Publications by authors named "Cheng-Yao Lin"

15 Publications

  • Page 1 of 1

Effect of diabetes mellitus comorbidity on outcomes in stages II and III colorectal cancer.

Asia Pac J Clin Oncol 2021 Nov 24. Epub 2021 Nov 24.

Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Aim: The effects of diabetes mellitus (DM) on the outcomes of colorectal cancer (CRC) are controversial. This retrospective study evaluated the effects of DM on American Joint Committee on Cancer (AJCC, 7th) Stages II and III CRC patients who received curative surgery.

Methods: We reviewed the records of CRC patients who were treated from January 2008 to December 2014 and identified the presence of DM and hypertension prior to CRC diagnosis. Cox proportional hazards analyses were used for prognostic factor determination, and survival was analyzed using the Kaplan-Meier method with the log-rank test.

Results: Total of 1066 consecutive eligible patients with stage II/III CRC were enrolled. There were 326 (30.6%) patients diagnosed with DM, and 311 (29.2%) CRC patients had recurrence. Patients with DM did not have a higher recurrence risk (p = 0.183) but had higher mortality (adjusted hazard ratio [aHR] = 1.381; 95% conference interval [CI], 1.069-1.782). In addition, HbA1c (≥7 vs. <7) was not associated with recurrence (p = 0.365). Patients with DM had more hypertension than patients without DM (69.1% vs. 37.6%, p < 0.001). A lower recurrence risk was noted in patients with hypertension (p = 0.002), but the overall survival (OS) did not reach statistical significance (aHR = 0.910; 95% CI, 0.707-1.169).

Conclusion: In our study, DM was a poor prognostic factor for survival in curative CRC patients. More studies are required to elucidate the effects that DM and other metabolic disorders, such as hypertension, have on the prognosis of patients with CRC.
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http://dx.doi.org/10.1111/ajco.13639DOI Listing
November 2021

The incidence of mumps in Taiwan and its association with the meteorological parameters: An observational study.

Medicine (Baltimore) 2021 Sep;100(37):e27267

Department of Occupational Medicine, Tainan Municipal Hospital, Tainan, Taiwan.

Abstract: Mumps is an acute and common childhood disease caused by paramyxovirus. It has been reported that the occurrence of mumps is influenced by seasonality. However, the role of meteorological variables in the incidence of mumps remains unclear. The purpose of this study was to explore the relationship between meteorological factors and the incidence of mumps infection. Poisson regression analysis was used to study the relationship between weather variability and the incidence of mumps in Taiwan. Between 2012 and 2018, 5459 cases of mumps cases were reported to the Centers for Disease Control, Taiwan (Taiwan CDC). The occurrence of mumps virus infections revealed significant seasonality in the spring and summer seasons in Taiwan. The incidence of mumps virus infections began to increase at temperatures of 15°C and started to decline if the temperature was higher than 29°C (r2 = 0.387, P = .008). Similarly, the number of mumps cases began to increase at a relative humidity of 65% to 69% (r2 = 0.838, P < .029). The number of mumps cases was positively associated with temperature and relative humidity during the period preceding the infection. This study showed that the occurrence of mumps is significantly associated with increasing temperature and relative humidity in Taiwan. Therefore, these factors could be regarded as early warning signals and indicate the need to strengthen the intervention and prevention of mumps.
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http://dx.doi.org/10.1097/MD.0000000000027267DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8447993PMC
September 2021

Age as a modifier of the effects of chemoradiotherapy with infusional 5-fluorouracil after D2 dissection in gastric cancer.

Aging (Albany NY) 2021 07 5;13(13):17337-17348. Epub 2021 Jul 5.

Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan.

Adjuvant concurrent chemoradiotherapy (CCRT) is the standard care for patients with resected advanced gastric cancer, but its survival benefits remain undetermined in patients undergoing D2 lymph node dissection (D2 dissection). We evaluated safety and efficacy of adjuvant CCRT with 5-fluorouracil (5-FU) versus chemotherapy alone in 110 gastric cancer patients with D2 dissection treated in Taiwan between January 2009 and January 2013. All the 71 patients receiving adjuvant CCRT were treated with daily infusional 5-FU and radiotherapy. Adjuvant CCRT was associated with higher risks of major hematologic (56.3% vs. 23.8%, = 0.002) and gastrointestinal (46.9% vs. 14.3%, = 0.027) toxicities and death (12.5% vs. 0.0%, = 0.041) in patients above 70 years old, but this was not the case in those ≤70 years of age. Univariate Cox proportional regressions identified adjuvant CCRT as a factor for better overall survival (OS) (hazard ratio [HR]=0.52; 95% confidence interval [CI]: 0.27-0.99) and disease-free survival (DFS) (HR=0.46, 95% CI: 0.24-0.88), but it was not a significant factor for OS or DFS after adjusting for other factors in the multivariate analysis. However, in stratified analyses by age, we found adjuvant CCRT was an independent prognostic factor for better OS (HR=0.07; 95% CI: 0.01-0.38) in patients ≤70 years old, but not in those above 70 years of age. Therefore, it was concluded that age may to be a modifier of the effects of adjuvant CCRT.
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http://dx.doi.org/10.18632/aging.203223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312439PMC
July 2021

Colorectal Cancer with EML4-ALK Fusion Gene Response to Alectinib: A Case Report and Review of the Literature.

Case Rep Oncol 2021 Jan-Apr;14(1):232-238. Epub 2021 Mar 1.

Division of Hematology-Oncology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.

Anti-epithelial growth factor receptor or anti-vascular endothelial growth factor agents combined with chemotherapy were the standard of treatment for metastatic colorectal cancer (CRC). However, increasing evidence of molecularly stratified treatment makes the complexity of treatment. Anaplastic lymphoma kinase (ALK) gene alternation is one of potential target for biomarker-guided therapy for CRC. We present a case of a 56-year-old man who suffered from advanced ascending colon cancer, harboring echinoderm microtubule associated protein-like 4 (EML4)-ALK fusion gene E21; A20 variant, a rare variant in EML4-ALK fusion gene in lung cancer. We also detected this fusion gene from different tissue types including circulating tumor DNA (ctDNA) and ascites fluid. The patient was offered alectinib, an ALK inhibitor, with partial response in lung, liver, and peritoneal metastasis for 8 months. Tumor heterogeneity, especially in gastrointestinal tract cancer, raise our interest in comprehensive genetic profiling in clinical practice. Convenience and reliability of next-generation sequencing, including using ctDNA, help physicians deal with clinical dilemma. ALK-positive CRC is rare. However, advanced CRC with ALK gene alteration responds to ALK inhibitor. It is reasonable to check ALK gene alteration in clinical practice for CRC.
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http://dx.doi.org/10.1159/000511069DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983623PMC
March 2021

Karnofsky Performance Status as A Predictive Factor for Cancer-Related Fatigue Treatment with Astragalus Polysaccharides (PG2) Injection-A Double Blind, Multi-Center, Randomized Phase IV Study.

Cancers (Basel) 2019 Jan 22;11(2). Epub 2019 Jan 22.

MacKay Memorial Hospital, New Taipei City 25160, Taiwan.

Fatigue is a common and debilitating symptom in patients with advanced cancer, resulting in poor quality of life and reduced treatment efficacy. Phytotherapeutic agents have shown potential effects to relieve cancer-related fatigue in these patients. The aim of this study was to evaluate the efficacy and safety of Astragalus Polysaccharides injection and identify predictive factors associated with this treatment. Patients with advanced cancer receiving palliative care with moderate to severe cancer-related fatigue were enrolled in this study for two treatment cycles. Fatigue improvement response rates were analyzed as the primary endpoint at the end of the first cycle to determine treatment efficacy. The drug safety profile was evaluated by the reporting of adverse events. Three hundred and ten patients were enrolled in this study and 214 patients were included ITT population. Improvement in fatigue scores by at least 10% was observed in greater than 65% of subjects after one treatment cycle compared to scores at baseline. Patients with higher Karnofsky Performance Status (KPS) responded better to the Astragalus Polysaccharides injection. Drug-related adverse event rates were less than 9%. This study identified KPS as a promising predictive factor for the therapeutic efficacy of Astragalus Polysaccharides injection.
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http://dx.doi.org/10.3390/cancers11020128DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406819PMC
January 2019

Laser Sintered Magnesium-Calcium Silicate/Poly-ε-Caprolactone Scaffold for Bone Tissue Engineering.

Materials (Basel) 2017 Jan 13;10(1). Epub 2017 Jan 13.

School of Dentistry, Chung Shan Medical University, Taichung 40201, Taiwan.

In this study, we manufacture and analyze bioactive magnesium-calcium silicate/poly-ε-caprolactone (Mg-CS/PCL) 3D scaffolds for bone tissue engineering. Mg-CS powder was incorporated into PCL, and we fabricated the 3D scaffolds using laser sintering technology. These scaffolds had high porosity and interconnected-design macropores and structures. As compared to pure PCL scaffolds without an Mg-CS powder, the hydrophilic properties and degradation rate are also improved. For scaffolds with more than 20% Mg-CS content, the specimens become completely covered by a dense bone-like apatite layer after soaking in simulated body fluid for 1 day. In vitro analyses were directed using human mesenchymal stem cells (hMSCs) on all scaffolds that were shown to be biocompatible and supported cell adhesion and proliferation. Increased focal adhesion kinase and promoted cell adhesion behavior were observed after an increase in Mg-CS content. In addition, the results indicate that the Mg-CS quantity in the composite is higher than 10%, and the quantity of cells and osteogenesis-related protein of hMSCs is stimulated by the Si ions released from the Mg-CS/PCL scaffolds when compared to PCL scaffolds. Our results proved that 3D Mg-CS/PCL scaffolds with such a specific ionic release and good degradability possessed the ability to promote osteogenetic differentiation of hMSCs, indicating that they might be promising biomaterials with potential for next-generation bone tissue engineering scaffolds.
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http://dx.doi.org/10.3390/ma10010065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344575PMC
January 2017

The Characteristics of Mineral Trioxide Aggregate/Polycaprolactone 3-dimensional Scaffold with Osteogenesis Properties for Tissue Regeneration.

J Endod 2017 Jun 25;43(6):923-929. Epub 2017 Apr 25.

3D Printing Medical Research Center, China Medical University Hospital, Taichung City, Taiwan; School of Dentistry, China Medical University Hospital, Taichung City, Taiwan; Department of Bioinformatics and Medical Engineering, Asia University, Taichung City, Taiwan. Electronic address:

Introduction: The aim of this study was to investigate whether the mineral trioxide aggregate/polycaprolactone (MTA/PCL) hybrid 3-dimensional (3D) scaffold supplies a suitable microenvironment for the osteogenic differentiation of human dental pulp cells (hDPCs) and to further consider the effect of the MTA/PCL composite on the biological performance of hybrid scaffolds.

Methods: MTA was suspended in absolute alcohol and dropped slowly into PCL that was generated with the printable MTA-matrix. Then, the MTA/PCL composite was prepared into highly uniform scaffolds with controlled macropore sizes and structure using a 3D printing technique. Mechanical properties and the apatite precipitation of the scaffolds were evaluated as well as the cell response to the scaffolds by culturing hDPCs.

Results: The results showed that the MTA/PCL 3D scaffold had uniform, 450-μm, high-porosity (70%) macropores and a compressive strength of 4.5 MPa. In addition, the MTA/PCL scaffold could effectively promote the adhesion, proliferation, and differentiation of hDPCs.

Conclusions: The 3D-printed MTA/PCL scaffolds not only exhibited excellent physical and chemical properties but also enhanced osteogenesis differentiation. All of the results support the premise that this MTA/PCL porous scaffold would be a useful biomaterial for application in bone tissue engineering.
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http://dx.doi.org/10.1016/j.joen.2017.01.009DOI Listing
June 2017

Fabrication and characterization of polycaprolactone and tricalcium phosphate composites for tissue engineering applications.

J Dent Sci 2017 Mar 9;12(1):33-43. Epub 2016 Aug 9.

3D Printing Medical Research Center, China Medical University Hospital, Taichung City, Taiwan.

Background/purpose: β-Tricalcium phosphate (β-TCP) is an osteoconductive material which has been used for clinical purposes for several years, as is polycaprolactone (PCL), which has already been approved for a number of medical and drug delivery devices. In this study we have incorporated various concentrations of β-TCP into PCL with the aim of developing an injectable, mechanically strong, and biodegradable material which can be used for medical purposes without organic solvents.

Materials And Methods: This study assesses the physical and chemical properties of this material, evaluates the bioactivity of the PCL/β-TCP composites, and analyzes cell proliferation and osteogenic differentiation when using human bone marrow mesenchymal stem cells (hBMSCs).

Results: The results show that weight losses of approximately 5.3%, 12.1%, 18.6%, and 25.2%, were observed for the TCP0, TCP10, TCP30, and TCP50 composites after immersion in simulated body fluid for 12 weeks, respectively, indicating significant differences (P < 0.05). In addition, PCL/β-TCP composites tend to have lower contact angles (47 ± 1.5° and 58 ± 1.7° for TCP50 and TCP30, respectively) than pure PCL (85 ± 1.3°), which are generally more hydrophilic. After 7 days, a significant (22% and 34%, respectively) increase (P < 0.05) in alkaline phosphatase level was measured for TCP30 and TCP50 in comparison with the pure PCL.

Conclusion: PCL/TCP is biocompatible with hBMSCs. It not only promotes proliferation of hBMSCs but also helps to differentiate reparative hard tissue. We suggest 50% (weight) PCL-containing β-TCP biocomposites as the best choice for hard tissue repair applications.
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http://dx.doi.org/10.1016/j.jds.2016.05.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395261PMC
March 2017

Risk of secondary cancers in women with breast cancer and the influence of radiotherapy: A national cohort study in Taiwan.

Medicine (Baltimore) 2016 Dec;95(49):e5556

Division of Hematology-Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying Department of Environmental and Occupational Health, National Cheng Kung University Department of Family Medicine, Chi-Mei Medical Center Department of Emergency Medicine, Chi-Mei Medical Center Department of Child Care and Education, Southern Taiwan University of Science and Technology, Tainan Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung Department of Biotechnology, Southern Taiwan University of Science and Technology Department of Ophthalmology, Chi-Mei Medical Center, Yong Kang Department of Optometry, Chung Hwa University of Medical Technology, Jen-Teh Department of Occupational Medicine, Chi-Mei Medical Center Department of Medical Research, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.

Breast cancer is the most common cancer in women worldwide; thus, the prolongation of survival, and the incidence and risk factors, including radiotherapy, for developing secondary malignancies are important. We compared the incidence of secondary and new primary cancers in women with breast cancer (CA) and well-matched for age, geographic region, and monthly income cancer-free controls (CA). The risk for secondary cancers with and without radiotherapy was also compared in CA women. We enrolled 2422 CA patients and CA 12,110 controls. In a 4-year follow-up, the secondary cancers risk was significant in the CA group (adjusted hazard ratio [AHR]: 1.59; 95% confidence interval [CI]: 1.17-2.18). Only the risk of uterine cancer was significant compared with the controls (AHR: 6.30; 95% CI: 2.28-17.38). CA patients and <50 years old had a higher risk for secondary cancers. Developing secondary cancers was significant in the first follow-up year (AHR: 1.51; 95% CI: 1.11-2.06). Radiotherapy had no significant effect on the CA group, but it was significant (P = 0.0298) in women ≥60 years old (elderly). We recommend monitoring secondary cancers in CA women, especially those <50 years old, and during the first year of follow-up. Radiotherapy should be used more carefully in elderly CA women.
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http://dx.doi.org/10.1097/MD.0000000000005556DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266032PMC
December 2016

A Comparison of Food Supply from 1984 to 2009 and Degree of Dietary Westernization in Taiwan with Asian Countries and World Continents.

Biomed Res Int 2015 29;2015:628586. Epub 2015 Jul 29.

Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan ; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, 138 Sheng-Li Road, Tainan 704, Taiwan.

Objective: To compare quality, quantity, and trends of food supply from 1984 to 2009 and degree of food westernization in Taiwan with Asian countries and world continents by using food balance data.

Methods: We compiled data from food balance sheets of Taiwan and Food and Agriculture Organization, including five continents and three most populated countries each in Eastern, Southern, and Southeastern Asia over the period 1984-2009. Quantity of food supply per capita was referenced to Taiwan food guides. The population-weighted means of food supply from Europe, North America, South America, and Australia and New Zealand continents in terms of energy and nutrient distributions, animal/plant sources, and sugar/alcohol contribution were used as indicators of westernization. Trends of food supply per capita of six food groups were plotted, and linear regression was applied to evaluate food changes.

Findings: Taiwan's food supply provided sufficient quantity in food energy, with the lowest cereals/roots supply and rice to wheat ratio, but the highest meat and oil supplies per capita among the 10 studied Asian countries. Taiwan food supply showed the most westernization among these countries.

Conclusion: Food supply of Taiwan, although currently sufficient, indicated some security problems and high tendency of diet westernization.
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http://dx.doi.org/10.1155/2015/628586DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4532817PMC
May 2016

Impact of high glucose on metastasis of colon cancer cells.

World J Gastroenterol 2015 Feb;21(7):2047-57

Cheng-Yao Lin, Division of Hematology-Oncology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan 736, Taiwan.

Aim: To investigate the possible mechanism of how glucose promotes invasion and metastasis of colon cancer cells.

Methods: CT-26 rat colorectal cancer cells were cultured in different concentrations of glucose environments (10, 20, and 30 mmol/L). Wound healing assay and transwell chamber invasion assay were utilized to test the migration and invasion, respectively. In order to understand the role of signal transducer and activator of transcription 3 (STAT3) in the process, STAT3 inhibitors, including Stattic (an STAT3 specific inhibitor) and small interfering RNA targeting STAT3, were used to block STAT3 function to evaluate their impact on CT-26 cell motion. To verify whether STAT3 and matrix metalloproteinase-9 (MMP-9) protein expression is associated with glucose-induced cell movement, Western blot was used to compare the differences in the expression of MMP-9 and STAT3 in cells incubated with and without STAT3 inhibitors in high glucose condition.

Results: In both wound healing and invasion assays, the migration and invasion of CT-26 cells increased gradually with the increase in glucose concentration. However, the glucose-induced migration and invasion were obviously inhibited by STAT3 inhibitors (P<0.05). Similarly, in Western blot assessment, both MMP-9 and STAT3 expression increased under a high glucose environment and the highest expression was achieved when 30 mmol/L glucose was used. However, in cells treated with 30 mmol/L mannitol, either MMP-9 or STAT3 expression did not increase (P>0.05). When STAT3 inhibitors were added in the 30 mM glucose group, not only STAT3 but also MMP-9 expression decreased significantly (P<0.05).

Conclusion: Our study provides evidence that glucose can promote both migration and invasion of CT-26 cells, and that the STAT3-induced MMP-9 signal pathway is involved in this process.
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http://dx.doi.org/10.3748/wjg.v21.i7.2047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326139PMC
February 2015

A phase II study of the efficacy and safety of the combination therapy of the MEK inhibitor refametinib (BAY 86-9766) plus sorafenib for Asian patients with unresectable hepatocellular carcinoma.

Clin Cancer Res 2014 Dec 7;20(23):5976-85. Epub 2014 Oct 7.

Department of Internal Medicine, Liver Research Institute, Kyungpook National University School of Medicine, Daegu, Republic of Korea.

Purpose: There is an unmet need for treatment options in hepatocellular carcinoma (HCC). Sorafenib is currently the only approved systemic treatment for HCC. Refametinib, an oral, allosteric MEK inhibitor, has demonstrated antitumor activity in combination with sorafenib in vitro and in vivo. A phase II study evaluated efficacy and safety of refametinib plus sorafenib in Asian patients with HCC (NCT01204177).

Experimental Design: Eligible patients received twice-daily refametinib 50 mg plus twice-daily sorafenib 200 mg (morning)/400 mg (evening), with dose escalation to sorafenib 400 mg twice daily from cycle 2 if no grade ≥ 2 hand-foot skin reaction, fatigue, or gastrointestinal toxicity occurred. Primary efficacy endpoint: disease control rate. Secondary endpoints: time to progression, overall survival, pharmacokinetic assessment, biomarker analysis, safety, and tolerability.

Results: Of 95 enrolled patients, 70 received study treatment. Most patients had liver cirrhosis (82.9%) and hepatitis B viral infection (75.7%). Disease control rate was 44.8% (primary efficacy analysis; n = 58). Median time to progression was 122 days, median overall survival was 290 days (n = 70). Best clinical responders had RAS mutations; majority of poor responders had wild-type RAS. Most frequent drug-related adverse events were diarrhea, rash, aspartate aminotransferase elevation, vomiting, and nausea. Dose modifications due to adverse events were necessary in almost all patients.

Conclusions: Refametinib plus sorafenib showed antitumor activity in patients with HCC and was tolerated at reduced doses by most patients. Frequent dose modifications due to grade 3 adverse events may have contributed to limited treatment effect. Patients with RAS mutations appear to benefit from refametinib/sorafenib combination.
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http://dx.doi.org/10.1158/1078-0432.CCR-13-3445DOI Listing
December 2014

Health-related quality of life in patients with hepatocellular carcinoma: the mediation effects of illness perceptions and coping.

Psychooncology 2013 Jun 30;22(6):1353-60. Epub 2012 Jul 30.

Department of Human Development, Tzu Chi University, Hualien, Taiwan.

Background: The aims of this study were to explore health-related quality of life (HRQOL) in patients with hepatocellular carcinoma (HCC). We report the following: (1) differences in HRQOL between patients with HCC and the general population; (2) significant physical and psychological predictors of HRQOL; and (3) mediation effects of illness perceptions and coping on HRQOL.

Methods: Patients with HCC (n = 286) from Taiwan completed standardized measures of HRQOL, illness perception (cognitive representations, emotional representations and illness comprehensibility) and coping (emotion-oriented and problem-orientation coping). Demographic and physical variables were also collected.

Results: Patients with HCC had worse global HRQOL, physical, role, cognitive and social functioning, but better emotional functioning than the general population. Physical variables and cognitive representation were significant predictors of global HRQOL, physical functioning and emotional functioning. Cognitive representation mediated the relationships between physical variables and global HRQOL, physical functioning and emotional functioning, but coping only mediated the relationship between cognitive representation and global HRQOL.

Conclusions: The results suggest that physical variables have direct effects on global HRQOL and physical functioning, but there were also partial mediations through cognitive representation. The effect of physical variables on emotional functioning was mediated through cognitive and emotional representations. Patients with better performance status and positive illness perceptions tended to report better HRQOL, but those with negative illness perceptions and who used more emotion-oriented coping had worse HRQOL. Limitations of the work associated with use of theory and measures developed in Europe and the US are discussed, as are the clinical implications for patients with HCC.
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http://dx.doi.org/10.1002/pon.3146DOI Listing
June 2013

Diabetes mellitus impairs the response to intra-arterial chemotherapy in hepatocellular carcinoma.

Med Oncol 2011 Dec 24;28(4):1080-8. Epub 2010 Aug 24.

Graduate Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, 1, Ta-Hsueh Road, Tainan City, 70101, Taiwan.

Diabetes mellitus is associated with a poorer outcome in patients with hepatocellular carcinoma. The impact of diabetes mellitus on the treatment of hepatocellular carcinoma, especially chemotherapy, is uncertain. Intra-arterial chemotherapy is one of the therapeutic options of unrespectable hepatocellular carcinoma. To clarify this point, we analyze the therapeutic effect of intra-arterial chemotherapy in unrespectable hepatocellular carcinoma patients with or without diabetes mellitus. Fifty-two patients with advanced hepatocellular carcinoma underwent intra-arterial chemotherapy with cisplatin and fluorouracil. Tumor response was assessed by computed tomography. An in vitro hepatocellular carcinoma cell line, Hep G2, was evaluated for the cytotoxic effect of cisplatin and fluorouracil in different concentrations of insulin and glucose mimicking diabetic conditions. Fifty-two patients were included, 14 had diabetes and 38 were non-diabetics. Non-diabetic patients had a lower rate of progressive disease (16% vs. 43%, P=0.039). The median time to progression was significantly longer in non-diabetics compared with the diabetic counterpart (a median of 206 days vs. 88 days, P=0.02). In the hepatocellular carcinoma cell line, Hep G2, insulin rather than glucose was more important for promoting cell proliferation and enhancing the drug resistance of cisplatin or fluorouracil. Our study showed that intra-arterial chemotherapy for unrespectable hepatocellular carcinoma was less effective in diabetic patients than the non-diabetic counterpart in terms of the progression-free rate and time to disease progression survival.
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http://dx.doi.org/10.1007/s12032-010-9650-9DOI Listing
December 2011

Hyperthyroidism as a latent complication of autologous hematopoietic stem cell transplantation.

Int J Hematol 2008 Sep 10;88(2):237-239. Epub 2008 May 10.

Department of Hematology and Oncology, Chi Mei Medical Center, Liou Ying Campus, Tainan, Taiwan.

Thyroid dysfunction after hematopoietic stem cell transplantation has been investigated in many studies. Most post-transplant thyroid disorders such as hypothyroidism are recognized as a late complication whilst hyperthyroidism is infrequent and transient, and usually happens early at the onset after transplant. Here, we report two rare hyperthyroid cases, developing more than 2 years after autologous stem cell transplant. We suggest that hyperthyroidism be alerted in the post-transplant care, and special attention be paid to any latent events.
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http://dx.doi.org/10.1007/s12185-008-0096-1DOI Listing
September 2008
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