Background: Metastatic renal cell carcinoma (mRCC) status as poor prognosis improved with the introduction of tyrosine-kinase inhibitors, especially sunitinib. There is sparse data reporting from our region on use of sunitinib in metastatic RCC. Thus the present study explores sunitinib usage at our institute. Materials and Methods: An unselected population of patients with metastatic RCC receiving sunitinib was analyzed with respect to patient characteristics, response, toxicity, and outcomes. Results: Fourty-nine patients with a median age of 50.5 years (range 21-71 years) were included. Most were male (61.2%). Twenty‑one (42.9%) had metastatic disease at presentation. Sunitinib was first line therapy in 45. Conventional clear cell carcinoma was the most common pathology present (39 patients; 79.59 %). The most common site of metastasis was the lung (75.5%). Most patients (30) were started at a dose of 50 mg once a day for 4 weeks and then 2 weeks rest. Clinical benefit rate was 73.5% (n= 36), and 22.5% (n= 11) demonstrated progressive disease at first imaging evaluation within the first 3-6 months. The following objective response performed for patients was 48.9% (n=24) and progression at 24.5 % (n=12). The median follow‑up was 16 months (range, 4-34 months), the overall estimated median PFS was 9 months and the estimated median OS was 15 months. Conclusions: This study demonstrated sunitinib is tolerable and effective in advanced/metastatic RCC Egyptian patients and indicates we should further seek second and third lines to increase survival equivalence as reported in the worldwide literature.
Kang, Shan;Sun, Hai-Yan;Zhou, Rong-Miao;Wang, Na;Hu, Pei;Li, Yan
Asian Pacific Journal of Cancer Prevention
/
v.14
no.2
/
pp.941-946
/
2013
Objective: The nucleotide excision repair (NER) and base excision repair (BER) pathways, two DNA repair pathways, are related to platinum resistance in cancer treatment. In this paper, we studied the association between single nucleotide polymorphisms (SNPs) of involved genes and response to platinum-based chemotherapy in epithelial ovarian cancer. Method: Eight SNPs in XRCC1 (BER), XPC and XPD (NER) were assessed in 213 patients with epithelial ovarian cancer using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and primer-introduced restriction analysis-polymerase chain reaction (PIRA-PCR) techniques. Results: The median progression-free survival (PFS) of patients carrying the Lys/Lys and Lys/Gln+Gln/Gln genotype of the XPC Lys/Gln polymorphism were 25 and 12 months, respectively (P=0.039); and the mean overall survival (OS) of patients was 31.1 and 27.8 months, respectively (P=0.048). Cox's multivariate analysis suggested that patients with epithelial ovarian cancer with the Gln allele had an increased risk of death (HR=1.75; 95% CI=1.06-2.91) compared to those with the Lys/Lys genotype. There are no associations between the XPC PAT+/-, XRCC1 Arg194Trp, Arg280His, Arg399Gln, and XPD Asp312Asn, Lys751Gln polymorphisms and the survival of patients with epithelial ovarian cancer when treated with platinum-based chemotherapy. Conclusion: Our results indicated that the XPC Lys939Gln polymorphism may correlate with clinical outcome of patients with epithelial ovarian cancer when treated with platinum-based chemotherapy in Northern China.
Korean Journal of Construction Engineering and Management
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v.8
no.6
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pp.129-138
/
2007
According to the preceding research outcomes, feasibility studies on public construction projects were incorrect and subjective. To resolve the problems, Korean government initiated Preliminary Feasibility Study (PFS) system prior to undertaking the main feasibility study. The PSF can be categorized into four areas such as road, railroad, harbor, airport, and Culture & Tourism (C&T). Especially when it comes to complex due to the introduction of five-weekday working system and local $government^{\circ}{\phi}s$ self administrative system. As a result, the standardization and legislation of the PSF can not be operated effectively. Accordingly this paper seeks to 1) identify actual condition of conducted PSF in C&T; 2) set up analytical model considering cost factor of economical efficiency and seek obstacles of PSF system; 3) suggest improvement plan for construction PSF projects.
KSCE Journal of Civil and Environmental Engineering Research
/
v.7
no.2
/
pp.141-153
/
1987
The prediction of the exact behavior of multistory building is one of the most complicated problem encountered in structural engineering practice. An efficient computer method for the three dimensional analysis of building structures is presented in this paper. A multistory building is idealized as an assemblage of a series of rectangular plane frames interconnected by rigid floor diaphragms. The matrix condensation technique is employed for the reduction of degrees of freedom, which results in a significant saving in computational efforts and the required memory size. Kinematical approach was used to assemble condensed stiffness matrices of plane frames into a three dimensional stick model stiffness matrix. The static analysis follows the modified tridiagonal approach. Since this procedure utilizes the condensed stiffness matrix of the structure, the dynamic equations of motion for the story displacement are developed by assigning proper mass for each story. Analysis results of several example structures are compared to those obtained by using the well-known SAP IV for verification of the accuracy and efficiency of the computer program PFS which was developed utilizing the method proposed in this study. The analysis method proposed in this study can be used as an efficient and economical means for the analysis of multistory buildings.
Xiang, Ziru;Chan, Tommy H.T.;Thambiratnam, David P.;Nguyen, Theanh
Smart Structures and Systems
/
v.17
no.6
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pp.917-933
/
2016
In a prestressed concrete bridge, the magnitude of the prestress force (PF) decreases with time. This unexpected loss can cause failure of a bridge which makes prestress force identification (PFI) critical to evaluate bridge safety. However, it has been difficult to identify the PF non-destructively. Although some research has shown the feasibility of vibration based methods in PFI, the requirement of having a determinate exciting force in these methods hinders applications onto in-service bridges. Ideally, it will be efficient if the normal traffic could be treated as an excitation, but the load caused by vehicles is difficult to measure. Hence it prompts the need to investigate whether PF and moving load could be identified together. This paper presents a synergic identification method to determine PF and moving load applied on a simply supported prestressed concrete beam via the dynamic responses caused by this unknown moving load. This method consists of three parts: (i) the PF is transformed into an external pseudo-load localized in each beam element via virtual distortion method (VDM); (ii) then these pseudo-loads are identified simultaneously with the moving load via Duhamel Integral; (iii) the time consuming problem during the inversion of Duhamel Integral is overcome by the load-shape function (LSF). The method is examined against different cases of PFs, vehicle speeds and noise levels by means of simulations. Results show that this method attains a good degree of accuracy and efficiency, as well as robustness to noise.
Shin, Hee Joon;Kim, Ji Sung;Wang, Joong San;Choi, Yoo Rim;Kim, Hong Rae;Park, Si Eun;An, Ho Jung;Min, Kyung Ok
Journal of International Academy of Physical Therapy Research
/
v.4
no.1
/
pp.488-493
/
2013
The purpose of this study was to investigate spirometric lung pattern, respiratory function and degree of fatigue by lung function tests and fatigue tests of 39 elderly people in a care facility aged 65 and over. The respiratory function tests were used to the Spirovit SP-1 and fatigue tests were used modified Piper fatigue scale(mPFS). Regarding the respiratory function, the FVC was $1.41{\pm}0.36$l, the FVC % predicted was $69.10{\pm}14.98$%, the $FEV_1$ was $1.02{\pm}0.31$l, the $FEV_1$ % predicted was $63.27{\pm}16.05$%, the $FEV_1$/FVC was $72.77{\pm}13.40$%, and the fatigue score was $5.83{\pm}1.09$. As for the spirometric lung pattern, 19 patients had a restrictive pattern(48.7%), followed by 11 with a mixed pattern(28.2%), 5 with an obstructive pattern( 12.8%), and 4 with a normal pattern(10.3%). Regarding the respiratory function and fatigue by spirometric lung pattern, the FVC and the FVC % predicted of patients with a normal pattern or an obstructive pattern were greater than other groups at a statistically significant level. As for the $FEV_1$, that of patients with a normal pattern was significantly higher than others, and for the $FEV_1$ % predicted, that of patients with a normal pattern or a restrictive pattern was significantly higher(p<.001). Fatigue score by patients with a normal pattern was significantly less than patients of other patterns(p<.001). Therefore, pulmonary physical therapy is considered necessary to improve respiratory function and fatigue degradation of elderly in a facility.
Wonju Hong;Hong Il Ha;Jung Woo Lee;Sang Min Lee;Min-Jeong Kim
Korean Journal of Radiology
/
v.20
no.4
/
pp.599-608
/
2019
Objective: To evaluate the effectiveness of computed tomography (CT) Hounsfield unit histogram analysis (HUHA) in postoperative pancreatic fistula (PF) prediction. Materials and Methods: Fifty-four patients (33 males and 21 females; mean age, 65.6 years; age range, 37-89 years) who had undergone preoperative CT and pancreaticoduodenectomy were included in this retrospective study. Two radiologists measured mean CT Hounsfield unit (CTHU) values by drawing regions of interest (ROIs) at the level of the pancreaticojejunostomy site on preoperative pre-contrast images. The HUHA values were arbitrarily divided into three categories, comprising HUHA-A ≤ 0 HU, 0 HU < HUHA-B < 30 HU, and HUHA-C ≥ 30 HU. Each HUHA value within the ROI was calculated as a percentage of the entire area using commercial 3-dimensional analysis software. Pancreas texture was evaluated as soft or hard by manual palpation. Results: Fifteen patients (27.8%) had clinically relevant PFs. The PF group had significantly higher HUHA-A (p < 0.01) and significantly lower mean CTHU (p < 0.01) values than those of the non-PF group. The HUHA-A value had a moderately strong correlation with PF occurrence (r = 0.60, p < 0.01), whereas the mean CTHU had a weak negative correlation with PF occurrence (r = -0.27, p < 0.01). The HUHA-A and mean CTHU areas under the curve (AUCs) for predicting PF occurrence were 0.86 and 0.65, respectively, with significant difference (p < 0.01). The HUHA-A and mean CTHU AUCs for predicting pancreatic softness were 0.86 and 0.64, respectively, with significant difference (p < 0.01). Conclusion: The HUHA-A values on preoperative pre-contrast CT images demonstrate a strong correlation with PF occurrence.
Background: In clinical trials with no upper age limit, the proportion of older patients is usually small, probably reflecting the more conservative approach adopted by clinicians when treating the elderly. An exploratory analysis of elderly patients in the RECORD-1 Trial showed that patients ${\geq}$ 65 y.o. had superior median PFS than overall RECORD-1 population (5.4 months and 4.9 months, respectively). We investigated the efficacy, relative benefit and safety of Everolimus (EVE) as sequential therapy after failure of VEGFr-TKI therapy for older patients with metastatic renal cell cancer (mRCC), in daily practice. Materials and Methods: 172 consecutive IRB approved patients with mRCC (median age 65, M:F 135/37, 78% clear cell) who received salvage EVE at 39 tertiary institutions between October 2009 and August 2011 were included in this analysis. Some 31% had progressed on sunitinib, 22% on sorafenib, 1% on axitinib, 41% on sequential therapy, and 5% had received other therapy. Patients with brain metastases were not included and 95% of the patients had a ECOG (Eastern Cooperative Oncology Group) performance status (PS) of 0 or 1. Previous radiotherapy was an exclusion criterion, but prior chemotherapy was permitted. Adequate organ function and hematologic parameters were mandatory. EVE administration was approved by the institutional review board at each participating institution and signed informed consent was obtained from all patients. Results: Median time of the whole cohort to last follow-up was 3.5 months (range 0.4-15.2 months). Forty four percent were continuing to take EVE at last followup. There were 86 (50%) patients ${\geq}$ 65 y.o. and 86 (50%) <65 y.o. The percentage of patients who showed PR/SD was higher in the older group than in the younger one (5.9%/61.2% vs 1.2%/46.5%, respectively). Median survival of older patients was also significantly longer (3.5 +/- 0.31 vs 3.1 +/- 0.34, hazard ratio=0.45, CI; 0.255-0.802). Analysis using Cox regression model adjusted for gender, PS, number of metastases, site of metastases, histology, smoking history and age detected an association between age and PFS (p=0.011). The frequency of adverse events in elderly patients treated with EVE was no greater than that in younger patients, although such toxicity may have had a greater impact on their quality of life. Conclusions: Older patients should not generally be excluded from accepted therapies (mTOR inhibitors after failure of VEGFr-TKI therapy) for mRCC.
Kim, Da Hye;Kim, Sang Jun;Jeong, Seung-Il;Yu, Kang-Yeol;Cheon, Chun Jin;Kim, Jang-Ho;Kim, Seon-Young
Journal of Life Science
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v.27
no.5
/
pp.509-516
/
2017
Perilla frutescens (L.) Britton var. sprouts (PFS) is a plant of the labiatae family. The purpose of this work was to assess the preventive effects of PFS ethanolic extracts (PFSEs) on cytokine-induced ${\beta}$-cell damage. Cytokines, which are released by the infiltration of inflammatory cells around the pancreatic islets, are involved in the pathogenesis of type 1 diabetes mellitus. The combination of interleukin-$1{\beta}$ (IL-1), interferon-${\gamma}$ (IFN-${\gamma}$), and tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) induced formation of reactive oxygen species (ROS). Accumulation of intracellular ROS led to ${\beta}$-cell dysfunction and apoptosis. PFSEs possess antioxidant activity and thus lead to downregulation of ROS generation. Cytokines decrease cell viability, stimulate the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), and induce the production of nitric oxide (NO). PFSEs prevented cytokine-induced cell viability in a dose-dependent manner. Incubation with PFSE resulted in significant reduction in cytokine-induced NO production that correlated with reduced levels of the iNOS and COX-2 protein expression. Furthermore, PFSE significantly decreased the activation of nuclear factor ${\kappa}B$ (NF-${\kappa}B$) by inhibition of $I{\kappa}B{\alpha}$ phosphorylation in RINm5F cells. In summary, our results suggest that the protective effects of PFSE might serve to counteract cytokine-induced ${\beta}$-cell destruction. Findings indicate that consumption of Perilla frutescens (L.) Britton var. sprouts alleviates hyperglycemia-mediated oxidative stress and pro-inflammatory cytokine-induced ${\beta}$-cell damage and thus has beneficial anti-diabetic effects.
Background: Efficacy of chemotherapy plus bevacizumab has been shown in patients with metastatic colorectal cancer (mCRC) compared with chemotherapy alone. The aim of the present study was to evaluate the efficacy and safety of FOLFIRI or XELIRI regimens in combination with bevacizumab for mCRC patients in a first-line setting. Materials and Methods: A total of 132 patients with previously untreated and histologically confirmed mCRC were included. They were treated with either FOLFIRI-Bevacizumab (Bev) or XELIRI-Bev according to physician preference. The efficacy and safety of the two regimens were compared. Results: Between 2006 and 2010, 68 patients were treated with the XELIRI-Bev regimen, while the remaining 64 patients received the FOLFIRI-Bev regimen. The median age was 58.5 years (53.6 years in the FOLFIRI-Bev and 59.7 years in the XELIRI-Bev arm, p=0.01). Objective response rate was 51.6% for FOLFIRI-Bev versus 41.2% for XELIRI-Bev (p=0.38). At the median follow-up of 24.5 months, the median progression-free survival (PFS) was not different between two groups (14.2 months in FOLFIRI-Bev vs. not reached in the XELIRI-Bev, p=0.30). However, median overall survival time for the FOLFIRI-Bev arm was better than that for patients treated with XELIRIBev, but these differences was not statistically significant (37.8 months vs. 28.7 months, respectively, p=0.58). Most commonly reported grade 3-4 toxicities (FOLFIRI-Bev vs XELIRI-Bev) were nausea/vomiting (7.8% vs. 14.7%, p=0.27), diarrhea (10.9% vs 22.1%, p=0.10), hand-foot syndrome (0% vs 8.8%, p=0.02) and neutropenia (18.7% vs 27.9%, p=0.22). Conclusion: Our results showed that FOLFIRI-Bev and XELIRI-Bev regimens were similarly effective treatments in a first-line setting for patients with untreated mCRC, with manageable adverse event profiles.
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