• 제목/요약/키워드: time to clinical union

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Therapeutic Effects and Adverse Drug Reactions are Affected by Icotinib Exposure and CYP2C19 and EGFR Genotypes in Chinese Non-Small Cell Lung Cancer Patients

  • Chen, Jia;Zheng, Xin;Liu, Dong-Yang;Zhao, Qian;Wu, Yi-Wen;Tan, Fen-Lai;Wang, Yin-Xiang;Jiang, Ji;Hu, Pei
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권17호
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    • pp.7195-7200
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    • 2014
  • Background: The aim of this study was to evaluate how CYP2C19 affects icotinib and metabolite' exposure, and to determine whether the exposure and EGFR genotype influences survival time, tumor metastasis and adverse drug reactions. Materials and Methods: 274 NSCLC patients who accepted 125mg icotinib/t.i.d. were chosen from a phase III study. Blood samples were obtained in $672^{nd}$ ($4^{th}$ week) and $1,680^{th}$ hours ($10^{th}$ week), and plasma was used to quantify the concentration of icotinib and blood cells were sampled to check the genotypes. Clinical data were also collected at the same time, including EGFR genotypes. Plasma concentrations were assessed by HPLC-MS/MS and genotype by sequencing. All data were analyzed through SPSS 17.0 and SAS 9.2. Results: CYP 2C19 genotypes affected bio-transformation from icotinib to M24 and M26, especially in poor-metabolisers. Higher icotinib concentrations (>1000 ng/mL) not only increased patient PFS and OS but also reduced tumor metastasis. Patients with mutant EGFR experienced a higher median PFS and OS (234 and 627 days), especially those with the 19del genotype demonstrating higher PR ratio. Patients who suffered grade II skin toxicity had a higher icotinib exposure than those with grade I skin toxicity or no adverse effects. Liver toxic reactions might occur in patients with greater M20 and M23 plasma concentrations. Conclusions: CYP2C19 polymorphisms significantly affect icotinib, M24 and M26 exposure. Patients with mutant EGFR genotype and higher icotinib concentration might have increased PFS and OS and lower tumor metastasis. Liver ADR events and serious skin effects might be respectively induced by greater M20, M23 and icotinib concentrations.

제5 중족골 기저부 제 I, II구역 비전위성 골절의 보존적 치료 (Conservative Treatment of Nondisplaced Fifth Metatarsal Base Zone I and II Fractures)

  • 성기선;고경환;구경효;박재철
    • 대한족부족관절학회지
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    • 제12권2호
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    • pp.185-188
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    • 2008
  • Purpose: Zone I fractures of the fifth metatarsal bone can generally be treated by conservative methods while both surgical and conservative methods are used for zone II fractures. However, the clinical results of conservative treatment have been rarely reported. The purpose of this study is to report the clinical results of conservative treatment for zone I and II nondisplaced fractures. Materials and Methods: Between July 2007 and August 2008, consecutive thirty seven patients (38 fractures) with zone I and II fractures of the fifth metatarsal bone were treated with tolerable weight bearing and minimum duration of immobilization based on pain on weight bearing. We evaluated the duration of immobilization, time to clinical and radiographic union, and time to pre-injury activity level. Results: Clinical and radiological union were achieved in all patients without any complications including malunion or nonunion. The mean duration of immobilization was 28.7 days. The mean 33.1 days and 48.9 days were required for clinical union and radiographic union respectively, after the initial injury. The mean time to pre-injury activity level was 4.8 months. Conclusion: Our study shows that the acute nondisplaced zone I, II fracture of fifth metatarsal bone can be treated effectively using tolerable weight bearing and minimum duration of immobilization, which is based on the pain on weight bearing.

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Precontoured Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료 (Operative Treatment of the Displaced Midshaft Clavicle Fracture Using Precontoured Locking Compression Plate)

  • 김정우;강홍제;노성현
    • Clinics in Shoulder and Elbow
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    • 제15권2호
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    • pp.117-122
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    • 2012
  • 목적: 전위성 쇄골 간부 골절에서 관혈적 정복술 후 윤곽 성형된 잠김 압박 금속판(precontoured locking compression plate)을 이용하여 내고정을 시행한 환자를 대상으로 방사선학적 결과 및 임상적 결과를 분석하여 윤곽 성형된 잠김 압박 금속판의 유용성을 알아보고자 하였다. 대상 및 방법: 2009년 3월부터 2010년 2월까지 본원에서 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용하여 관혈적 정복 및 금속 고정술을 시행하고 1년 이상의 추시가 가능했던 34예를 대상으로 하였다. 수술 후 방사선학적 결과는 골유합 여부와 성별 및 나이에 따른 골유합 시기의 차이를 평가 하였으며 임상적 결과는 최종 추시 시 quick DASH Score 및 반대측과 관절 운동 범위의 차이를 평가 하여 분석하였다. 결과: 방사선학적 평가에서 모든 예에서 골유합을 얻을 수 있었으며 평균 골유합 기간은 12.3주였으며 성별 및 나이에 따른 골유합 기간은 통계학적으로 유의한 차이를 보이지 않았다(p=0.87). 임상적 평가에서 최종 quick DASH Score는 평균 23.5점 (12~42)이었으며, 최종 추시시 견관절의 운동은 건측과 비교 시 통계학적으로 유의한 차이를 보이지 않았다 (p=0.69). 결론: 전위성 쇄골 간부 골절에 대해 윤곽 성형된 잠김 압박 금속판을 이용한 내고정술은 정확한 해부학적 정복과 견고한 내고정을 유지 할 수 있어 조기 운동이 가능하여 견관절 운동의 회복과 함께 전례에서 골유합을 얻을 수 있어 쇄골 간부 골절 치료에서 유용하게 사용될 수 있다고 사료된다.

원위 경골 골절에서 금속정 및 금속판 고정술의 결과 비교 (Comparison of the Results between Intramedullary Nailing and Plate Fixation for Distal Tibia Fractures)

  • 김정한;곽희철;이창락;정양환
    • 대한족부족관절학회지
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    • 제19권3호
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    • pp.86-90
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    • 2015
  • Purpose: We analyzed and compared the clinical and radiologic results between minimally invasive plate osteosynthesis and internal fixation using intramedullary (IM) nail in the treatment of distal tibia fractures. Materials and Methods: From March 2005 to June 2013, 65 cases of distal tibia fractures treated with either plate fixation or IM nail fixation were analyzed retrospectively by clinical and radiologic evaluations. The clinical results were compared using the American Orthopaedic Foot and Ankle Society (AOFAS) score, Olerud-Molander ankle score (OMAS), and visual analogue scale (VAS) score at the last follow-up. The radiologic results were compared by time to bone union, complications such as nonunion, delayed union, and malunion. Results: The clinical results (according to OMAS, AOFAS score, and VAS score) were 77.47, 84.76, and 1.75, respectively, in the plating group, and 90.21, 91.00, and 1.25, respectively, in the nailing group, and there was no statistically significant difference. Plating group showed earlier union than the nailing group and the nailing group showed higher frequency of non-union and delayed union than plating group. Conclusion: In treatment of distal tibia fractures, two methods showed appropriate results. Therefore, thorough investigation of the types of fracture, state of soft tissues, and advantages and disadvantages of the two methods should be conducted in the treatment of distal tibia fractures.

다요소 금연 프로그램이 성인골절 환자의 금연 및 골유합에 미치는 효과 분석 (The Effect of a Multi-component Smoking Cessation Program on Bone Union in Adult Patients with Fracture)

  • 김인숙;이한주;이선희
    • 근관절건강학회지
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    • 제27권1호
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    • pp.31-40
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    • 2020
  • Purpose: This study was done to examine the effect of a multi-component cessation program on bone union by comparing the union time between the experimental group and the control group. Methods: A non-equivalent control group posttest design was used. The subjects were 33 patients in the experimental group and 33 patients in the control group, 66 patients in total. The subjects of the experimental group were provided with a face-to-face multi-component smoking cessation program. After the discharge, telephone consultation was provided once a week for 10 weeks. Results: Bone union time was 51.6±10.9 days in the experimental group and 60.9±13.83 days in the control group (p=.003). Among 33 subjects who participated in the smoking cessation program, the average union period of the participants who succeeded in quitting smoking was 44.56 days, the participants who reduced smoking were 50.67 days, and failed to quit smoking group was 60.11 days (p=.006). Conclusion: This study indicated the importance of smoking cessation in patients with fracture and the decrease in the union time by providing smoking cessation education. If the multi-component smoking cessation program is used as a nursing intervention in clinical practice, it will be effective for bone union by increasing the smoking cessation rate of patients with fracture.

Expression and Clinical Significance of MicroRNA-376a in Colorectal Cancer

  • Mo, Zhan-Hao;Wu, Xiao-Dong;Li, Shuo;Fei, Bing-Yuan;Zhang, Bin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권21호
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    • pp.9523-9527
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    • 2014
  • The incidence of colorectal cancer (CRC) is increasing in many Asian countries and microRNAs have already been proven to be associated with tumorigenesis. Currently, microRNA-376a (miR-376a) expression and association with clinical factors in CRC remains unclear. In this study, real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) was carried out on 53 matched pairs of CRC and adjacent normal mucosa to investigate the expression levels of miR-376a. According to the high or low expression of miR-376a, patients were divided into two groups. The relationship between miR-376a expression and clinicopathological factors of 53 patients was evaluated. Survival analysis of 53 CRC patients was performed with clinical follow-up information and survival curves were assessed by the Kaplan-Meier method. Immunohistochemistry (IHC) staining was performed on sections of paraffin-embedded tissue to investigate the vascular endothelial growth factor (VEGF) expression. MiR-376a showed low expression in cancer tissues compared to the adjacent normal tissues and altered high miR-376a expression tended to be positively correlated with advanced lymph node metastasis and shorter patient survival. VEGF IHC positivity was significantly more common in patients with high expression levels of miR-376a.Those results demonstrated that miR-376a may be a meaningful prognostic biomarker and potential therapeutic target in colorectal cancer.

유관 나사와 분쇄 골이식을 사용한 거골하 관절 유합술 (Subtalar Arthrodesis using Cannulated Screws and Morselized Bone Graft)

  • 안재훈;김갑중;최원식;나규현
    • 대한족부족관절학회지
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    • 제10권1호
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    • pp.66-70
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    • 2006
  • Purpose: To analyze the clinical and radiological outcome of subtalar arthrodesis using cannulated screws and morselized bone graft. Materials and Methods: Twenty one patients with follow-up of more than 1 year after subtalar arthrodesis were included in this study. Mean age was 40.8 years, and mean follow-up duration was 38 months. Underlying diseases were 19 cases of posttraumatic arthritis (18 calcaneal fractures and 1 talar fracture) and 2 cases of tarsal coalition. Clinically AOFAS ankle-hindfoot score, operation time, complication and satisfaction of patients were analyzed. Radiologically time to union, arthritis of surrounding joints, preoperative and postoperative talar declination angle were analyzed. Results: AOFAS ankle-hindfoot score was improved from preoperative 33 points to postooperative 79 points. Eighteen patients (86%) were satisfied with the results. Mean operation time was 91 minutes. All cases were fixed with 1-2 cannulated screws and morselized bone graft. Mean time to radiologic union was 12.1 weeks. There was 1 case of delayed union. There was no significant perioperative changes in talar declination angles. Conclusion: Subtalar arthrodesis using cannulated screws and morselized bone graft seems to be relatively simple and effective treatment method for subtalar arthritis.

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경골에 시행한 유리 생비골 및 피부편 이식 (Free Vascularized Osteocutaneous Fibular Graft to the Tibia)

  • 이광석;한승범;이병택;김형식
    • Archives of Reconstructive Microsurgery
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    • 제11권1호
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    • pp.1-10
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    • 2002
  • Purpose : To analyze the clinical results of free vascularized osteocutaneous fibula graft to tibial defect combined with soft tissue defect and infection. Materials and Methods : In the retrospective study of 51 consecutive cases of vascularized osteocutaneous fibular graft, the length of the grafted fibula, size of the skin flap, anastomosed vessels, ischemic time of the flap, time for union, hypertrophy of fibula and the complications were evaluated. Results : Initial bony union of the grafted fibula was obtained at 3.74 months after operation, except 4 cases of nonunion and delayed union. The weight bearing without external supports was possible at 18 months after operation in average. The fracture of grafted fibula was most common complication(16 cases). Conclusion : The vascularized osteocutaneous fibula graft provided satisfactory bony union and functional results in the cases not responsible for conventional treatment methods.

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Factors Affecting the Healing of Radial Fractures Using Acrylic Pin External Fixation in Small Breed Dogs

  • Chun, Bong-Su;Lee, Seoung-Jin;Seok, Seong Hoon;Yeon, Seong-Chan
    • 한국임상수의학회지
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    • 제36권2호
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    • pp.93-97
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    • 2019
  • Healing of 48 cases of radial fractures in small breed dogs treated with acrylic pin external fixation was evaluated retrospectively to investigate the factors affecting the healing of radial fractures. The mean age of the subjects was 15.02 months, the mean body weight was 3.48 kg, and the mean maximum length of the radius (MLR) was 90.77 mm. External skeletal fixation frames type 1a, 2a, and 3 were used; among them type 2a was used most frequently (75%). The mean time to clinical union (TCU) was 67.17 days, and the success rate was 95.8%. Age, bodyweight, MLR, and occurrence of complications increased TCU significantly. Among complications, pin loosening, swelling of the operated forelimb tissue for more than 2 weeks, and coexistence of two or more complications increased TCU significantly (p < 0.05). There was no relationship between location of the fracture and TCU. The results of this study may be useful to predict the prognosis of radial fractures in small dogs.

Clinical Outcomes of Basaloid Squamous Cell Carcinoma of the Esophagus: A Retrospective Analysis of 142 Cases

  • Zhang, Bai-Hua;Cheng, Gui-Yu;Xue, Qi;Gao, Shu-Geng;Sun, Ke-Lin;Wang, Yong-Gang;Mu, Ju-Wei;He, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1889-1894
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    • 2013
  • Background: Basaloid squamous cell carcinoma of the esophagus (BSCCE) is a rare and distinctive tumor with no standard treatment. This study aimed to explore treatment in relation to prognosis of the disease. Methods: A total of 142 patients with BSCCE that underwent treatment in our hospital from March 1999 to July 2010 were retrospectively analyzed. All patients received surgery, 42 postoperative radiotherapy and 28 patients chemotherapy. Results: There were 26 patients included in stage I, 60 in stage II, 53 in stage III and 3 in stage IV. The clinical symptoms and macroscopic performances of BSCCE did not differ from those of typical esophageal squamous cell carcinoma. Among 118 patients receiving endoscopic biopsy, only 12 were diagnosed with BSCCE. The median survival time (MST) of the entire group was 32 months, with 1-, 3- and 5-year overall survival (OS) of 81.4%, 46.8% and 31.0%, respectively. The 5-year OS of stage I and II patients was significantly longer than that of stages III/IV, at 60.3%, 36.1% and 10.9%, respectively (p<0.001, p=0.001). The MST and 5-year OS were 59.0 months and 47.4% in patients with tumors located in the lower thoracic esophagus, and 27.0 months and 18.1% in those with lesions in the upper/middle esophagus (p=0.002). However, the survival was not significantly improved in patients undegoing adjunctive therapy. Multivariate analysis showed TNM stage and tumor location to be independent prognostic factors. Furthermore, distant metastasis was the most frequent failure pattern, with a median recurrence time of 10 months. Conclusion: BSCCE is an aggressive disease with rapid progression and a propensity for distant metastasis. It is difficult to make a definitive diagnosis via preoperative biopsy. Multidisciplinary therapy including radical esophagectomy with extended lymphadenectomy should be recommended, while the effectiveness of radiochemotherapy requires further validation for BSCCE.