• 제목/요약/키워드: Hospital Phase

검색결과 1,071건 처리시간 0.026초

Prognostic Factor Analysis of Overall Survival in Gastric Cancer from Two Phase III Studies of Second-line Ramucirumab (REGARD and RAINBOW) Using Pooled Patient Data

  • Fuchs, Charles S.;Muro, Kei;Tomasek, Jiri;Van Cutsem, Eric;Cho, Jae Yong;Oh, Sang-Cheul;Safran, Howard;Bodoky, Gyorgy;Chau, Ian;Shimada, Yasuhiro;Al-Batran, Salah-Eddin;Passalacqua, Rodolfo;Ohtsu, Atsushi;Emig, Michael;Ferry, David;Chandrawansa, Kumari;Hsu, Yanzhi;Sashegyi, Andreas;Liepa, Astra M.;Wilke, Hansjochen
    • Journal of Gastric Cancer
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    • 제17권2호
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    • pp.132-144
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    • 2017
  • Purpose: To identify baseline prognostic factors for survival in patients with disease progression, during or after chemotherapy for the treatment of advanced gastric or gastroesophageal junction (GEJ) cancer. Materials and Methods: We pooled data from patients randomized between 2009 and 2012 in 2 phase III, global double-blind studies of ramucirumab for the treatment of advanced gastric or GEJ adenocarcinoma following disease progression on first-line platinum- and/or fluoropyrimidine-containing therapy (REGARD and RAINBOW). Forty-one key baseline clinical and laboratory factors common in both studies were examined. Model building started with covariate screening using univariate Cox models (significance level=0.05). A stepwise multivariable Cox model identified the final prognostic factors (entry+exit significance level=0.01). Cox models were stratified by treatment and geographic region. The process was repeated to identify baseline prognostic quality of life (QoL) parameters. Results: Of 1,020 randomized patients, 953 (93%) patients without any missing covariates were included in the analysis. We identified 12 independent prognostic factors of poor survival: 1) peritoneal metastases; 2) Eastern Cooperative Oncology Group (ECOG) performance score 1; 3) the presence of a primary tumor; 4) time to progression since prior therapy <6 months; 5) poor/unknown tumor differentiation; abnormally low blood levels of 6) albumin, 7) sodium, and/or 8) lymphocytes; and abnormally high blood levels of 9) neutrophils, 10) aspartate aminotransferase (AST), 11) alkaline phosphatase (ALP), and/or 12) lactate dehydrogenase (LDH). Factors were used to devise a 4-tier prognostic index (median overall survival [OS] by risk [months]: high=3.4, moderate=6.4, medium=9.9, and low=14.5; Harrell's C-index=0.66; 95% confidence interval [CI], 0.64-0.68). Addition of QoL to the model identified patient-reported appetite loss as an independent prognostic factor. Conclusions: The identified prognostic factors and the reported prognostic index may help clinical decision-making, patient stratification, and planning of future clinical studies.

Induction of Forkhead Class box O3a and apoptosis by a standardized ginsenoside formulation, KG-135, is potentiated by autophagy blockade in A549 human lung cancer cells

  • Yao, Chih-Jung;Chow, Jyh-Ming;Chuang, Shuang-En;Chang, Chia-Lun;Yan, Ming-De;Lee, Hsin-Lun;Lai, I-Chun;Lin, Pei-Chun;Lai, Gi-Ming
    • Journal of Ginseng Research
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    • 제41권3호
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    • pp.247-256
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    • 2017
  • Background: KG-135, a standardized formulation enriched with Rk1, Rg3, and Rg5 ginsenosides, has been shown to inhibit various types of cancer cells; however, the underlying mechanisms are not fully understood. In this study, we explored its effects in A549 human lung cancer cells to investigate the induction of Forkhead Class box O3a (FOXO3a) and autophagy. Methods: Cell viability was determined by sulforhodamine B staining. Apoptosis and cell cycle distribution were analyzed using flow cytometry. The changes of protein levels were determined using Western blot analysis. Autophagy induction was monitored by the formation of acidic vesicular organelles stained with acridine orange. Results: KG-135 effectively arrested the cells in G1 phase with limited apoptosis. Accordingly, a decrease of cyclin-dependent kinase-4, cyclin-dependent kinase-6, cyclin D1, and phospho-retinoblastoma protein, and an increase of p27 and p18 proteins were observed. Intriguingly, KG-135 increased the tumor suppressor FOXO3a and induced the accumulation of autophagy hallmark LC3-II and acidic vesicular organelles without an increase of the upstream marker Beclin-1. Unconventionally, the autophagy adaptor protein p62 (sequestosome 1) was increased rather than decreased. Blockade of autophagy by hydroxychloroquine dramatically potentiated KG-135-induced FOXO3a and its downstream (FasL) ligand accompanied by the cleavage of caspase-8. Meanwhile, the decrease of Bcl-2 and survivin, as well as the cleavage of caspase-9, were also drastically enhanced, resulting in massive apoptosis. Conclusion: Besides arresting the cells in G1 phase, KG-135 increased FOXO3a and induced an unconventional autophagy in A549 cells. Both the KG-135-activated extrinsic FOXO3a/FasL/caspase-8 and intrinsic caspase-9 apoptotic pathways were potentiated by blockade of autophagy. Combination of KG-135 and autophagy inhibitor may be a novel strategy as an integrative treatment for cancers.

뇌내출혈로 입원치료 받던 중 만성B형간염 면역관용기에서 면역활동기로 전환된 환자에 대한 생간탕가감 치험 1례 (A Case Report of the Efficacy of Saenggan-tang-gagam in the Treatment of a Patient with Chronic Hepatitis B Who Showed Conversion of the Immune-Tolerant Phase to Immune-Clearance Phase during Hospitalization for Intracerebral Hemorrhage)

  • 배정한;김하연;주성희;장은경;이장훈;김영철
    • 대한한방내과학회지
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    • 제38권2호
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    • pp.164-171
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    • 2017
  • Objectives: The purpose of this case report is to describe the efficacy of Saenggan-tang-gagam treatment in a patient with immune-tolerant chronic hepatitis B who converted to the immune active phase during hospitalization for Intracerebral hemorrhage. Methods: A 61-year-old male patient with chronic hepatitis B was hospitalized from July 21, 2016 to October 24, 2016. On September 5, the patient showed fatigue and dyspepsia, and his urine was dark. These symptoms were accompanied by a dramatic elevation of aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) levels. Saenggan-tang-gagam was administered three times a day until the patient was discharged from the hospital. Results: After the Saenggan-tang-gagam treatment, AST and ALP levels decreased significantly, below the upper limit level. In addition, the levels of ALT and GG were significantly decreased. In addition, the fatigue, dyspepsia, and dark urine induced by hepatitis improved after the Saenggan-tang-gagam treatment. Conclusion: This case report suggests that traditional Korean medicine has a beneficial effect on the immune active phase of chronic hepatitis B.

한국형 출혈열의 임상경과에 따른 갑상선홀몬의 변동 (Thyroid Hormones and Thyroid Function status in each clinical phase of Korean Hemorrhagic Fever)

  • 신영태;전병숙;윤성열;이헌영;김삼용;노흥규
    • 대한핵의학회지
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    • 제17권1호
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    • pp.63-69
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    • 1983
  • Fifteen cases of Korean hemorrhagic fever who were admitted Chungnam National University Hospital from October 1981 to December 1981 were analysed on the evaluation of metabolic.changes of the thyroid hormones, and thyroid function status in each clinical phase. 1. Serum $T_3,\;T_4$ concentratron, $FT_4I\;and\;T_4/TBG$ ratio were significantly lower (p<0.001, p<0.005, p<0.005, p<0.001, respectively) than control group in oliguric and early diuretic phase of Korean hemorrhagic fever. With the recovery of illness, abnormal thyroid hormones and thyroid function indices tend to become normal range. But Serum $FT_4$, TSH and TBG concentration were within normal range in all phase of KHF. Thus in Korean hemorrhagic fever, euthyroidism is probably maintained by normal or elevated serum $FT_4$ 2. $T_4/T_3\;and\;rT_3/T_3$ rato (p<0.005, p<0.005) were increased in oliguric and early diuretic phase of KHF. These results might be explained by decreased peripheral conversion of $T_4\;to\;T_3$ in oliguric and early diuretic phase.

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불면증에서 순환교대파형의 의미 (Cyclic Alternating Pattern : Implications for Insomnia)

  • 신재공
    • 수면정신생리
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    • 제17권2호
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    • pp.75-84
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    • 2010
  • The cyclic alternating pattern (CAP) is a periodic EEG activity in NREM sleep, characterized by sequences of transient electrocortical events that are distinct from background EEG activities. A CAP cycle consists of two periodic EEG features, phase A and subsequent phase B whose durations are 2-60 s. At least two consecutive CAP cycles are required to define a CAP sequence. The CAP phase A is a phasic EEG event, such as delta bursts, vertex sharp transients, K-complex sequences, polyphasic bursts, K-alpha, intermittent alpha, and arousals. Phase B is repetitive periods of background EEG activity. The absence of CAP more than 60 seconds or an isolated phase A is classified as non-CAP. Phase A activities can be classified into three subtypes (A1, A2, and A3), based on the amounts of high-voltage slow waves (EEG synchrony) and low-amplitude fast rhythms (EEG desynchrony). CAP rate, the percentage of CAP durations in NREM sleep is considered to be a physiologic marker of the NREM sleep instability. In insomnia, the frequent discrepancy between self-reports and polysomnographic findings could be attributed to subtle abnormalities in the sleep tracing, which are overlooked by the conventional scoring methods. The conventional scoring scheme has superiority in analysis of macrostructure of sleep but shows limited power in finding arousals and transient EEG events that are major component of microstructure of sleep. But, it has recently been found that a significant correlation exists between CAP rate and the subjective estimates of the sleep quality in insomniacs and sleep-improving treatments often reduce the amount of CAP. Thus, the extension of conventional sleep measures with the new CAP variables, which appear to be the more sensitive to sleep disturbance, may improve our knowledge on the diagnosis and management of insomnia.

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Knockdown of a Proliferation-inducing Ligand (PRIL) Suppresses the Proliferation of Gastric Cancer Cells

  • Cui, Jiu-Wei;Li, Yan;Wang, Chang;Yao, Cheng;Li, Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권2호
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    • pp.633-636
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    • 2012
  • Purpose: PRIL (proliferation-inducing ligand) is a newly identified member of the tumor necrosis factor (TNF) family and modulates death ligand-induced apoptosis. Here, we investigated the effect of PRIL on cellular characteristics relating to tumor progression in human gastric cancer. Method: Recombinant lentivirus containing PRIL siRNA was constructed and then infected MGC803 and SGC7901 gastric cancer cells. MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] colony formation and cell cycle analysis were used to study the effect of PRIL knockdown on gastric cancer cell proliferation. Results: PRIL expression in lentivirus infected cells was significantly reduced as evidenced by quantitative real-time PCR. Cell viability and colony formation of MGC803 and SGC7901 cells were significantly hampered in PRIL knock-down cells. Moreover, the cell cycle was arrested at G2/M phase, elucidating the mechanism underlying the inhibitory effect of siRNA on cell proliferation. Conclusions: Our study indicated that PRIL functions in promoting cell growth, and lentivirus-mediated PRIL gene knockdown might be a promising strategy in the treatment of gastric cancer.

The development of a fully automated homemade system for [11C] acetate synthesis using an open source PLC

  • Kang, Se Hun;Hong, Sung Tack;Park, Kwangseo;Kim, Seok-ki
    • 대한방사성의약품학회지
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    • 제2권2호
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    • pp.103-107
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    • 2016
  • Solid phase extraction (SPE) purification method is the efficient and well-known tool for automated [$^{11}C$]acetate synthesis. A fully automated homemade module adopting the SPE method and 'pinch' valves was developed very economically with a universal interface board, a relay card and an open source programmable logic controller. The radiochemical yield of the optimized [$^{11}C$]acetate synthesis by this system was $58.8{\pm}2.1%$ (n=10, decay-corrected) from $15.5{\pm}0.19GBq$ of $[^{11}C]CO_2$ as starting activity, and total synthetic time was 15 minutes. HPLC analysis showed its high radiochemical purity as $97.4{\pm}1.1%$ without possible by-products.

MicroRNA-328 Inhibits Proliferation of Human Melanoma Cells by Targeting TGFB2

  • Li, Jing-Rong;Wang, Jian-Qin;Gong, Qing;Fang, Rui-Hua;Guo, Yun-Long
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권4호
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    • pp.1575-1579
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    • 2015
  • Some microRNAs (miRNAs) have been shown to act as oncogenes or tumor suppressor genes in human melanomas. miR-328 is upregulated in blood cells of melanoma patients compared to in healthy controls. This suggests a role for miR-328 in melanoma that warrants investigation. In this study, we demonstrated miR-328 levels to be dramatically decreased in human melanoma cell lines. Moreover, forced expression of miR-328 inhibited proliferation and induced G1-phase arrest of the SK-MEL-1 melanoma cell line. We identified TGFB2 as a direct target gene for miR-328 using a fluorescent reporter assay and western blotting. Levels of TGFB2 were dramatically increased in human melanoma cell lines and were inversely correlated with the miR-328 expression level. Our findings provide new insights into the mechanisms of human melanoma development, indicating that miR-328 has therapeutic potential for this disease.

병원중심 가정간호 뇌혈관질환자의 중증도별 서비스 특성 및 비용 분석 (Analysis of Services and Cost in CVA Patients by Severity in Hospital-based Home Health Care)

  • 장인순;황나미
    • 대한간호학회지
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    • 제31권4호
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    • pp.619-630
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    • 2001
  • Purpose: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. Method: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). Conclusion: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.

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Knockdown of HMGN5 Expression by RNA Interference Induces Cell Cycle Arrest in Human Lung Cancer Cells

  • Chen, Peng;Wang, Xiu-Li;Ma, Zhong-Sen;Xu, Zhong;Jia, Bo;Ren, Jin;Hu, Yu-Xin;Zhang, Qing-Hua;Ma, Tian-Gang;Yan, Bing-Di;Yan, Qing-Zhu;Li, Yan-Lei;Li, Zhen;Yu, Jin-Yan;Gao, Rong;Fan, Na;Li, Bo;Yang, Jun-Ling
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3223-3228
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    • 2012
  • HMGN5 is a typical member of the HMGN (high mobility group nucleosome-binding protein) family which may function as a nucleosomal binding and transcriptional activating protein. Overexpression of HMGN5 has been observed in several human tumors but its role in tumorigenesis has not been fully clarified. To investigate its significance for human lung cancer progression, we successfully constructed a shRNA expression lentiviral vector in which sense and antisense sequences targeting the human HMGN5 were linked with a 9-nucleotide loop. Inhibitory effects of siRNA on endogenous HMGN5 gene expression and protein synthesis were demonstrated via real-time RT-PCR and western blotting. We found HMGN5 silencing to significantly inhibit A549 and H1299 cell proliferation assessed by MTT, BrdU incorporation and colony formation assays. Furthermore, flow cytometry analysis showed that specific knockdown of HMGN5 slowed down the cell cycle at the G0/G1 phase and decreased the populations of A549 and H1299 cells at the S and G2/M phases. Taken together, these results suggest that HMGN5 is directly involved in regulation cell proliferation in A549 and H1299 cells by influencing signaling pathways involved in cell cycle progression. Thus, our finding suggests that targeting HMGN5 may be an effective strategy for human lung cancer treatment.