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Lee TY, Chang HM, Shih ML, Chen TW, Hsieh CB, Chan DC, Yu JC, Liao GS. Blunt Abdominal Trauma with Left Kidney Dropped into Lower Retroperitoneal Cavity: A Case Report and Literature Review. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791602300307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Blunt abdominal injury with kidney laceration is not unusually seen in high-energy traffic accident. It can present with no symptoms and yet lead to fatal complications. High-grade lacerations of kidney (American Association for the Surgery of Trauma [AAST] grade IV to V) will show up with contrast extravasation and disrupted kidney/pelvicalyceal system morphology in computed tomography (CT). However, it is rare to see kidney dislocation from retroperitoneal space because of the presence of the Gerota's fascia. We present a case of a 16-year-old boy suffering from traffic accident with blunt truncal/abdominal injury. The contrast CT of abdomen revealed that his left kidney was dislocated from the original retroperitoneal space and sagged to the lower retroperitoneal cavity. We performed emergency left nephrectomy. He recovered well and there was no complication noted after the surgical intervention. We also review the literature of kidney laceration regarding diagnosis and treatment. (Hong Kong j.emerg.med. 2016;24:176-179)
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Chang HM, Wang ZH, Luo HN, Xu M, Ren XY, Zheng GX, Wu BJ, Zhang XH, Lu XY, Chen F, Jing XH, Wang L. Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate)-based scaffolds for tissue engineering. ACTA ACUST UNITED AC 2014; 47:533-9. [PMID: 25003631 PMCID: PMC4123831 DOI: 10.1590/1414-431x20143930] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [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: 02/18/2014] [Accepted: 03/12/2014] [Indexed: 01/18/2023]
Abstract
Development and selection of an ideal scaffold is of importance for tissue engineering. Poly(3-hydroxybutyrate-co-3-hydroxyhexanoate) (PHBHHx) is a biocompatible bioresorbable copolymer that belongs to the polyhydroxyalkanoate family. Because of its good biocompatibility, PHBHHx has been widely used as a cell scaffold for tissue engineering. This review focuses on the utilization of PHBHHx-based scaffolds in tissue engineering. Advances in the preparation, modification, and application of PHBHHx scaffolds are discussed.
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Affiliation(s)
- H M Chang
- Department of Otolaryngology-Head and Neck Surgery, Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - Z H Wang
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - H N Luo
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - M Xu
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - X Y Ren
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - G X Zheng
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - B J Wu
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - X H Zhang
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - X Y Lu
- School of Life Science and Technology of Xi'an Jiaotong University, Xi'an, China
| | - F Chen
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - X H Jing
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - L Wang
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
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Wang ZH, Li XL, He XJ, Wu BJ, Xu M, Chang HM, Zhang XH, Xing Z, Jing XH, Kong DM, Kou XH, Yang YY. Delivery of the Sox9 gene promotes chondrogenic differentiation of human umbilical cord blood-derived mesenchymal stem cells in an in vitro model. ACTA ACUST UNITED AC 2014; 47:279-86. [PMID: 24652327 PMCID: PMC4075291 DOI: 10.1590/1414-431x20133539] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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: 10/01/2013] [Accepted: 12/11/2013] [Indexed: 12/11/2022]
Abstract
SRY-related high-mobility-group box 9 (Sox9) gene is a cartilage-specific
transcription factor that plays essential roles in chondrocyte differentiation and
cartilage formation. The aim of this study was to investigate the feasibility of
genetic delivery of Sox9 to enhance chondrogenic differentiation of human umbilical
cord blood-derived mesenchymal stem cells (hUC-MSCs). After they were isolated from
human umbilical cord blood within 24 h after delivery of neonates, hUC-MSCs were
untreated or transfected with a human Sox9-expressing plasmid or an empty vector. The
cells were assessed for morphology and chondrogenic differentiation. The isolated
cells with a fibroblast-like morphology in monolayer culture were positive for the
MSC markers CD44, CD105, CD73, and CD90, but negative for the differentiation markers
CD34, CD45, CD19, CD14, or major histocompatibility complex class II. Sox9
overexpression induced accumulation of sulfated proteoglycans, without altering the
cellular morphology. Immunocytochemistry demonstrated that genetic delivery of Sox9
markedly enhanced the expression of aggrecan and type II collagen in hUC-MSCs
compared with empty vector-transfected counterparts. Reverse transcription-polymerase
chain reaction analysis further confirmed the elevation of aggrecan and type II
collagen at the mRNA level in Sox9-transfected cells. Taken together, short-term Sox9
overexpression facilitates chondrogenesis of hUC-MSCs and may thus have potential
implications in cartilage tissue engineering.
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Affiliation(s)
- Z H Wang
- Department of Otolaryngology - Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - X L Li
- Department of Dermatology, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - X J He
- Department of Orthopedics, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - B J Wu
- Department of Otolaryngology - Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - M Xu
- Department of Otolaryngology - Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - H M Chang
- Department of Otolaryngology - Head and Neck Surgery, Affiliated Hospital of Xi'an Medical University, Xi'an, China
| | - X H Zhang
- Department of Otolaryngology - Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Z Xing
- Department of Clinical Dentistry, Faculty of Dentistry, Center for Clinical Dental Research, University of Bergen, Bergen, Norway
| | - X H Jing
- Department of Otolaryngology - Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - D M Kong
- Department of Otolaryngology - Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - X H Kou
- Department of Otolaryngology - Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Y Y Yang
- Department of Otolaryngology - Head and Neck Surgery, The Second Hospital, Xi'an Jiaotong University, Xi'an, China
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Chan DC, Chang HM, Chou YC, Hsu SD, Liao GS, Chen TW, Hsieh CB, Chen CJ, Yu JC. Predictive risk factors for fracture at catheter of totally implantable venous access devices via subclavian vein insertion. J Med Sci 2014. [DOI: 10.4103/1011-4564.139186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Min DY, Jameel H, Chang HM, Lucia L, Wang ZG, Jin YC. The structural changes of lignin and lignin–carbohydrate complexes in corn stover induced by mild sodium hydroxide treatment. RSC Adv 2014. [DOI: 10.1039/c3ra47032f] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Song HR, Park HS, Yun KE, Cho SH, Choi EY, Lee SY, Kim JH, Sung HN, Kim JH, Choi SI, Yoon YS, Lee ES, Han JH, Shin CI, Chang HM, Bae SC. Gender and age differences in the impact of overweight on obesity-related quality of life among Korean adults. Obes Res Clin Pract 2013; 4:e1-e82. [PMID: 24345622 DOI: 10.1016/j.orcp.2009.07.003] [Citation(s) in RCA: 17] [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: 08/08/2008] [Revised: 07/17/2009] [Accepted: 07/21/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY OBJECTIVE To investigate gender and age difference in impact of overweight on health-related quality of life (HRQOL) among Korean adults. METHODS Cross-sectional obesity-related quality of life (QOL) scores were measured by a Korean obesity-related QOL scale (KOQOL) from 448 Korean adults aged 20-80 years. A body mass index (BMI) was categorized with normal-weight as BMI < 23 kg/m(2), overweight as BMI ≥ 23 kg/m(2) based on the alternative cutoff points for Asians. Each gender was respectively stratified by median age, 45 years for men and 50 years for women, to examine the obesity-related QOL by age groups. RESULTS Women had a poorer obesity-related QOL compared to men (p < 0.001). In the younger age group, overweight women had a poorer obesity-related QOL compared with normal-weight women (p < 0.001), however normal-weight and overweight men showed no difference in obesity-related QOL. In the older age group, overweight men showed better QOL on the domains of work-related and psychosocial health than those for normal-weight men, but overweight women still suffered from work-related and routine life QOL. CONCLUSIONS This study showed the impact of overweight on obesity-related QOL was different for gender and age group. We should consider the results to manage weight in overweight persons.
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Affiliation(s)
- H R Song
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - H S Park
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea.
| | - K E Yun
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - S H Cho
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - E Y Choi
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - S Y Lee
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - J H Kim
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - H N Sung
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - J H Kim
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - S I Choi
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - Y S Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - E S Lee
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - J H Han
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - C I Shin
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - H M Chang
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
| | - S C Bae
- Department of Internal Medicine, Hanyang University College of Medicine, South Korea
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Jo JC, Lee JL, Ryu MH, Chang HM, Kim M, Lee HJ, Kim HS, Shin JG, Kim TW, Kang YK. Phase II and UGT1A1 genotype study of irinotecan dose escalation as salvage therapy for advanced gastric cancer. Br J Cancer 2012; 106:1591-7. [PMID: 22516947 PMCID: PMC3349177 DOI: 10.1038/bjc.2012.143] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [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: 01/13/2023] Open
Abstract
Background: To assess the efficacy and safety of individualised dose optimisation of irinotecan monotherapy as salvage treatment for advanced gastric cancer (AGC). Methods: A total of 43 patients were enrolled. Intravenous irinotecan (350 mg m−2) was administered every 3 weeks. The dose was increased (425 mg m−2 and 500 mg m−2) or decreased (250 mg m−2) depending on patient tolerance. UGT1A1 genotypes were determined by direct sequencing of genomic DNA extracted from peripheral blood. Results: A total of 183 cycles of irinotecan were administered, with a median of four cycles per patient. The overall response rate was 9.3%, and the disease control rate was 62.8%. Median time to disease progression was 2.8 months, and median overall survival was 8.0 months. Grade 3–4 neutropenia was the most common toxicity (53.5%), and febrile neutropenia was the least common toxicity (4.6%). Compared with defective allele groups, UGT1A1 *1/*1 was associated with a lower incidence of grade 3–4 neutropenia during the first cycle (P=0.018). Conclusion: Individualised irinotecan dose escalation based on patient tolerance was not associated with increased toxicity and shows modest activity as salvage chemotherapy for AGC. The role of UGT1A1 genotype in clinical toxicity requires further evaluation.
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Affiliation(s)
- J-C Jo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 138-736, Korea
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Venketasubramanian N, Chan BPL, Chang HM, Chua HC, Gan RN, Hui F, Lee W, Ng I, Sharma VK, Singh R, Teoh HL, Wang E, Chen CLH. Brain attack: needing resuscitation. Singapore Med J 2011; 52:620-630. [PMID: 21879224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The brain is extremely susceptible to focal ischaemia. Following vascular occlusion, a core of severely damaged brain tissue develops, surrounded by an ischaemic penumbra. This potentially-salvageable penumbra may be estimated by advanced neuroimaging techniques, particularly by diffusion-perfusion mismatch. Clinical trials have demonstrated the efficacy of intravenous thrombolysis within three hours of onset of ischaemic stroke in reducing short-term disability. Recanalisation is enhanced by intra-arterial thrombolysis, sonothrombolysis and clot-retrieval devices. Occasionally, reperfusion injury may lead to clinical deterioration. The search continues for effective neuroprotectants. Brain perfusion needs to be maintained through blood and intracranial pressure management. Hemicraniectomy for 'malignant' cerebral oedema reduces death and disability. Elevated glucose should be controlled and hypoxia alleviated. Public education of symptoms and the need for immediate presentation to a medical facility is needed. Stroke unit care reduces death and disability with little increase in cost. Current evidence supports urgent efforts to resuscitate the brain after stroke.
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Affiliation(s)
- N Venketasubramanian
- Division of Neurology, University Medicine Cluster, National University Health Systems, 5 Lower Kent Ridge Road, Singapore 119074.
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Ryu GY, Shin SE, Seo JH, Park JS, Chang HM, Shin S, Kim YK, Shin DM. A study on white organic light-emitting diodes co-doped with red fluorescent and blue phosphorescent dopants. J Nanosci Nanotechnol 2011; 11:4430-4433. [PMID: 21780470 DOI: 10.1166/jnn.2011.3706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
White organic light-emitting diodes (WOLEDs) have drawn increasing attention due to their potential use in various applications such as solid-state lighting and backlight of liquid crystal displays and full-color OLEDs of red, green, and blue pixel. N,N'-dicabazolyl-3,5-benzene (mCP), the host material, was co-doped with Iridium (III) bis[(4,6-difluorophenyl)-pyridinato-N,C2']-picolinate (FIrpic), which functions not only as phosphorescent sensitizer but also blue emitter, and (2Z,2'Z)-3,3'-[4,4"-bis (dimethylamino)-1,1':4',1"-terphenyl-2',5'-diyl]bis (2-phenylacrylonitrile) (ABCV-P), which is a red fluorescent material. The fabricated device structures were as follows: (device A) Indium tin oxide (ITO)/N,N'-bis-(1-naphyl)-N,N'-diphenyl-1,1'-biphenyl-4,4'-diamine (NPB)/(mCP)/mCP:ABCV-P (1%)/4,7-diphenyl-1,10-phenanthroline (Bphen)/lithium quinolate (Liq)/aluminum (Al), (device B) ITO/NPB/mCP/mCP:FIrpic (8%)/Bphen/Liq/Al and (device C) ITO/NPB/mCP/mCP:FIrpic:ABCV-P (8%, 1%)/Bphen/Liq/Al, respectively. Phosphorescent FIrpic harvesting both singlet and triplet excitions not only emitted blue light but also transferred energy to fluorescent ABCV-P. The maximum luminance efficiency, external quantum efficiency, and luminance of white light device were measured to be 5.95 cd/A, 2.45% and 2500 cd/m2, respectively. The white device gave practically white light with the Commision Internationale de l'Eclairage (CIE(xy)) coordinate of (0.44, 0.49) which was close to warm white color (CIE(xy) = 0.45, 0.45).
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Affiliation(s)
- G Y Ryu
- Department of Mechanical and System Design, Hong-ik University, Seoul 121-791, Korea
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De Silva DA, Manzano JJF, Chang HM, Wong MC. Reconsidering recent myocardial infarction as a contraindication for IV stroke thrombolysis. Neurology 2011; 76:1838-40. [DOI: 10.1212/wnl.0b013e31821ccc72] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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11
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Narasimhalu K, Effendy S, Sim CH, Lee JM, Chen I, Hia SB, Xue HL, Corrales MP, Chang HM, Wong MC, Chen CP, Tan EK. A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease. Acta Neurol Scand 2010; 121:217-24. [PMID: 19951274 DOI: 10.1111/j.1600-0404.2009.01263.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The safety and efficacy of early acetylcholinesterase inhibitors therapy in patients with cognitive impairment no dementia (CIND) after a cerebrovascular accident have not been examined. In this study, we investigated the safety and efficacy of rivastigmine in cognition, particularly executive function in patients with CIND because of cerebrovascular disease. METHODS This study was a 24-week, double-blind, randomized, placebo-controlled trial of ischemic stroke patients seen at a tertiary hospital who had cognitive impairment no dementia because of cerebrovascular disease. The intervention was either rivastigmine or placebo up to 9 mg/day. The primary outcome of interest was mean change from baseline in the Ten-Point Clock Drawing and Color Trails 1 and 2. RESULTS Fifty patients were randomized into rivastigmine (n = 25) and placebo (n = 25) arms. Patients in the rivastigmine group showed statistically significant improvement (1.70 vs 0.13, P = 0.02) on the animal subtask of the verbal fluency measure compared with placebo. There was also a trend (non-significant) towards improvement in Color Trails II. CONCLUSIONS In this pilot study, we demonstrated that rivastigmine was well tolerated in patients with CIND because of cerebrovascular disease and may potentially improve executive functioning.
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Affiliation(s)
- K Narasimhalu
- Center for Molecular Epidemiology, National University of Singapore, Singapore
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Yoo KM, Shin HK, Chang HM, Caplan LR. Middle cerebral artery occlusive disease: the New England Medical Center Stroke Registry. J Stroke Cerebrovasc Dis 2009; 7:344-51. [PMID: 17895111 DOI: 10.1016/s1052-3057(98)80053-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/1997] [Accepted: 03/10/1998] [Indexed: 10/24/2022] Open
Abstract
To analyze the clinical features, vascular lesions, and infarct distribution in Asian and white patients with middle cerebral artery (MCA) territory ischemia, we studied age, sex, race, risk factors, angiographic, and neuroimaging findings among patients in the New England Medical Center Stroke Registry. We included patients with well-defined intrinsic occlusive lesions of the MCAs and patients with embolic MCA territory infarcts. Among 695 patients in the stroke registry, 89 (12.8%) qualified. They had 28 MCA intrinsic stenoses, 17 MCA embolic occlusions (cardiogenic or unknown origin), and 44 carotid artery (CA) stenoses or occlusions. MCA intrinsic disease patients were more often Asians and women, and more often had hypertension. Asians were older than whites. Coronary artery disease (27%), peripheral vascular disease (20.5%), and smoking (39%) were more common in CA disease patients. The most common site of MCA intrinsic stenosis (78%) and embolic occlusion (59%) was the mainstem MCA. Infarcts in patients with MCA intrinsic disease mostly involved the striatocapsular area (61%). Infarcts in patients with MCA embolic occlusion (75%) and CA disease (43%) most often involved the parietal lobe. In our hospital, most patients with MCA intrinsic disease are Asians and women and have hypertension and striatocapsular infarctions. Asian patients are usually older than white patients. The most common site of vascular lesions is the mainstem MCA.
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Affiliation(s)
- K M Yoo
- Department of Neurology, New England Medical Center, Boston, MA, USA
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Han SS, Lee M, Park GH, Bang SH, Kang YK, Kim TW, Lee JL, Chang HM, Ryu MH. Investigation of papulopustular eruptions caused by cetuximab treatment shows altered differentiation markers and increases in inflammatory cytokines. Br J Dermatol 2009; 162:371-9. [PMID: 19903175 DOI: 10.1111/j.1365-2133.2009.09536.x] [Citation(s) in RCA: 22] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Epidermal growth factor receptor (EGFR) critically regulates tumour cell division, survival and metastasis. Agents that inhibit EGFR have been used in the treatment of advanced-stage malignancies, but cause variable cutaneous side-effects, most often papulopustular eruptions and xerosis. OBJECTIVES We assayed expression of inflammatory cytokines [interleukin (IL)-1alpha, tumour necrosis factor (TNF)-alpha, interferon (IFN)-gamma, human leucocyte antigen (HLA)-DR and intercellular adhesion molecule (ICAM)-1], differentiation markers (filaggrin, involucrin and loricrin) and phosphorylated EGFRs (pEGFRs) in papulopustular eruptions to determine the association between these markers and the eruptions caused by cetuximab. PATIENTS/METHODS Twelve papulopustular lesion biopsies were selected from patients with colon cancer who had received cetuximab treatment. Immunohistochemistry and immunofluorescence with a confocal laser scanning microscopy were performed. RESULTS Filaggrin expression decreased and expression of involucrin, various inflammatory markers (IL-1alpha, TNF-alpha, ICAM-1 and HLA-DR) increased and the expression of pEGFR was markedly downregulated in papulopustular eruptions. In perilesions, decreased pEGFR expression was noted in hair follicles compared with interfollicular epidermis. The increase of IL-1alpha and TNF-alpha was observed in perilesions as in the lesions. CONCLUSIONS The early inflammatory events (IL-1alpha and TNF-alpha expression) seen, and the lack of pEGFR in perilesional follicles, indicate that inflammatory events induced by EGFR inhibition may initiate papulopustular eruptions along with the altered differentiations. The decrease of filaggrin may contribute to the pathogenesis of the xerosis caused by cetuximab.
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Affiliation(s)
- S S Han
- Department of Dermatology, Asan Medical Center, SongPa-Gu PyongNab-Dong, Seoul 138-736, Korea
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Kim K, Jang GD, Lim HS, Kim HS, Shin JG, Lee JL, Ryu MH, Chang HM, Kang YK, Kim TW. Pharmacokinetic and pharmacogenetic study of S-1 in Korean patients with metastatic biliary cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.2505] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
2505 Background: S-1 is an oral anticancer agent composed of tegafur (FT), CDHP, and oxonate. CYP2A6 is related to the biotransformation of FT to 5-FU. We evaluated associations of genetic variants of CYP2A6 with PK/PD of S-1 when combined with oxaliplatin in metastatic biliary cancer. Methods: This is a prospective study of patients with histologically confirmed metastatic adenocarcinoma of the biliary tract. S-1 was administered orally at a dose of 40 mg/m2 twice daily for 14 days followed by a 7-day rest period. For PK study, S-1 was given only once at day 1 of cycle 1. From day 2, it was administered twice daily. Oxaliplatin was administered intravenously at a dose of 130 mg/m2 for 2 hours every 3 weeks. CYP2A6 polymorphism (*1, *4, *7, *9 or *10) were genotyped. Results: A total of 49 patients were enrolled. Median age was 52 years (range 23–68) and male accounted for 63%. Thirty patients (61%) had intrahepatic cholangiocarcinoma and 10 (20%) gallbladder cancer. Response rate was observed in 24.5%. The median PFS and OS were 3.7 months and 8.7 months . Grade 3–4 adverse events include vomiting (22%), diarrhea (4%) and neutropenia (14%). The allele frequencies of CYP2A6*4, *7, *9 and *10 were 10.2%, 8.2%, 19.4%, and 4.1%, respectively. AUC0–24hr of 5-FU was 1030±617.3 hr*ng/mL (range 249.5–3969, CV: 59.9%). Log- transformed AUC0–24hr were significantly different for FT and 5-FU in the *1/*1 group; metabolic ratio (AUC0- 24hr of 5-FU/AUC0–24hr of FT) of the *1/*1 group was 1.85-times higher than the other group (90% CI 1.37–2.49). AUC0–24hr of CDHP was not significantly associated with CYP2A6 genotype. Despite differences in exposure, CYP2A6 genotypes were not significantly associated with diarrhea (P=0.0740), neutropenia (P=0.396) and clinical efficacy (response rate: P=0.583, PFS: P=0.916). Conclusions: CYP2A6 genotypes was associated with transformation of FT to 5-FU; however, this association did not translate into different clinical efficacy or toxicity. [Table: see text] No significant financial relationships to disclose.
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Affiliation(s)
- K. Kim
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - G. D. Jang
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - H. S. Lim
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - H. S. Kim
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - J. G. Shin
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - J. L. Lee
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - M. H. Ryu
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - H. M. Chang
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - Y. K. Kang
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
| | - T. W. Kim
- Asan Medical Center, Seoul, Republic of Korea; Inje University College of Medicine, Busan, Republic of Korea
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Han JH, Park HS, Shin CI, Chang HM, Yun KE, Cho SH, Choi EY, Lee SY, Kim JH, Sung HN, Kim JH, Choi SI, Yoon YS, Lee ES, Song HR, Bae SC. Metabolic syndrome and quality of life (QOL) using generalised and obesity-specific QOL scales. Int J Clin Pract 2009; 63:735-41. [PMID: 19392923 DOI: 10.1111/j.1742-1241.2009.02021.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES We investigated the association between metabolic syndrome (MS) and health-related quality of life (HRQOL) assessed using generalised and obesity-specific QOL instruments. METHODS We recruited 456 outpatients [age: 19-81 years, body mass index (BMI): 16.3-36.7 kg/m2] in the primary care division from 12 general hospitals in Korea. HRQOL was measured using EuroQol comprising the health states descriptive system (EQ-5D) and visual analogue scale (EQ-VAS) as a general instrument. The Korean Obesity-related QOL scale (KOQOL) composed of six domains was used as a disease-specific QOL instrument. MS was defined on the basis of International Diabetes Federation (IDF) criteria with Korean-specific waist circumference cutoffs (men: 90 cm, women: 85 cm). RESULTS Subjects with MS displayed significantly higher impairment of EQ-5D and KOQOL. Binary logistic regression analysis of MS patients with controls for age, gender, smoking, alcohol, exercise, education, income, marital status and medication history disclosed odds ratio (OR) values of 2.13 (1.33-3.41) for impaired total KOQOL, 2.07 (1.31-3.27) for impaired physical health, 1.63 (1.03-2.60) for impaired work-related health, 2.42 (1.45-4.04) for impaired routine life, 2.08 (1.27-3.40) for impaired sexual life and 2.56 (1.59-4.11) for diet distress. Among the EQ-5D dimensions, only pain/discomfort displayed a significantly increased OR of 1.60 (1.01-2.56) in MS group. CONCLUSIONS Subjects with MS displayed a significantly impaired HRQOL compared with those without MS. MS and HRQOL were more strongly associated in obesity-specific QOL than in generalised QOL.
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Affiliation(s)
- J H Han
- Department of Family Medicine, Eulji University School of College, Seoul, Korea
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16
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Venketasubramanian N, Chen CLH, Gan RN, Chan BPL, Chang HM, Tan SB, Picard D, Navarro JC, Baroque AC, Poungvarin N, Donnan GA, Bousser MG. A double-blind, placebo-controlled, randomized, multicenter study to investigate CHInese Medicine Neuroaid Efficacy on Stroke recovery (CHIMES Study). Int J Stroke 2009; 4:54-60. [PMID: 19236501 DOI: 10.1111/j.1747-4949.2009.00237.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Rationale Traditional Chinese Medications(TCM) have been reported to have beneficial effects in stroke patients, but were not rigorously evaluated by GCP standards. Aim This study tests the hypothesis that Neuroaid, a TCM widely used in China post-stroke, is superior to placebo in reducing neurological deficit and improving functional outcome in patients with acute cerebral infarction of an intermediate severity. Design This is a multicenter, randomised, double-blind, placebo-controlled study of Neuroaid in ischemic stroke patients with National Institute of Health Stroke Scale(NIHSS) 6-14 treated within 48 h of stroke onset. Neuroaid or placebo is taken (4 capsules) 3 times daily for 3 months. Treatments are assigned using block randomization, stratified for centers, via a central web-randomization system. With a power of 90% and two-sided test of 5% type I error, a sample size is 874. Allowing for a drop-out rate of up to 20%, 1100 individuals should be enrolled in this study. Study Outcomes The primary efficacy endpoint is the modified Rankin Scale(mRS) grades at 3 months. Secondary efficacy endpoints are the NIHSS score at 3 months; difference of NIHSS scores between baseline and 10 days, and between baseline and 3 months; difference of NIHSS sub-scores between baseline and 10 days, and between baseline and 3 months; mRS at 10 days, 1 month, and 3 months; Barthel index at 3 months; Mini Mental State Examination at 10 days and 3 months. Safety outcomes include complete blood count, renal and liver panels, and electrocardiogram. STUDY REGISTRATION ClinicalTrials.gov identifier: NCT00554723.
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17
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Abstract
Dried Coptidis Rizoma was extracted with boiling water. Conditioned medium was prepared by stimulating human peripheral blood mononuclear cells with Coptidis Rizoma extract (CR). The conditioned medium was then added to human leukemic U937 cells suspension for investigating the antiproliferation effect and the induction of apoptosis. Apparent DNA fragmentation and morphological changes occurred in U937 cells after incubating for 48 h to 72 h with the conditioned medium that had been prepared with 400 microg CR solids/mL. Flow cytometric analysis revealed that the percentage of apoptotic U937 cells increased in a time- and concentration-dependent manner. The upregulation of Bax expression, the downregulation of Bcl-2 and procaspase-3 expression, and the release of cytochrome c from the mitochondria in U937 cells were all observed. Reverse transcription-polymerase chain reaction detected cytokine-related mRNA expressions in human mononuclear cells incubated with CR. An increase in the concentration of CR in culturing medium downregulated granulocyte macrophage colony-stimulatory factor mRNA expression while upregulated interleuken-2 mRNA expression. All the above-mentioned evidences suggest that CR induces the apoptosis of human leukemic U937 cells via the changes in cytokine profile and protein expressions in mitochondria pathway and that CR has the potential to be used in the therapy of leukemia due to its strong apoptosis-promoting effect.
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Affiliation(s)
- C Y Ma
- Dept. of Restaurant Management, Northern Taiwan Inst. of Science and Technology, Taipei City 112, Taiwan
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18
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Lee JL, Kang YK, Kang HJ, Lee KH, Zang DY, Ryoo BY, Kim JG, Park SR, Kang WK, Shin DB, Ryu MH, Chang HM, Kim TW, Baek JH, Min YJ. A randomised multicentre phase II trial of capecitabine vs S-1 as first-line treatment in elderly patients with metastatic or recurrent unresectable gastric cancer. Br J Cancer 2008; 99:584-90. [PMID: 18665164 PMCID: PMC2527839 DOI: 10.1038/sj.bjc.6604536] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [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: 12/14/2022] Open
Abstract
This randomised multicentre phase II study was conducted to investigate the activity and safety of two oral fluoropyrimidines, capecitabine or S-1, in elderly patients with advanced gastric cancer (AGC). Elderly (⩾65 years) chemo-naive patients with AGC were randomly assigned to receive capecitabine 1250 mg m−2 two times daily on days 1–14 every 3 weeks or S-1 40–60 mg two times daily according to body surface area on days 1–28 every 6 weeks. Ninety-six patients were enrolled and 91 patients were randomised to capecitabine (N=46) or S-1 (N=45). Overall response rate, the primary end point, was 27.2% (95% CI, 14.1–40.4, 12 of 44 assessable patients) with capecitabine and 28.9% (95% CI, 15.6–42.1, 13 of 45) with S-1. Median times to progression and overall survival in the capecitabine arm (4.7 and 9.5 months, respectively) were similar to those in the S-1 arm (4.2 and 8.2 months, respectively). The incidence of grade 3–4 granulocytopenia was 6.8% with capecitabine and 4.8% with S-1. Grade 3–4 nonhaematologic toxicities were: asthenia (9.1% with capecitabine vs 7.1% with S-1), anorexia (6.8 vs 9.5%), diarrhoea (2.3 vs 0%), and hand–foot syndrome (6.8 vs 0%). Both capecitabine and S-1 monotherapies were active and tolerable as first-line treatment for elderly patients with AGC.
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Affiliation(s)
- J-L Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
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Lurje G, Zhang W, Schultheis AM, Yang D, Groshen S, Hendifar AE, Husain H, Gordon MA, Nagashima F, Chang HM, Lenz HJ. Polymorphisms in VEGF and IL-8 predict tumor recurrence in stage III colon cancer. Ann Oncol 2008; 19:1734-41. [PMID: 18550579 DOI: 10.1093/annonc/mdn368] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Identifying molecular markers for tumor recurrence is critical in successfully selecting patients with stage III colon cancer who are more likely to benefit from adjuvant chemotherapy. The present study analyzed a subset of 10 polymorphisms within eight genes involved in the tumor angiogenesis pathway and their impact on prognosis in stage III colon cancer patients treated with adjuvant chemotherapy. PATIENTS AND METHODS Blood samples were obtained from 125 patients with locally advanced colon cancer at University of Southern California medical facilities. DNA was extracted from peripheral blood and the genotypes were analyzed using PCR-restriction fragment length polymorphism and 5'-end [gamma-(33)P] ATP-labeled PCR protocols. RESULTS Polymorphisms in vascular endothelial growth factor (VEGF) (C+936T; P = 0.003, log-rank test) and interleukin-8 (IL-8) (T-251A; P = 0.04, log-rank test) were independently associated with risk of recurrence in stage III colon cancer patients. In combined analysis, grouping alleles into favorable versus nonfavorable alleles, high expression variants of VEGF C+936T and IL-8 T-251A were associated with a higher likelihood of developing tumor recurrence (P < 0.001). CONCLUSION High expression variants of VEGF C+936T and IL-8 T-251A were associated with shorter time to tumor recurrence, indicating that the analysis of angiogenesis-related gene polymorphisms may help to identify patient subgroups at high risk for tumor recurrence.
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Affiliation(s)
- G Lurje
- Division of Medical Oncology, University of SouthernCalifornia, Sharon A Carpenter Laboratory, Norris Comprehensive Cancer Center, Keck School of Medicine, Los Angeles, CA 90033, USA
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20
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Lin YH, Sun YC, Jian WB, Chang HM, Huang YS, Lin JJ. Electrical transport studies of individual IrO(2) nanorods and their nanorod contacts. Nanotechnology 2008; 19:045711. [PMID: 21817528 DOI: 10.1088/0957-4484/19/04/045711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
We have studied the electrical transport properties of individual single-crystalline IrO(2) nanorods prepared by the metal-organic chemical vapour deposition method. With the help of the standard electron-beam lithographic technique, individual nanorods are contacted by Cr/Au submicron electrodes from above. Utilizing two-probe, three-probe and four-probe measurement configurations, not only the intrinsic electrical transport properties of the individual nanorods but also the electronic contact resistances, R(c)(T), have been determined from 300 K down to liquid-helium temperatures. Our measured resistivity behaviour of the nanorods is in close agreement with the current theoretical understanding of this rutile material. On the other hand, we found that the temperature behaviour of the electronic contact resistance obeys the law [Formula: see text] over an extremely wide temperature range, from approximately 100 K down to liquid-helium temperatures. This latter conduction process is ascribed to the hopping of electrons through nanoscale Cr granules and/or an amorphous coating incidentally formed at the interface between the submicron Cr/Au electrode and the nanorod.
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Affiliation(s)
- Y H Lin
- Institute of Physics, National Chiao Tung University, Hsinchu 30010, Taiwan
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21
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Ryu MH, Kang YK, Jang SJ, Kim TW, Lee H, Kim JS, Park YH, Lee SS, Ryoo BY, Chang HM, Lee JL, Yook JH, Kim BS, Lee JS. Prognostic significance of p53 gene mutations and protein overexpression in localized gastrointestinal stromal tumours. Histopathology 2007; 51:379-89. [PMID: 17727479 DOI: 10.1111/j.1365-2559.2007.02797.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIMS Mutation of c-kit is a relatively early event in the tumorigenesis of gastrointestinal stromal tumours (GISTs). The aim was to determine the prognostic significance of p53 alterations as an additional genetic change in GISTs. METHODS AND RESULTS We reviewed 125 patients with localized GISTs subjected to complete resection between 1990 and 2002. Mutational analyses of c-kit exons 9, 11, 13 and 17, p53 exons 4-8 and immunohistochemistry for p53 protein were conducted using paraffin-embedded tissues. Alterations of p53 were observed in 50 patients (40.0%). Based on the National Institutes of Health's risk category, p53 alterations were noted more frequently in the higher risk categories (P = 0.041). With a median follow-up of 56.5 months (range: 2.3-126.8), 5-year relapse-free survival (RFS) rates were 61.7% without p53 alterations, compared with only 40.2% with p53 alterations (P = 0.009). Multivariate analysis indicated that p53 alterations comprised an independent, poor prognostic factor for RFS, in addition to c-kit mutations, large size, a high mitotic count and non-gastric primary sites. CONCLUSIONS Alterations in p53 were more commonly observed in localized GISTs at higher risk of relapse. This suggests that they are significant as an independent, poor prognostic factor.
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Affiliation(s)
- M H Ryu
- Department of Internal Medicine, Asan Medical Centre, Seoul, Korea
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22
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Shaye OS, Chang HM, Yang DY, Shriki J, Schultheis AM, Zhang W, Lurje G, Iqbal S, Lenz HJ, El- Khoueiry AB. Polymorphisms in angiogenesis related genes predict clinical outcome in patients (pts) with metastatic colorectal cancer (mCRC) treated with first line 5-FU or capecitabine in combination with oxaliplatin and bevacizumab (FOLFOX/BV or XELOX/BV). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10576 Background: The inhibition of angiogenesis is central to the mechanism of action of BV, a monoclonal antibody to vascular endothelial growth factor (VEGF). We evaluated functionally significant polymorphisms of genes involved in the angiogenesis/VEGF pathway as potential molecular predictors of clinical outcome in pts with mCRC who received BV as part of their frontline therapy. These genes included: VEGF, VEGF receptor 2 (KDR), neuropilin 1 (NRP 1), Interleukin (IL) 6 and 8, IL receptor 1 and 2 (CXCR 1, CXCR 2) adrenomedullin (AM), leptin, fibroblast growth factor receptor 4 (FGFR4), tissue factor (TF), matrix metalloproteinases (MMP 2,7,9), epidermal growth factor receptor (EGFR), aryl hydrocarbon receptor nuclear translocator (ARNT), and nuclear factor kappa b (NFkb). Methods: PCR-RFLP assays were performed on genomic DNA extracted from the blood of 30 pts with mCRC treated with first-line FOLFOX/BV or XELOX/BV at USC. Results: the cohort consisted of 21 males and 9 females with a median age of 56 years (range: 29–81). 20 pts received XELOX/BV as part of an on-going phase II study, 10 pts received FOLFOX/BV. Radiologic response was evaluable in 27/30 pts: 2/27 (7%) complete response (CR), 14/27 (52%) partial response (PR), and 10/27 (37%) stable disease (SD) and 1/28 (4%) progressive disease. At a median follow-up of 19.4 months, 16/30 pts progressed with a median progression free survival (PFS) of 11.8 months. Pts homozygous A/A at the leptin 5'UTR region had a higher probability of response than pts with the G/A or G/G genotypes (p=0.03, Fisher's exact test). Pts with one or more G allele (G/G or A/G) at locus -181 in the promoter region of MMP7 had a higher probability of response than pts with the AA genotype (p=0.014, Fisher's exact test). There were statistically significant associations between genomic polymorphisms of KDR, CXCR2, MMP7 and PFS (<0.05, Log-rank test). Conclusions: This pilot study demonstrated, in a preliminary fashion, the potential predictive and prognostic value of several genomic polymorphisms in pts with mCRC treated with FOLFOX/BV or XELOX/BV. No significant financial relationships to disclose.
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Affiliation(s)
- O. S. Shaye
- University of Southern California, Los Angeles, CA
| | - H. M. Chang
- University of Southern California, Los Angeles, CA
| | - D. Y. Yang
- University of Southern California, Los Angeles, CA
| | - J. Shriki
- University of Southern California, Los Angeles, CA
| | | | - W. Zhang
- University of Southern California, Los Angeles, CA
| | - G. Lurje
- University of Southern California, Los Angeles, CA
| | - S. Iqbal
- University of Southern California, Los Angeles, CA
| | - H. J. Lenz
- University of Southern California, Los Angeles, CA
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Nagashima F, Zhang W, Gordon M, Chang HM, Lurje G, Borucka E, Yang D, Ladner R, Rowinsky E, Lenz HJ. EGFR, Cox-2, and EGF polymorphisms associated with progression-free survival of EGFR-expressing metastatic colorectal cancer patients treated with single-agent cetuximab (IMCL-0144). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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
4129 Background: A phase II study of cetuximab (IMCL-0144) has shown response rate of 12 % in patients with EGFR expressing metastatic colorectal cancer (mCRC). Recently, we reported that polymorphisms in the EGFR pathway may be useful molecular markers to predict clinical outcome. In this larger study, we tested whether polymorphisms in genes involved in the EGFR and angiogenesis pathway will be associated with clinical outcome. Methods: We analyzed 136 tissue samples from 346 mCRC pts enrolled in the phase II study of cetuximab (IMCL-0144), 133 cases were informative. The response rate in these 133 pts was 10% with a median progression-free survival (PFS) of 1.3 months (95% CI, 1.2 to 1.5) and an overall survival time (OS) of 5.5 months (95% CI, 4.1 to 7.5). Gr3–4 toxicity was observed in 56%. Gene polymorphisms of EGFR, Cox-2, EGF, cyclin D1, fragment c γ receptor 2A (FCGR2A), FCGR3A, VEGF, IL-8 were assessed from gDNA extracted from tissue samples by using PCR-based RFLP technique. Univariate analysis (Fisher’s exact test for response; log-rank test for PFS and OS) was performed to examine associations between polymorphisms and clinical outcome. A classification and regression tree (CART) analysis was used to identify subgroups of patients who were more likely to benefit from cetuximab. Results: Pts with EGFR G497C GA, Cox-2 G-765C CC, EGF A61G GG genotype showed better PFS (p=0.02, 1.8mo. vs. 1.2mo.; p=0.03, 6.9mo. vs. 1.3mo.; p=0.04, 1.4mo. vs. 1.2mo.), respectively. We found trends in associations between Cox-2 and tumor response (p=0.09), between EGF and Gr3–4 toxixity (p=0.06). CART analyses indicated that germline polymorphisms in EGFR, EGF, Cox-2, Cyclin D1, IL-8, FCGR2A and FCGR3A genes could be used to identify patients who benefit most likely of cetuximab therapy. Conclusions: Our data suggest that the polymorphisms of EGFR, Cox-2, and EGF may be useful molecular markers to predict clinical outcome in mCRC pts treated with single-agent cetuximab. And prospective studies will need to be done to confirm these preliminary findings. [Table: see text]
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Affiliation(s)
- F. Nagashima
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - W. Zhang
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - M. Gordon
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - H. M. Chang
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - G. Lurje
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - E. Borucka
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - D. Yang
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - R. Ladner
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - E. Rowinsky
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
| | - H. J. Lenz
- Univ of Southern California, Los Angeles, CA; Imclone Systems Inc, New York, NY
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Lurje G, Schultheis AM, Hendifar AE, Ashouri S, Zhang W, Gordon MA, Nagashima F, Chang HM, Yang D, Lenz HJ. VEGF and VEGF receptor-2 (VEGFR2) gene polymorphisms predict tumor recurrence in stage II and III colon cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4004 Background: Despite recent advances in the treatment of metastatic colorectal cancer, tailoring adjuvant treatment of stage II and III colon cancer patients remains controversial. Identifying a reliable panel of prognostic and predictive markers for tumor recurrence is critical in selecting an individualized and tailored chemotherapy. Tumor angiogenesis plays an important role in tumor development, progression and metastasis. In this retrospective study, we tested whether a specific pattern of 40 functionally significant polymorphisms in 37 genes involved in angiogenesis and tumor microenvironment will predict the risk of tumor recurrence in stage II and III colon cancer patients treated with adjuvant chemotherapy. Methods: Between 1999 and 2006 blood specimens from 140 patients (69 females and 71 males with a median age of 59 years; range=28–86) were obtained at the University of Southern California/Norris Comprehensive Cancer Center (USC/NCCC). Sixty-three patients had stage II and 77 had stage III colon cancer. The median follow-up was 5.4 years (range=2.0–16.8). 51 of 140 patients (36.4%) developed tumor recurrence with a 5-year probability of 0.28 ± 0.06 for stage II and 0.40 ± 0.06 for stage III colon cancer patients. Genomic DNA was extracted from peripheral blood and genotypes were determined using PCR based RFLP. Results: Polymorphisms in VEGF (C936T; p=0.009, log-rank) and VEGFR2 (+4422 AC- repeat; p=0.04, log-rank and +1416 T/A; p=0.0009, log-rank) were associated with risk of tumor recurrence in stage III colon cancer patients (n=77). VEGFR2 AC-repeat polymorphisms were additionally associated with risk of recurrence in Stage II colon cancer patients (n=63, p=0.02, log-rank). Conclusion: VEGF C936T and VEGFR2 (+4422 AC-repeat and +1416 T/A) polymorphisms may help to identify Stage II and III colon cancer patients who are at increased risk for developing tumor recurrence. Angiogenesis seems to play a crucial role in tumor recurrence, thus targeting VEGF and VEGFR2 may be of clinical benefit for stage II and stage III colon cancer patients. Large prospective trials are needed to validate these preliminary data. No significant financial relationships to disclose.
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Affiliation(s)
- G. Lurje
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | | | - A. E. Hendifar
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | - S. Ashouri
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | - W. Zhang
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | - M. A. Gordon
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | - F. Nagashima
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | - H. M. Chang
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | - D. Yang
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
| | - H. J. Lenz
- USC / Norris Comprehensive Cancer Center, Los Angeles, CA
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Koo DH, Chang HM, Jung JY, Song JH, Lee JL, Ryu MH, Kim TW, Yook JH, Song JS, Lee JS, Kang YK. Cutaneous metastasis resembling acute dermatitis in patient with advanced gastric cancer. Clin Exp Dermatol 2007; 32:284-6. [PMID: 17263831 DOI: 10.1111/j.1365-2230.2007.02361.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The most common metastatic sites from gastric cancer are the liver, intra-abdominal lymph nodes, ovary and peritoneal cavity. Cutaneous metastasis of gastric cancer is rare, and most cutaneous metastases are typically solitary, nodular, have a firm consistency, and are red or hyperpigmented. Thus, cutaneous metastasis is easily distinguished from other skin disease. We report a case of a 60-year-old woman with cutaneous metastasis of gastric cancer, whose facial skin showed painless pruritic eczema, resembling acute dermatitis. She had earlier undergone a total gastrectomy for advanced gastric cancer in our hospital. After 14 months, she developed eczematous facial lesions; the presumptive diagnosis was acute dermatitis. However, skin biopsy unexpectedly revealed cutaneous metastasis of gastric cancer. After 6 months of systemic chemotherapy with capecitabine and cisplatin, the cutaneous metastasis was markedly improved and a clinically complete remission was accomplished.
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Affiliation(s)
- D H Koo
- Department of Internal Medicine (Division of Oncology), Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea
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Koo DH, Lee JL, Kim TW, Chang HM, Ryu MH, Yook JH, Oh ST, Kim BS, Lee JS, Kang YK. Adjuvant chemotherapy with 5-fluorouracil, doxorubicin and mitomycin-C (FAM) for 6 months after curative resection of gastric carcinoma. Eur J Surg Oncol 2007; 33:843-8. [PMID: 17207959 DOI: 10.1016/j.ejso.2006.11.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Accepted: 11/28/2006] [Indexed: 11/18/2022] Open
Abstract
AIM This study aimed to evaluate the efficacy and safety of 5-fluorouracil (5-FU), doxorubicin and mitomycin-C (FAM) adjuvant chemotherapy in patients who had undergone curative resection of gastric carcinoma. METHODS From Nov 1999 to Jan 2002, 291 consecutive patients with stage IB-IIIB gastric adenocarcinoma were given FAM adjuvant chemotherapy. Chemotherapy comprised intravenous 5-FU 600 mg/m(2) (days 1, 8, 29 and 36), doxorubicin 30 mg/m(2) (days 1 and 29) and mitomycin-C 10 mg/m(2) (day 1), every 8 weeks for 6 months. RESULTS The median follow-up time was 60.6 months, 92 patients died, and 93 patients had recurrent disease. The 5-year overall survival (OS) rates were 85.9% for stage IB, 72.1% for stage II, 58.0% for stage IIIA, and 48.2% for stage IIIB (p=0.002). The 5-year relapse-free survival (RFS) rates were 85.2% for stage IB, 71.2% for stage II, 53.3% for stage IIIA, and 39.2% for stage IIIB (p<0.001). A total of 769 cycles of chemotherapy were delivered, and 15 patients experienced grade 3 or higher leukopenia. The most common grade 3 or higher non-hematologic toxicity was nausea/vomiting (11 patients), followed by stomatitis (3 patients). CONCLUSIONS Adjuvant chemotherapy with FAM for 6 months for gastric carcinoma indicated comparable RFS and OS with an acceptable toxicity profile.
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Affiliation(s)
- D H Koo
- Division of Oncology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, Republic of Korea
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Chang HM, Hsieh HF, Hsu SD, Liao GS, Lin CH, Hsieh CB, Yu JC. Guidewire assisted cephalic vein cutdown for insertion of totally implantable access ports. J Surg Oncol 2007; 95:156-7. [PMID: 17262733 DOI: 10.1002/jso.20584] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Totally implantable access ports (TIAP) placed by the cephalic vein cutdown technique have high failure rates. METHODS We describe a guidewire assisted technique of the cephalic vein cutdown for TIAP placement that can be easily introduced catheter when difficulties in insertion of the catheter. The key point of the presented technique is the use of J guidewire to go beyond the stenosis and advancement of catheter through the guidewire into the superior vena cava. RESULTS We used this technique for introducing the catheter in six patients without failure or complication. CONCLUSION The presented technique is easy and simple. It can be used where there are difficulties in insertion of the catheter by cephalic vein cutdown method.
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Affiliation(s)
- H M Chang
- Department of Surgery, Division of General Surgery, Tri-Service General Hospital, National Defense Medical Center, Nei Hu, Taipei, Taiwan, ROC
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Charng MJ, Chiou KR, Chang HM, Cheng HM, Ye ZX, Lin SJ. Identification and characterization of novel low-density lipoprotein receptor mutations of familial hypercholesterolaemia patients in Taiwan. Eur J Clin Invest 2006; 36:866-74. [PMID: 17087781 DOI: 10.1111/j.1365-2362.2006.01735.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Familial hypercholesterolaemia (FH) is an autosomal dominant disease associated with a very high risk of coronary vascular disease. The study objective was to identify patients with FH in Taiwan and characterize novel mutations. MATERIALS AND METHODS Fifty-one patients with suspected FH living in Taiwan were screened for mutations in both the low-density lipoprotein (LDL) receptor and the apolipoprotein (apoB) genes using the multiplex polymerase chain reaction and exon-by-exon DNA sequencing technique. Functional consequences on LDL receptor activity were characterized in vitro for novel mutations and family pedigree was also analyzed. RESULTS Thirteen different functional mutations in the LDL receptor gene and one mutation in the apoB gene were found in 21 patients. Among the 13 mutations in the LDL receptor gene, 10 were single-point missense mutations, one was a two-point mutation in the same allele, one was a non-sense mutation and one was a frame-shift mutation. There were three novel mutations, including two missense mutations (M510K and W512R) and one frame-shift mutation (1953 delTA mutation). The characterization of missense M510K retained 36.2% of the activity of the normal receptor. Conversely, frame-shift 1953 delTA and missense W512R led to defective proteins, with only 0-6% of normal receptor activity. CONCLUSIONS The study identified 13 LDL receptor gene mutations and characterized three novel mutations causing FH in Taiwan. This facilitated a better understanding of FH among the Chinese population and may enable diagnosis of FH at the molecular level at a presymptomatic, early age.
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Affiliation(s)
- M J Charng
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
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Park IJ, Kim HC, Yu CS, Ryu MH, Chang HM, Kim JH, Ryu JS, Yeo JS, Kim JC. Efficacy of PET/CT in the accurate evaluation of primary colorectal carcinoma. Eur J Surg Oncol 2006; 32:941-7. [PMID: 16843635 DOI: 10.1016/j.ejso.2006.05.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2006] [Accepted: 05/31/2006] [Indexed: 10/24/2022] Open
Abstract
AIM This study was performed to assess in the accurate evaluation of primary colorectal carcinoma using PET/CT. METHODS One hundred patients with primary colorectal carcinoma were evaluated during 2004. All patients underwent PET/CT when their preoperative serum carcinoembryonic antigen was >or=10 ng/mL or when CT showed equivocal findings. The appropriateness of PET/CT-induced changes was noted by subsequent operative findings and follow-up. RESULTS PET/CT more detected 15 intra-abdominal metastatic lesions than abdomino-pelvic CT scan. PET/CT showed true negative findings in 13 patients and false positive or negative findings in 10. Due to PET/CT results, management plans were altered in 27 patients; 9 had inter-modality changes, 10 received more extensive surgery, and 8 avoided unnecessary procedures. CONCLUSIONS PET/CT altered management plan in 24% of patients with primary colorectal carcinoma in correct direction. These findings suggest that PET/CT should be considered a part of standard work up for preoperative evaluation in a subset of patients with colorectal carcinoma.
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Affiliation(s)
- I J Park
- DongGuk University Hospital, Digestive Disease Center, Department of Surgery, Goyang, South Korea
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Chang HM, Hsieh CB, Hsieh HF, Chen TW, Chen CJ, Chan DC, Yu JC, Liu YC, Shen KL. An alternative technique for totally implantable central venous access devices. A retrospective study of 1311 cases. Eur J Surg Oncol 2006; 32:90-3. [PMID: 16289481 DOI: 10.1016/j.ejso.2005.09.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2005] [Accepted: 09/20/2005] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of the present study was to report our experience of totally implantable central venous access devices (TICVAD) implantation using two techniques and attempt to define the better technique. MATERIALS AND METHODS From January 1998 to September 2003, 1131 patients were reviewed and divided into two groups with implantation by cephalic vein cut-down (group A) done by general surgeons and subclavian vein puncture with the Seldinger technique (group B) done by vascular surgeons. The operative time, early and late complications of these two groups were compared. Data were analysed by Student's t-test. RESULTS The average of operative time was 43 min in group A (35-70 min) and 40 min in group B (35-60 min) (P>0.05). No post-operative pneumothorax, hemothorax and fragmentation occurred in group A; the incidence of peri-operative complication was higher in group B. The overall and early complications of group A were significantly lower than that of group B (P<0.0001). CONCLUSION This retrospective study showed that the cephalic vein cut-down approach for TICVAD placement avoided the risks of pneumothorax, hemothorax and catheter fragmentation.
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Affiliation(s)
- H M Chang
- Division of General Surgery, Department of Surgery, National Defense Medical Center, Tri-Service General Hospital, No. 325, Sec 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan, ROC
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31
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Ryu MH, Lee H, Kim TW, Chang HM, Lee JL, Kang WK, Bang YJ, Shin DB, Lee KH, Park YH, Kang YK. p53 mutation as a determinant of prognosis in GIST patients treated with imatinib mesylate. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M.-H. Ryu
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - H. Lee
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - T. W. Kim
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - H. M. Chang
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - J.-L. Lee
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - W. K. Kang
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - Y.-J. Bang
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - D. B. Shin
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - K. H. Lee
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - Y. H. Park
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
| | - Y.-K. Kang
- Asan Medcl Ctr, Seoul, Republic of Korea; Samsung Medcl Ctr, Seoul, Republic of Korea; Seoul National Univ Hosp, Seoul, Republic of Korea; Gil Medcl Ctr, Incheon, Republic of Korea; Yeungnam Univ Medcl Ctr, Daegu, Republic of Korea; Korea Cancer Ctr Hosp, Seoul, Republic of Korea
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Lee JL, Ryu MH, Kang HJ, Chang HM, Kim TW, Lee JS, Kang YK. Efficacy and safety study of docetaxel as salvage chemotherapy in metastatic gastric cancer failing fluoropyrimidine and platinum combination chemotherapy. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4220] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- J.-L. Lee
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - M.-H. Ryu
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - H. J. Kang
- Asan Medcl Ctr, Seoul, Republic of Korea
| | | | - T.-W. Kim
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - J. S. Lee
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - Y.-K. Kang
- Asan Medcl Ctr, Seoul, Republic of Korea
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Chang HM, Ryu MH, Lee JL, Kim TW, Lee JS, Kim WK, Kang YK. Phase II trial of gemcitabine plus capecitabine in patients with advanced biliary tract cancer. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.4173] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - M.-H. Ryu
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - J.-L. Lee
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - T. W. Kim
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - J. S. Lee
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - W. K. Kim
- Asan Medcl Ctr, Seoul, Republic of Korea
| | - Y.-K. Kang
- Asan Medcl Ctr, Seoul, Republic of Korea
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Kang HJ, Chang HM, Kim TW, Ryu MH, Sohn HJ, Yook JH, Oh ST, Kim BS, Lee JS, Kang YK. Phase II study of capecitabine and cisplatin as first-line combination therapy in patients with gastric cancer recurrent after fluoropyrimidine-based adjuvant chemotherapy. Br J Cancer 2005; 92:246-51. [PMID: 15655540 PMCID: PMC2361863 DOI: 10.1038/sj.bjc.6602336] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
To evaluate the efficacy and safety of capecitabine and cisplatin in patients with recurrent gastric cancer after fluoropyrimidine-based adjuvant therapy. Patients with histologically confirmed and measurable advanced gastric cancer that had relapsed after fluoropyrimidine-based adjuvant chemotherapy received oral capecitabine (1250 mg m−2 twice daily, days 1–14) and intravenous cisplatin (60 mg m−2 over 1 h, day 1) every 3 weeks. In total, 32 patients were enrolled, of whom 30 were evaluable for efficacy and 32 for safety. A median of 5 cycles (range 1–10) was administered. One patient achieved a complete response and eight had partial responses, giving an overall response rate of 28% (95% CI, 13–44%). The median time to progression and median overall survival were 5.8 months (95% CI, 4.1–7.5 months) and 11.2 months (95% CI, 5.5–16.9 months), respectively. Grade 3 neutropenia and thrombocytopenia were observed in 38 and 6% of patients, respectively. Grade 2/3 nonhaematological toxicities included diarrhoea (19%), stomatitis (19%) and hand-foot syndrome (31%). No grade 4 toxicity, neutropenic fever or treatment-related deaths occurred. Capecitabine in combination with cisplatin was effective and well tolerated as first-line treatment in patients with recurrent gastric cancer after fluoropyrimidine-based adjuvant chemotherapy.
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Affiliation(s)
- H J Kang
- Division of Oncology, Department of Medicine, Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, South Korea.
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Hwu Y, Tsai WL, Chang HM, Yeh HI, Hsu PC, Yang YC, Su YT, Tsai HL, Chow GM, Ho PC, Li SC, Moser HO, Yang P, Seol SK, Kim CC, Je JH, Stefanekova E, Groso A, Margaritondo G. Imaging cells and tissues with refractive index radiology. Biophys J 2004; 87:4180-7. [PMID: 15465870 PMCID: PMC1304927 DOI: 10.1529/biophysj.103.034991] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Can individual cells, including live cells, be imaged using hard x rays? Common wisdom until now required sophisticated staining techniques for this task. We show instead that individual cells and cell details can be detected in culture solution and tissues with no staining and no other contrast-enhancing preparation. The sample examined can be much thicker than for many other microscopy techniques without sacrificing the capability to resolve cells. The key factor in our approach is the use of a coherent synchrotron source and of contrast mechanisms based on the refractive index. The first successful tests were conducted on a variety of cell systems including skin and internal leaf cells, mouse neurons, rabbit fibroblast cells, and human tumor cells.
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Affiliation(s)
- Y Hwu
- Institute of Physics, Academia Sinica, Nankang, Taipei, Taiwan
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Chang HM, Kim TW, Ahn JH, Ryu MH, Lee JS, Kim WK, Kang YK. Phase II study of gemcitabine, capecitabine and cisplatin in patients with advanced pancreatic cancer. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. M. Chang
- Asan Medical Center, Seoul, Republic of Korea
| | - T. W. Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - J. H. Ahn
- Asan Medical Center, Seoul, Republic of Korea
| | - M. H. Ryu
- Asan Medical Center, Seoul, Republic of Korea
| | - J. S. Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - W. K. Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - Y.-K. Kang
- Asan Medical Center, Seoul, Republic of Korea
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Kang HJ, Kim TW, Chang HM, Ryu MH, Yook JH, Oh ST, Kim BS, Lee JS, Kim WK, Kang YK. A phase II study of paclitaxel and capecitabine combination chemotherapy in patients with advanced gastric cancer as a first-line therapy. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.4051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- H. J. Kang
- Asan Medical Center, Seoul, Republic of Korea
| | - T. W. Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - H. M. Chang
- Asan Medical Center, Seoul, Republic of Korea
| | - M.-H. Ryu
- Asan Medical Center, Seoul, Republic of Korea
| | - J. H. Yook
- Asan Medical Center, Seoul, Republic of Korea
| | - S. T. Oh
- Asan Medical Center, Seoul, Republic of Korea
| | - B. S. Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - J. S. Lee
- Asan Medical Center, Seoul, Republic of Korea
| | - W. K. Kim
- Asan Medical Center, Seoul, Republic of Korea
| | - Y.-K. Kang
- Asan Medical Center, Seoul, Republic of Korea
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Kim JC, Lee KH, Yu CS, Kim HC, Kim JR, Chang HM, Kim JH, Kim JS, Kim TW. The clinicopathological significance of inferior mesenteric lymph node metastasis in colorectal cancer. Eur J Surg Oncol 2004; 30:271-9. [PMID: 15028308 DOI: 10.1016/j.ejso.2003.12.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2003] [Indexed: 11/18/2022] Open
Abstract
AIMS There are few studies reporting survival or recurrence patterns in colorectal cancer patients with inferior mesenteric lymph node metastasis (IMLN+). The present study evaluated the prognostic significance of patients being IMLN+ or IMLN- in colorectal cancer. METHODS Survival, recurrence pattern and treatment protocols were compared between 63 IMLN+ patients and 108 IMLN- patients with stage III and IV rectal and sigmoid cancer undergoing curative surgery. Lymph node sampling was routinely performed prior to inferior mesenteric artery ligation and excision flush with aorta. Limited principal node dissection including IMLN was performed in cases of identified node metastasis. RESULTS The 5-year disease-free survival rates were 50% in IMLN- and 31% in IMLN+ patients (P=0.004). The 5-year disease-free survival rate was greater in the N1 group than the N2 group (P=0.038). Cox regression analysis showed IMLN+, lymphovascular tumour invasion, T4, M1, and pre-operative serum CEA level over 6 ng/ml were independently associated with unfavorable disease-free survival. The prognostic significance of M category was greater when the IMLN+ was included in the M1 as opposed to the N category. In patients undergoing absolute curative surgery, post-operative recurrence rates were 34% for IMLN- and 57% for IMLN+ patients (P=0.009; OR, 2.611; 95% CI, 1.313-5.194). For IMLN+ patients, post-operative adjuvant treatment independently correlated with disease-free survival (P=0.029). CONCLUSIONS IMLN+ is an independent survival factor enhancing the prognostic significance of the M category in the AJCC staging. Curative radical surgery and post-operative chemoradiotherapy appears to be warranted for IMLN+ colorectal cancer patients as it resulted in 5-year disease-free survival rates of up to 31% compared to 50% in IMLN- patients.
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Affiliation(s)
- J C Kim
- Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, 388-1 Poongnap-2-Dong Songpa-Ku, Seoul 138-736, South Korea.
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Kim TW, Chang HM, Kang HJ, Lee JR, Ryu MH, Ahn JH, Kim JH, Lee JS, Kang YK. Phase II study of capecitabine plus cisplatin as first-line chemotherapy in advanced biliary cancer. Ann Oncol 2003; 14:1115-20. [PMID: 12853355 DOI: 10.1093/annonc/mdg281] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A phase II study was conducted to assess the efficacy and tolerability of substituting capecitabine for 5-fluorouracil in combination with cisplatin in patients with advanced biliary cancer. PATIENTS AND METHODS Patients with previously untreated metastatic or unresectable measurable biliary adenocarcinoma received oral capecitabine 1250 mg/m(2) twice daily on days 1-14, and intravenous cisplatin 60 mg/m(2) on day 1. This cycle was repeated every 21 days. RESULTS Forty-two patients were enrolled in this study. Of these, 38 were assessable for efficacy and 41 were assessable for safety. A median of three cycles of treatment (range one to eight) were administered. One patient achieved a complete response, and eight had partial responses, giving an overall response rate of 21.4% in the intention-to-treat population (95% confidence interval 9.1% to 33.9%). The median response duration was 5.1 months. The median time to progression and median overall survival were 3.7 and 9.1 months, respectively. The most common grade 3/4 adverse events were neutropenia (20% of patients), vomiting (12%), diarrhea (7%) and stomatitis (5%). There were no treatment-related deaths. CONCLUSIONS The combination of capecitabine and cisplatin has promising antitumor activity and is well tolerated in patients with advanced biliary cancer.
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Affiliation(s)
- T W Kim
- Section of Hematology-Oncology, Department of Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
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Kim TW, Kang YK, Ahn JH, Chang HM, Yook JH, Oh ST, Kim BS, Lee JS. Phase II study of capecitabine plus cisplatin as first-line chemotherapy in advanced gastric cancer. Ann Oncol 2002; 13:1893-8. [PMID: 12453857 DOI: 10.1093/annonc/mdf323] [Citation(s) in RCA: 95] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A phase II study was conducted to assess the efficacy and tolerability of combination therapy with capecitabine and cisplatin in patients with advanced gastric cancer. PATIENTS AND METHODS Patients with previously untreated metastatic or unresectable measurable gastric adenocarcinoma received oral capecitabine 1250 mg/m(2) twice daily, days 1-14, and i.v. cisplatin 60 mg/m(2) on day 1. This cycle was repeated every 3 weeks. RESULTS Forty-two patients were enrolled in this study. Of these, 38 patients were assessable for efficacy and 40 were assessable for toxicity. One patient achieved a complete response and 22 patients had partial responses, giving an overall response rate of 54.8% in the intention-to-treat population (95% confidence interval 39.8% to 69.8%). The median time to progression was 6.3 months and the median overall survival was 10.1 months. The principal adverse events were neutropenia and hand-foot syndrome. Grade 3/4 adverse events were neutropenia (32.5% of patients), thrombocytopenia (10%), stomatitis (2.5%) and diarrhea (5%). Grade 2 and 3 hand-foot syndrome occurred in 20% and 7.5% of patients, respectively. There were no treatment-related deaths. CONCLUSIONS The combination of capecitabine and cisplatin is active and well tolerated in patients with advanced gastric cancer.
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Affiliation(s)
- T W Kim
- Section of Hematology-Oncology, Department of Medicine and Department of General Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Venketasubramanian N, Chang HM, Chan BPL. Update in the management of stroke. Ann Acad Med Singap 2002; 31:717-20; quiz 721. [PMID: 12520824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Recent advances have improved the outlook for patients with stroke, Singapore's fourth leading cause of death. Stroke unit care reduces death, dependency and institutionalisation, independent of age, gender and stroke severity. Neuroimaging is essential prior to initiation of specific therapies. While computed tomography (CT) Head remains the most widely used modality, magnetic resonance imaging (MRI), particularly diffusion weighted imaging (DWI) has enhanced the positive diagnosis of ischaemic stroke. General medical measures include close monitoring, adequate oxygenation, avoidance of excessive blood pressure lowering, reduction of hyperthermia, control of hyperglycaemia, adequate nutrition, prevention of complications and early rehabilitation. Despite the risk of fatal intracranial haemorrhage, thrombolysis may improve outcomes in appropriately selected patients with ischaemic stroke. No safe and effective neuroprotectant has been found. While suboccipital craniectomy is established for large cerebellar infarcts and haemorrhage, surgical evacuation of supratentorial haemorrhage has not been shown to be beneficial. Hemicraniectomy reduces mortality after massive hemispheric ischemic stroke. Early and sustained antiplatelet use after atherothrombotic stroke reduces stroke recurrence. Stroke recurrence is also reduced by sustained warfarin use for cardioembolic stroke, carotid endarterectomy for severe symptomatic internal carotid artery stenosis, blood pressure lowering starting after the acute phase of stroke and lipid lowering. On-going clinical trails are likely to provide better treatments in the near future.
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Affiliation(s)
- N Venketasubramanian
- Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433.
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Chang HM, Jung KH, Kim TY, Kim WS, Yang HK, Lee KU, Choe KJ, Heo DS, Bang YJ, Kim NK. A phase III randomized trial of 5-fluorouracil, doxorubicin, and mitomycin C versus 5-fluorouracil and mitomycin C versus 5-fluorouracil alone in curatively resected gastric cancer. Ann Oncol 2002; 13:1779-85. [PMID: 12419751 DOI: 10.1093/annonc/mdf302] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A phase III single-center randomized trial was performed in order to determine whether the addition of mitomycin C (MMC) and/or doxorubicin to 5-fluorouracil (5-FU) as adjuvant chemotherapy could influence survival in patients with curatively resected gastric cancer. PATIENTS AND METHODS A total of 416 patients who had undergone curative resection for stage IB-IIIB gastric adenocarcinoma were stratified according to the stage and type of surgery, and then randomized to receive one of the three chemotherapy regimens, 5-FU alone (F) or 5-FU and MMC (FM) or 5-FU, doxorubicin and MMC (FAM) within 5 weeks after surgery. RESULTS Of 416 patients registered, 395 (133 in F, 131 in FM and 131 in FAM) were assessable. Median follow-up duration was 91 months. Five-year overall survival rates were 67.2% for F, 67.0% for FM and 66.7% for FAM (P = 0.97). Five-year disease-free survival rates were 62.1% for F, 63.3% for FM and 62.5% for FAM (P = 0.83). Hematological toxicities were more frequent in the FM and FAM groups, whereas stomatitis was more common in the F group. CONCLUSIONS Compared with adjuvant 5-FU alone, the addition of MMC and/or doxorubicin to 5-FU did not influence survival in patients with resected gastric cancer.
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Affiliation(s)
- H M Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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Chang HM, Jaffe HH, Masmanidis CA. Use of the CNDO method in spectroscopy. XIII. Direct calculation of self-consistent triplet excited states of organic molecules. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100578a016] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Chang HM, Jaffe HH, Masmanidis CA. Use of the CNDO method in spectroscopy. XIV. Electronic spectra of free radicals and free radical ions. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100578a017] [Citation(s) in RCA: 94] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lucchesi CA, Kao LW, Young GA, Chang HM. Titrimetric analysis of carboxylic acid-anhydride mixtures with tetrabutylammonium hydroxide. Anal Chem 2002. [DOI: 10.1021/ac60345a021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chan LL, Khoo JBK, Thng CH, Lim WEH, Tay KH, Tan EK, Chang HM, Chen C, Wong MC, Tan KP. Diffusion weighted MR imaging in acute stroke: the SGH experience. Singapore Med J 2002; 43:118-23. [PMID: 12005336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Cerebrovascular accident (CVA) is a leading cause of death and disability in many countries. Diffusion-weighted (DW) magnetic resonance (MR) imaging has been reported to be useful in the detection of acute strokes and as an investigative tool evaluating the therapeutic effects of neuroprotective and thrombolytic agents. The objectives of this study are to share our experience using the commercially available isotropic DW scan in imaging of acute stroke, assess its usefulness over conventional T2-weighted (T2W) scans in a busy clinical radiology unit and highlight it pitfalls. We found the rapid sub-minute DW technique well suited for ill and restless stroke patients and superior to T2W scans in many ways. It was highly sensitive to acute ischaemic lesions, made lesions easily identifiable and readily differentiated the acute lesion from a background of multiple chronic infarcts. However, there are potential pitfalls in the evaluation of small hyperacute posterior fossa strokes and venous infarcts. The major strength of this MR technique lies in its ability to diagnose hyperacute strokes and thence the potential for therapeutic thrombolysis, but unfortunately patients qualifying for the "therapeutic window" were a minority. More efforts need to be focused on public education in order for this powerful imaging modality to find its true value and contribute to viability of an effective thrombolytic programme.
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Affiliation(s)
- L L Chan
- Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
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Valdés LJ, Chang HM, Visger DC, Koreeda M. Salvinorin C, a new neoclerodane diterpene from a bioactive fraction of the hallucinogenic Mexican mint Salvia divinorum. Org Lett 2001; 3:3935-7. [PMID: 11720573 DOI: 10.1021/ol016820d] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Salvinorin C (1), a minor component from a biologically active TLC fraction, was isolated from the leaves of the Mexican mint Salvia divinorum. Its structure was elucidated on the basis of extensive proton and C-13 NMR experiments, as well as by comparison of the NMR data with those of the mono- and diacetate derivatives 5-7 of the major NaBH(4)-reduction product of salvinorin A (2). [structure: see text]
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Affiliation(s)
- L J Valdés
- University of Michigan Hospital, Pharmacy Services, Ann Arbor, MI 48109, USA
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Jiang CM, Wu MC, Chang WH, Chang HM. Determination of random- and blockwise-type de-esterified pectins by capillary zone electrophoresis. J Agric Food Chem 2001; 49:5584-5588. [PMID: 11714363 DOI: 10.1021/jf0105642] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Capillary zone electrophoresis (CZE) was employed to determine the correlations between migration time and degree of esterification (DE) of pectinesterase-de-esterified pectins (PDPs) and alkaline-de-esterified pectins (ADPs) using 50 mM phosphate buffer (pH 6.5) as carrier electrolyte solution and 15 KV as applied voltage. Results showed that pectins with higher DEs exhibited shorter migration times. Linear correlation (r = 0.995) between migration time and DE of ADPs was observed, whereas down-curve correlation in PDPs was observed, regardless of the capillary length used (effective length, 30 and 60 cm). In addition, PDP appeared to migrate faster than ADP with the same DE under the same experimental conditions.
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Affiliation(s)
- C M Jiang
- Department of Seafood Science, National Kaohsiung Institute of Marine Technology, Kaohsiung 811, Taiwan
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Bang SM, Cho EK, Oh JH, Chang HM, Ahn JS, Lee JA, Park YI, Ahn MJ, Park YS, Shin DB, Lee JH. Combination Chemotherapy of Oxaliplatin, 5-Fluorouracil, and Leucovorin in 5-Fluorouracil-Pretreated Patients with Metastatic Colorectal Cancer. Cancer Res Treat 2001; 33:414-9. [PMID: 26680816 DOI: 10.4143/crt.2001.33.5.414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To evaluate the efficacy and toxicity of oxaliplatin in combination with 5-fluorouracil (5-FU) and leucovorin (LV) in patients with metastatic colorectal cancer who previously treated with 5-FU-based chemotherapy. MATERIALS AND METHODS Between April 1999 and January 2001, thirty-two patients were enrolled in this study. Oxaliplatin 130 mg/m2 was given intravenously (IV) on day 1 as was 5-FU 500 mg/m2 IV followed by continuous infusion of 5-FU 3,000 mg/m2 and LV 100 mg/m2 for 48 hours administered every 3 weeks. Six patients had received 5-FU as an adjuvant setting and 26 patients as a palliative regimen. RESULTS The median age of the patients was 50 years (range; 19-69) and the dominant sites of metastasis were the liver, lung or both in 9, 5 and 2 patients respectively. In 30 evaluable patients, the overall response rate was 27% including 1 complete response and 7 partial responses. The median response duration was 28 weeks (95% confidence interval; 22~34 weeks) and the median progression free survival of all patients was 24 weeks (95% confidence interval; 15~33 weeks). A median 5 cycles (range; 2~9) and total 155 cycles were performed in 32 patients. 150 cycles were evaluable for toxicity. The most common hematologic toxicity was grade 1~2 anemia in 78 cycles (52%). Leukopenia (39%) and thrombocytopenia (23%) were fully reversible. The most common non-hematologic toxicity was nausea/vomiting (43/30%) followed by diarrhea (23%), hepatotoxicity (21%) and neurotoxicity (21%). One patient ceased therapy due to grade 4 diarrhea. No other severe toxicity interrupted this treatment. CONCLUSION Oxaliplatin, 5-FU and LV in combination showed significant activity in previously treated metastatic colorectal cancer with favorable toxicity.
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