Protection & Utilization of Biological Resources in Tarim Basin, Alar, Xinjiang, China
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31
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Lin MH, Chang SC, Chiu YC, Jiang BC, Wu TH, Hsu CH. Structural, Biophysical, and Biochemical Elucidation of the SARS-CoV-2 Nonstructural Protein 3 Macro Domain. ACS Infect Dis 2020; 6:2970-2978. [PMID: 32946224 PMCID: PMC7537548 DOI: 10.1021/acsinfecdis.0c00441] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 06/20/2020] [Indexed: 12/16/2022]
Abstract
The pandemic outbreak of a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has threatened the global public health and economy since late December 2019. SARS-CoV-2 encodes the conserved macro domain within nonstructural protein 3, which may reverse cellular ADP-ribosylation and potentially cut the signal of a viral infection in the cell. Herein, we report that the SARS-CoV-2 macro domain was examined as a poly-ADP-ribose (ADPR) binding module and possessed mono-ADPR cleavage enzyme activity. After confirming the ADPR binding ability via a biophysical approach, the X-ray crystal structure of the SARS-CoV-2 macro domain was determined and structurally compared with those of other viruses. This study provides structural, biophysical, and biochemical bases to further evaluate the role of the SARS-CoV-2 macro domain in the host response via ADP-ribose binding but also as a potential target for drug design against COVID-19.
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Affiliation(s)
- Meng-Hsuan Lin
- Genome and Systems Biology Degree
Program, National Taiwan University and Academia
Sinica, Taipei 10617,
Taiwan
| | - San-Chi Chang
- Department of Agricultural Chemistry,
National Taiwan University, Taipei
10617, Taiwan
| | - Yi-Chih Chiu
- Genome and Systems Biology Degree
Program, National Taiwan University and Academia
Sinica, Taipei 10617,
Taiwan
| | - Bo-Chen Jiang
- Department of Agricultural Chemistry,
National Taiwan University, Taipei
10617, Taiwan
| | - Tsung-Han Wu
- Genome and Systems Biology Degree
Program, National Taiwan University and Academia
Sinica, Taipei 10617,
Taiwan
| | - Chun-Hua Hsu
- Genome and Systems Biology Degree
Program, National Taiwan University and Academia
Sinica, Taipei 10617,
Taiwan
- Department of Agricultural Chemistry,
National Taiwan University, Taipei
10617, Taiwan
- Institute of Biochemical Sciences,
National Taiwan University, Taipei
10617, Taiwan
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32
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Hung HC, Hsu PJ, Lee JC, Wang YC, Cheng CH, Wu TH, Wu TJ, Chou HS, Chan KM, Lee WC, Lee CF. Plasma cytomegalovirus DNA load predicts outcomes in liver transplant recipients. Immun Inflamm Dis 2020; 9:134-143. [PMID: 33145985 PMCID: PMC7860522 DOI: 10.1002/iid3.371] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022]
Abstract
Objective Cytomegalovirus (CMV) infection has a significant negative impact on liver transplant (LT) recipients. We aimed to evaluate the efficacy of real‐time DNA quantitative polymerase chain reaction (qPCR) in the early detection of CMV and predicting post‐transplant outcomes. Materials and Methods This was a retrospective study that enrolled a total of 49 adult LT recipients between December 2016 and October 2019. Serial CMV qPCR were tested weekly. We used operating characteristic curve analysis to quantify qPCR replication numbers to decide the optimal threshold to predict posttransplant complications and overall survival. Results The optimal cut‐off value of 180 copies/ml (=164 IU/ml) was determined. We had 40 patients in the low qPCR group (<180 copies/ml) and nine patients in the high qPCR group (≥180 copies/ml). Higher qPCR was associated with more severe CMV disease, early allograft dysfunction, major posttransplant complications, longer ICU stays, and lower 2‐year overall survival (OS; all p < .05). In the univariate logistic regression model, persistent DNAemia ≥ 4 weeks after anti‐CMV treatment, coexisted bacterial and/or fungal infection, and high CMV qPCR ≥ 180 copies/ml with p < .100. High CMV qPCR ≥ 180 copies/ml (p = .016; hazard ratio [HR] = 19.5; 95% confidence interval [CI] = 1.73–219.49) remained to be the only independent risk factors for major complication by the multivariate analysis. The overall 2‐year OS rates were 92.5% and 66.7% in the low and the high qPCR group, respectively (p = .030). Conclusion Our findings support evidence that qPCR is effective in detecting CMV infection provides an objective perspective in predicting posttransplant outcomes. High plasma CMV DNA load (defined as CMV qPCR ≥ 180 copies/ml or 164 IU/ml) not only indicates a hazard in developing major posttransplant complications but also associates with prolonged and refractory treatment courses.
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Affiliation(s)
- Hao-Chien Hung
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
| | - Po-Jung Hsu
- Department of General Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan
| | - Jin-Chiao Lee
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
| | - Yu-Chao Wang
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
| | - Chih-Hsien Cheng
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
| | - Tsung-Han Wu
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
| | - Ting-Jung Wu
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
| | - Hong-Shiue Chou
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
| | - Kun-Ming Chan
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
| | - Wei-Chen Lee
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
| | - Chen-Fang Lee
- Department of Liver and Transplantation Surgery, Chang-Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,Chang-Gung University College of Medicine, Taoyuan City, Taiwan
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Lee WC, Hung HC, Lee JC, Wang YC, Cheng CH, Wu TH, Lee CF, Wu TJ, Chou HS, Chan KM. Treatment strategy of adding transcatheter arterial chemoembolization to sorafenib for advanced stage hepatocellular carcinoma. Cancer Rep (Hoboken) 2020; 4:e1294. [PMID: 33048465 PMCID: PMC7941557 DOI: 10.1002/cnr2.1294] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/11/2020] [Accepted: 09/07/2020] [Indexed: 12/21/2022] Open
Abstract
Background Therapeutic effect and immunosuppressor cell alteration in adding transcatheter arterial chemoembolization (TACE) to sorafenib for advanced stage hepatocellular carcinoma (HCC) remain unclear. Aims To examine the therapeutic effect and immunosuppressor cell alteration in adding TACE to sorafenib. Methods Forty‐four advanced stage HCC patients were divided into group A (n = 17) treated by sorafenib (400‐600 mg/day) alone and group B patients (n = 27) treated by sorafenib and TACE. The frequency of regulatory T‐cells and myeloid‐derived suppressor cells (MDSC), and patients' outcomes were examined. Advanced HCC patients' survival was improved by adding TACE to sorafenib if N/L was reduced from ≥2.5 to <2.5 by TACE. Results The median (interquartile) follow‐up for all patients was 8.5 (3.5 to 15.5) with a range from 1 to 71 months. The median (interquartile) survival was 5.0 (2.3‐11.3) months for group A and 11.0 (5.0‐19.0) months for group B patients (P = .024). In group A, the patients (n = 8) with neutrophil‐to‐lymphocytes ratio (N/L) < 2.5 had better survival than the patients (n = 9) with N/L ≥ 2.5 (P = .006). In group B, 6 of 13 patients with N/L ≥ 2.5 had N/L reduction to <2.5 after combination therapy of sorafenib and TACE, and their 6‐month, 1‐year and 2‐year survival were improved (P = .013). For immune cell examination, the frequency of CD4+ and CD8+ T‐lymphocytes, regulatory T‐cell and MDSC were not altered by sorafenib treatment. However, actual number of lymphocytes had a tendency to increase (from 978.5 ± 319.4/mm3 prior to treatment to 1378.0 ± 403.3/mm3, P = .086) for the patients with N/L reduction. Conclusion Immunosuppressor cells were not altered by sorafeinb. Patients' survival was improved if N/L ≥ 2.5 was reduced to <2.5 by TACE.
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Affiliation(s)
- Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.,Department of Medicine, Chang-Gung University College of Medicine, Taoyuan, Taiwan
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Lai Y, Lee JC, Hung HC, Cheng CH, Wu TH, Lee CF, Wu TJ, Chou HS, Chan KM, Lee WC. Models to predict disease-free survival for hepatocellular carcinoma patients with surgical resections. J Surg Oncol 2020; 122:1444-1452. [PMID: 32875573 DOI: 10.1002/jso.26169] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 07/27/2020] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Precise prognostic prediction for an individual hepatocellular carcinoma (HCC) patient before and after liver resection is important. We aimed to establish simple prognostic models to predict disease-free survival (DFS) for these patients. METHODS Six hundred and ninety-eight HCC patients with liver resections were reviewed. Preoperative (model 1) and postoperative (model 2) nomogram-based scoring systems were constructed by multivariate analyses, and DFS was estimated. RESULTS Among 698 patients, 490 (70.2%) patients had tumor recurrence at a median follow-up of 84.4 months. Risk factors of tumor recurrence in model 1 included viral hepatitis, platelet count, albumin, indocyanine green retention rate, multiplicity of tumor, and radiologic total tumor volume (TTV). Prognostic variables identified in model 2 were viral hepatitis, platelet count, multiplicity of tumor, cirrhosis, microvascular invasion, and pathologic TTV. By nomogram in model 1, the patients were classified into three groups with 5-year DFS of 61.0%, 35.7%, and 21.1%, respectively (P < .0001). In model 2, the patients were divided into five groups with 5-year DFS of 58.0%, 43.7%, 24.0%, 15.4%, and 0.0%, respectively (P < .0001). CONCLUSION Based on nomogram models, DFS for the patients who had liver resection for HCC can be predicted before liver resection and re-assessed after liver resection.
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Affiliation(s)
- Yin Lai
- Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Jin-Chiao Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Hao-Chien Hung
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan, Taiwan
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Liu YM, Wu TH, Chiu YH, Wang H, Li TL, Hsia S, Chan YL, Wu CJ. Positive Effects of Preventive Nutrition Supplement on Anticancer Radiotherapy in Lung Cancer Bearing Mice. Cancers (Basel) 2020; 12:E2445. [PMID: 32872195 PMCID: PMC7565278 DOI: 10.3390/cancers12092445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/11/2022] Open
Abstract
(1) Background: Radiotherapy (RT) is one of the major treatments for non-small cell lung cancer, but RT-associated toxicities usually impede its anticancer effect. Nutrient supplementation has been applied for cancer prevention or a complementary measure to anticancer therapy. Here, we explored the influence of total nutrition supplementation before and after cancer occurrence on the anticancer benefit and side effects of RT. (2) Methods: C57BL/6JNarl mice were inoculated with Lewis lung carcinoma cells and then treated with radiotherapy. TNuF, a total nutrition formula, was prescribed by oral gavage. In the preventive groups, TNuF supplementation started from seven days before tumor inoculation. In the complementary groups, TNuF supplementation began after tumor inoculation. (3) Results: TNuF successfully enhanced the anticancer effect of RT against primary tumor and lung metastasis. Additionally, the complementary supplement improved the high serum TNF-α level and the wasting of sartorius muscle in mice receiving RT. In histologic and molecular analysis, TNuF was observed to modulate EGFR, apoptosis, and VEGF and PD-1/PD-L1 pathways. Furthermore, the anticancer benefit of the preventive supplement was comparable to that of the complementary administration. (4) Conclusions: Our results demonstrated that the prescription of the TNuF total nutrition formula before and after cancer diagnosis attains similar benefits in testing subjects with typical anticancer RT. TNuF is also a potential sensitizer to anti-PD-1 immune therapy.
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Affiliation(s)
- Yu-Ming Liu
- Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
| | - Tsung-Han Wu
- Department of Food Science and Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung 20224, Taiwan;
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 20401, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33320, Taiwan
| | - Yi-Han Chiu
- Department of Nursing, St. Mary’s Junior College, Yilan 26647, Taiwan;
- Institute of Long-term Care, Mackay Medical College, New Taipei City 25245, Taiwan
| | - Hang Wang
- Institute of Biomedical Nutrition, Hung-Kuang University, Taichung 43302, Taiwan;
| | - Tsung-Lin Li
- Genomics Research Center, Academia Sinica, Taipei 11529, Taiwan;
| | - Simon Hsia
- Taiwan Nutraceutical Association, Taipei 104, Taiwan;
| | - Yi-Lin Chan
- Department of Life Science, Chinese Culture University, Taipei 11114, Taiwan
| | - Chang-Jer Wu
- Department of Food Science and Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung 20224, Taiwan;
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
- Department of Health and Nutrition Biotechnology, Asia University, Taichung 41354, Taiwan
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Yu MC, Wu TH, Lee CW, Lee YS, Lian JH, Tsai CL, Hsieh SY, Tsai CN. Percentage genome change and chromosome 7q amplification predict sorafenib response in advanced hepatocellular carcinoma. Biomed J 2020; 44:S73-S83. [PMID: 35747997 PMCID: PMC9038951 DOI: 10.1016/j.bj.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 07/05/2020] [Accepted: 07/13/2020] [Indexed: 12/24/2022] Open
Abstract
Background Hepatocellular carcinoma (HCC) may arise from genomic instability and has dismal outcome. Sorafenib is the first-line treatment for advanced stage HCC, but its therapeutic efficacy is less than 50%. Biomarkers for predicting the therapeutic efficacy of sorafenib administration to patients with advanced HCC are required. Here, we evaluated the role of chromosomal copy number aberrations (CNAs) in patients with advanced HCC who were treated with sorafenib along with their drug response. Methods The response to sorafenib treatment of twenty-three HCC patients who developed advanced recurrence after partial hepatectomy was analyzed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Formalin fixed paraffin embedded (FFPE) tissue specimens obtained after tumor resection were analyzed using the Affymetrix OncoScan® FFPE assay. Results From the 23 patients analyzed in this study, 7 (30.4%) had complete/partial response to sorafenib (CR/PR), 7 (30.4%) had stable disease (SD), and 9 (39.1%) had progressive disease (PD). The mean genome-wide percentage of genome change acquisition via the OncoScan platform was 19.8% for patients with CR/PR/SD and 50.02% in the PD group (p = 0.055). Percentage of genome change above 33% was associated with adverse outcomes for sorafenib treatment in the time-to-progression analysis (p = 0.007) and overall survival (p = 0.096). Among these CNAs, amplification of chromosome 7q, containing the multidrug resistance gene ATP Binding Cassette Subfamily B Member 1 (ACBC1), significantly associated with poor overall survival (p = 0.004) and time-to-progression (p < 0.001). Conclusions Higher percentage genome change and amplification of chromosome 7q in advanced HCC is associated with sorafenib resistance.
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Cheng CH, Lee CF, Wang YC, Wu TH, Wu TJ, Chou HS, Chan KM, Lee WC. ABO-Incompatible Liver Transplantation: State of Art and Future Perspectives. Curr Pharm Des 2020; 26:3406-3417. [PMID: 32370710 DOI: 10.2174/1381612826666200506094539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/26/2020] [Indexed: 11/22/2022]
Abstract
ABO-incompatible (ABO-I) liver transplantation (LT) has been limited due to the increased rate of complications, including severe cellular and antibody-mediated rejection, hepatic necrosis, hepatic artery thrombosis, and biliary complications. However, several strategies for reducing preformed anti-donor ABO antibodies and B cell desensitization have improved the outcomes of ABO-I LT. As a result, ABO-I LT has become a routine procedure and is a feasible option in countries with a scarce deceased-organ donation or in cases without an available compatible organ donor. In this review, we describe past and present desensitizing protocols as well as emergent therapies for depleting B cell and anti-ABO antibodies with the objective of identifying approaches that could lead to new, refined strategies for maximizing the results of ABO-I LT.
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Affiliation(s)
- Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China
| | - Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang-Gung University College of Medicine, Taoyuan, Taiwan, China
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Hung HC, Lee JC, Cheng CH, Wang YC, Wu TH, Lee CF, Wu TJ, Chou HS, Chan KM, Lee WC. Protein S for Portal Vein Thrombosis in Cirrhotic Patients Waiting for Liver Transplantation. J Clin Med 2020; 9:jcm9041181. [PMID: 32326024 PMCID: PMC7230503 DOI: 10.3390/jcm9041181] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/12/2020] [Accepted: 04/16/2020] [Indexed: 12/17/2022] Open
Abstract
Portal vein thrombus (PVT) is a challenge in liver transplantation. How PVT develops in cirrhotic patients who already have coagulopathy is unclear. This study aimed to investigate possible contributing factors to PVT in cirrhotic patients. A total of 349 cirrhotic patients who waited liver transplantation were included in this study and 48 of them had PVT. For all the patients, the mean age was 53.5 ± 9.0 year old, and 75.9% of the patients were male. There were 233 (66.8%) patients who had either hepatitis B or C. The mean Model For End-Stage Liver Disease (MELD) score was 16.4 ± 7.5. Eighteen of 48 patients with PVT and 145 of 301 patients without PVT received liver transplantation. Multivariate analysis showed that low protein S level (hazard ratio = 2.46, p = 0.017) was the only independent risk factor for PVT development. Protein S deficiency also demonstrated prognostic value on short-term survival, not only for cirrhotic patients awaiting liver transplantation (69.9% versus 84.1% at 1 year survival, p = 0.012), but also for the patients having liver transplantation (70.4% versus 84.8% at 1 year survival, p = 0.047). In conclusion, protein S level was an independent risk factor for PVT development in decompensated cirrhotic patients, and protein S deficiency was also a prognostic factor for the patients waiting for liver transplantation.
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Affiliation(s)
- Hao-Chien Hung
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Jin-Chiao Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Chih-Hsien Cheng
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Yu-Chao Wang
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Tsung-Han Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Chen-Fang Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Ting-Jung Wu
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Hong-Shiue Chou
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Kun-Ming Chan
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, Chang-Gung University College of Medicine, Taoyuan 333, Taiwan; (H.-C.H.); (J.-C.L.); (C.-H.C.); (Y.-C.W.); (T.-H.W.); (C.-F.L.); (T.-J.W.); (H.-S.C.); (K.-M.C.)
| | - Wei-Chen Lee
- Division of Liver and Transplantation Surgery, Department of General Surgery, Chang-Gung Memorial Hospital, 5, Fu-Hsing Street, Kwei-Shan, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 3366); Fax: +886-3-3285818
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Ling HH, Yeh KY, Ng SH, Wang CH, Lai CH, Wu TH, Chang PH, Chou WC, Chen FP, Lin YC. Determining Malnutrition Assessment Criteria to Predict One-Year Mortality for Locally Advanced Head and Neck Cancer Patients Undergoing Concurrent Chemoradiotherapy. Nutrients 2020; 12:nu12030836. [PMID: 32245095 PMCID: PMC7146124 DOI: 10.3390/nu12030836] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/12/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 12/11/2022] Open
Abstract
Study on the impact of pretreatment malnutrition on treatment outcomes in locally advanced head and neck cancer (LAHNC) patients is still lacking. We prospectively collected various malnutrition assessment methods including nutrition indexes, inflammatory biomarkers, and lean body mass index (LBMI) data before treatments. The one year mortality rate was assessed, and the factors associated with this outcome were investigated. Furthermore, the association between malnutrition assessment methods was examined. A total of 113 patients were enrolled. By prognostic stratification based on the prognostic nutritional index (PNI) and platelet-to-lymphocyte ratio (PLR) combination, the low PNI/high PLR group had highest and the high PNI/low PLR group had the lowest mortality rate. Furthermore, the PNI was positively correlated with the LBMI, and the PLR was inversely correlated with the LBMI. PNI and PLR were found to be independent prognostic factors of one year mortality and also associated with the loss of muscle.
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Affiliation(s)
- Hang Huong Ling
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, College of Medicine, Keelung 204, Taiwan (K.-Y.Y.); (C.-H.W.); (C.-H.L.); (T.-H.W.); (P.-H.C.)
| | - Kun-Yun Yeh
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, College of Medicine, Keelung 204, Taiwan (K.-Y.Y.); (C.-H.W.); (C.-H.L.); (T.-H.W.); (P.-H.C.)
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou & Chang Gung University, Taoyuan 333, Taiwan;
| | - Cheng-Hsu Wang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, College of Medicine, Keelung 204, Taiwan (K.-Y.Y.); (C.-H.W.); (C.-H.L.); (T.-H.W.); (P.-H.C.)
| | - Chien-Hong Lai
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, College of Medicine, Keelung 204, Taiwan (K.-Y.Y.); (C.-H.W.); (C.-H.L.); (T.-H.W.); (P.-H.C.)
| | - Tsung-Han Wu
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, College of Medicine, Keelung 204, Taiwan (K.-Y.Y.); (C.-H.W.); (C.-H.L.); (T.-H.W.); (P.-H.C.)
| | - Pei-Hung Chang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung & Chang Gung University, College of Medicine, Keelung 204, Taiwan (K.-Y.Y.); (C.-H.W.); (C.-H.L.); (T.-H.W.); (P.-H.C.)
| | - Wen-Chi Chou
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou & Chang Gung University, College of Medicine, Taoyuan 333, Taiwan;
| | - Fang-Ping Chen
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung 204, Taiwan;
- College of Medicine, Healthy Aging Research Center, Chang Gung University, Taoyuan 333, Taiwan
- Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital, Keelung 204, Taiwan
| | - Yu-Ching Lin
- Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital, Keelung 204, Taiwan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung & Chang Gung University, Keelung 204, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 2575); Fax: +886-3-3971936
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Chan KM, Wu TH, Cheng CH, Lee CF, Wu TJ, Chou HS, Lee WC. Inferior Outcomes Associated with the Coexistence of Hepatocellular Carcinoma Recurrence and Hepatic Virus Reinfection After Living Donor Liver Transplantation. J Gastrointest Surg 2020; 24:353-360. [PMID: 30719678 DOI: 10.1007/s11605-019-04116-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/08/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Chronic viral hepatitis remains a major etiology of liver cirrhosis and hepatocellular carcinoma. Liver transplantation has been considered an effective treatment for this condition. This study aims to analyze living donor liver transplantation for patients with hepatocellular carcinoma and its relationship with hepatitis virus status. METHODS A retrospective analysis of 268 patients who received living donor liver transplantation for hepatocellular carcinoma was performed. Patients were analyzed according to their serologic status of hepatitis virus; clinicopathologic features, operative parameters, and outcomes were also assessed and compared. RESULTS Twenty-three patients (8.6%) had hepatocellular carcinoma recurrence following liver transplantation; the most common pattern of recurrence was systemic spreading (n = 10). Hepatitis B virus relapse was encountered in 41 out of 188 patients (21.8%) with hepatitis B virus-positive, and hepatitis C virus reactivation was noted in 48 (60.8%) patients among 79 hepatitis C virus-positive patients. Incidence of hepatitis C virus reactivation was significantly higher than that of hepatitis B virus relapse (p < 0.0001). Hepatocellular carcinoma recurrence and overall survival were not significantly different in relation to hepatitis virus; however, patients who had hepatocellular carcinoma recurrence combined with hepatitis virus reinfection had the significantly lowest survival rate compared with other groups (p < 0.0001). CONCLUSION Living donor liver transplantation based on expanded hepatocellular carcinoma criteria achieved a satisfactory result, but reinfection of hepatic virus remains a great concern particularly in patient with hepatitis C. Moreover, hepatocellular carcinoma recurrence accompanied with reinfection of hepatic virus after liver transplantation is associated with inferior outcomes.
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Affiliation(s)
- Kun-Ming Chan
- Department of General Surgery & Department of Organs Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kwei-Shan District, Taoyuan City, 33305, Taiwan.
| | - Tsung-Han Wu
- Department of General Surgery & Department of Organs Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kwei-Shan District, Taoyuan City, 33305, Taiwan
| | - Chih-Hsien Cheng
- Department of General Surgery & Department of Organs Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kwei-Shan District, Taoyuan City, 33305, Taiwan
| | - Chen-Fang Lee
- Department of General Surgery & Department of Organs Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kwei-Shan District, Taoyuan City, 33305, Taiwan
| | - Ting-Jung Wu
- Department of General Surgery & Department of Organs Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kwei-Shan District, Taoyuan City, 33305, Taiwan
| | - Hong-Shiue Chou
- Department of General Surgery & Department of Organs Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kwei-Shan District, Taoyuan City, 33305, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery & Department of Organs Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, 5 Fu-Hsing Street, Kwei-Shan District, Taoyuan City, 33305, Taiwan
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Wu TH, Wang YC, Cheng CH, Lee CF, Wu TJ, Chou HS, Chan KM, Lee WC. Outcomes associated with the intention of loco-regional therapy prior to living donor liver transplantation for hepatocellular carcinoma. World J Gastrointest Surg 2020; 12:17-27. [PMID: 31984121 PMCID: PMC6943093 DOI: 10.4240/wjgs.v12.i1.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/06/2019] [Accepted: 11/30/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Loco-regional therapy for hepatocellular carcinoma (HCC) during the period awaiting liver transplantation (LT) appears to be a logical approach to reduce the risk of tumor progression and dropout in the waitlist. Living donor LT (LDLT) offers a flexible timing for transplantation providing timeframe for well preparation of transplantation.
AIM To investigate outcomes in relation to the intention of pre-transplantation loco-regional therapy in LDLT for HCC patients.
METHODS A total of 308 consecutive patients undergoing LDLTs for HCC between August 2004 and December 2018 were retrospectively analyzed. Patients were grouped according to the intention of loco-regional therapy prior to LT, and outcomes of patients were analyzed and compared between groups.
RESULTS Overall, 38 patients (12.3%) were detected with HCC recurrence during the follow-up period after LDLT. Patients who were radiologically beyond the University of California at San Francisco criteria and received loco-regional therapy as down-staging therapy had significant inferior outcomes to other groups for both recurrence-free survival (RFS, P < 0.0005) and overall survival (P = 0.046). Moreover, patients with defined profound tumor necrosis (TN) by loco-regional therapy had a superior RFS (5-year of 93.8%) as compared with others (P = 0.010).
CONCLUSION LDLT features a flexible timely transplantation for patient with HCC. However, the loco-regional therapy prior to LDLT does not seem to provide benefit unless a certain effect in terms of profound TN is noted.
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Affiliation(s)
- Tsung-Han Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Yu-Chao Wang
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Chih-Hsien Cheng
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Chen-Fang Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Ting-Jung Wu
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Hong-Shiue Chou
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
| | - Kun-Ming Chan
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
- Department of Organs Transplantation Institute, Chang Gung University College of Medicine, Taoyun 33305, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery and Chang Gung Transplantation Institute, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan 33305, Taiwan
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Su BC, Wu TH, Hsu CH, Chen JY. Distribution of positively charged amino acid residues in antimicrobial peptide epinecidin-1 is crucial for in vitro glioblastoma cytotoxicity and its underlying mechanisms. Chem Biol Interact 2019; 315:108904. [PMID: 31758921 DOI: 10.1016/j.cbi.2019.108904] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 10/25/2019] [Accepted: 11/17/2019] [Indexed: 12/11/2022]
Abstract
Epinecidin-1 (epi) was identified from orange-spotted grouper (Epinephelus coioides) and exhibits diverse biological activities. The aims of this study were to investigate how the distribution of positively charged amino acid residues affects epi-mediated cytotoxicity and to examine the molecular mechanism underlying epi-induced cytotoxicity in U87MG human glioblastoma cells. MTS/PMS and trypan blue exclusion assay were used to measure cell viability. Necrotic cell death was confirmed by detecting cyclophilin A release and propidium iodide incorporation. DNA damage was evaluated by measuring phosphorylated H2AX. Intracellular reactive oxygen species (ROS) were analyzed by flow cytometry using dihydroergotamine. Mitochondrial membrane potential was detected by flow cytometry using tetramethylrhodamine, ethyl ester. Overall, we found that epi caused cytotoxicity in U87MG cells by inducing DNA damage and necrosis through mitochondrial hyperpolarization and subsequent ROS production. The proper folding of epi into an α-helical structure was essential for epi-mediated anti-glioblastoma effects. In addition, NFκB signaling was activated in U87MG cells after exposure to epi. Suppression of NFκB further enhanced epi-induced cytotoxicity, ROS generation and DNA damage, indicating that NFκB may play a protective role in epi-induced cytotoxicity. Our findings may be useful for the design and improvement of antimicrobial peptides with anti-cancer activity.
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Affiliation(s)
- Bor-Chyuan Su
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Han Wu
- Genome and Systems Biology Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan
| | - Chun-Hua Hsu
- Genome and Systems Biology Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan; Department of Agricultural Chemistry, National Taiwan University, Taipei, Taiwan
| | - Jyh-Yih Chen
- Marine Research Station, Institute of Cellular and Organismic Biology, Academia Sinica, 23-10 Dahuen Road, Jiaushi, Ilan, 262, Taiwan.
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Huang TH, Wu TH, Guo YH, Li TL, Chan YL, Wu CJ. The concurrent treatment of Scutellaria baicalensis Georgi enhances the therapeutic efficacy of cisplatin but also attenuates chemotherapy-induced cachexia and acute kidney injury. J Ethnopharmacol 2019; 243:112075. [PMID: 31291609 DOI: 10.1016/j.jep.2019.112075] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/03/2019] [Accepted: 07/06/2019] [Indexed: 06/09/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cisplatin is an important chemotherapy to lung cancer, but it usually induces severe cachexia and acute kidney injury in patients. Scutellaria baicalensis Georgi (SB), commonly known as a skullcap, is a popular Chinese herbal medicine mainly used to treat inflammation, infection, and malignancy. In this study, we report the synergic effect of SB and cisplatin to Lewis lung carcinoma (LLC) cells, and the ameliorative effect of SB to cisplatin-induced cachexia and acute kidney injury. MATERIALS AND METHODS The extract of SB was applied by water boiling and lyophilization. The MTS assay was used to exam the in-vitro effects of SB and cisplatin on the LLC viability. In the animal experiment, male C57BL/6J mice were inoculated with LLC cells, and then treated by cisplatin intraperitoneally and the SB extract orally. Tumor volume, weights of tumor, murine body, white adipose tissue and gastrocnemius muscle, as well as serum levels of BUN and creatinine were measured during the experiment. Murine kidney sample was observed after the H&E and annexin V staining. RESULTS SB provided an enhancement of cisplatin action to inhibit tumor growth in vitro and in vivo. In the animal experiment, SB improved the loss of murine body weight and gastrocnemius muscle, the elevating BUN level, and the apoptosis of renal tubular cells in mice receiving cisplatin therapy. Meanwhile, the current treatment of SB did not further interfere with the blood cell counts of mice receiving chemotherapy. CONCLUSION SB can enhance the anti-cancer effect of cisplatin. It also attenuates cisplatin-induced cachexia and acute kidney injury.
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Affiliation(s)
- Tse-Hung Huang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Keelung, 20401, Taiwan; School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, 33302, Taiwan; School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, 11219, Taiwan; Graduate Institute of Health Industry Technology, Chang Gung University of Science and Technology, Taoyuan, 33303, Taiwan
| | - Tsung-Han Wu
- Department of Food Science and Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung, 20224, Taiwan; Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 20401, Taiwan and College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Yi-Hui Guo
- Department of Food Science and Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung, 20224, Taiwan
| | - Tsung-Lin Li
- Genomics Research Center, Academia Sinica, Taipei, 11529, Taiwan
| | - Yi-Lin Chan
- Department of Life Science, Chinese Culture University, Taipei, 11114, Taiwan.
| | - Chang-Jer Wu
- Department of Food Science and Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung, 20224, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 40402, Taiwan; Department of Health and Nutrition Biotechnology, Asia University, Taichung, 41354, Taiwan; Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan.
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Sowemimo OA, Wu TH, Lee YL, Asaolu SO, Chuang TW, Akinwale OP, Badejoko BO, Gyang VP, Nwafor T, Henry E, Fan CK. Toxoplasma gondii: seroprevalence and associated risk factors among preschool-aged children in Osun State, Nigeria. Trans R Soc Trop Med Hyg 2019; 112:486-491. [PMID: 30137567 DOI: 10.1093/trstmh/try083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/09/2018] [Indexed: 11/13/2022] Open
Abstract
Background Toxoplasma gondii is an ubiquitous apicomplexan parasite, which causes toxoplasmosis in animals and humans worldwide. However, little is known about T. gondii infection among preschool-aged children in Nigeria. Methods A cross-sectional study of 272 preschool children aged 2.25±1.09 years from four communities (Edunabon, Erin-Ijesha, Ijebu-jesa and Ile-Ife) in Osun State, Nigeria was conducted between January and July 2016, and the demographic data was obtained via questionnaires. Antibody titres against T. gondii of serum samples were assessed by ELISA. Results The overall seroprevalence of T. gondii infection was 6.9% (19/272). There was no significant difference in seroprevalence of T. gondii infection between boys (7.04%; 10/142) and girls (6.92%; 9/130; p=0.97). No associations were found between age, gender, parental educational level, occupation and religion, and T. gondii seropositivity. None showed statistical significance between the risk factors tested after multivariate adjustment; nevertheless, residing in Ijebu-jesa community was shown to be associated with an increased risk of infection (p=0.04). Conclusion This is the first report of T. gondii infection among preschool children in Nigeria. Prevalence studies such as this could help in the development of strategies for the future for disease prevention and control of T. gondii transmission.
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Affiliation(s)
- Oluyomi A Sowemimo
- Department of Zoology, Obafemi Awolowo University, Ile-Ife, Osun State.,Department of Zoology, University of Lagos, Akoka, Lagos State, Nigeria
| | - Tsung-Han Wu
- Department of Pulmonary Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Lun Lee
- Department of Microbiology and Immunology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Samuel O Asaolu
- Department of Zoology, Obafemi Awolowo University, Ile-Ife, Osun State
| | - Ting-Wu Chuang
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Olaoluwa P Akinwale
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State
| | | | - Vincent P Gyang
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State
| | - Timothy Nwafor
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State
| | - Emmanuel Henry
- Molecular Parasitology Research Laboratory, Department of Public Health, Nigerian Institute of Medical Research, Yaba, Lagos State
| | - Chia-Kwung Fan
- Department of Molecular Parasitology and Tropical Diseases, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Tropical Medicine Division, International PhD Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Chang PH, Hsieh JCH, Yeh KY, Chen EYC, Yang SW, Huang JS, Lai CH, Wu TH, Huang YM, Chang YS, Chou WC, Wang CH. Prognostic nutritional index relevance in chemoradiotherapy for advanced oral cavity, oropharyngeal and hypopharyngeal cancer. Asia Pac J Clin Nutr 2019; 27:996-1001. [PMID: 30272847 DOI: 10.6133/apjcn.032018.04] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES This study was designed to evaluate the impact of the prognostic nutritional index (PNI) on treatment-related toxicities and tolerance in patients with advanced head and neck cancers who were undergoing concurrent chemoradiotherapy (CCRT). METHODS AND STUDY DESIGN We retrospectively analyzed and compared the clinical characteristic, toxicities and survival of 143 patients with stage III, IVA, and IVB head and neck cancer who were treated with CCRT according to their PNI between 2007 and 2010. RESULTS Low PNI was correlated with T classification and advanced tumor stage. Patients with low PNI were less likely to tolerate CCRT, required tube feeding support more frequently and had higher percentages of grade 3/4 hematological toxicities, sepsis and toxic death. CONCLUSIONS Pretreatment PNI predicts treatment-tolerance and toxicity in patients with advanced head and neck cancer undergoing CCRT.
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Affiliation(s)
- Pei-Hung Chang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.,Cancer Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Jason Chia-Hsun Hsieh
- Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kun-Yun Yeh
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.,Cancer Center, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Eric Yen-Chao Chen
- Departments of Radiation Oncology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan
| | - Shih-Wei Yang
- Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan
| | - Jen-Seng Huang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan
| | - Chien-Hong Lai
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan
| | - Tsung-Han Wu
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan
| | - Yen-Min Huang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan
| | - Yueh-Shih Chang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan
| | - Wen-Chi Chou
- Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Cheng-Hsu Wang
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan. .,Cancer Center, Chang Gung Memorial Hospital, Keelung, Taiwan
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Chan WH, Huang SF, Lee CW, Wu TH, Pan KT, Lin SM, Yu MC, Hung CF. Incorporation of biochemical factors for survival analysis of transarterial chemoembolization in patients with hepatocellular carcinoma: A retrospective cohort study. J Int Med Res 2019; 47:4862-4871. [PMID: 31446817 PMCID: PMC6833392 DOI: 10.1177/0300060519866941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Introduction Hepatocellular carcinoma (HCC) is a common gastrointestinal cancer that occurs worldwide, and conventional transarterial chemoembolization (cTACE) is one of the first treatment choices for advanced HCC. However, biochemical factors and comorbidity have seldom been reported in the long-term outcomes. Methods This retrospective cohort study included 444 HCC patients who underwent cTACE-based therapy in 2010 to 2012. Survival outcomes were analyzed using a Kaplan–Meier curve and Cox regression analysis. Results The mean age was 62.1 ± 12.5 years, and 74.3% were men. Analysis of the mean biochemical values indicated that the presence of portal vein thrombosis, α-fetoprotein (AFP) >200 ng/mL, AJCC 7th stage III, diabetes, albumin <3 g/dL, and hemoglobin were significantly and independently associated with poorer long-term outcomes. Discussion The presence of venous thrombus and elevation of AFP levels are the most important factors in cTACE treatment. The host factors, including metabolic status and liver damage, should be evaluated in these patients.
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Affiliation(s)
- Wen-Hui Chan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan
| | - Song-Fong Huang
- Department of General surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan
| | - Chao-Wei Lee
- Department of General surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan
| | - Tsung-Han Wu
- Department of General surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan
| | - Kuan-Tse Pan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan
| | - Shi-Ming Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan
| | - Ming-Chin Yu
- Department of General surgery, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan.,Department of Surgery, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
| | - Chien-Fu Hung
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan.,Department of Radiology, Xiamen Chang Gung Hospital, Xiamen, Fujian, China
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Liu YM, Chan YL, Wu TH, Li TL, Hsia S, Chiu YH, Wu CJ. Antitumor, Inhibition of Metastasis and Radiosensitizing Effects of Total Nutrition Formula on Lewis Tumor-Bearing Mice. Nutrients 2019; 11:nu11081944. [PMID: 31426614 PMCID: PMC6723674 DOI: 10.3390/nu11081944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/23/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 12/14/2022] Open
Abstract
Non-small-cell lung cancer (NSCLC) causes high mortality. Radiotherapy is an induction regimen generally applied to patients with NSCLC. In view of therapeutic efficacy, the outcome is not appealing in addition to bringing about unwanted side effects. Total nutrition is a new trend in cancer therapy, which benefits cancer patients under radiotherapy. Male C57BL/6JNarl mice were experimentally divided into five groups: one control group, one T group (borne with Lewis lung carcinoma but no treatment), and three Lewis lung carcinoma-bearing groups administrated with a total nutrition formula (T + TNuF group), a local radiotherapy plus daily 3 Gy in three fractions (T + R group), or a combination TNuF and radiotherapy (T + R + TNuF group). These mice were assessed for their mean tumor volumes, cachectic symptoms and tumor metastasis. TNuF administration significantly suppressed tumor growth and activated apoptotic cell death in NSCLC-bearing mice under radiation. The body-weight gain was increased, while the radiation-induced cachexia was alleviated. Analysis of mechanisms suggests that TNuF downregulates EGFR and VEGF signaling pathways, inhibiting angiogenesis and metastasis. In light of radiation-induced tumor cell death, mitigation of radiation-induced cachexia and inhibition of tumor cell distant metastasis, the combination of TNuF and radiotherapy synergistically downregulates EGFR and VEGF signaling in NSCLC-bearing mice.
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Affiliation(s)
- Yu-Ming Liu
- Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
| | - Yi-Lin Chan
- Department of Life Science, Chinese Culture University, Taipei 11114, Taiwan
| | - Tsung-Han Wu
- Department of Food Science and Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung 20224, Taiwan
- Division of Hemato-oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung 20401, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33320, Taiwan
| | - Tsung-Lin Li
- Genomics Research Center, Academia Sinica, Taipei 11529, Taiwan
| | - Simon Hsia
- Taiwan Nutraceutical Association, Taipei 10596, Taiwan
| | - Yi-Han Chiu
- Department of Nursing, St. Mary's Junior College of Medicine, Nursing and Management, Yilan 26647, Taiwan.
- Institute of Long-Term Care, Mackay Medical College, New Taipei City 25245, Taiwan.
| | - Chang-Jer Wu
- Department of Food Science and Center of Excellence for the Oceans, National Taiwan Ocean University, Keelung 20224, Taiwan.
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan.
- Department of Health and Nutrition Biotechnology, Asia University, Taichung 41354, Taiwan.
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.
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Chan KM, Cheng CH, Wu TH, Lee CF, Wu TJ, Chou HS, Lee WC. Salvage living donor liver transplantation for posthepatectomy recurrence: a higher incidence of recurrence but promising strategy for long-term survival. Cancer Manag Res 2019; 11:7295-7305. [PMID: 31447587 PMCID: PMC6684549 DOI: 10.2147/cmar.s215732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/12/2019] [Indexed: 12/29/2022] Open
Abstract
Background The scarcity of deceased donor organ donation has led to increasing utilization of living donor liver transplantation (LDLT), which is an optimal treatment for cirrhosis associated with hepatocellular carcinoma (HCC). The study thus aims to analyze prognostic factors and beneficial effects of LDLT for patients with HCC. Methods All patients who underwent LDLT for HCC were included in this study. A multivariate analysis of patients’ clinicopathologic parameters was performed to determine prognostic factors. Subsequently, the type of LDLT was further analyzed and compared based on the result of multivariate analysis. Results Overall, 36 (11.9%) of 303 patients were identified as having HCC recurrence after LDLT. Salvage LDLT (sLDLT) defined by liver transplantation for those patients with recurrent HCC after primary liver resection (LR) was identified as the major prognostic factor of HCC recurrence following the transplantation (HR=2.49 [1.12–5.54], p=0.025). The HCC recurrence incidence and recurrence-free survival after LDLT were significantly inferior in the salvage group than the other group. The pre-transplantation factors were further evaluated and resulted in only maximum tumour size ≥5 cm at primary LR(HR=10.79 [2.10–55.43], p=0.004) affecting post-transplantation HCC recurrence in those patients who had been performed sLDLT. However, patients receiving salvage LDLT had 5- and 10-year overall survival of 86.7% and 52.9%, respectively, measured from the time of initial HCC diagnosis. Conclusion Overall, LDLT achieves a satisfactory result with low incidence of HCC recurrence based on certain transplantation criteria. Despite the higher incidence of HCC recurrence after sLDLT, it remains a promising strategy to improve long-term outcomes.
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Affiliation(s)
- Kun-Ming Chan
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Hsien Cheng
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Tsung-Han Wu
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chen-Fang Lee
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ting-Jung Wu
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hong-Shiue Chou
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Wei-Chen Lee
- Department of General Surgery, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan
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Chan KM, Cheng CH, Wu TH, Lee CF, Wu TJ, Chou HS, Lee WC. "Left at right" liver transplantation with heterotopic implantation of left liver graft in the right subphrenic space: Reappraisal and technical concerns for decision making. Medicine (Baltimore) 2019; 98:e16415. [PMID: 31305458 PMCID: PMC6641801 DOI: 10.1097/md.0000000000016415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Conventional orthotopic implantation of left liver grafts is technically demanding and requires consideration of limited space and vascular complications. The study proposed a modified approach termed "left at right" liver transplantation (LAR-LT), wherein left liver grafts were rotated and implanted in right subphrenic spaces. The selection of recipients for this approach is based on the measurement of the right subphrenic space width and left liver graft length, in which a rotated left liver graft could be comfortably placed in the right subphrenic space. A total of 36 recipients who had undergone LAR-LT between July 2006 and December 2017 were retrospectively reviewed. None of recipients died of complications related to this approach immediately after operation. All grafts showed remarkable increment in liver volume and bi-directional regeneration to fit well within the right abdominal cavity. Meanwhile, the alignment of the biliary tree in LAR-LT is quite straight, making no difficulty in both anastomosis during operation and dealing with biliary stenosis afterward. As such, long-term outcome of LAR-LT is satisfactory. Keeping in mind certain technical concerns, a heterotopic LAR-LT might be safely applied as an alternative with an easier reconstruction procedure for select patients.
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Chiang LH, Wu TH, Tsai TC, Lee WC. Coadministration of Erythromycin to Increase Tacrolimus Concentrations in Liver Transplant Recipients. Transplant Proc 2019; 51:1439-1441. [DOI: 10.1016/j.transproceed.2019.01.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 01/31/2019] [Indexed: 01/07/2023]
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